Energy expenditure and perceived effort during uphill and downhill walking in people with multiple sclerosis.

BACKGROUND
Walking on different slopes is a common daily activity for many ambulatory people with multiple sclerosis (pwMS).


AIM
Investigate energy expenditure measures of walking on level, uphill and downhill slopes in pwMS.


DESIGN
Observational case-control study.


SETTING
Sheba Multiple Sclerosis Center, Tel-Hashomer, Israel.


POPULATIONS
Eighteen pwMS; 10 women and 8 men, aged 39.7 (SD=6.8), mean EDSS was 2.9 (SD=1.2) and 23 healthy adults; 8 women and 15 men, aged 37.1 (S.D.=5.3).


METHODS
Energy expenditure values were obtained via a metabolic device during four conditions: sitting, comfortable walking, uphill and downhill walking. Each walking trial, obtained on a treadmill, lasted 6-min and were separated by10-min recovery intervals.


RESULTS
For both pwMS and healthy controls, the O2 rate and O2 cost was higher during uphill walking compared to level walking and lower during downhill walking compared with level walking. O2 rate and net O2 cost during uphill walking was lower in pwMS compared with the healthy controls. The most demanding effort was during uphill walking, with pwMS rating it more demanding compared with the healthy controls.


CONCLUSIONS
Perceived effort of walking on different slopes is not consistent with changes in the energy expenditure values in pwMS.


CLINICAL REHABILITATION IMPACT
pwMS describe the effort of walking on different slopes higher than normal, regardless of the energy expenditure values.