Which type of cane is the most efficient, based on oxygen consumption and balance capacity, in chronic stroke patients?

Abstract

Canes are widely prescribed as walking aids, but little is known about the effects of canes on the physiological cost of walking. The purpose of this study was to investigate the differences in oxygen consumption associated with the gaits of hemiplegic patients in terms of balance capacity according to the type of cane used. Twenty-nine patients with chronic stroke were divided into poor-balance (n=15) and relatively-better-balance groups (n=14) based on a cutoff score of 49 on the Berg balance scale (BBS). Each patient completed three consecutive days of walking with a randomly assigned singlepoint cane, quad cane, or hemi-walker. We measured the oxygen expenditure and oxygen cost using a portable gas analyzer and heart rate during a 6-min walk test (6MWT) and a 10-m walk test (10MWT). The oxygen expenditure, gait endurance, and gait velocity were higher with the single-point cane (p<0.01) than with any of the other cane types, and the oxygen costs were lower (p<0.01) with the single-point cane among the patients with relatively better balance. The oxygen cost for the quad cane was lower (p<0.01) than that found for any the other cane types among the patients with relatively poor balance. Our study revealed that single-point canes require less oxygen use at a given speed and permits greater speed at the same oxygen consumption for hemiplegic patients with good balance. Walking aids with a greater base support may be more suitable than those with a smaller base support for patients with relatively poor balance. However, our conclusions are only preliminary because of the small sample size (KCT0001076).