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Cardiorespiratory Responses to Pool Floor Walking in People Poststroke

Published:October 05, 2017DOI:https://doi.org/10.1016/j.apmr.2017.09.112

      Abstract

      Objective

      To compare cardiorespiratory responses between pool floor walking and overground walking (OW) in people poststroke.

      Design

      Cross-sectional study.

      Setting

      University-based therapeutic exercise facility.

      Participants

      Participants (N=28) were comprised of 14 community-dwelling individuals poststroke (5.57±3.57y poststroke) and 14 age- and sex-matched healthy adults (mean age, 58.00±15.51y; male/female ratio, 9:5).

      Interventions

      Not applicable.

      Main Outcome Measures

      A telemetric metabolic system was used to collect cardiorespiratory variables, including oxygen consumption ( V ˙ o2), energy expenditure (EE), and expired volume per unit time ( V ˙ e), during 6-minute walking sessions in chest-depth water and on land at a matched speed, determined by average of maximum walking speed in water.

      Results

      Individuals poststroke elicited no significant differences in cardiorespiratory responses between pool floor walking and OW. However, healthy controls showed significant increases in mean V ˙ o2 values by 94%, EE values by 109%, and V ˙ e values by 94% (all P<.05) during pool floor walking compared with OW. A 2×2 mixed model analysis of variance revealed a significant group × condition interaction in V ˙ o2, in which the control group increased V ˙ o2 from OW to pool floor walking, whereas the stroke group did not.

      Conclusions

      Our results indicate that people poststroke, unlike healthy adults, do not increase EE while walking in water compared with on land. Unlike stationary walking on an aquatic treadmill, forward locomotion during pool floor walking at faster speeds may have increased drag force, which requires greater EE from healthy adults. Without demanding excessive EE, walking in water may offer a naturally supportive environment for gait training in the early stages of rehabilitation.

      Keywords

      List of abbreviations:

      EE (energy expenditure), OW (overground walking), VE (minute ventilation), V˙o2 (oxygen consumption)
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