Your therapist should be incorporating this knowledge into your walking protocol in the next week.
Postural threat during walking: effects on energy cost and accompanying gait changes
Journal of NeuroEngineering and Rehabilitation 2014, 11:71
doi:10.1186/1743-0003-11-71
Published: 22 April 2014
Published: 22 April 2014
Abstract (provisional)
Background
Balance control during walking has been shown to involve a metabolic cost in healthy
subjects, but it is unclear how this cost changes as a function of postural threat.
The aim of the present study was to determine the influence of postural threat on
the energy cost of walking, as well as on concomitant changes in spatiotemporal gait
parameters, muscle activity and perturbation responses. In addition, we examined if
and how these effects are dependent on walking speed.
Methods
Healthy subjects walked on a treadmill under four conditions of varying postural threat.
Each condition was performed at 7 walking speeds ranging from 60-140% of preferred
speed. Postural threat was induced by applying unexpected sideward pulls to the pelvis
and varied experimentally by manipulating the width of the path subjects had to walk
on.
Results
Results showed that the energy cost of walking increased by 6-13% in the two conditions
with the largest postural threat. This increase in metabolic demand was accompanied
by adaptations in spatiotemporal gait parameters and increases in muscle activity,
which likely served to arm the participants against a potential loss of balance in
the face of the postural threat. Perturbation responses exhibited a slower rate of
recovery in high threat conditions, probably reflecting a change in strategy to cope
with the imposed constraints. The observed changes occurred independent of changes
in walking speed, suggesting that walking speed is not a major determinant influencing
gait stability in healthy young adults. (Who is going to research this in stroke patients?).
Conclusions
The current study shows that in healthy adults, increasing postural threat leads to
a decrease in gait economy, independent of walking speed. This could be an important
factor in the elevated energy costs of pathological gait.
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