Impact du cout energetique de la marche sur la participation sociale apres AVC : etude longitudinale
Celine Ladrat (LIMOGES, France), Jean-Christophe Daviet (LIMOGES, France), Romain Joste (LIMOGES, France), Jean-Yves Salle (LIMOGES, France), Maxence Compagnat (LIMOGES, France)
Objective : After a stroke, walking is a key function for social reintegration. Individuals with stroke, at spontaneous walking speed have an energy cost of walking (Cw) two to three times higher than healthy subjects. The correlation between increased Cw and activity limitation and reduced quality of life has already been demonstrated. The aim of this study was to determine the relationship between Cw and social participation and to identify factors that predict social participation in the sub-acute stage of stroke.
Material / Patients and Methods : Prospective follow-up of a cohort of patients treated and followed in PRM in Limoges University Hospital. We assessed data collection, estimation of Cw using a validated equation in hemispheric stroke patients (Cw = 0.2109.(walking speed)^-0.877) and assessment of social participation using the Reintegration to Normal Life Scale (RNLI).
Results : Twenty-five patients were reevaluated at chronic stage of their stroke, on average seven years later. A good level of correlation (r = 0.682; p < 0.001) was found between Cw and RNLI. A correlation was also found between Cw in the sub-acute stage and Cw in the chronic stage of the stroke. Ambulation abilities in the sub-acute stage were also correlated with RNLI in the chronic stage.
Discussion - Conclusion : Systematic assessment of Cw from the sub-acute phase of the stroke, combined with rehabilitative interventions to reduce Cw, should enable better social reintegration for these patients.
Keywords : social participation, stroke, energy cost