Energy expenditure and perceived effort in patients with stroke during sit to stand

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2022

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Harington, Tracy

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Abstract

Background The energy expenditure of adults with no known disease has previously been calculated and the determinants of sit to stand in individuals with hemiparesis post stroke have also been established. Perceived effort has been established for patients with stroke during walking and other activities. However, the amount of energy expended and their perceived effort in a patient with stroke during sit to stand has not yet been established. Objectives The aim of the study was to establish the actual energy expended and perceived effort of a patient with stroke during sit to stand. Methods A descriptive cross sectional pilot study was conducted. The study used nine participants and took place at the Chris Hani Baragwanath Academic Hospital Physiotherapy Department and Life Flora Hospital. The participants were sourced from both in and outpatient physiotherapy departments. The study was explained to them, and an information document was issued. Once consent was given, a once off demographic questionnaire was completed and participants’ weight and height were measured to calculate the body mass index. The triaxial accelerometer (RT3) was positioned at their hips on a belt, they stood up from a chair twice and on finishing this movement they completed the Modified Borg Scale for perceived effort. Information was captured on a Microsoft Excel™ for data analysis. STATA was used to analyse the data. Results Nine participants were included in this pilot study and consisted of four (44.4%) male and five (55.5%) female participants. The mean age of the group was 52.77 (±11.33) years with most having had a haemorrhagic stroke (n=6, 66.6%) who presented with left hemiplegia (n=6, 66.6%). The median energy expenditure during sit to stand was 2.62 (2.09-3.17) kCal/min. The median perceived effort was 3 (3-4) indicating a ‘somewhat severe’ effort rating. The correlation coefficient between the perceived effort and metabolic equivalent of task (METS) was r = 0.35 (p = 0.36). Conclusion This study found that participants could use the Modified Borg Scale to report their perceived effort during sit to stand and energy expenditure during sit to stand was much higher compared to published literature of healthy individuals. A fair positive correlation between perceived effort and METs was noted for patients with stroke during sit to stand. The results from this study show that the participants did have increase in EE compared to normal adults, thus training should focus to prevent the unnecessary waste of energy that can be reserved for other activities such as walking, running and stair climbing.

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A dissertation submitted in fulfillment of the requirements for the degree of Master of Science in Physiotherapy to the Faculty of Health Sciences, University of the Witwatersrand, 2022

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