title: Metabolic evaluation of the criteria used to fit elbow crutches by measurement of oxygen consumption.
abstract: OBJECTIVE
  To investigate if elbow crutches fitted using conventional guidelines are the most metabolically efficient.
  
  
  METHODS
  Repeated measure connivance sample using crutch length as the independent variable.
  
  
  METHODS
  A university exercise physiology laboratory. OTHER PARTICIPANT: Connivance sample of 10 students free from cardiovascular disease, with previous experience in crutch ambulation, and between heights of 160 and 175 cm. Four potential subjects refused to participate in the study.
  
  
  METHODS
  Crutch length was adjusted using conventional guidelines, and to lengths 2.5 cm above and below this setting. Oxygen consumption was measured using indirect open-circuit spirometry during the final 3 minutes of ambulation using self-selected walking speeds.
  
  
  METHODS
  Crutches adjusted to the convention setting are not the most efficient in terms of metabolic energy expenditures.
  
  
  RESULTS
  A significant reduction in oxygen rate (p = .012), oxygen cost (p = .010), and respiratory exchange ratio (p = .009) were observed when comparing crutches adjusted to -2.5 cm of the standard height with conventional crutch height. Crutches adjusted 2.5 cm above the standard height also required less energy, but these values failed to reach any statistical significance (p > .05).
  
  
  CONCLUSIONS
  The importance of fitting crutches to the correct length using conventional guidelines has not been substantiated in this study. Clinically, there should be a move away from adherence to crutch-fitting criteria and more incorporation of patient feedback to fit crutches to the optimal height. Future research should evaluate the reliability of practical clinical measures such as heart rate and perceived exertion to fit crutches to the optimal height.
authors.affiliation: Brighton School of Physiotherapy, Faculty of Health, University of Brighton, Eastbourne, East Sussex, England.
authors.forename: T R
authors.initials: TR
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Enright
mesh_terms: D000328:Adult; D000886:Anthropometry; D003446:Crutches; D004562:Electrocardiography; D004734:Energy Metabolism / Q000502:physiology; D004867:Equipment Design; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010101:Oxygen Consumption / Q000502:physiology*; D010809:Physical Fitness; D011659:Pulmonary Gas Exchange; D012016:Reference Values; D012046:Rehabilitation / Q000379:methods*