Physiological cost index of paraplegic locomotion using the ORLAU parawalker

Energy expenditure is an important parameter in the assessment of gait and orthotic treatment of locomotor disabilities. Up until now oxygen uptake measurement has been the most common method used to assess this. In able bodied subjects heart rate monitoring is also increasingly used. In high thoracic level lesion paraplegics monitoring heart rate was considered to be unreliable because of suspicion of injury to the sympathetic contribution to the cardiac plexus. Bar-On & Nene found that in paraplegics below the lesion level T3 heart rate still shows linear relation to oxygen uptake. MacGregor combined the heart rate and speed of locomotion to produce a single index called physiological cost index. This study consists of monitoring heart rate and speed of 16 adult thoracic level paraplegics walking with the ORLAU ParaWalker, calculation of their physiological cost index, and establishing a range of physiological cost index of paraplegic locomotion using the ORLAU ParaWalker.