Differential responses to measures of gait performance among healthy and neurologically impaired individuals.

Abstract

To compare gait during a 5-minute walk among healthy individuals, persons with spinal cord injury (SCI), and stroke survivors and to investigate whether simultaneous measures of oxygen consumption enhance information about performance. Descriptive study. Veterans Affairs medical center. Thirty-nine healthy individuals, 10 persons with SCI, and 20 stroke survivors. Participants were fitted with a portable gas analyzer and walked on a 5-m walkway for 5 minutes. Measures of walk distance, gait speed, gait energy expenditure (GEE), and gait cost were obtained, along with measures of ventilation (.Ve), ventilation and carbon dioxide production slope (.Ve . .VCo2), oxygen pulse, and heart rate. The SCI group (127.65+/-81.74m) walked less than the stroke survivors (148.80+/-64.3m) or the healthy group (268.90+/-35.01m) but had higher energy demands, as shown by GEE (SCI group, 13.28+/-3.23mL.kg(-1).min(-1); stroke group, 10.18+/-2.14mL.kg(-1).min(-1); healthy group, 9.61+/-1.90mL.kg(-1).min(-1)) and by gait cost (SCI group,.57+/-.40 mL.kg(-1).m(-1); stroke group,.40+/-.52mL.kg(-1).m(-1); healthy group,.18+/-.02mL.kg(-1).m(-1)). Compared with the healthy group, the stroke group had higher .Ve (stroke group, 22.34+/-5.20L/min vs healthy group, 16.11+/-3.22L/min) and .Ve . .VCo2 slope (24.22+/-8.80 vs 18.73+/-5.44, respectively). Use of metabolic assessment during the 5-minute walk was feasible and provided further information for evaluating gait performance with the subjects studied.