title: High metabolic cost and low energy expenditure for typical motor activities among individuals in the chronic phase after stroke.
abstract: OBJECTIVE
  Energy variables, such as metabolic cost (MC) and energy expenditure (EE), are important characteristics of motor activities that can influence daily activity and have implications for health. In individuals poststroke, these variables have previously been described only for walking. Our goal was to characterize the MC and EE of typical motor activities among individuals in the chronic phase poststroke and compare them with those of able-bodied individuals.
  
  
  METHODS
  Eleven individuals with poststroke and 8 able-bodied individuals participated in this study. Four activities were tested: sit-to-walk-to-sit, walking over an obstacle course, walking at a comfortable speed, and reaching for an object while in a standing position. Each activity was performed repeatedly for 8 minutes, while oxygen consumption was recorded. The MC of the activities was calculated by dividing the mean oxygen consumption by walking speed or the number of repetitions. The EE was represented by metabolic equivalents.
  
  
  RESULTS
  There was a significant interaction effect of group and activity on MC and EE (P = 0.001 and P = 0.007, respectively). In the participants poststroke, the MC of mobility activities ranged from 0.24 (0.06) to 0.3 (0.06) mL/kg/m, and the MC of the standing activity was 0.1 (0.03) mL/kg/repetition. The MC was higher for the participants poststroke than for the able-bodied participants (P < 0.001). The EE of the participants poststroke ranged from 1.96 (0.4) to 3.83 (0.6) metabolic equivalents and was lower compared with the able-bodied participants (P = 0.001).
  
  
  CONCLUSIONS
  Individuals poststroke have high MC and low EE across various motor activities. These findings suggest that rehabilitation programs need to specifically address the energetic domain.Video Abstract available. See Video (Supplemental Digital Content 1, http://links.lww.com/JNPT/A75) for more insights from the authors.
authors.affiliation: Rivers Lab (M.K., V.K.G., J.E.D.), and Human Performance Lab (M.J.M.), Department of Rehabilitation and Movement Sciences, Rutgers, Newark, New Jersey.
authors.forename: Michal
authors.initials: M
authors.lastname: Kafri
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Myslinski
authors.forename: Venkata K
authors.initials: VK
authors.lastname: Gade
authors.forename: Judith E
authors.initials: JE
authors.lastname: Deutsch
mesh_terms: D000328:Adult; D000368:Aged; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D020521:Stroke / Q000378:metabolism* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*