Energy cost of level walking

Area of Science:

• Biomechanics
• Rehabilitation Medicine
• Clinical Measurement

Background:

• Assessing walking ability and energy expenditure is crucial for evaluating treatment efficacy in patients with mobility impairments.
• Objective measures of walking efficiency are needed to supplement subjective clinical assessments.

Purpose of the Study:

• To develop and validate devices and methods for accurately measuring walking speed and oxygen cost during level walking.
• To assess the impact of specific orthopedic conditions and interventions on walking parameters.

Main Methods:

• Utilized a speedometer cart for controlled walking speed measurement.
• Employed an argon-dilution method with a backpack-mounted mixing box to determine oxygen uptake.
• Monitored patients with coxarthrosis before and after total hip arthroplasty (THA).
• Evaluated patients with moderate and severe gonarthrosis before and after knee prosthetic replacement.
• Studied patients with spastic paraparesis undergoing hip adductor muscle stretching.

Main Results:

• The developed methods demonstrated high validity and reproducibility for measuring walking speed (CV < 1.9%) and oxygen cost (CV < 3.2%).
• Impaired knee or ankle mobility significantly reduced walking speed and increased oxygen cost.
• Post-THA patients showed improved Harris hip scores and walking speed, with decreased oxygen cost.
• Patients with gonarthrosis improved clinically, with some recovering normal walking ability; oxygen cost remained unchanged in severe cases.
• Hip adductor stretching in spastic paraparesis reduced oxygen cost or blood lactate levels during walking.

Conclusions:

• Objective measurements of walking speed and oxygen cost are valuable tools for assessing walking disorders and treatment outcomes.
• These parameters provide a more sensitive reflection of recovery and complications than clinical scores alone in certain conditions.
• Interventions like THA and knee replacement can significantly improve walking efficiency, as evidenced by objective measures.