Oxygen consumption, oxygen cost and physiological cost index in polio survivors: A comparison of walking without orthosis, with an ordinary or a carbon-fibre reinforced plastic knee-ankle-foot orthosis

Author： Hachisuka Kenji Makino Kenichiro Wada Futoshi Saeki Satoru Yoshimoto Nami

Publisher： Medical Journals Limited

ISSN： 1650-1977

Source： Journal of Rehabilitation Medicine, Vol.39, Iss.8, 2007-10, pp. : 646-650

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Abstract

Objective: To examine, for polio survivors, whether walking with a carbon-fibre reinforced plastic knee-ankle-foot orthosis (carbon KAFO) is more efficient than walking with an ordinary KAFO or without an orthosis.Design: Consecutive sample.Setting: Post-polio clinic, University Hospital of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.Participants: Eleven polio survivors who had a carbon KAFO prescribed at the post-polio clinic.Interventions: A carbon KAFO was prescribed, fabricated and inspected.Main outcome measures: Oxygen consumption, oxygen cost and physiological cost index.Results: An ordinary KAFO weighed 1403 g (standard deviation(SD) 157 g), whereas a carbon KAFO weighed 992 g (SD 168 g). Subjects walking with a carbon KAFO showed a tendency to increase step length, and to increase speed significantly compared with walking without an orthosis and with an ordinary KAFO (paired t-test, p < 0.05). Oxygen consumption per body weight, oxygen cost (O₂ consumption for 1-m walk divided by body weight) and physiological cost index ((heart rate at 3-min walk – heart rate at rest)/speed) were significantly lower than those walking without an orthosis (−16%, −35%, −33%; paired t-test, p < 0.05) and were lower than those walking with an ordinary KAFO (−9%, −14%, −15%; paired t-test, p < 0.05).Conclusion: The gait efficiency of polio survivors with a carbon KAFO was objectively better than those without an orthosis or with an ordinary KAFO.