Anderson ND., Mitchell KR. O’Connell DG. O’Connell JK.; Department of Physical Therapy, Hardin-Simmons University, Abilene, TX 79698. Funded by the HSU Academic Foundation.

PURPOSE: The purpose of this study was to compare energy expenditure, ambulation speed, and ambulation velocity as subjects with cerebral vascular accidents (CVAs) ambulated across different terrains. SUBJECTS: Five volunteers (3 males, 2 females, 40-90 years of age) preparing for discharge from inpatient rehabilitation at Hendrick Center for Rehabilitation participated. METHODS: A K4b² portable breath-by-breath pulmonary gas exchange system was used to analyze energy expenditure of each subject during the ambulation trials. Subjects rested for 15 minutes to accommodate to the system then ambulated at self-selected speeds for 5 minutes on each of the three terrains. Random selection of ambulation terrain sequence was determined for each subject. Rest periods of at least 5 minutes were given between each ambulation trial so that subjects heart rates returned to within ± 5 beats/min of resting rate. ANALYSIS: Non-parametric Friedman tests for more than two related samples were performed comparing ambulation energy expenditure, minute ventilation, distance, and velocity between the tile, dirt, and gravel terrains. Alpha levels of p < 0.05 were used to test for significance. RESULTS: No significant difference was found for energy expenditure (ml/kg/min/m) across terrains. Significant differences were found for minute ventilation (l/min), distance (meters) and velocity (m/min). CONCLUSION: Patients ambulated faster with greater minute ventilation and covered more distance on tile than dirt or gravel. Energy expenditure was not significantly different across the terrains; although the trend supported the increased values seen with ambulation over tile. RELEVANCE: Rehabilitation of patients with CVAs should include ambulation training on various terrains, particularly if patients will be returning to rural communities. Physical therapists should include distance and velocity goals with ambulation training on different terrains to better enable patients with CVAs to return to independent functional community ambulation.

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