Background Patients with chronic heart failure frequently report intolerance to exercise and present with changes in walk pattern, but information about heart transplant patients is lacking. Alterations of the gait pattern are related to interaction changes between the metabolism, neurological system and the mechanical demands of the locomotor task. The aim of this study was to investigate the electromyographic cost, coactivation and cost of transport of walking of chronic heart failure and heart transplant patients. Design This research was of an exploratory, cross-sectional design. Methods Twelve chronic heart failure patients, twelve healthy controls and five heart transplant patients participated in the study. Electromyographic data and oxygen uptake were collected simultaneously at five walking speeds. Results In the experimental groups, the electromyographic cost, percentage of coactivation in the leg and cost of transport were higher than in controls. The electromyographic cost was in line with the cost of transport. The minimum electromyographic cost matched with the self-selected walking speed in controls, while in chronic heart failure and heart transplant patients, it was reached at speeds higher than the self-selected walking speed. Conclusion The largest postural isometric activation and antagonist activation resulted in the highest metabolic demand. These findings are of great clinical relevance because they support the concept that interventions in order to improve the muscle performance in these patients can increase the self-selected walking speed and therefore the metabolic economy of walking.
RESUMOIntrodução: A velocidade de progressão é, em geral, determinada em pesquisas na área da locomoção. Objetivo: Comparar as medidas de velocidade autosselecionada no solo, na esteira rolante e a velocidade ideal estimada pelo número de Froude em sujeitos amputados transfemorais. Método: Primeiramente foi determinada a velocidade no solo; em seguida, realizou-se o teste na esteira, e a velocidade ideal foi estimada a partir dos dados antropométricos. Todos os sujeitos utilizavam joelho hidráulico e pé em fibra de carbono. Para comparação entre as velocidades foi realizada ANOVA de duas vias. Resultados: A velocidade autosselecionada na esteira foi menor (22%) do que no solo. Tanto a velocidade autosselecionada na esteira como a do solo foram 44% e 22% menores do que a velocidade ideal estimada, respectivamente. Conclusão: As velocidades analisadas no presente estudo foram diferentes, provavelmente, devido à variação dos parâmetros cinemáticos.
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