Energy costs of walking: Comparing household and community ambulators after stroke

Background Walking speed is a vital health indicator and predicts community ambulation post-stroke. Hemiplegic patients face difficulty walking independently due to many factors, including the higher energy cost of walking (ECW). Objectives To compare the energy cost of walking and functional characteristics between household ambulators versus community ambulators in chronic stroke patients. Methods From September 2022 to October 2023, 151 chronic stroke patients were screened in a university rehabilitation center for this cross-sectional study. Patients were divided into three groups based on the walking speed: Household ambulators (<0.49 m/s), limited community ambulators (0.49–0.92 m/s), and unlimited community ambulators (>0.92 m/s). Multiple outcome measures were used, including the Physiological Cost Index (PCI), Berg Balance Scale, and Trunk Impairment Scale. Results The household ambulators (Group A) consumed more energy than the limited community ambulators (Group B) p < .01 and unlimited community ambulators (Group C) p < .001. The energy cost of walking between Group B and Group C yielded no significant results p > .05; however, the Berg Balance Scale ( p < .05) and Trunk Impairment Scale ( p =< .05) were found to be significant variables among limited and unlimited community ambulators. Conclusion Our study provides evidence that chronic stroke patients in different ambulation groups have varying energy costs for walking. Balance control and trunk performance were significant predictors that differentiated between limited and unlimited community ambulators.