Low compliance of orthosis locomotion. Selection criteria based on energy expenditure

A. Veicsteinas, M. Ferrarin, G. Merati

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Oxygen consumption (V̇O2), heart rate (HR) and cost of locomotion (C, energy required to cover 1 m per unit of transported mass) were measured in 14 paraplegics (age 19-59 yrs, BW 48-100 Kg, injury level C7-T11), during both wheelchair (Whch) and orthosis-assisted locomotion at 2-4 speeds, up to exhaustion (peak value, p). Subjects were divided into three groups; the HIP Guidance Orthosis Orlau Parawalker (PW, n=4), the Reciprocating Gait Orthosis (RGO, n=6) and the RGO with functional neuromuscular stimulation (RGO+FNS, n=4). Alms of the study were: a) to find out indicators of the poor long-term compliance (all but 2 RGO withdrawals in 5 yrs) on the basis of cost of locomotion and physical fitness; b) to assess selection criteria for the assignment of the different type of orthoses; c) to estimate whether electrical stimulation improves locomotion reducing fatigue. In RGO+FNS walking the slope difference of HR/V̇O2 curves between Whch and orthosis (ΔslHR/V̇O2) is significantly lower than in the other groups (=0 beats-l-1 for RGO+FNS vs 39 and 61 beats-I-1, for RGO and PW, respectively). Neither C, nor V̇O2P or ΔslHR/V̇O2 correlates with ortnosis length of use. C was higher (p2·m-1·Kg-1. It appears that: a) the poor long-term compliance for orthosis use depends on mechanisms (presumably psychological) apparently not related to fitness level; b) only those subjects who can deambulate at higher speeds might be suitable for electrical-stimulated types of orthosis. Hypothesis is made that adequate psychological and specific muscular training may improve compliance.

Original languageEnglish
JournalFASEB Journal
Issue number5
Publication statusPublished - Mar 20 1998

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Biochemistry
  • Cell Biology


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