A randomized comparison of energy consumption when using different canes, inpatients after stroke

Abstract

Objectives: To investigate the differences in oxygen consumption associated with gait in hemiplegic patients according to the type of cane they use. Design: A randomized crossover design. Setting: University hospital-based rehabilitation center, Korea. Subjects: Thirty consecutive patients (mean SD age, 56.3 3.2 years) with chronic stroke, 17 (56.7%) males and 13 (43.3%) females. Interventions: At approximately the same time of day for three consecutive days, each participant completed a walk with one of three randomly assigned types of canes: a single-point cane, a quad cane, and a hemi-walker. Main outcome measure: Energy expenditure (O2 rate, mL/kg/min), energy cost (O2 cost, mL/kg/m), and heart rate (HR) via a portable gas analyzer, a 10-meter walk test (10MWT), and a 6-minute walk test (6MWT). Results: Energy expenditure, gait endurance, and gait velocity for a single-point cane were higher (p<0.001 or p=0.005) than for any other type of cane. Energy cost (0.5 +/- 0.2 mL/kg/m vs. 0.6 +/- 0.2 mL/kg/m vs. 0.6 +/- 0.2 ml/kg/m, respectively, p=0.001) was lower for the single-point cane, except for HR (p 0.05) after the Bonferroni correction (0.05/5=0.01). Conclusions: A single-point cane requires less oxygen use at a given speed, or permits greater speed for the same oxygen consumption.