Physiological responses and energy cost of walking on the Gait Trainer with and without body weight support in subacute stroke patients.
BACKGROUND
Robotic-assisted walking after stroke provides intensive task-oriented training. But, despite the growing diffusion of robotic devices little information is available about cardiorespiratory and metabolic responses during electromechanically-assisted repetitive walking exercise. Aim of the study was to determine whether use of an end-effector gait training (GT) machine with body weight support (BWS) would affect physiological responses and energy cost of walking (ECW) in subacute post-stroke hemiplegic patients.


METHODS



METHODS
six patients (patient group: PG) with hemiplegia due to stroke (age: 66 ± 15y; time since stroke: 8 ± 3 weeks; four men) and 6 healthy subjects as control group (CG: age, 76 ± 7y; six men).


METHODS
overground walking test (OWT) and GT-assisted walking with 0%, 30% and 50% BWS (GT-BWS0%, 30% and 50%).


METHODS
heart rate (HR), pulmonary ventilation, oxygen consumption, respiratory exchange ratio (RER) and ECW.


RESULTS
Intervention conditions significantly affected parameter values in steady state (HR: p = 0.005, V'E: p = 0.001, V'O2: p < 0.001) and the interaction condition per group affected ECW (p = 0.002). For PG, the most energy (V'O2 and ECW) demanding conditions were OWT and GT-BWS0%. On the contrary, for CG the least demanding condition was OWT. On the GT, increasing BWS produced a decrease in energy and cardiac demand in both groups.


CONCLUSIONS
In PG, GT-BWS walking resulted in less cardiometabolic demand than overground walking. This suggests that GT-BWS walking training might be safer than overground walking training in subacute stroke patients.
Fondazione Santa Lucia, I,R,C,C,S, Via Ardeatina, 306, 00179 Rome, Italy. s.delussu@hsantalucia.it.
Anna Sofia
AS
Delussu
Giovanni
G
Morone
Marco
M
Iosa
Maura
M
Bragoni
Marco
M
Traballesi
Stefano
S
Paolucci
D000328:Adult; D000368:Aged; D004734:Energy Metabolism / Q000502:physiology*; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology