Rollator use does not consistently change the metabolic cost of walking in people with chronic obstructive pulmonary disease

Arch Phys Med Rehabil. 2012 Jun;93(6):1077-80. doi: 10.1016/j.apmr.2012.01.009. Epub 2012 Mar 29.

Abstract

Objectives: To (1) evaluate whether the use of a rollator changed metabolic cost during a controlled walking task, and (2) explore relationships between the difference in dyspnea and metabolic cost associated with rollator use.

Design: Single-group interventional study in which patients completed 2 corridor walks: 1 without and 1 with a rollator, at the same individualized constant speed.

Setting: Rehabilitation hospital.

Participants: Patients with chronic obstructive pulmonary disease (N=15; 10 men; median age [interquartile range; IQR]=69 [12]y; forced expiratory volume in 1 second=42 [20]% predicted).

Intervention: Rollator use.

Main outcome measures: Oxygen uptake, converted to metabolic equivalent units (METs), and minute ventilation were measured throughout both tasks using a portable gas analysis system; dyspnea and arterial oxygen saturation (SpO(2)) were collected on completion.

Results: Median [IQR] walk speed [IQR] was 48 (10)m/min. Walking with a rollator, compared with walking without, reduced dyspnea (median [IQR]=1.0 [1.5] vs 2.0 [2.0]; P=.01) without changing energy expenditure (median [IQR]=2.8 [1.2] vs 3.2 [0.9] METs; P=.65), minute ventilation (median [IQR]=30.3 [9.6] vs 27.7 [9.9]L/min; P=.50), or SpO(2) (median [IQR]=92 [8]% vs 94 [10]%; P=.41). The association between the reduction in dyspnea and any difference in energy expenditure related to rollator use was of borderline significance (r(s)=.50; P=.06). Six of the 8 participants who experienced a reduction in dyspnea also demonstrated a reduction in the metabolic cost of walking.

Conclusions: The mechanism responsible for the amelioration in dyspnea during rollator-assisted walking is multifactorial. A reduction in the metabolic cost of walking may play a part in some, but not all, patients.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dyspnea / prevention & control
  • Dyspnea / rehabilitation
  • Energy Metabolism / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Oxygen Consumption / physiology*
  • Physical Endurance / physiology
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Pulmonary Gas Exchange
  • Rehabilitation Centers
  • Respiratory Function Tests
  • Self-Help Devices / statistics & numerical data
  • Severity of Illness Index
  • Walkers / statistics & numerical data*
  • Walking / physiology*