OBJECTIVE
Evaluate the effect of a contralateral shoe-lift on the oxygen cost of walking with an artificially immobilized knee.
DESIGN
A prospective quantitative evaluation of oxygen cost of walking under varying conditions. Subjects walked (1) normally (N), (2) with one knee immobilized (1), (3) with one knee immobilized and with a one-half-inch shoe-lift applied to the contralateral shoe (I1/2"L), and (4) with one knee immobilized and with a one-inch shoe-lift (I1"L).
SETTING
Exercise physiology laboratory.
SUBJECTS
Ten able-bodied subjects without known cardiopolmonary or musculoskeletal problems.
MAIN OUTCOME MEASURE
Breath-by-breath oxygen consumption measurements in mL/kg/m.
RESULTS
Oxygen cost on average was 20% more with the knee immobilized (I) compared to normal (N) (mean difference = .0298 +/- .0245mL/kg/m, p = .002). Oxygen cost was significantly less (11% versus 20% above that of normal walking) with the half-inch shoe-lift (mean difference between I1/2" and I = .0167 +/- .0138mL/kg/m, p = .002). Similarly, oxygen cost was significantly less (12% versus 20% above that of normal walking) with the one-inch shoe-lift (mean difference between I1"L and I = .0142 +/- .0116, p = .002).
CONCLUSION
This study demonstrates that a subject with an immobilized knee requires less energy to walk with a contralateral shoe-lift and provides scientific evidence for prescribing a shoe-lift in patients with an immobilized knee as a result of knee joint fusion, knee immobilization as a result of casting or orthotics, or spastic paretic stiff-legged gait associated with upper motor neuron disease.
[1]
S. Simon.
Gait Analysis, Normal and Pathological Function.
,
1993
.
[2]
P. Corcoran,et al.
Energy Expenditure During Ambulation
,
1994
.
[3]
L. Broström,et al.
The increase in energy cost of walking with an immobilized knee or an unstable ankle.
,
2020,
Scandinavian journal of rehabilitation medicine.
[4]
J. Saunders,et al.
The major determinants in normal and pathological gait.
,
1953,
The Journal of bone and joint surgery. American volume.
[5]
R. Waters,et al.
Energy‐speed relationship of walking: Standard tables
,
1988,
Journal of orthopaedic research : official publication of the Orthopaedic Research Society.
[6]
Corcoran Pj,et al.
Oxygen uptake in normal and handicapped subjects, in relation to speed of waing beside velocity-controlled cart.
,
1970
.
[7]
G. Brengelmann,et al.
Oxygen uptake in normal and handicapped subjects, in relation to speed of waing beside velocity-controlled cart.
,
1970,
Archives of physical medicine and rehabilitation.
[8]
H J RALSTON,et al.
Measurement of energy expenditure during ambulation, with special reference to evaluation of assistive devices.
,
1959,
Archives of physical medicine and rehabilitation.