Short-stepping gait in severe heart failure

Heart J 1992;55:469-72
Short-stepping gait in severe heart failure
S W Davies, C A Greig, S L Jordan, D W Grieve, D P Lipkin
Abstract
Background-Patients with severe
chronic heart failure seem to take shorter
steps than healthy controls when walking
on a treadmill and when walking freely
along a corridor. In healthy individuals
the pattern of walking affects the oxygen
cost of exercise, and so this observation
might be relevant to the limitation of
exercise in heart failure.
Method-Length of stride was analysed
as stride/stature index in 15 controls, 10
patients with moderate heart failure,
10 patients with severe heart failure, and
10 patients with angina, walking at a
constant speed/stature index.
Results-The stride/stature index was
0-64 in the controls in patients with New
York Heart Association (NYHA) class II
heart failure, and in patients with angina.
It was 0 49 in patients with NYHA class III
heart failure. In the patients with heart
failure the stride/stature index correlated
with exercise capacity determined
as peak oxygen consumption
VO2max (R = + 062, p < 0-005). When
healthy controls walked in time to a,
metronome adjusted to decrease their
stride/stature index to approximately
that seen in severe heart failure steadystate
oxygen consumption increased by a
mean of 15%.
Conclusions-The length of stride is
reduced in severe heart failure, and when
healthy controls adopt this gait the
oxygen cost of walking is increased. A
short-stepping gait may contribute to the
limitation of exercise capacity in heart
failure.
(Br Heart J 1992;68:469-72)