Energy Cost of Walking with the Parawalker
J. V. BANTA, M.D., JIM FEZIO, C.O., ELIZABETH MUIK, M.S., AND KATHARINE BELL, M.S.
The ParaWalker is a hip guidance orthosis providing rigid trunk and hip stability which allows reciprocal gait for children and adults with thoracic level paraplegia. Four subjects ranging in age from 7 to 10 years walked independently with the reciprocating gait orthosis (RGO) and the ParaWalker. The energy cost of walking was determined from oxygen consumption values measured by a portable oxygen consumption meter (Oxylog, P. K. Morgan, Inc., Andover, Massachusetts) as described by Nene and Patrick. Each subject walked at a self selected pace until steady state was maintained for three minutes. The Oxylog was carried along side the subject by a tester that followed the pace set by the subject. Heart rate and velocity were also monitored for the duration of the test.
Three children with myelomeningocele had functional T12 level paraplegia and the fourth child with a spinal cord injury had a funcational T4 level.
Preliminary results indicate a mean 12-15 percent reduction in the energy costs of walking with the ParaWalker when compared to their performance in a reciprocating gait orthosis.
While the comparative results of the two different orthotic walking aids are insightful, the relatively high energy cost associated with either device must be appreciated. For example, in addition to the four pediatric subjects that were evaluated, one adult thoracic level T6 paraplegic demonstrated a ten-fold increase in energy cost utilizing the ParaWalker in contrast to his self selected velocity in a wheelchair. These preliminary findings suggest that although wheelchair propulsion offers a more practical and energy efficient means of mobility for individuals with thoracic level paraplegia, for activities of daily living, using the ParaWalker appears to be lower in energy cost than using the conventional reciprocating gait orthosis.
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