Walking Speed and Step Length Asymmetry Modify the Energy Cost of Walking After Stroke

Well, do I have enough energy to walk and talk at the same time? Inquiring minds want to know.
From this your PT should be figuring out a way to get your walking more symmetric.
http://nnr.sagepub.com/content/29/5/416?etoc

1. Louis N. Awad, DPT1,2
2. Jacqueline A. Palmer, DPT1,2
3. Ryan T. Pohlig, PhD1,3
4. Stuart A. Binder-Macleod, PhD1,2,3
5. Darcy S. Reisman, PhD1,2

1. ¹Department of Physical Therapy, University of Delaware, Newark, DE, USA
2. ²Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE, USA
3. ³Delaware Clinical and Translational Research Accel Program, University of Delware, Newark, DE, USA

1. Darcy Reisman, PhD, University of Delaware, 540 South College Avenue, Newark, DE 19713, USA. Email: dreisman@udel.edu

Abstract

Background. A higher energy cost of walking poststroke has been linked to reduced walking performance and reduced participation in the community.  

Objective. To determine the contribution of postintervention improvements in walking speed and spatiotemporal gait asymmetry to the reduction in the energy cost of walking after stroke. Methods. In all, 42 individuals with chronic hemiparesis (>6 months poststroke) were recruited to participate in 12 weeks of walking rehabilitation. The energy cost of walking, walking speed, and step length, swing time, and stance time asymmetries were calculated pretraining and posttraining. Sequential regression analyses tested the cross-sectional (ie, pretraining) and longitudinal (ie, posttraining changes) relationships between the energy cost of walking versus speed and each measure of asymmetry.  

Results. Pretraining walking speed (β = −.506) and swing time asymmetry (β = .403) predicted pretraining energy costs: _adj R ² = 0.713; F(3, 37) = 34.05; P < .001. In contrast, change in walking speed (β = .340) and change in step length asymmetry (β = .934) predicted change in energy costs with a significant interaction between these independent predictors: _adj R ² = 0.699; F(4, 31) = 21.326; P < .001. Moderation by the direction or the magnitude of pretraining asymmetry was not found. 

Conclusions. For persons in the chronic phase of stroke recovery, faster and more symmetric walking after intervention appears to be more energetically advantageous than merely walking faster or more symmetrically. This finding has important functional implications, given the relationship between the energy cost of walking and community walking participation.

Reiki Heals Stroke

I wonder what the physical reason is that Reiki could supposedly do that?
http://www.reiki.org/reikistories/reikistories.html#Stroke
Considering this:

How Do I Convince Someone That Reiki Is Nonsense?

Reiki Is Nonsense

O maybe you'd rather read about a Reiki practioner defending it here;
Cherrypicking in my opinion.

http://thereikiblog.wordpress.com/2013/06/13/reiki-is-nonsense/ 

Your choice.

 

Banish fatigue and enjoy greater physical and mental energy starting now!

I'm quite sure this is the answer to all my fatigue problems! What could be wrong about it? Its from the Harvard Medical School.  Tell your doctor to get it and then write back to them that they know nothing about stroke fatigue.
The actual email;

Be ready to take on the day — every day!
Learn how you can banish fatigue and enjoy greater physical and mental energy starting now!

Dear dean,

When you are “on your game,” you know it. You think more clearly and quickly. You tackle daily chores more confidently and look forward with enthusiasm to whatever is next. You also know when you are “off your game.”

If you find that you don’t always have the pep you once did, you are not alone. Lack of energy is a common complaint. But the good news is that you can end the blahs. You can have more energy. You can achieve more consistent alertness, stamina, and drive.

Boosting Your Energy, a new Special Health Report, will make you more “energy efficient.” It explains how, by instituting easy-to-adopt lifestyle changes, you can dramatically increase your capacity for physical exertion and add to your powers of mental concentration.

In this report, Harvard Medical School doctors will expand your understanding of the factors that affect your energy level, including the amount and type of stress you’re under, your sleep habits, your exercise routine, and your diet.

As you read Boosting Your Energy, you’ll be introduced to the sensible steps and strategies that will help you maintain your “get-up-and-go” for all the things you want — and need — to do.

You’ll read about the foods that fuel your muscles and your mind. The report pinpoints low-glycemic-load foods that keep your energy on an even keel, highlights the vitamins and minerals that are key to efficient energy production, explains why caffeine has the power it does, and details why you should think twice before spending time and money on energy bars and sports drinks.

Boosting Your Energy will tell you about exercises that add to your energy reserves. You’ll discover why some of us are morning people and others are night owls. You’ll get tips for lessening the effects of jet lag. You’ll be alerted to the consequences of too little or too much sleep. You’ll find four ways to reduce energy-sapping stress. And you’ll learn about a six-step plan to jump-start your natural energy.

There’s no reason to face an energy shortage! Order your copy of Boosting Your Energy now!

To your good health,

Anthony Komaroff, M.D.
Professor of Medicine, Harvard Medical School
Senior Physician, Brigham and Women's Hospital
Editor in Chief, Harvard Health Publications

Reduction of Metabolic Cost during Motor Learning of Arm Reaching Dynamics

Discussions on brain energy expenditure, your doctor needs to analyze this to see if this could explain your fatigue.
Article discussing it here; 
Over-Practicing Makes Perfect

Abstract here;
 Reduction of Metabolic Cost during Motor Learning of Arm Reaching Dynamics

1. Helen J. Huang,
2. Rodger Kram, and
3. Alaa A. Ahmed

+ Author Affiliations

1. Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado 80309-0354

1. H.J.H., R.K., and A.A.A. designed research; H.J.H. performed research; H.J.H., R.K., and A.A.A. analyzed data; H.J.H., R.K., and A.A.A. wrote the paper.

Abstract

It is often assumed that the CNS controls movements in a manner that minimizes energetic cost. While empirical evidence for actual metabolic minimization exists in locomotion, actual metabolic cost has yet to be measured during motor learning and/or arm reaching. Here, we measured metabolic power consumption using expired gas analysis, as humans learned novel arm reaching dynamics. We hypothesized that (1) metabolic power would decrease with motor learning and (2) muscle activity and coactivation would parallel changes in metabolic power. Seated subjects made horizontal planar reaching movements toward a target using a robotic arm. The novel dynamics involved compensating for a viscous curl force field that perturbed reaching movements. Metabolic power was measured continuously throughout the protocol. Subjects decreased movement error and learned the novel dynamics. By the end of learning, net metabolic power decreased by ∼20% (∼0.1 W/kg) from initial learning. Muscle activity and coactivation also decreased with motor learning. Interestingly, distinct and significant reductions in metabolic power occurred even after muscle activity and coactivation had stabilized and movement changes were small. These results provide the first evidence of actual metabolic reduction during motor learning and for a reaching task. Further, they suggest that muscle activity may not explain changes in metabolic cost as completely as previously thought. Additional mechanisms such as more subtle features of arm muscle activity, changes in activity of other muscles, and/or more efficient neural processes may also underlie the reduction in metabolic cost during motor learning.

Nourish - Carbohydrates Fuel Your Brain

Anything to learn more about your brain.
http://www.fi.edu/learn/brain/carbs.html

Glucose is the form of sugar that travels in your bloodstream to fuel the mitochondrial furnaces responsible for your brain power. Glucose is the only fuel normally used by brain cells. Because neurons cannot store glucose, they depend on the bloodstream to deliver a constant supply of this precious fuel.

This blood sugar is obtained from carbohydrates: the starches and sugars you eat in the form of grains and legumes, fruits and vegetables. (The only animal foods containing a significant amount of carbohydrates are dairy products.)

Too much sugar or refined carbohydrates at one time, however, can actually deprive your brain of glucose – depleting its energy supply and compromising your brain's power to concentrate, remember, and learn. Mental activity requires a lot of energy.

Carbohydrate Topics:
Brain Energy Demand
Complex vs. Simple Carbohydrates
Brain Power – The Energy of Thought and Memory Read this one
Too Much Blood Sugar – Too Little Brain Sugar
Soft Drinks are Hard on Your Brain
Sugar, Diabetes and The Brain
How to Control Blood Sugar Swings
Check the Glycemic Index

Brain Energy Demand Your brain cells need two times more energy than the other cells in your body. Neurons, the cells that communicate with each other, have a high demand for energy because they're always in a state of metabolic activity. Even during sleep, neurons are still at work repairing and rebuilding their worn out structural components. They are manufacturing enzymes and neurotransmitters that must be transported out to the very ends of their– nerve branches, some that can be several inches, or feet, away. Most demanding of a neuron's energy, however, are the bioelectric signals responsible for communication throughout the nervous system. This nerve transmission consumes one-half of all the brain's energy (nearly 10% of the whole body's energy).