Stepping Forward: Evaluating the Impact of Gait Training on Post-Stroke Patients’ Energy Cost of Walking: A Pre-Test Post-Test Analysis

Stroke is a leading cause of disability and death globally, increasingly affecting younger populations and presenting significant rehabilitation challenges, particularly in restoring independent ambulation. Despite the established impact of energy cost of walking on gait performance, the specific effects of gait training interventions on walking economy remain underexplored. Objectives: To examine the effectiveness of an intensive gait training exercise intervention on Energy cost of walking (ECW) and ambulatory performance in chronic stroke patients. Methods: A randomized controlled trial (Clinical trial ID: IRCT20211011052727N2) was conducted from Apr 2023 to Nov 2023, in which fifty-eight chronic stroke patients, aged over 18 and being able to walk 14 meters with or without walking aids, were recruited for this design. The key outcome measures were the Physiological cost index, 10 meter walk test, Fugl-Myer Assessment and the 6-minute walk test. Patient received six weeks of gait training exercise intervention at a university rehabilitation center. Outcome evaluations were conducted at bassline, as well as at two, four and six-weeks post intervention. Results: The mean Physiological cost index (PCI) score at baseline was 0.73 ± 0.37 beats/min, was found significantly different from Post intervention score 0.56 ± 0.30 beats/min (F=52.32 p<0.01). Similarly, significant differences were noted in walking speed and walking endurance post intervention (p< 0.05). Post hoc Tukey’s multiple compression showed significant improvement in walking economy at 2 weeks (p<0.05), 4 weeks (p<0.01) and 6 weeks (p<0.01). Conclusions: Gait training exercises may significantly improve walking economy, ambulatory speed, and endurance in chronic stroke patients over a six-week intervention.