Associations between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait

James M. Finley, Amy J. Bastian

Research output: Contribution to journalArticle

Abstract

Stroke survivors often have a slow, asymmetric walking pattern. They also walk with a higher metabolic cost than healthy, age-matched controls. It is often assumed that spatial-temporal asymmetries contribute to the increased metabolic cost of walking poststroke. However, elucidating this relationship is made challenging because of the interdependence between spatial-temporal asymmetries, walking speed, and metabolic cost. Here, we address these potential confounds by measuring speed-dependent changes in metabolic cost and implementing a recently developed approach to dissociate spatial versus temporal contributions to asymmetry in a sample of stroke survivors. We used expired gas analysis to compute the metabolic cost of transport (CoT) for each participant at 4 different walking speeds: self-selected speed, 80% and 120% of their self-selected speed, and their fastest comfortable speed. We also computed CoT for a sample of age- and gender-matched control participants who walked at the same speeds as their matched stroke survivor. Kinematic data were used to compute the magnitude of a number of variables characterizing spatial-temporal asymmetries. Across all speeds, stroke survivors had a higher CoT than controls. We also found that our sample of stroke survivors did not choose a self-selected speed that minimized CoT, contrary to typical observations in healthy controls. Multiple regression analyses revealed negative associations between speed and CoT and a positive association between asymmetries in foot placement relative to the trunk and CoT. These findings suggest that interventions designed to increase self-selected walking speed and reduce foot-placement asymmetries may be ideal for improving walking economy poststroke.

Original languageEnglish (US)
Pages (from-to)168-177
Number of pages10
JournalNeurorehabilitation and Neural Repair
Volume31
Issue number2
DOIs
StatePublished - 2017

Fingerprint

Gait
Foot
Costs and Cost Analysis
Walking
Survivors
Cost Control
Biomechanical Phenomena
Gases
Regression Analysis

Keywords

  • asymmetry
  • locomotion
  • metabolic cost
  • stroke

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

Cite this

Associations between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait. / Finley, James M.; Bastian, Amy J.

In: Neurorehabilitation and Neural Repair, Vol. 31, No. 2, 2017, p. 168-177.

Research output: Contribution to journalArticle

Finley, James M.; Bastian, Amy J. / Associations between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait.

In: Neurorehabilitation and Neural Repair, Vol. 31, No. 2, 2017, p. 168-177.

Research output: Contribution to journalArticle

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