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Original Research
The energy expenditure of people with spinal cord injury whilst walking compared to an able-bodied population
Submitted: 14 April 2015 | Published: 31 March 2016
About the author(s)
Jana Vosloo, Department of Physiotherapy, University of the Witwatersrand, South AfricaM. Veronica Ntsiea, Department of Physiotherapy, University of the Witwatersrand, South Africa
Piet Becker, Biostatistics Unit, South African Medical Research Council, South Africa
Abstract
Background: In the field of spinal cord injury (SCI) research there is an emphasis on the ability to ambulate.
Purpose: To determine the ambulation energy expenditure (EE) and factors that affect ambulation EE in SCI participants compared to able-bodied participants.
Methods: This was a cross-sectional study. Participants were recruited from seven SCI rehabilitation units within the Johannesburg area. The following were used: demographic questionnaire to capture participants’ characteristics, modified Ashworth scale for spasticity; goniometer for range of movement (ROM); American Spinal Injury Association (ASIA) scale for patient classification; accelerometer for EE and the six-minute walk test (6MWT) for endurance. Characteristics of the study participants were summarised using descriptive statistics. Data were analysed as follows: two-sample t-test for comparison between the able-bodied and SCI sample and Pearson product moment correlations for relationship between identified factors and EE.
Results: Participants comprised 45 in the SCI group and 21 in the able-bodied group. The mean energy expenditure per metre (EE/m) for the SCI participants was 0.33 (± 0.29) calories compared to 0.08 (± 0.02) calories for the able-bodied participants. A decrease in walking velocity resulted in an increase in EE. For SCI participants, every decrease in degree of hip flexion ROM resulted in a 0.003 increase in EE/m walked. A unit decrease in velocity resulted in an increase of 0.41 in EE/m walked. Energy expenditure per metre decreased from ASIA A to ASIA D. Crutch walking utilised 0.34 calories per metre less energy than walking frames (p = 0.03).
Conclusion: Based on this study’s findings, factors to consider in order to maximise energy efficiency whilst walking are maintaining hip flexion ROM and optimising velocity of walking.
Keywords: Energy expenditure; Factors affecting energy expenditure; Range of motion; Walking Velocity
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African Journal of Disability vol: 6 year: 2017
doi: 10.4102/ajod.v6i0.337