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.

References 

  1. Zamparo P, Francescato MP, De Luca G, Lovati L, di Prampero PE. The energy cost of level walking in patients with hemiplegia. Scand J Med Sci Sports. 1995;5:348–352
  2. Waters RL, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture. 1999;9:207–231
  3. Detrembleur C, Dierick F, Stoquart G, Chantraine F, Lejeune T. Energy cost, mechanical work, and efficiency of hemiparetic walking. Gait Posture. 2003;18:47–55
  4. Platts MM, Rafferty D, Paul L. Metabolic cost of over ground gait in younger stroke patients and healthy controls. Med Sci Sports Exerc. 2006;38:1041–1046
  5. Roth EJ. Heart disease in patients with stroke: incidence, impact, and implications for rehabilitation (Part 1: Classification and prevalence). Arch Phys Med Rehabil. 1993;74:752–760
  6. Corcoran PJ, Jebsen RH, Brengelmann GL, Simons BC. Effects of plastic and metal leg braces on speed and energy cost of hemiparetic ambulation. Arch Phys Med Rehabil. 1970;51:69–77
  7. Franceschini M, Massucci M, Ferrari L, Agosti M, Paroli C. Effects of an ankle-foot orthosis on spatiotemporal parameters and energy cost of hemiparetic gait. Clin Rehabil. 2003;17:368–372
  8. Danielsson A, Sunnerhagen KS. Energy expenditure in stroke subjects walking with a carbon composite ankle foot orthosis. J Rehabil Med. 2004;36:165–168
  9. Burridge JH, Taylor PN, Hagan SA, Wood DE, Swain ID. The effects of common peroneal stimulation on the effort and speed of walking: a randomized controlled trial with chronic hemiplegic patients. Clin Rehabil. 1997;11:201–210
  10. da Cunha-Filho IT, Henson H, Wankadia S, Protas EJ. Reliability of measures of gait performance and oxygen consumption with stroke survivors. J Rehabil Res Dev. 2003;40:19–25
  11. Eng JJ, Dawson AS, Chu KS. Submaximal exercise in persons with stroke: test-retest reliability and concurrent validity with maximal oxygen consumption. Arch Phys Med Rehabil. 2004;85:113–118
  12. Åstrand PO, Rodahl K. Textbook of work physiology: physiological bases of exercise. 3rd ed.. New York: McGraw Hill; 1986;
  13. MacGregor J. The evaluation of patient performance using long-term ambulatory monitoring technique in the domiciliary environment. Physiotherapy. 1981;67(2):30–33
  14. Engsberg JR, Herbert LM, Grimston SK, Fung TS, Harder JA. Relation among indices of effort and oxygen uptake in below-knee amputee and able-bodied children. Arch Phys Med Rehabil. 1994;75:1335–1341
  15. Chin T, Sawamura S, Fujita H, et al. The efficacy of physiological cost index (PCI) measurement of a subject walking with an Intelligent Prosthesis. Prosthet Orthot Int. 1999;23:45–49
  16. Bowen TR, Lennon N, Castagno P, Miller F, Richards J. Variability of energy-consumption measures in children with cerebral palsy. J Pediatr Orthop. 1998;18:738–742
  17. IJzerman M, Baardman G, van ’t Hof MA, Boom HB, Hermens HJ, Veltink PH. Validity and reproducibility of crutch force and heart rate measurements to assess energy expenditure of paraplegic gait. Arch Phys Med Rehabil. 1999;80:1017–1023
  18. Graham RC, Smith NM, White CM. The reliability and validity of the Physiological Cost Index in healthy subjects while walking on 2 different tracks. Arch Phys Med Rehabil. 2005;86:2041–2046
  19. Bailey MJ, Ratcliffe CM. Reliability of physiological cost index measurements in walking normal subjects using steady-state, non-steady-state and post-exercise heart rate recording. [published erratum in: Physiotherapy 1996;82:216] Physiotherapy. 1995;81:618–623
  20. Boyd R, Fatone S, Rodda J, et al. High- or low-technology measurements of energy expenditure in clinical gait analysis?. Dev Med Child Neurol. 1999;41:676–682
  21. Hood VL, Granat MH, Maxwell DJ, Hasler JP. A new method of using heart rate to represent energy expenditure: the Total Heart Beat Index. Arch Phys Med Rehabil. 2002;83:1266–1273
  22. IJzerman MJ, Nene AV. Feasibility of the physiological cost index as an outcome measure for the assessment of energy expenditure during walking. Arch Phys Med Rehabil. 2002;83:1777–1782
  23. Raja K, Joseph B, Benjamin S, Minocha V, Rana B. Physiological cost index in cerebral palsy: its role in evaluating the efficiency of ambulation. J Pediatr Orthop. 2007;27:130–136
  24. Mossberg KA. Reliability of a timed walk test in persons with acquired brain injury. Am J Phys Med Rehabil. 2003;82:385–390quiz 91-2
  25. Mossberg KA, Linton KA, Friske K. Ankle-foot orthoses: effect on energy expenditure of gait in spastic diplegic children. Arch Phys Med Rehabil. 1990;71:490–494
  26. Winchester PK, Carollo JJ, Parekh RN, Lutz LM, Aston JW. A comparison of paraplegic gait performance using two types of reciprocating gait orthoses. Prosthet Orthot Int. 1993;17:101–106
  27. Harvey LA, Davis GM, Smith MB, Engel S. Energy expenditure during gait using the walkabout and isocentric reciprocal gait orthoses in persons with paraplegia. Arch Phys Med Rehabil. 1998;79:945–949
  28. Steven MM, Capell HA, Sturrock RD, MacGregor J. The physiological cost of gait (PCG): a new technique for evaluating nonsteroidal anti-inflammatory drugs in rheumatoid arthritis. Br J Rheumatol. 1983;22:141–145
  29. Olney SJ, Nymark J, Brouwer B, et al. A randomized controlled trial of supervised versus unsupervised exercise programs for ambulatory stroke survivors. Stroke. 2006;37:476–481
  30. Stein RB, Chong S, Everaert DG, et al. A multicenter trial of a footdrop stimulator controlled by a tilt sensor. Neurorehabil Neural Repair. 2006;20:371–379
  31. Naver HK, Blomstrand C, Wallin BG. Reduced heart rate variability after right-sided stroke. Stroke. 1996;27:247–251
  32. Korpelainen JT, Sotaniemi KA, Makikallio A, Huikuri HV, Myllyla VV. Dynamic behavior of heart rate in ischemic stroke. Stroke. 1999;30:1008–1013
  33. Colivicchi F, Bassi A, Santini M, Caltagirone C. Cardiac autonomic derangement and arrhythmias in right-sided stroke with insular involvement. Stroke. 2004;35:2094–2098
  34. Lakusic N, Mahovic D, Babic T. Gradual recovery of impaired cardiac autonomic balance within first six months after ischemic cerebral stroke. Acta Neurol Belg. 2005;105:39–42
  35. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient (1. A method for evaluation of physical performance). Scand J Rehabil Med. 1975;7:13–31
  36. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14:377–381
  37. Bland JM, Altman DG. Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol. 2003;22:85–93
  38. Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med. 1998;26:217–238
  39. Nene AV. Physiological cost index of walking in able-bodied adolescents and adults. Clin Rehabil. 1993;7:319–326
  40. Witte US, Carlsson JY. Self-selected walking speed in patients with hemiparesis after stroke. Scand J Rehabil Med. 1997;29:161–165
  41. Green J, Forster A, Young J. Reliability of gait speed measured by a timed walking test in patients one year after stroke. Clin Rehabil. 2002;16:306–314
  42. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37:75–82
  43. Peebles KC, Woodman Aldridge AD, Skinner MA. The Physiological Cost Index in elderly subjects during treadmill and floor walking. N Z J Physiother. 2003;31:11–16
  44. Pearce ME, Cunningham DA, Donner AP, Rechnitzer PA, Fullerton GM, Howard JH. Energy cost of treadmill and floor walking at self-selected paces. Eur J Appl Physiol Occup Physiol. 1983;52:115–119
  45. Ralston HJ. Comparison of energy expenditure during treadmill walking and floor walking. J Appl Physiol. 1960;15:1156
  46. Rose J, Gamble JG, Lee J, Lee R, Haskell WL. The energy expenditure index: a method to quantitate and compare walking energy expenditure for children and adolescents. J Pediatr Orthop. 1991;11:571–578

 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