The relative efficiency of 'swing through' gait on axillary, elbow and Canadian crutches compared to normal walking.
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Biomedical subjects
Publications and source records attributed to J Stallard.
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Crutches can be used by patients with injuries to the lower extremities in order to perform 'swing-through' gait. Because axillary crutches have been associated with axillary artery thrombosis and crutch palsy, they have to a large extent been superseded by elbow crutches. Canadian crutches combine many of the features of axillary and elbow crutches, and a study of the three types suggests that they have advantages in terms of energy cost.
Energy expenditure is an important parameter in the assessment of gait and orthotic treatment of heavily handicapped patients, since any orthosis which increases the effort required is likely to be discarded with consequently disturbing implications. Heart rate has been shown to be a reliable monitor of energy expenditure and is convenient because ECG can be telemetered by a miniature radio transmitter. Using a transmitter causes minimal interference with the patient, but care must be employed to obtain ECG signals free of artefact from subjects who are exercising. Means of reducing artefact are discussed, as are ways in which heart rate monitoring by radio telemetry is being used in the routine assessment of orthotic treatment of paediatric patients and the development of new orthotic devices.
A new design of swivel walker for the severely disabled is described which has advantages over previous types. Increased rigidity improves the confidence of apprehensive patients, greater strength gives better reliability for those with good ambulation function and a novel construction gives more opportunity for independent transfer into and out of the orthosis, besides easing the burden of those caring for users of swivel walkers.
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