The Interplay Between Walking Speed, Economy, and Stability After Stroke.
Louis N Awad, Brian A Knarr, Pawel Kudzia and 1 others
PMID 36867550WHAT IT FOUND
In seven people with chronic stroke, walking faster on a treadmill reduced energy cost per meter but made pelvis motion more irregular.
Walking slower made pelvis motion more regular but increased energy cost per meter.
Key findings
01Walking faster than preferred speed improved economy by 8.6±8.1% and made pelvis motion 16.96±5.28% more irregular.
02Walking slower than preferred speed made walking 10.27±4.50% more regular and reduced a pelvis-motion divergence measure by 26.11±16.01%, but worsened economy by 11.9±5.5%.
03The margin of stability did not significantly differ across speeds for non-paretic steps (p=0.062) or paretic steps (p=0.37).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Seven people with chronic stroke who could walk on a treadmill without orthotic support were studied, so results do not show what happens in earlier recovery or in people who cannot walk this way. Testing was done on a treadmill, so the results may not extend to overground walking. Some participants used a handrail with light touch for safety, which may have affected stability measures and may have hidden part of the stability loss when walking faster. For three participants, the fastest trial was stopped early because of high heart rate and exertion, so their fast-speed data came from a lower fast trial. Minimal detectable change scores were not established for the stability and metabolic measures. It was a preliminary investigation of speed, economy, and stability, not a trial of speed-targeted therapy. The margin of stability did not significantly change with speed, so not all stability measures moved together.
Declared interests
The supplied text does not include a conflict-of-interest declaration. The journal metadata lists research support from NIH extramural funding.
The easy way to misread this
Do not conclude that faster treadmill walking should be used as a therapy target because economy improved. The study included seven people, used a treadmill with handrail light touch, and showed faster walking increased irregular pelvis motion while margin of stability did not significantly change.