The energy cost of level walking before and after hydro-kinesi therapy in patients with spastic paresis

In this study the energy cost of level walking was measured in 23 patients with stationary spastic paresis before and after a two-week treatment (45 min daily) of hydro-kinesi therapy, the latter consisting of passive and active movements in warm (32°C) sea water, free swimming and water immersion walking. Among the subjects (80.2±13.2 kg body mass; 56.0±14.6 years of age; 10.7±6.6 years of duration of spasticity), 12 were affected by hemiparesis, 4 by multiple sclerosis and 7 by spinal cord injury. The energy cost of level walking (C_w) was measured before and after therapy from the ratio of the overall steady-state oxygen consumption to the effective speed of progression. The differences in C_w due to the treatment, at matched speeds, were found to be negligible at speeds higher than 0.75 m · s⁻¹ (less than 5%) but to increase, with decreasing speed, up to about 17% at 0.1 m · s⁻¹. The treatment was therefore effective in improving the gait characteristics of the subjects, through a decrease of their C_w, mainly at low speeds of progression.