High‐ or low‐technology measurements of energy expenditure in clinical gait analysis?

Boyd, Randolph; Fatone, Stefania; Rodda, Jill; Olesch, Christine; Starr, Roland; Cullis, Elise; Gallagher, Donatus; Nattrass, Gary; Graham, Kerr

doi:10.1111/j.1469-8749.1999.tb00522.x

Cited by 28 publications

(42 citation statements)

References 16 publications

(18 reference statements)

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“…However, it is uncomfortable for patients and involves sophisticated and expensive equipment, requiring restricted and specialized handling. 5 Other methods used to estimate energy expenditure are based on cardiac activity. 6 Heart rate (HR) and oxygen uptake are linearly correlated during aerobic exercise.…”

Section: Introductionmentioning

confidence: 99%

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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Study design: Cross-sectional study. Objectives: To validate heart rate (HR) indexes for the evaluation of energy expenditure during wheelchair propulsion in people with spinal cord injury (SCI). Setting: SARAH Rehabilitation Hospital Network-Brasilia, Brazil. Methods: Forty-eight men aged 29.0 ± 7.8 years with a SCI between C6 and L3 causing complete motor impairment were enrolled in the study. The assessment consisted of 5 min of rest while seated in the wheelchair, followed by 5 min of wheelchair propulsion at a self-selected comfortable speed. The main outcomes measured were oxygen consumption, HR, physiological cost index (PCI), total heart beat index (THBI) and propulsion cardiac cost index (PCCI). Results: Using oxygen uptake as gold standard, the highest correlations were found between this and PCCI (r ¼ 0.59, Po0.001, 95% confidence interval (CI) 0.36-0.75) and THBI (r ¼ 0.58, Po0.001, 95% CI 0.36-74.0), independently of the injury level. The PCI had the lowest correlation coefficient (r ¼ 0.38, Po0.01, 95% CI 0.11-0.60). Spearman correlation analysis showed that the indexes mostly associated with lesion level were PCCI (r ¼ À0.531; Po0.001; 95% CI À0.708 to À0.291) and THBI (r ¼ À0.524; Po0.001; 95% CI À0.704 to À0.282). Conclusions: Both THBI and PCCI seem to be valid measures for assessing energy expenditure. Both indexes showed a coherent correlation with the spinal injury level.

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Section: Introductionmentioning

confidence: 99%

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

2014

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“…However, the reliability of the Physiologic CostIndex as a measuring tool when dealing with treatment outcomes in patients with cerebral palsy is in doubt. Recent investigations have shown that it is somewhat unreliable when compared to other metabolic measurements [9] .Energy Expenditure Index heart rate expressed per distance walked provides information on energy economyas oxygen uptake perdistancewalked does.Therefore the heart rate by the distance walked provides an easily, reliable measure and assessment of the degree of walking impairment.…”

Section: Introductionmentioning

confidence: 99%

Oxygen Consumption Estimation VS.Normalized Concentric Energy in Diplegic Children

Cerrolaza¹,

Rupcich²,

Bravo³

et al. 2012

BER

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Abstract-Energy expenditure is considered an essential tool for assessing functional ability. However in most motion analysis laboratories this is not routinely measured.When the goal of surgical treatment is to functionality or to make easier the task effort,energy assessment provides a unique and important tool. An energyconsumption index which can be highly correlated with metabolic energy expenditure is presented in this work.It would enable physicians and researchers to evaluate physical performance on an individual basis and to perform retrospective studies.Since by definition concentric contraction of muscles is power generating while eccentric contraction is power absorbing, this work is focused on the concentric (positive) power intervals. It is assumed that energy cost increases during pathological gait due to the high percentage of concentric contractions.Then, concentric areas of power generation in the kinetic power graphs of hip, knee and ankle in children with cerebral palsy were calculated and then normalized with respect to subject weight, thus obtaining the Normalized Concentric Energy (NCE) index.The concentric energy obtained from NCE calculation on kinetic datafrom42diplegicchildren with the metabolic energy expenditure (oxygen consumption)were analyzed and compared. Four regression models (linear, exponential, quadratic and cubic) were carried out and a model validation was performed. Thecubic regression model showed the best fit to dataset.

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“…Wheelchair ergometers, roller systems, and arm crank tests are convenient methods for laboratory testing but may not accurately assess daily wheelchair propulsion. The optimal test of functioning incorporates the individual's usual aids and orthoses at his or her self-selected speed instead of an imposed speed on a treadmill or ergometer [20].…”

Section: Introductionmentioning

confidence: 99%

Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user

Perdios¹,

Sawatzky²,

Sheel³

2007

JRRD

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Abstract-The objective of this study was to determine whether energy costs differed between 0°, 3°, and 6° of camber during steady state overground wheeling. Three subject groups were examined: experienced wheelchair users with disabilities (thoracic lesion level 6 and below), nondisabled individuals with manual wheeling experience, and nondisabled individuals with no manual wheeling experience. Heart rate, rating of perceived exertion, visual analog scale for comfort, and a user preference questionnaire were collected for all subjects. Expired gas analysis data were collected for the group with disabilities. No statistically significant differences emerged in respiratory measures for camber angle or group. A camber of 6 degrees was most preferred in terms of stability on a side slope, hand comfort on the pushrims, maneuverability, and overall preference. Rear-wheel camber angle did not affect the energy expenditure of manual wheelchair propulsion, as measured by cardiopulmonary means. The individual manual wheelchair user's perceived level of comfort should be the determining factor in rear-wheel camber selection.

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High‐ or low‐technology measurements of energy expenditure in clinical gait analysis?

Cited by 28 publications

References 16 publications

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

Validity of heart rate indexes to assess wheeling efficiency in patients with spinal cord injuries

Oxygen Consumption Estimation VS.Normalized Concentric Energy in Diplegic Children

Effects of camber on wheeling efficiency in the experienced and inexperienced wheelchair user

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