{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:37:54Z","timestamp":1787161074658,"version":"build-2736575974"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100022107","name":"Universit\u00e9 de Limoges","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022107","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Stroke survivors often exhibit reduced walking efficiency, reflected by an increased energy cost of walking (Cw). Although Cw has been associated with walking performance, its relationship with impairment severity and independence in activities of daily living (ADL) remains unclear, particularly across real\u2010life walking conditions. This study aimed to examine the association between impairment severity and Cw across real\u2010life walking tasks. A secondary objective was to assess the association between Cw and independence in ADL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary analysis used data from a cross\u2010sectional study including 30 stroke survivors. Participants performed walking tasks under real\u2010life conditions (overground, irregular surface, slope, and stairs) at self\u2010selected speeds. Oxygen consumption was measured using portable indirect calorimetry, and Cw was calculated as the ratio of oxygen consumption to walking speed. Impairment severity and independence in ADL were assessed using the NIHSS and the Barthel Index. Associations were analyzed using Spearman's correlations, with additional analyses adjusted for walking speed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Unadjusted analyses showed significant associations between Cw and impairment severity across overground walking, stair descent, irregular terrain walking, and downhill walking (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u00a0=\u00a00.38\u20130.59). Cw was also significantly associated with independence in ADL across overground walking, stair descent, irregular terrain walking, uphill, and downhill walking (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u00a0=\u00a0\u22120.38 to \u22120.59), with the strongest associations generally observed during irregular terrain and downhill walking. After adjustment for walking speed, none of these associations remained statistically significant (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Cw was associated with both impairment severity and independence in ADL, but these relationships were largely explained by walking speed. These findings suggest that gait velocity is a central factor linking walking energetics to clinical and functional outcomes after stroke. Limitations include the relatively mild impairment level and the cross\u2010sectional design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT05477238\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70287","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:01:11Z","timestamp":1784030471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Energy Cost of Walking in Relation to Impairment and Functional Independence After Stroke: The Role of Walking Speed"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4365-1204","authenticated-orcid":false,"given":"Amine","family":"Guediri","sequence":"first","affiliation":[{"name":"HAVAE, UR 20217 University of Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxence","family":"Compagnat","sequence":"additional","affiliation":[{"name":"HAVAE, UR 20217 University of Limoges  Limoges France"},{"name":"Department PMR CHU Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alix","family":"Poyet","sequence":"additional","affiliation":[{"name":"Department PMR CHU Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Christophe","family":"Daviet","sequence":"additional","affiliation":[{"name":"HAVAE, UR 20217 University of Limoges  Limoges France"},{"name":"Department PMR CHU Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2072-3022","authenticated-orcid":false,"given":"St\u00e9phane","family":"Mandigout","sequence":"additional","affiliation":[{"name":"HAVAE, UR 20217 University of Limoges  Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968314552528"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/str.0000000000000022"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/959120"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000214218"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.20.7.871"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.26502\/fccm.92920199"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2021.01.085"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20130175"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/464176"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2022.100412"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzx038"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056669"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.116.015309"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/phm.0000000000002649"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u2010981\u201010\u20104304\u20108_9"},{"key":"e_1_2_12_17_1","volume-title":"Consultation et prescription m\u00e9dicale d'activit\u00e9 physique \u00e0 des fins de sant\u00e9 chez l'adulte","author":"Haute Autorit\u00e9 de Sant\u00e9","year":"2022"},{"key":"e_1_2_12_18_1","volume-title":"Applied Statistics for the Behavioral Sciences","author":"Hinkle D. 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