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Comparative study on Physiological Energy Cost of a Paraplegic Subject with Wheel Chair & HKAFO

Paraplegia is impairment in motor and/or sensory function of the lower extremities. It is usually the result of spinal cord injury or a congenital condition such as spina bifida which affects the neural elements of the spinal canal. The area of the spinal canal which is affected in paraplegia is either the thoracic, lumbar, or sacral regions. If the arms are also affected by paralysis, quadriplegia is the proper terminology.

The degree at which the person is paralyzed can vary from the impairment of leg movement, to complete paralysis of the legs and abdomen up to the nipple line. Paraplegics have full use of their arms and hands. While some people with paraplegia can walk to a degree, many are dependent on wheelchairs or other supportive measures. Impotence and various degrees of urinary and fecal incontinence are very common in those affected. Many use catheters and/or a bowel management program (often involving suppositories, enemas, or digital stimulation of the bowels) to address these problems.

In this study a subject with Paraplegia due to spinal cord injury has been examined. The study has been segmented in two phase. First phase of the test has been done with Wheel chair & second one is with the conventional HKAFO. The physiological energy cost has been examined by Cosmed ® K4B2 at National Institute for the Orthopaedically Handicapped, Kolkata, India.

The functional characteristics of HKAFO are as follows

  1. De-weighting the anatomical structure.
  2. Stability of knee & hip joints.
  3. Prevention from buckling & hypertension of knee joints.
  4. Locking mechanism of knee & hip joints.

The certain goals to achieve with HKAFO are

  1. Correction of the deformity.
  2. Prevention from further deterioration.
  3. Prevention from any secondary disorder.
  4. To bring back the person to the main stream of society as a functional individual.

The result shows that

  1. The Gait Efficiency of the person with HKAFO has been found higher than that with Wheel Chair.
  2. The person consumes 19% less energy in Kcal/mint with HKAFO compared to the Wheel Chair.
  3. VO2 increases up to 80% with Wheel Chair than that with HKAFO.

The subject has been clinically examined by the Mr. Subhomay Chatterjee, PO Professional of the institute.


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