Energy cost of spontaneous walking in Parkinson’s disease patients

Abstract

In healthy subjects, comfortable walking minimizes the energy cost (E (c)) of locomotion. In Parkinson's disease (PD) patients walking is slower than in healthy subjects: this may increase E (c). Our aims were to analyze gait and E (c) in PD patients during walking, particularly at self-selected speed, and the possible pathological, mechanical, and cardiorespiratory limitations. Fourteen mild-to-moderate PD and 14 control subjects were enrolled. Subjects underwent 5-min walking tests at two speeds: self-selected and as-fast-as-possible speeds. Cardiopulmonary and gait parameters (heart rate, ventilation, gas exchanges, step count) were recorded. Velocity was reduced in PD compared to control subjects at both speeds (P < 0.05), and PD patients had shorter strides (P < 0.05) at both speeds and reduced cadence (P = 0.01) at fastest speed. No significant difference was found in E (c) at self-selected (0.12 ± 0.04 versus 0.11 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) and maximal (0.14 ± 0.03 versus 0.15 ± 0.02 mLO(2) kg(-1) m(-1) in PD and control subjects, respectively) speed. However, the E (c) increment from self-selected to fastest velocity was significantly lower (P = 0.02) in PD patients. PD patients failed to walk at a self-selected speed, which minimizes the E (c). This could be mainly due to the inability to develop a wider stride. Cardiorespiratory adaptation was not affected, except for the possible reduced cardiac adaptation observed in some (28%) cases. Presumably, rehabilitation procedures that improve flexibility and step length may help maintain walking ability.

Effect of concurrent walking and interlocutor distance on conversational speech intensity and rate in Parkinson's disease

“…The effect of changes in walking speed on locomotive parameters such as gait velocity, stride length and cadence has also between investigated (Morris et al, 1994a b;Mak, M., 2013;Maggioni et al, 2011;Murray et al, 1978). The purpose of these studies has primarily been to investigate whether stride length and cadence of disordered participants will approximate normal levels when velocity is controlled or equalized.…”

Mechanical Energy Recovery during Walking in Patients with Parkinson Disease

“…Very few studies, with unclear results, investigated energetic expenditure in PD patients. In particular, patients were investigated in unspecified meds-on state [ 16 ], or while walking on a treadmill [ 17 ], a condition which has been shown to alter the gait pattern with respect to over-ground walking [ 18 , 19 ]. In addition, PD patients were never compared to healthy subjects walking at similar velocities.…”

A new method to calculate external mechanical work using force-platform data in ecological situations in humans: Application to Parkinson's disease

“…In support of this hypothesis, during the TUG, the ''activity rate'' of Parkinsonian patients was lower than that of healthy subjects. In the same way, no significant difference was found between Parkinsonian patients and control subjects for the energy cost of locomotion at a self-selected speed [34] (even though a higher energy cost of locomotion was noted when exercise intensity was imposed [35,36]). However, the TUG for our participants was particularly long (the cables connecting participants to the calorimeter probably lengthened the duration of the TUG by hindering walking).…”