Abstract
Introduction.
Physiological responses are rarely considered during walking after
stroke and if considered, only during a short period (3-6 minutes). The
aims of this study were to examine physiological responses during
30-minute robot-assisted and body weight–supported treadmill and
overground walking and compare intensities with exercise guidelines.
Methods.
A total of 14 ambulatory stroke survivors (age: 61 ± 9 years; time
after stroke: 2.8 ± 2.8 months) participated in 3 separate randomized
walking trials. Patients walked overground, on a treadmill, and in the
Lokomat (60% robotic guidance) for 30 minutes at matched speeds (2.0 ±
0.5 km/h) and matched levels of body weight support (BWS; 41% ± 16%).
Breath-by-breath gas analysis, heart rate, and perceived exertion were
assessed continuously.
Results. Net oxygen consumption, net
carbon dioxide production, net heart rate, and net minute ventilation
were about half as high during robot-assisted gait as during body
weight–supported treadmill and overground walking (P < .05).
Net minute ventilation, net breathing frequency, and net perceived
exertion significantly increased between 6 and 30 minutes (respectively,
1.8 L/min, 2 breaths/min, and 3.8 units). During Lokomat walking,
exercise intensity was significantly below exercise recommendations;
during body weight–supported overground and treadmill walking, minimum
thresholds were reached (except for percentage of heart rate reserve
during treadmill walking).
Conclusion. In ambulatory stroke
survivors, the oxygen and cardiorespiratory demand during robot-assisted
gait at constant workload are considerably lower than during overground
and treadmill walking at matched speeds and levels of body weight
support. Future studies should examine how can be exploited to induce
aerobic exercise.(And why precisely do you want to induce aerobic exercise?)
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