Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1298-1303, October 2007

Measurement of Energy Cost by the Physiological Cost Index in Walking After Stroke

  • Anna Danielsson, RPT, Med fac lic

      Affiliations

    • Sahlgrenska Academy at Göteborg University, Institute of Neuroscience and Physiology/Rehabilitation Medicine, Göteborg, Sweden
    • Corresponding Author InformationReprint requests to Anna Danielsson, RPT, Institute of Neuroscience and Physiology/Rehabilitation Medicine, Guldhedsgatan 19, S-41345 Göteborg, Sweden
    • ,
  • Carin Willén, RPT, PhD

      Affiliations

    • Sahlgrenska Academy at Göteborg University, Institute of Neuroscience and Physiology/Rehabilitation Medicine, Göteborg, Sweden
    • ,
  • Katharina S. Sunnerhagen, MD, PhD

      Affiliations

    • Sahlgrenska Academy at Göteborg University, Institute of Neuroscience and Physiology/Rehabilitation Medicine, Göteborg, Sweden
    • Sunnaas Rehabilitation Hospital and Faculty of Medicine, University of Oslo, Norway.

Abstract 

Danielsson A, Willén C, Sunnerhagen KS. Measurement of energy cost by the Physiological Cost Index in walking after stroke.

Objective

To compare the Physiological Cost Index (PCI) with direct measurement of oxygen consumption (V̇o2) as an estimate of energy cost in persons with stroke and healthy subjects.

Design

Test-retest on separate days. A comparison of 2 methods of measurement. Measurements with and without an orthosis.

Setting

A university hospital.

Participants

A convenience sample of 20 persons with hemiparesis more than 6 months after stroke and 16 healthy subjects, ages 30 to 63 years.

Interventions

Five minutes of treadmill walking at self-selected speeds while recording V̇o2 levels and heart rates. Additional data was recorded for 11 of the stroke subjects with and without an ankle-foot orthosis.

Main Outcome Measures

V̇o2 and the PCI.

Results

No significant differences were found in the PCI or V̇o2 between test and retest. Both PCI and V̇o2 per distance were higher for the stroke subjects compared with healthy subjects. PCI showed a larger dispersion than V̇o2 between test and retest. The regression analysis for PCI showed that the model including age, sex, group assignment, and V̇o2 could explain 53% of the variation. The PCI did not show a significant difference in walking with or without an orthosis, whereas V̇o2 differed significantly.

Conclusions

The PCI showed limited reliability and validity as a measure of energy cost after stroke due to the extensive variability between test and retest.

Key Words: Cerebrovascular accident, Energy expenditure, Rehabilitation, Walking

 

 Supported by the Council of Research and Development of Gothenburg and Southern Bohuslan, the Foundation of the Swedish Stroke Association, Hjalmar Svensson’s Research Foundation, John and Brit Wennerström’s Foundation for Neurological Research, the Swedish Association of Persons with Neurological Disabilities, the Norrbacka-Eugenia Foundation, and the Swedish Research Council (grant no. VR K2002-27-VX-14318-01A).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)00440-6

doi:10.1016/j.apmr.2007.06.760

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 10 , Pages 1298-1303, October 2007

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