The effect of an arm sling on energy consumption while walking in hemiplegic patients: a randomized comparison

OBJECTIVE To evaluate the effect of an arm sling on gait speed and energy efficiency of patients with hemiplegia. DESIGN A randomized crossover design. SETTING A rehabilitation department of a university hospital. SUBJECTS Thirty-seven outpatients with hemiplegia were included in this study. INTERVENTIONS All patients walked on a 20-m walkway twice on the same day, randomly with and without an arm sling, at a self selected speed. MAIN MEASURES The heart rate, gait speed, oxygen cost and oxygen rate were measured on all patients. We analysed all values with and without an arm sling and also compared them after all patients being stratified according to demographic and clinical characteristics. RESULTS When we compared the heart rate between walking with (90.7 ± 17.2 beats/min) and without (91.2 ± 18.6 beats/min) the arm sling, it was significantly decreased while walking with the arm sling. When we compared the gait speed between walking with (32.8 m/min) and without (30.1 m/min), it was significantly increased with the arm sling walking. The O(2) rate in hemiplegic patients walking with the arm sling was significantly decreased by 7%, compared to walking without arm sling (5.8 mL/kg min and 6.2 mL/kg min, respectively). The O(2) cost in hemiplegic patients walking without arm sling was significantly 1.4 times greater than walking with it (0.2 mL/kg m and 0.3 mL/kg m, respectively). CONCLUSION An arm sling can be used to improve the gait efficiency.