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Training Persons with Spinal Cord Injury to Ambulate Using a Powered Exoskeleton
Published on: June 16, 2016
Metabolic energy expenditure during spring-loaded crutch ambulation
Matthew K Seeley1, Ryan P Sandberg, Joshua F Chacon
1Dept of Exercise Sciences, Brigham Young University, Provo, UT, USA.
Context:
Individuals using traditional axillary crutches to ambulate expend approximately twice as much energy as individuals who perform able-bodied gait. A relatively novel spring-loaded crutch now being marketed may reduce metabolic energy expenditure during crutch ambulation. This idea, however, had not yet been tested.
Objective:
To determine whether the novel spring-loaded crutch reduces oxygen consumption during crutch ambulation, relative to traditional-crutch ambulation. A secondary purpose was to evaluate the design for subject-perceived comfort and ease of use.
Design:
Within-subject.
Setting:
Indoor track.
Participants:
10 able-bodied men and 10 able-bodied women.
Interventions:
The independent variable was crutch design. Each subject ambulated using 3 different crutch designs (traditional, spring-loaded, and modified spring-loaded), in a randomized order.
Main Outcome Measures:
The primary dependent variable was oxygen consumption. Secondary dependent variables were subject-perceived comfort and ease of use, as rated by the subjects using a 100-mm visual analog scale. Dependent variables were compared among the 3 crutch designs using a 1-way repeated-measures ANOVA (α = .05).
Results:
Oxygen consumption during spring-loaded-crutch ambulation (17.88 ± 2.13 mL · kg⁻¹ · min⁻¹) was 6.2% greater (P = .015; effect size [ES] = .50) than during traditional axillary-crutch ambulation (16.84 ± 2.08 mL · kg⁻¹ · min⁻¹). There was no statistically significant difference (P = .068; ES = -.45) for oxygen consumption between spring-loaded-crutch ambulation and ambulation using the modified crutch (17.03 ± 1.61 mL · kg⁻¹ · min⁻¹). Subjects perceived the spring-loaded crutch to be more comfortable (P < .001; ES = .56) than the traditional crutch. There was no difference (P = .159; ES = -.09) between the spring-loaded and traditional crutches for subject-perceived ease of use.
Conclusions:
Compared with traditional axillary crutches, the novel spring-loaded crutch may be more comfortable but does not appear to benefit subjects via reduced metabolic energy expenditure.
