Energy consumption of locomotion with orthosis versus Parastep-assisted gait: A single case study

R. Spadone, G. Merati, E. Bertocchi, E. Mevio, A. Veicsteinas, A. Pedotti, M. Ferrarin

Research output: Contribution to journalArticlepeer-review


Study design: Single case study. Objectives: To evaluate the energy expenditure during ambulation with the Advanced Reciprocating Gait Orthosis (ARGO), with and without functional electrical stimulation (FES), and with the Parastep system in a single subject, in order to avoid the effect of intersubject variability. Setting: The Centre of Sport Medicine and Bioengineering Centre 'Don C Gnocchi' Foundation ONLUS IRCCS, Milano, Italy. Methods: A single patient (lesion level T5-T6) was trained specifically for each walking system and was evaluated after each training period. The effects of FES on muscle conditioning, spasticity and bone density were also evaluated. The HR/VO2 relationship and the energy cost of locomotion were measured during wheelchair (WHCH) use, during locomotion with ARGO (with and without FES) and Parastep system at different speeds. Results: The following was observed at the end of the whole training: (a) circumferences of both lower limbs and quadriceps forces were increased, whereas fatigue index was slightly decreased, spasticity and bone density were unchanged; (b) compared to WHCH locomotion, the slope of HR/VO2 curves with ARGO was higher (slope difference = 51.1 b 1O2 -1), with ARGO + FES was similar (slope difference = -5.3 b 1O2 -1) and with Parastep was smaller (slope difference = -55.6 b 1O2 -1); (c) HR increased linearly with all locomotion systems, but did not rise above 125 bpm with Parastep; (d) the cost of locomotion was higher with Parastep than with ARGO (with and without FES), tested at each velocity; (e) Parastep appears to be easier to use for the subject. Conclusions: (a) FES can improve ambulation with orthosis, but the cost of locomotion remains very high; (b) the Parastep assisted gait elicits a higher energy expenditure than other orthoses, probably due to the lower speed of locomotion and to the high isometric effort of the stimulated muscles. Sponsorship: This work has been partially supported by the Italian Minister of Public Health.

Original languageEnglish
Pages (from-to)97-104
Number of pages8
JournalSpinal Cord
Issue number2
Publication statusPublished - Feb 1 2003


  • Functional electrical stimulation
  • Gait
  • Orthosis
  • Parastep system
  • Spinal cord injury

ASJC Scopus subject areas

  • Clinical Neurology


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