Walking Performance: Correlation between Energy Cost of Walking and Walking Participation. New Statistical Approach Concerning Outcome Measurement

PLoS ONE, 2013 · DOI: 10.1371/journal.pone.0056669 · Published: February 28, 2013

Simple Explanation

This study investigates if the energy cost of walking (CW) can predict walking performance and community participation in patients with neurological disorders. The Walking Handicap Scale (WHS) was used to assess walking restriction in community activities. A statistical model was developed to classify patients based on their energy cost of walking, distinguishing between those who can and cannot walk in the community.

Study Duration

January 2007 to December 2009

Participants

107 subjects (31 Stroke, 26 Spinal Cord Injury, 50 Multiple Sclerosis)

Evidence Level

Cross-sectional study

Key Findings

1
The study found that the energy cost of walking (CW) is a predictor of walking performance in the community, as measured by the Walking Handicap Scale (WHS).
2
A cut-off value of 0.40 for CW was identified, which can classify cases correctly with a percentage of 85.0%.
3
The cut-off value can distinguish between individuals who can walk in the community and those who cannot.

Research Summary

The aim of this study is to evaluate if the energy cost of walking (CW) in a mixed group of patients with neurological diseases, almost 6 months after discharge from rehabilitation wards, can predict the walking performance and the walking restriction to participate in the community, as indicated by Walking Handicap Scale categories (WHS). The multivariable binary logistical regression analysis has produced a statistical model with good characteristics of fit and good predictability. These values could be used to predict the ability to walk in the community when discharged from the rehabilitation units, and to adjust the rehabilitative treatment to improve the performance.

Practical Implications

Prediction of Community Walking Ability

The findings can be used to predict a patient's ability to walk in the community upon discharge from rehabilitation.

Adjustment of Rehabilitation Treatment

The results can help tailor rehabilitation treatment to improve walking performance.

Informing Patients and Families

The cut-off value can provide useful information to patients and their families regarding the choice of aids and home modifications.

Study Limitations

1
Single-center study
2
Lack of cross-language validation of WHS for SCI and MS
3
Assessment of CW requires active participation and motivation from the subject

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