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The Functional Independence of Patients With Stroke Sequelae: How Important Is the Speed, Oxygen Consumption, and Energy Cost of Walking?
Archives of Physical Medicine and Rehabilitation ( IF 3.6 ) Pub Date : 2021-02-20 , DOI: 10.1016/j.apmr.2021.01.085
Maxence Compagnat 1 , Stéphane Mandigout 2 , Anaick Perrochon 2 , Justine Lacroix 2 , Nicolas Vuillerme 3 , Jean Yves Salle 1 , Jean Christophe Daviet 1
Affiliation  

Objective

To evaluate the association between self-selected walking speed (Sfree), oxygen consumption at Sfree (Vo2free), the oxygen cost of walking (Cw) at Sfree, and mobility independence and independence for activities of daily living in individuals poststroke.

Design

Cross-sectional study.

Setting

Hospital.

Participants

Individuals with stroke who were able to walk without human assistance were included. We included 90 individuals (N=90; mean age, 63.5±14.0y).

Interventions

Not applicable.

Main Outcome Measures

Cw was captured during walking from measurements of Sfree and Vo2free. We assessed mobility independence based on the modified Functional Ambulation Classification (mFAC) and independence in activities of daily living by the Barthel Index (BI). Multiple linear regression analyses were performed to evaluate the independence of Cw, Vo2free, and Sfree from the determination of BI and mFAC among the various characteristics of the population (age, stroke delay, body mass index, motor function, spasticity).

Results

We reported Cw=0.36 mL/kg/m (interquartile range [IQR]=0.28 mL/kg/m), Sfree=0.60±0.32 m/s, Vo2free=11.2 mL/kg/min (IQR=1.8 mL/kg/min). The multiple linear regression analyses showed that Cw and Sfree were independently associated with the BI (P<.01) and the mFAC (P<.01) scores. Vo2free was not found to be an explanatory variable of functional independence (P>.05).

Conclusions

Cw was independently associated with functional independence. This association appears to be primarily determined by Sfree and not Vo2free, underscoring the importance of evaluating and acting on Sfree to improve the functional independence of individuals with stroke.



中文翻译:

中风后遗症患者的功能独立性:步行的速度、耗氧量和能量消耗有多重要?

客观的

为了评估自我选择步行速度之间的关系(S免费),在耗氧量免费(V Ø 2free),走路的氧耗(CW)处为自由和流动性的独立性和自主日常生活中的个人活动中风后。

设计

横断面研究。

环境

医院。

参与者

包括能够在没有人类帮助的情况下行走的中风个体。我们纳入了 90 个人(N=90;平均年龄,63.5±14.0 岁)。

干预

不适用。

主要观察指标

Cw 是在步行过程中根据 S free和 V o 2free 的测量值捕获的。我们根据改良的功能行走分类 (mFAC) 和 Barthel 指数 (BI) 的日常生活活动独立性评估了行动独立性。进行多元线性回归分析以评估 Cw、V o 2free和 S free与 BI 和 mFAC 在人群的各种特征(年龄、中风延迟、体重指数、运动功能、痉挛状态)之间的独立性。

结果

我们报告了 Cw=0.36 mL/kg/m(四分位距 [IQR]=0.28 mL/kg/m),S free =0.60±0.32 m/s,V o 2free =11.2 mL/kg/min(IQR=1.8 mL /公斤/分钟)。多元线性回归分析表明,Cw 和 S游离与 BI ( P <.01) 和 mFAC ( P <.01) 分数独立相关。未发现V o 2free是功能独立性的解释变量(P > .05)。

结论

Cw 与功能独立性独立相关。这种关联似乎主要由 S free而不是 V o 2free 决定,强调了评估和作用于 S free以改善卒中患者功能独立性的重要性。

更新日期:2021-02-20
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