Measurement Properties of Mechanical Cost of Walking for Individuals With Walking Impairment

Measurement Properties of Mechanical Cost of Walking for Individuals With Walking Impairment

Walking impairment following neurologic injury can increase the energy cost of walking threefold, acting as a functional barrier to independence. The goal of this cross-sectional study is to determine the measurement properties of a novel biomechanical cost of walking measure in chronic stroke capable of pinpointing the origins of movement inefficiencies. This research aims to:

1. determine the convergent validity of biomechanical cost of walking with functional measures in relation to metabolic cost of walking,
2. determine the reliability of biomechanical cost of walking in relation to metabolic cost of walking,
3. determine the responsiveness of biomechanical cost of walking in relation to metabolic cost of walking.

Individuals with walking impairment from stroke will complete three 5-minute comfortable speed treadmill walking trials. The 3rd walking trial will be against resistance to increase cost of walking. This single session study will compare the metric properties of biomechanical cost of walking in relation to metabolic cost of walking.

Inclusion Criteria:

• Age 30-80 years at the time of consent
• Hemiparesis from ischemic and/or hemorrhagic strokes
• Most recent stroke for which participant sought treatment, at least 3 months prior to study consent
• Walking speed <1.0 m/s on the 10-meter walk test
• Able to walk 10m over ground with assistive devices as needed
• Able to walk at least 5 minutes continuously on the treadmill ≥ 0.1 mile per hour
• No contraindications to exercise according to ACSM guidelines
• Able to communicate with investigators, follow a 2-step command and correctly answer consent comprehension questions

Exclusion Criteria:

• Hospitalization for cardiac or pulmonary disease within past 3 months
• Implanted pacemaker or defibrillator
• Severe lower limb hypertonia (Ashworth >2)
• Foot drop or lower limb joint instability without adequate stabilizing device
• Clinically significant neurologic disorder other than stroke
• Other significant medical condition likely to jeopardize safety (e.g. joint contracture, gait limited by pain)
• Pregnancy