Comparable energy expenditure after arthrodesis of the hip and ankle.

Waters, Robert L.; Barnes, George; Husserl, T; Silver, Lester; Liss, Reverse

doi:10.2106/00004623-198870070-00011

Cited by 106 publications

(59 citation statements)

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“…Waters et al (1988), found that patients with an ankle arthrodesis had an 11% increase in oxygen cost compared to healthy controls, both walking at their SWS. In healthy participants walking with and without a below-knee plaster cast the oxygen cost at SWS was found to be 16% to 27% higher compared to unconstrained walking (Fowler et al, 1993;Waters et al, 1982).…”

Section: Discussionmentioning

confidence: 98%

“…Restriction of ankle function has been shown to affect metabolic cost of walking both in practice and theory. From experimental research it is known that restriction of ankle motion by an external immobilization (Fowler et al, 1993;Waters, Campbell, Thomas, Hugos, & Davis, 1982) or through ankle arthrodesis (Waters et al, 1988) raises energy consumption during walking. However, a satisfying biomechanical explanation for this phenomenon remains to be given.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic cost and mechanical work for the step-to-step transition in walking after successful total ankle arthroplasty

Doets

Vergouw

Veeger

et al. 2009

Human Movement Science

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The aim of this study was to investigate whether impaired ankle function after total ankle arthroplasty (TAA) affects the mechanical work during step-to-step transition and the metabolic cost of walking. Respiratory and force plate data were recorded in 11 patients and 11 healthy controls while they walked barefoot at a fixed walking speed (FWS, 1.25 m/s) and at their self-selected speed (SWS). At FWS metabolic cost of transport was 28% higher for the TAA group, but at SWS there was no significant increase. During the stepto-step transition, positive mechanical work generated by the trailing TAA leg was lower and negative mechanical work in the leading intact leg was larger. Despite the increase in mechanical work dissipation during double support, no significant differences in total mechanical work were found over a complete stride. This might be a result of methodological limitations of calculating mechanical work. Nevertheless, mechanical work dissipated during the step-to-step transition at FWS correlated significantly with metabolic cost of transport: r = .540. It was concluded that patients after successful TAA still experienced an impaired lower leg function, which contributed to an increase in mechanical energy dissipation during the step-to-step transition, and to an increase in the metabolic demand of walking.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Metabolic cost and mechanical work for the step-to-step transition in walking after successful total ankle arthroplasty

Doets

Vergouw

Veeger

et al. 2009

Human Movement Science

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“…Therefore, it appears that scoliosis patients exert more physical effort than healthy subjects just to walk. For example, in amputees affected by the loss of joint motion at different levels, the rate of energy expenditure and energy cost increase from the ankle, to the knee, and to the hip respectively by 3% [30], 23% [31], and 32% [34]. AIS patients exhibit nearly the same energy cost as walking with an immobilized hip [17].…”

Section: Discussionmentioning

confidence: 99%

“…Disturbances of the vertical displacement of the COM b in normal conditions (e.g., walking on sand or carrying loads as an African woman) [6,18] or conditions of pathologic gait (e.g., stiffknee gait after a stroke or walking with a prosthesis) [10,12,27,28] affect the mechanical work and metabolic cost of the gait [10-13, 18, 22, 27, 29, 30, 33]. More precisely, any handicap increases these two parameters [10,27,29,30,33,34]. Both muscular mechanical work, which is assessed by the production of mechanical energy due to the energy changes of the COM b relative to the ground and of the body segments relative to the COM b [4,5], and the energy expenditure due to the oxygen consumption [32,34] allow assessment of the efficiency of locomotion.…”

Section: Introductionmentioning

confidence: 99%

Gait in adolescent idiopathic scoliosis: energy cost analysis

et al. 2009

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Walking is a very common activity for the human body. It is so common that the musculoskeletal and cardiovascular systems are optimized to have the minimum energetic cost at 4 km/h (spontaneous speed). A previous study showed that lumbar and thoracolumbar adolescent idiopathic scoliosis (AIS) patients exhibit a reduction of shoulder, pelvic, and hip frontal mobility during gait. A longer contraction duration of the spinal and pelvic muscles was also noted. The energetic cost (C) of walking is normally linked to the actual mechanical work muscles have to perform. This total mechanical work (W tot ) can be divided in two parts: the work needed to move the shoulders and lower limbs relative to the center of mass of the body (COM b ) is known as the internal work (W int ), whereas additional work, known as external work (W ext ), is needed to accelerate and lift up the COM b relative to the ground. Normally, the COM b goes up and down by 3 cm with every step. Pathological walking usually leads to an increase in W tot (often because of increased vertical displacement of the COM b ), and consequently, it increases the energetic cost. The goal of this study is to investigate the effects of scoliosis and scoliosis severity on the mechanical work and energetic cost of walking. Fiftyfour female subjects aged 12 to 17 were used in this study. Thirteen healthy girls were in the control group, 12 were in scoliosis group 1 (Cobb angle [Cb] B 20°), 13 were in scoliosis group 2 (20°\ Cb \ 40°), and 16 were in scoliosis group 3 (Cb C 40°). They were assessed by physical examination and gait analysis. The 41 scoliotic patients had an untreated progressive left thoracolumbar or lumbar AIS. During gait analysis, the subject was asked to walk on a treadmill at 4 km h -1 . Movements of the limbs were followed by six infrared cameras, which tracked markers fixed on the body. W int was calculated from the kinematics. The movements of the COM b were derived from the ground reaction forces, and W ext was calculated from the force signal. W tot was equal to W int ? W ext . Oxygen consumption _ VO 2 À Á was measured with a mask to calculate energetic cost (C) and muscular efficiency (W tot /C). Statistical comparisons between the groups were performed using an analysis of variance (ANOVA). The external work (W ext ) and internal work (W int ) were both reduced from 7 to 22% as a function of the severity of the scoliosis curve. Overall, the total muscular mechanical work (W tot ) was reduced from 7% to 13% in the scoliosis patients. Within scoliosis groups, the W ext for the group 1 (Cb C 20°) and 2 (20 B Cb B 40°) was significantly different from group 3 (Cb C 40°). No significant differences were observed between scoliosis groups for the W int . The W tot did not showed any significant difference between scoliosis groups except between group 1 and 3. The energy cost and _ VO 2 were increased by around 30%. As a result Muscle efficiency was significantly decreased by 23% to 32%, but no significant differences related to the severi...

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“…Depending on the length of time the subject was able to walk, expired air was collected during the fourth, fifth, tenth, fifteenth, and twentieth minutes using a modified Douglas bag collection technique described in previous reports (Waters, 1988). Because the number of measurement points available were different for different subjects, i.e.…”

Section: Testing Proceduresmentioning

confidence: 99%

Changes in ambulation parameters in spinal cord injury individuals following rehabilitation

1990

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SummaryThe energy cost and gait parameters of 10 spinal cord injury patients (mean age = 21-7 ± 2-3 years) were measured at discharge from initial rehabilitation and at 1 year follow-up_ At follow-up testing patients walked faster (59-5 m/minute vs 40-4 m/minutes; p < 0-001), more efficiently (0-26 ml 02/kg-m vs 0-40 ml 02/kg-m; p < 0-05) had slower heart rates (115 beats/minute vs 133 beats/minute; p < 0-01), and required decreased axial load on upper extremity assistive devices (18% body weight vs 26% body weight; p < 0-03)_ At follow-up testing, those patients with remaining weakness in the lower limbs had greater conditioning effects (increased rate of oxygen consumption and oxygen pulse) than those patients with relatively stronger limbs_ These findings indicate that clinicians can expect significant improvements in functional ambulation performance in the first year following initial rehabilitation due to improved strength and conditioning_ Key words: Spinal cord injuries; Gait; Oxygen consumption; Rehabilitation_ The majority of energy cost studies involving spinal cord injured (SCI) individuals have been performed on newly injured inpatients or chronic injuries in which repeat testing was not performed (Chantraine, 1984;Clinkingbeard, 1964;Gordon, 1956;Huang, 1979;Merkel, 1985;Waters, 1985;Waters, 1989)_ Clinkingbeard retested 11 SCI ambulators to assess longitudinal changes during rehabilitation, however, repeat testing of SCI ambulators has not been done on patients following discharge more than 1 year post-injury (Clinkingbeard, 1964)_ Yet, in clinical practice, many patients continue to gain strength after rehabilitation, increase their capacity to exercise, and improve overall gait performance_ The purpose of this study was to quantify changes in physiological and gait performance parameters of SCI ambulators which may occur following discharge from initial rehabilitation_

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Comparable energy expenditure after arthrodesis of the hip and ankle.

Cited by 106 publications

References 0 publications

Metabolic cost and mechanical work for the step-to-step transition in walking after successful total ankle arthroplasty

Metabolic cost and mechanical work for the step-to-step transition in walking after successful total ankle arthroplasty

Gait in adolescent idiopathic scoliosis: energy cost analysis

Changes in ambulation parameters in spinal cord injury individuals following rehabilitation

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