A comparison of energy consumption between the use of a walking frame, crutches and a Stride-on rehabilitation scooter

Patel, Nandish V.; Batten, Timothy; Roberton, Andrew; Enki, Doyo; Wansbrough, Guy; Davis, James

doi:10.1016/j.foot.2016.04.002

Cited by 14 publications

(14 citation statements)

References 8 publications

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“…Sample size for the study was estimated from previous studies on energy expenditure and substrate utilization with mobility devices. 5 , 6 , 18 , 26 Retrospective analysis determined the sample size of 40 participants was at 100% power with an alpha level of 0.05. Recruitment was completed via electronic advertisements and presentations at the university.…”

Section: Methodsmentioning

confidence: 99%

“… 14 The medical knee scooter (MKS) is another mobility device that is commonly used by patients during the nonweightbearing period. MKS is generally associated with less energy expenditure during movement 18 ; however, the hands are still required to steer the device, and the surface used while maneuvering can limit utility or lead to complications including falls. 30 …”

Section: Introductionmentioning

confidence: 99%

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Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Hackney

Bradley

Roehl

et al. 2022

Foot & Ankle Orthopaedics

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Background: A Hands-Free crutch (HFC) is a relatively new device that can be used during the nonweightbearing period to increase mobility. The primary aim of this investigation was to examine aerobic oxygen consumption (V.o2) and substrate utilization with HFC compared to conventional ambulation devices as well as normal ambulation. A secondary purpose was to quantify perceived exertion, pain, and performance during each ambulation condition. Methods: Forty participants completed 4 separate 10-minute ambulation conditions around a rectangular course. The order of the ambulation conditions was randomized and consisted of (1) walking, (2) medical knee scooter (MKS), (3) HFC, and (4) axillary crutch (AC). Indirect calorimetry was used to determine V.o2 and the respiratory exchange ratio (RER), an indicator of substrate utilization. Perceived exertion and pain were also assessed using questionnaires. Results: All mobility devices significantly elevated V.o2 (+35%) compared to walking (13.14 ± 1.70 mL/kg/min; P < .001). AC had significantly greater V.o2 requirements (20.26 ± 2.62 mL/kg/min) compared to both the MKS (15.28 ± 2.29 mL/kg/min; P < .001) and HFC (15.88 ± 2.03 mL/kg/min; P < .001). There was no difference in average V.o2 between MKS and HFC ( P = .368). Compared to walking (0.78 ± 0.43), RER was significantly elevated in MKS (0.81 ± 0.05, P < .001) and AC (0.84 ± 0.06, P < .001), but not in HFC (0.79 ± 0.04, P = .350). RPE and pain were elevated in all ambulatory conditions (all P values <.001). Pain was significantly greater in AC compared with MKS ( P < .001) and HFC ( P < .001). Conclusion: HFC and MKS share similar V.o2 requirements over a 10-minute ambulation interval and are below those needed in AC. Substrate utilization in HFC was similar to regular walking with a greater reliance on lipid utilization for energy as evidenced by a lower RER. Exertion and pain scores were the most tolerable in HFC and MKS. Level of Evidence: Level II, prospective comparative study.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Hackney

Bradley

Roehl

et al. 2022

Foot & Ankle Orthopaedics

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“…It is also crucial to educate healthcare providers on their need to report such complications. 103 This is of topical importance as new devices such as knee scooters 104 and hands-free crutches 105 are being marketed without adequate means for assessing safety among consumers.…”

Section: Device-related Injury Surveillancementioning

confidence: 99%

Injuries Associated with Crutch Use: A Narrative Review

Manocha

MacGillivray

Eshraghi

et al. 2020

PM&R

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Crutches are commonly prescribed in physiatric settings to help offload the lower extremities. Crutch use, however, results in abnormal and repetitive weight-bearing through the upper extremities that may result in secondary injury. This narrative review investigates injury types and risk factors associated with crutch use in order to guide healthcare providers on injury prevention strategies. Medline, EMBASE, CINAHL, and the Cochrane Library were systematically reviewed for publications between 1950 and 2018 on neurological, musculoskeletal, or vascular complications associated with crutch use. Titles and abstracts (n = 2395) were screened by two authors. Sixty studies were eligible. Articles were reviewed for level of evidence, crutch type, participant characteristics, and injury characteristics. There were 42 axillary crutch studies, 12 forearm crutch studies, and 6 studies that did not specify crutch type. These studies incorporated 622 individuals, and most were case series or case reports (n = 54). Axillary crutch use was most commonly associated with axillobrachial arterial complications due to pressure from the axillary bar (n = 34). Forearm crutch use was most commonly associated with compressive neuropathies due to pressure from the forearm cuff (n = 6). Improper crutch fitting and/or use were identified as contributing factors to injury in 22 cases. Duration of crutch use and medical comorbidities also influenced the types of injuries seen. There are rare but potentially serious complications associated with crutch use. When prescribing crutches, clinicians should ensure they are properly fit, engage in appropriate gait training, be aware of common crutch-related injuries, and consider potential patient-specific injury risk factors in order to minimize injury risk.

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“…7 In healthy young adult populations (24-38 years of age and 35 ± 9 years, respectively), WKW use resulted in approximately 40% less VO 2 intake and 23% lower heat rate compared with a walker or crutches and was preferred over axillary crutches 88% of the time. 8,13 However, a current knowledge gap exists as to whether adults aged ≥50 years and older would experience similar benefits from WKW use.…”

Section: Introductionmentioning

confidence: 99%

Implications of Walking Aid Selection for Nonweightbearing Ambulation on Stance Limb Plantar Force, Walking Speed, Perceived Exertion, and Device Preference in Healthy Adults 50 Years of Age and Older

Kingston

Ferwerda

Fontaine

et al. 2021

Foot & Ankle Orthopaedics

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Background: Young adults often tolerate the increased energy expenditure, coordination, and stance limb discomfort associated with walking aids for nonweightbearing ambulation. Adults aged ≥50 years may not have the same tolerance. Therefore, the objective of this study was to determine how walking aid selection affects stance limb plantar force, walking speed, perceived exertion, and device preference in adults aged ≥50 years. Methods: A prospective randomized crossover study was performed using healthy adults, aged ≥50 years, with no use of walking aids within 5 years. Participants walked 200 m in 4 randomized conditions: single nonweightbearing ambulation using crutches, a walker, a wheeled knee walker, and unaided walking. An in-shoe sensor measured stance limb plantar force, a stopwatch timed each walk, perceived exertion was reported using the BORG CR-10 scale, and device preference was identified. Results: Twenty-one participants (7 male; age: 56 ± 5 years; BMI: 26.6 ±1.9) showed stance limb plantar force was lowest when using a wheeled knee walker ( P < .001). Walking speed was similar in unaided and wheeled knee walker conditions (1.41 and 1.31 m/s), but slower with crutches or a walker (42%-68%, P < .001). Perceived exertion was similar in unaided and wheeled knee walker conditions (1.6 and 2.8), but higher with crutches or a walker (5.7 and 6.1, P < .001). Most (20/21) participants preferred the wheeled knee walker. Conclusions: Using a wheeled knee walker for nonweightbearing ambulation reduced stance limb plantar force, maintained unaided walking speed and perceived exertion, and was preferred to crutches or a walker. Level of Evidence: Level II, comparative study.

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A comparison of energy consumption between the use of a walking frame, crutches and a Stride-on rehabilitation scooter

Cited by 14 publications

References 8 publications

Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Energy Expenditure and Substrate Utilization with Hands-Free Crutches Compared to Conventional Lower-Extremity Injury Mobility Devices

Injuries Associated with Crutch Use: A Narrative Review

Implications of Walking Aid Selection for Nonweightbearing Ambulation on Stance Limb Plantar Force, Walking Speed, Perceived Exertion, and Device Preference in Healthy Adults 50 Years of Age and Older

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