Acute physiologic and perceptual responses during three modes of ambulation: Walking, axillary crutch walking, and running

Bhambani, Yagesh; Clarkson, Hazel M.

doi:10.1016/0003-9993(89)90004-x

Cited by 17 publications

(11 citation statements)

References 25 publications

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“…Crutches are used to reduce weight bearing on the lower limbs by supporting some weight through the arms in order to compensate for temporary or permanent disabilities [1][2]. Proper crutch use, by supporting loads through the arms, increases the energy expenditure of walking [1,[3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking

Borrelli¹,

Haslach²

2013

JRRD

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Abstract-Supporting weight on the upper support of crutches is not recommended because it can lead to axillary nerve damage. Despite this warning, improper axillary loadings may still occur because of a lack of arm strength or fatigue. It is generally accepted that improper use of conventional axillary crutches contributes to axillary nerve damage, but surprisingly there are no studies characterizing axillary support/underarm configurations. In this study, we compared traditional and horizontal axillary support designs by measuring various biomechanical parameters on the axillary support during a swingthrough gait while supporting weight on the axillary support. Subjects found the axillary support that remains horizontal to be more comfortable than the axillary support of axillary crutches. The higher perceived comfort may be attributed to the lower force and contact area, both average and maximum, developed on the horizontal axillary support and/or shorter excursion of the position of the center of force during a stride. These findings suggest that avoiding all weight bearing on the axillary support may be an overly conservative recommendation for supports that remain horizontal. Individuals with insufficient arm strength may benefit by considering this type of support, but because further study is needed, a physical therapist should be consulted.

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Section: Introductionmentioning

confidence: 99%

“…Proper crutch use, by supporting loads through the arms, increases the energy expenditure of walking [1,[3][4][5][6][7]. The high energy cost may lead some users to support weight through the axillary support, which some evidence suggests is easier, and may also keep others from ambulating upright altogether.…”

Section: Introductionmentioning

confidence: 99%

Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking

Borrelli¹,

Haslach²

2013

JRRD

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“…Ambulating with axillary crutches is often prescribed to reduce or eliminate weight bearing following acute lower-limb injury or surgery, or during chronic disability [1]. As the user essentially performs a push-up with each step, axillary crutch use increases physiological energy demands and generates increased palmar forces through the device handles [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…Noble et al reported a close correlation between ratings using the 10-category Borg perceived exertion scale and increases in blood lactate and muscle lactate levels during exercise among 10 nonimpaired men [28]. Borg and Bhampani et al have reported on the importance of evaluating associated perceptual stressors such as stability/security and comfort when considering physical exertion ratings [1,27,29].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Easy Strutter Functional Orthosis System and axillary crutches during modified 3-point gait

Nyland¹,

Bernasek²,

Markee³

et al. 2004

JRRD

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The Easy Strutter Functional Orthosis System ™ (ESFOS) was designed to improve assistive device ambulatory efficiency. This crossover design study compared the ESFOS to axillary crutches during modified 3-point gait. Thirty-eight subjects (40-65 years of age) at > 1 year after unilateral total knee or hip replacement participated in this study. Heart rate, mean peak palmar and plantar force magnitude, and onset timing were monitored during self-directed pace ambulation. Between trials, subjects responded to questions on perceived exertion, stability/security, and comfort. One-way analyses of variance were used to evaluate condition differences for ratio or interval data (p ≤ 0.01). Statistically significant differences were noted for mean peak palmar forces (reduced 45% and delayed 31%), mean peak plantar force onsets (delayed 30%), and energy expenditure index (EEI) (reduced 25%). Wilcoxon signed rank tests were used to evaluate condition differences for ordinal data. Subjects preferred the ESFOS to axillary crutches for comfort and security/stability on flat surfaces and stairs (p ≤ 0.001). Results suggest greater ambulatory gait efficiency during ESFOS use. Further study is indicated with other patient populations.

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“…The Borg Scale has been used to record the perceived exertion during dierent modes of ambulation ± walking, auxiliary crutch walking, and running in healthy volunteer women. 8 Little is known, however, about the measurement of functional ability of individuals with a spinal cord lesion using the RPE. This study is the ®rst to use the Borg Scale to rate the perceptual eort in order to analyze quantitatively the functional activities of individuals with a spinal cord lesion.…”

Section: Introductionmentioning

confidence: 99%

Functional ability, perceived exertion and employment of the individuals with spinal cord lesion in Taiwan

Wang¹,

Yang²,

Yen

et al. 2002

Spinal Cord

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Study design: A survey on functional ability, perceived exertion, and employment was mailed to 190 individuals with spinal cord lesion. Analysis is based on the 91 completed replies. Objectives: To establish a database of individuals with spinal cord lesions and to assess the eectiveness of training programs designed to improve life quality and employment chances among the individuals with spinal cord lesion. Settings: Subjects selected from the Spinal Cord Injury Association of the Republic of China (SCIAROC) and from the Asylum Center Spinal Cord Injury (ASCCI) in Taiwan. Methods: Information was obtained from a survey sent to the subjects who are chosen randomly from the SCIAROC and from all the subjects through ACSCI training program. Results: Respondents in ACSCI had a higher functional activity level and lower perceived exertion during activities than those in SCIAROC. The employment status is related to the functional independence and level of injury. Conclusion:The database provides information on functional and employment status of individuals with spinal cord lesion. The present study also demonstrates the ecacy of a vocational training program for individuals with spinal cord lesion in Taiwan.

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Acute physiologic and perceptual responses during three modes of ambulation: Walking, axillary crutch walking, and running

Cited by 17 publications

References 25 publications

Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking

Experimental characterization of axillary/underarm interface pressure in swing-through crutch walking

Comparison of the Easy Strutter Functional Orthosis System and axillary crutches during modified 3-point gait

Functional ability, perceived exertion and employment of the individuals with spinal cord lesion in Taiwan

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