ENERGY EXPENDITURE ON AMBULATION IN PARAPLEGICS

Oxygen uptake and energy expenditure in ambulation were studied in patients with spinal cord injury.In addition to basal metabolic rate (BMR), O2 consumption and CO2 production were studied at rest and ambulation periods using the “breath analyser”. BMR of paraplegics was lower by 15 to 20% than that of normal individuals. During the wheelchair propelling, RMR (relative metabolic rate) of paraplegic patients was 0.3 to 1.0.A linear relationship appeared to exist between the RMR and the speed at wheelchair propelling. The RMR in patients with thoracic lesions during swing through gait, with speed of 11m/min., was 4.83 on an average.The RMR in patients with lumber lesions was 4.62 at swing through gait and 4.02 at four point gait. Speed was 30m/min. at swing through gait and 11m/min. at four point gait.Certainly RMR of thoracic paraplegics in ambulation was higher than that of lumbar paraplegics.RMR, above 4.0 was seem a heavy work for paraplegic patients, and ambulation at this RMR was considered not to be functional, whereas patients with distal segment lesions were considered as functional ambulators.In conclusion, walking with crutches for paraplegics was not functional. On the other hand, wheelchair propelling required less energy.Since inadequate amount of daily physical activity causes loss of physical strength, it is important to encourage the patient to walk with braces and crutches.