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Short-stepping gait in severe heart failure
S W Davies1, C A Greig, S L Jordan
1Department of Cardiology, Royal Free Hospital, London.
British Heart Journal
|November 1, 1992
Summary
Patients with severe heart failure walk with shorter strides, increasing the oxygen cost of exercise. This reduced stride length may contribute to exercise limitation in heart failure patients.
Area of Science:
- Cardiology
- Exercise Physiology
- Biomechanics
Background:
- Patients with severe chronic heart failure exhibit shorter stride lengths compared to healthy individuals during walking.
- Gait patterns influence exercise oxygen cost in healthy populations, suggesting relevance to heart failure exercise limitations.
Purpose of the Study:
- To investigate the relationship between stride length and exercise capacity in patients with heart failure.
- To determine if adopting a shorter stride length increases the oxygen cost of walking.
Main Methods:
- Stride length was quantified as the stride/stature index in healthy controls and patients with varying degrees of heart failure (NYHA class II and III) and angina.
- Participants walked at a constant speed normalized for stature.
Main Results:
- Patients with NYHA class III heart failure had a significantly lower stride/stature index (0.49) compared to controls and NYHA class II patients (0.64).
- A reduced stride/stature index correlated with lower peak oxygen consumption (VO2max) in heart failure patients (R = +0.62, p < 0.005).
- Healthy controls experienced a 15% increase in steady-state oxygen consumption when their stride length was artificially shortened to mimic severe heart failure gait.
Conclusions:
- Reduced stride length is characteristic of severe heart failure.
- A short-stepping gait increases the metabolic cost of walking, potentially contributing to exercise intolerance in heart failure.