The functional independence of patients with stroke sequelae: How important is the speed, oxygen consumption and energy cost of walking?

Abstract Objective To evaluate the association between walking speed at self-selected comfort pace (Sfree), oxygen consumption at Sfree (VO2free), the oxygen cost of walking at Sfree (Cw), and mobility independence and independence for activities of daily living in post-stroke individuals. Design cross sectional study Setting hospital Participants All individuals with stroke who were able to walk without human assistance were included. Intervention N/A Main outcome measures Cw was captured during walking from measurements of Sfree and VO2free. Mobility independence was assessed based on the Modified Functional Ambulatory Classification (mFAC) and independence in activities of daily living by the Barthel Index (BI). Multiple linear regression analyses were performed to evaluate the independence of Cw, VO2free and Sfree on the determination of BI and mFAC among the various characteristics of the population (age, stroke delay, body mass index, motor function, and spasticity). Results We included 90 individuals (age=63.5±14.0 years). We reported Cw = 0.36mL.kg-1.m-1; IQR=0.28 mL.kg-1.m-1, Sfree = 0.60±0.32 m.s-1, VO2free = 11.2 mL.kg-1.min-1 ; IQR = 1.8 mL.kg-1.min-1. The multiple linear regression analyses showed that Cw and Sfree were independently associated with the BI (p 0.05). Conclusion Cw was independently associated with functional independence. This association appears to be primarily determined by Sfree and not VO2free, underscoring the importance of evaluating and acting on Sfree to improve the functional independence of individuals with stroke.