Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Energy Expenditure during Wheelchair Propulsion in Different Levels of Paraplegics Using Physiological Cost Index


Affiliations
1 Srinivas College of Physiotherapy, Mangalore, India
2 Department of Physiotherapy, MCOAHS, Manipal University, India
     

   Subscribe/Renew Journal


Background&objective

Wheelchair is considered as an efficient means of locomotion with optimal independence for a subject with paraplegia. This study was aimed to evaluate the energy expenditure during standard wheelchair propulsion in different levels of paraplegics using Physiological Cost Index (PCI). It also aimed to correlate the energy expenditure to various levels of spinal injury and to the duration since wheelchair use.

Methodology

Male subjects with paraplegia (n =24) between T7 to T12 spinal level injury, who were using wheelchair were included in the study. Patients were given 5 minutes rest at the starting line in order to attain a steady resting heart rate, which was measured by the palpation of radial pulse. Subjects were instructed to propel the wheelchair at their normal propulsion speed on a standard leveled corridor (walkway of 25 m) for a minimum duration of 5 minutes to attain a steady physiological heart rate. At the end of 5 minutes, they were instructed to stop and steady propulsion heart rate was measured. Energy expenditure (PCI) was calculated by: PCI (beats/ meter) = Steady propulsion heart rate - Resting heart rate (beats per min) / Propulsion speed (meter/min).

Results

Descriptive statistics was used to calculate the mean and standard deviation of PCI in different levels of paraplegics. Pearson correlation was used for correlating the PCI values to level of injury and weeks since use of wheelchair. Mean PCI during wheelchair propulsion was 0.67 (SD ± 0.37) beats/meter. There was no correlation between different levels of spinal injury and energy expenditure (p value = 0.511), but there was a strong correlation between weeks since use of wheelchair after injury and energy expenditure (p value = 0.000).

Interpretation&conclusion

The mean PCI during wheelchair propulsion in different levels of paraplegics (T7-T12) was found to be 0.67 (SD± 0.37) beats/meter. There is a strong correlation between the duration since use of wheelchair and the energy expenditure. This suggests that with longer usage, wheelchair propulsion may become a more energy efficient form of ambulation in paraplegics.


Keywords

Pci; Wheelchair Propulsion; Energy Expenditure
Subscription Login to verify subscription
User
Notifications
Font Size


  • Susan B O Sullivan, Thomas J Schmitz. Physical rehabilitation 5th edition. Jaypee brothers;2007.

  • A V Nene, S J Jennings. Physiological cost index of paraplegic locomotion using the ORLAU parawalker. Paraplegia. 1992;246-252.

  • Claire E Beekman, Leslie Miller-Porter, Marion Schoneberger. Energy cost of propulsion in standard and ultralight wheel chairs in people with spinal cord injuries. Physical therapy.1999; 79:147-157.

  • Goutham Mukherjee, Amalendu Samanta. Evaluation of ambulatory performance of the arm propelled three wheeled chair using heart rate as the control index. Disability and rehabilitation.2000; 10: 464-470.

  • Rachel C Graham, Nicola M Smith, Claire M White. The reliability and validity of physiological cost index in healthy subjects while walking on 2 different tracks. Arch phys med rehabil.2005; 86:2041-46.

  • Rose J Gamble, J G J, Lee , R and Haskell ,W L. The energy expenditure index: A method to quantitate and compare the walking energy expenditure for children and adolescents. Journal of pediatric orthopedics. 1991; 11:571-578.

  • King E, Cobbin D, Walsh S, Ryan D. The reliable measurement of radial pulse characteristics. Acupunct Med. 2002; 20:150-9.

  • Raja K, Joseph B, Benjamin S, Minocha V, Rana B. Physiological Cost Index in cerebral palsy: Its role in evaluating the efficiency of ambulation.J Pediatr. Orthop. 2007; 27 (2): 130-6.

  • Mulroy SJ, Farrokhi S, Newsam CJ, Perry J. Effects of spinal cord injury level on the activity of shoulder muscles during wheelchair propulsion: an electromyographic study. Arch Phys Med Rehabil. 2004 Jun; 85(6):925-34.

  • Yang YS, Koontz AM, Triolo RJ, Mercer JL, Boninger ML. Surface electromyography activity of trunk muscles during wheelchair propulsion. Clin Biomech. 2006 Dec; 21(10):1032-41.

  • Mary M. Rodgers, Randall E. Keyser, Elizabeth K. Rasch, Peter H. Gorman, Pamela J. Russell. Influence of training on biomechanics of wheelchair propulsion. Journal of Rehabilitation Research and Development. 2001 Sep; 38 (5): 505–511


Abstract Views: 360

PDF Views: 0




  • Energy Expenditure during Wheelchair Propulsion in Different Levels of Paraplegics Using Physiological Cost Index

Abstract Views: 360  |  PDF Views: 0

Authors

R. Preetha
Srinivas College of Physiotherapy, Mangalore, India
M. Ramprasad
Srinivas College of Physiotherapy, Mangalore, India
Joseley Sunderraj Pandian
Srinivas College of Physiotherapy, Mangalore, India
M. John Solomon
Department of Physiotherapy, MCOAHS, Manipal University, India

Abstract


Background&objective

Wheelchair is considered as an efficient means of locomotion with optimal independence for a subject with paraplegia. This study was aimed to evaluate the energy expenditure during standard wheelchair propulsion in different levels of paraplegics using Physiological Cost Index (PCI). It also aimed to correlate the energy expenditure to various levels of spinal injury and to the duration since wheelchair use.

Methodology

Male subjects with paraplegia (n =24) between T7 to T12 spinal level injury, who were using wheelchair were included in the study. Patients were given 5 minutes rest at the starting line in order to attain a steady resting heart rate, which was measured by the palpation of radial pulse. Subjects were instructed to propel the wheelchair at their normal propulsion speed on a standard leveled corridor (walkway of 25 m) for a minimum duration of 5 minutes to attain a steady physiological heart rate. At the end of 5 minutes, they were instructed to stop and steady propulsion heart rate was measured. Energy expenditure (PCI) was calculated by: PCI (beats/ meter) = Steady propulsion heart rate - Resting heart rate (beats per min) / Propulsion speed (meter/min).

Results

Descriptive statistics was used to calculate the mean and standard deviation of PCI in different levels of paraplegics. Pearson correlation was used for correlating the PCI values to level of injury and weeks since use of wheelchair. Mean PCI during wheelchair propulsion was 0.67 (SD ± 0.37) beats/meter. There was no correlation between different levels of spinal injury and energy expenditure (p value = 0.511), but there was a strong correlation between weeks since use of wheelchair after injury and energy expenditure (p value = 0.000).

Interpretation&conclusion

The mean PCI during wheelchair propulsion in different levels of paraplegics (T7-T12) was found to be 0.67 (SD± 0.37) beats/meter. There is a strong correlation between the duration since use of wheelchair and the energy expenditure. This suggests that with longer usage, wheelchair propulsion may become a more energy efficient form of ambulation in paraplegics.


Keywords


Pci; Wheelchair Propulsion; Energy Expenditure

References