Differential Responses to Measures of Gait Performance among Healthy and Neurologically Impaired Individuals

Objectives: To compare gait during a 5-minute walk among healthy individuals, persons with spinal cord injury (SCI), and stroke survivors and to investigate whether simultaneous measures of oxygen consumption enhance information about performance. Design: Descriptive study. Setting: Veterans Affairs medical center. Participants: Thirty-nine healthy individuals, 10 persons with SCI, and 20 stroke survivors. Interventions: Participants were fitted with a portable gas analyzer and walked on a 5-m walkway for 5 minutes. Main Outcome Measures: Measures of walk distance, gait speed, gait energy expenditure (GEE), and gait cost were obtained, along with measures of ventilation (V̇E), ventilation and carbon dioxide production slope (V̇E·V̇CO₂), oxygen pulse, and heart rate. Results: The SCI group (127.65±81.74m) walked less than the stroke survivors (148.80±64.3m) or the healthy group (268.90±35.01m) but had higher energy demands, as shown by GEE (SCI group, 13.28±3.23mL· kg^-1·min^-1; stroke group, 10.18± 2.14mL·kg^-1·min^-1; healthy group, 9.61± 1.90mL·kg^-1·min^-1) and by gait cost (SCI group, .57±.40 mL·kg^-1·m ^-1; stroke group, .40±.52mL·kg^-1· m^-1; healthy group, .18±.02mL·kg^-1· m^-1). Compared with the healthy group, the stroke group had higher V̇E (stroke group, 22.34±5.20L/min vs healthy group, 16.11±3.22L/min) and V̇E·V̇CO₂ slope (24.22±8.80 vs 18.73±5.44, respectively). Conclusion: Use of metabolic assessment during the 5-minute walk was feasible and provided further information for evaluating gait performance with the subjects studied.