title: Energy expenditure during everyday activities--a study comparing people with varying mobility limitations due to multiple sclerosis and healthy controls.
abstract: OBJECTIVE
  To investigate energy expenditure of people with multiple sclerosis (MS) during everyday activities.
  
  
  METHODS
  Fifteen healthy controls, 19 people with MS who used at most a stick to walk outdoors (MS-A), and 11 people with MS who used bilateral support for gait (MS-B) completed scripted everyday activities. A portable indirect calorimetry unit calculated energy expenditure. Steps were counted from video.
  
  
  RESULTS
  There was no significant difference in kcal between the three groups (ANOVA: F(2, 42) = 2.877, p = 0.067). There was a significant difference in steps: F(2, 42) = 17.93, p < 0.001. (Controls-MS-A 470.5, 95% CI 85.2, 855.7, Control-MS-B 1091.3, 95% CI 648.5, 1534.1, MS-A-MS-B 620.8, 95% CI 198.2, 1043.4.) Energy cost of movement was estimated by dividing kcal by steps. The Kruskal-Wallis analysis found significant difference for total (x(2 )= 11.726, df2, p = 0.003), Walking (x(2 )= 9.01, p = 0.011), Stairs (x(2 )= 16.436, 2, p < 0.001). Post-hoc analysis revealed significant differences between MS-B group and control and MS-A groups.
  
  
  CONCLUSIONS
  People with MS do not use more energy than healthy controls during everyday activities at a self-selected pace. People with MS take significantly fewer steps during activities of daily living's. People who use bilateral support for gait have greater energy cost per step for walking and stairs activities. Implications for Rehabilitation This study found that the energy cost of movement is greater for people with MS with significant disability. Energy expenditure is an important consideration when prescribing physical activity and structured exercise for people with disability. It may be more appropriate to have energy, rather than movement, targets when prescribing physical activity for this population.
authors.affiliation: Department of Clinical Therapies, Centre for Physical Activity and Health Research, University of Limerick , Limerick , Ireland.
authors.forename: Susan
authors.initials: S
authors.lastname: Coote
authors.forename: Catriona
authors.initials: C
authors.lastname: O'Dwyer
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002153:Calorimetry, Indirect / Q000379:methods; D003430:Cross-Sectional Studies; D051341:Dependent Ambulation / Q000502:physiology*; D004734:Energy Metabolism; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity / Q000502:physiology; D009103:Multiple Sclerosis / Q000378:metabolism / Q000503:physiopathology / Q000534:rehabilitation
keywords: Activities; energy expenditure; multiple sclerosis