The Evaluation of Walking Energy Consumption and Plantar Pressure Distribution in Patients with Lumbar Spinal Stenosis: A cross-sectional, case control study

Abstract

To evaluate the alterations of walking energy expenditure and plantar pressure distribution of patients with lumbar spinal stenosis. Material and Methods: Twenty-six subjects of both genders were included in the study, 13 patients suffering from lumbar spinal stenosis served as patient group and 13 healthy participants served as a control group. Preferred walking speeds were determined on the over ground. Oxygen consumption was recorded via a metabolic analyzer during walking on a treadmill for 2 km at preferred walking speed that determined on the over ground. Net oxygen consumption and oxygen cost were calculated for obtaining walking energy consumption. Plantar area was subdivided into six zones to measure plantar pressure distribution with a pedobarography device. Results: Compared with control group, patient group had significantly lower preferred walking speed (62.56±13.90 m/minimum and 76.66±10.90 m/minimum, p=0.008) and maximum walking distance [674.6 (105.0-2000.0) m and 2000.0 (2000.0-2000.0) m, p=0.019]. However, there were no statistically significant differences between groups in terms of energy expenditure parameters during walking at preferred walking speed (p>0.05). Similar findings were recorded between right and left foot with regard to weight distribution (%) to forefoot/hindfoot in patient group in the static pedobarographic measurements (p>0.05). Contact area value was significantly different between the affected and unaffected side at lateral forefoot in patient group (22.73±2.97 and 24.90±2.9, p=0.001). Conclusion: Patients with lumbar spinal stenosis do not exhibit more pressure on unaffected side compared to healthy subjects in both static and dynamic condition except contact area of lateral forefoot. Patient group optimized energy expenditure and oxygen cost by reducing their preferred walking speed owing to the pain.