http://nnr.sagepub.com/content/27/9/872.abstract?etoc
- Alyssa D. Stookey, PhD1
- Michael G. McCusker, MA2
- John D. Sorkin, MD, PhD1,2
- Leslie I. Katzel, MD, PhD1,2
- Marianne Shaughnessy, PhD1,2
- Richard F. Macko1,2
- Frederick M. Ivey, PhD1,2
- 1Baltimore VA Medical Center, Baltimore, MD, USA
- 2University of Maryland School of Medicine, Baltimore, MD, USA
- Alyssa D. Stookey, Baltimore VA Medical Center, Geriatrics Service/GRECC BT(18) GR, 10 North Greene St, Baltimore, MD 21201-1524, USA. Email: alyssa.stookey@va.gov
Abstract
Purpose. Impaired economy of gait,
prevalent in chronic stroke secondary to residual gait deficits, is
associated with intolerance
for performing activities of daily living. Gait
economy/efficiency is traditionally assessed by determining the rate of
oxygen
consumption during submaximal treadmill walking.
However, the mechanics and energetics of treadmill versus overground
walking
are very different in stroke survivors with
ambulatory deficits. Clearly, overground cardiopulmonary measures are
needed to
accurately profile movement economy after stroke.
An obstacle to obtaining such measures after stroke has been the absence
of reliable portable metabolic monitoring
equipment. The purpose of this study was to establish the test–retest
reliability
of a portable metabolic monitoring device during
overground walking in hemiparetic stroke survivors.
Methods. Twenty-three chronic hemiparetic stroke survivors underwent two 6-minute walk tests while wearing a COSMED K4b2
portable metabolic measurement system. Intraclass correlations
coefficients (ICC) were calculated for both cardiopulmonary
parameters and distance covered to determine
test–retest reliability. An ICC of ≥0.85 was considered reliable. Results. ICCs for relative Vo2 (0.90), absolute Vo2 (0.93), Vco2
(0.93), and minute ventilation (0.95) demonstrated high reliability,
but not for heart rate (0.76) or respiratory exchange
ratio (0.64). There was no significant difference
in the distance each participant walked between the first and second
tests,
eliminating distance as a potential confounder of
our analyses (ICC = 0.99).
Conclusions. Our results strongly support the reliability of the K4b2
for quantifying overground gait efficiency after stroke. Use of this
device may enable researchers to study how varying poststroke
rehabilitation interventions affect this central
measure of health and function.
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