Abstract
Background.
Understanding the factors that limit mobility in stroke patients is
fundamental for proposing appropriate rehabilitation strategies. A high
oxygen cost during walking (Cw) has a strong impact on the community
ambulation of hemiparetic patients. The Cw in poststroke cerebellar
ataxia is poorly evaluated, unlike hemiparetic gait.
Objective.
To compare the oxygen cost/self-selected walking speed (S) relationship
in stroke individuals with cerebellar ataxia or hemiparetic gait.
Methods.
Thirty-three subjects were included (14 cerebellar stroke, 19
hemispheric stroke), with stroke confirmed by brain imaging and able to
walk without human assistance. We measured Cw using the Metamax3B. The
relationship between Cw and self-selected walking speed was modelled by
logistic regression and then compared between the cerebellar and
hemispheric groups.
Results.
No significant difference was found
between the 2 groups for all characteristics of the population, except
motor impairments, spasticity, and ataxia (P < .01). We
identified 2 separate Cw/S relationships with different logistic
regression equations for the 2 groups. Faster than 0.4 m s−1,
Cw was 30.6% to 39.9% higher in patients with cerebellar stroke in
comparison with hemispheric stroke individuals. The Cw was correlated
with ataxia (r = 0.88; P < .001) in the cerebellar group, whereas there was a correlation with motor impairments (r = −0.61; P < .01), spasticity (r = 0.59; P < .01), and ataxia (r = 0.81; P < .01) in hemispheric stroke individuals.
Conclusion.
The Cw in poststroke cerebellar ataxia is significantly higher compared
with hemiparetic patients at an equivalent walking speed. The impact on
community walking needs to be explored in stroke survivors with
cerebellar stroke.
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