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Article
June 23, 1956

PHYSIOLOGICAL APPROACH TO AMBULATION IN PARAPLEGIA

JAMA. 1956;161(8):686-688. doi:10.1001/jama.1956.02970080016006
Abstract

• The intensity of effort involved in crutch walking was measured in 11 patients who represented three types of paraplegia. The measurements concerned the rate of oxygen consumption, the amount of the oxygen debt, and the concentration of lactic acid in the blood. Data from normally ambulant persons were obtained for comparison.

Some patients were found to be so severely handicapped that they showed an unfavorable balance between total energy cost and ability to meet it for a given speed of ambulation; in others the balance was favorable. In some patients, crutch walking with a swing-through gait on a continuous basis produced exhaustion comparable to that seen in a normal person performing a 440-yd. run.

Ambulation was seen to be impractical as a usual mode of progression for some paraplegic persons. Vocational training in a wheel chair is, for the more severely involved patients, better than demanding prolonged heroic efforts in a fruitless attempt at sustained ambulation.

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