title: A comparison of energy consumption between the use of a walking frame, crutches and a Stride-on rehabilitation scooter.
abstract: BACKGROUND
  Following foot and ankle surgery, patients may be required to mobilise non-weight bearing, requiring a walking aid such as crutches, walking frame or a Stride-on rehabilitation scooter, which aims to reduce the amount of work required. The energy consumption of mobilising using a Stride-on scooter has not previously been investigated, and we aim to establish this.
  
  
  METHODS
  Ten healthy volunteers (5 males:5 females) aged 20-40 years mobilised independently, then with each mobility device for 3min at 1km/h on a treadmill, with rest periods, whilst undergoing Cardio-Pulmonary Exercise Testing (CPET). Oxygen consumption (VO2), carbon dioxide excretion (VCO2), minute ventilation (MV), respiratory rate (RR) and pulse (HR) were measured at baseline, and after 3min of walking, without and with all 3 devices. Wilcoxon signed rank test was carried out to calculate significance with non-parametric values with Bonferroni correction.
  
  
  RESULTS
  Three-point crutch mobilisation demonstrated significant increases in VO2(0.7L), VCO2(0.7L), MV (16.7L/min), pulse (24.8bpm) and RR (11.4breaths/min) compared to walking (p<0.05). Mobilisation with a frame produced significant (p<0.05) increases compared to walking; VO2(0.7L), VCO2(0.7L), MV (18.3L/min), pulse (35.9bpm), and RR (11.7breaths/min). Tests using the Stride-on demonstrated no significant increase compared to walking with regards to VO2(0.1L; p=0.959), VCO2(0.2L; p=0.332), pulse (10.1bpm; p=0.575), and RR (4.7breaths/min; p=0.633). The MV was significantly higher compared to walking (4.3L/min; p<0.05).
  
  
  CONCLUSIONS
  Energy required for unit distance ambulation with a Stride-on device is similar to walking, and significantly lower than with a walking frame in single legged stance and three-point crutch mobilisation. This justifies its use as part of routine practice aiding early mobilisation of patients requiring restricted weight bearing or single legged weight bearing, especially in those with reduced cardio-pulmonary reserve as it is less physiologically demanding and does not rely on upper body strength.
authors.affiliation: Department of Trauma and Orthopaedics, Torbay Hospital, Torquay TQ2 7AA, UK. Electronic address: Dr.nimeshpatel1@gmail.com.
authors.forename: Nimesh
authors.initials: N
authors.lastname: Patel
authors.affiliation: Department of Trauma and Orthopaedics, Torbay Hospital, Torquay TQ2 7AA, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Batten
authors.affiliation: Department of Trauma and Orthopaedics, Torbay Hospital, Torquay TQ2 7AA, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Roberton
authors.affiliation: Department of Health Statistics, Plymouth University, UK.
authors.forename: Doyo
authors.initials: D
authors.lastname: Enki
authors.affiliation: Department of Trauma and Orthopaedics, Torbay Hospital, Torquay TQ2 7AA, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Wansbrough
authors.affiliation: Department of Trauma and Orthopaedics, Torbay Hospital, Torquay TQ2 7AA, UK.
authors.forename: James
authors.initials: J
authors.lastname: Davis
mesh_terms: D000328:Adult; D002245:Carbon Dioxide / Q000378:metabolism; D003446:Crutches; D005080:Exercise Test; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D009983:Orthopedic Equipment; D010101:Oxygen Consumption; D011674:Pulse; D056152:Respiratory Rate; D014853:Walkers; D055815:Young Adult
chemical_list: D002245:Carbon Dioxide
keywords: Crutches; Energy consumption; Energy efficiency; Frame; Lower limb injuries; Stride-on; Walking aids