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Relationship Between Energy Expenditure During Walking and Step Length in Patients With Heart Failure

Yoshimura, Kae, MSc, PT; Urabe, Yukio, PhD, PT; Maeda, Noriaki, PhD, PT; Yoshida, Toshinobu, MD

Topics in Geriatric Rehabilitation: April/June 2019 - Volume 35 - Issue 2 - p 97–103
doi: 10.1097/TGR.0000000000000206
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Objective: Step length (SL) is an important indicator of physical function in older individuals and patients with heart failure (HF). The aim of this study was to investigate correlations between energy expenditure during walking and SL in patients with HF in different age groups.

Subjects and Methods: A total of 44 patients participated in this study. The patients were divided into 2 groups with age younger than 65 years (the nonelderly group) and 65 years or older (the elderly group). Oxygen uptake (

O2) during walking was measured for 6 minutes at a self-selected speed using the FitMate Pro (COSMED, Rome, Italy). The highest values of

O2 (h

O2) and O2 cost during walking were determined. Step length (m), SL/height ratio (%), walking speed, and handgrip strength (HS) were also measured. All patients underwent a symptom-limited, graded exercise test on a cycle ergometer to derive peak


Results and Conclusions: Height was significantly correlated with SL in the nonelderly group (r = 0.56, P = .010) but not in the elderly group. h

O2 was not correlated with SL or SL/height ratio. In the elderly group, O2 cost was negatively correlated with SL (r =−0.61, P = .027) but not with SL/height ratio. There was a significant correlation between HS and SL only in the elderly group (r = 0.58, P = .001). These results suggest that SL might be a useful index that reflects energy expenditure during walking in elderly patients with HF.

Departments of Rehabilitation (Ms Yoshimura) and Cardiovascular Medicine (Dr Yoshida), The Sakakibara Heart Institute of Okayama, Okayama City, Okayama, Japan; and Department of Sports Rehabilitation, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan (Ms Yoshimura and Drs Urabe and Maeda).

Correspondence: Kae Yoshimura, MSc, PT, Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, 2-5-1, Nakai-cho, Kita-ku, Okayama City, Okayama 700-0804, Japan (

The authors have no conflict of interest.

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