R. Mullis et Rm. Dent, Crutch length: Effect on energy cost and activity intensity in non-weight-bearing ambulation, ARCH PHYS M, 81(5), 2000, pp. 569-572
Objective: To investigate the effect of forearm crutch length on energy cos
t in three-point, non-weight-bearing (NWB) ambulation.
Design: Double-blind repeated measures design using crutch length as the in
dependent variable.
Setting: Overland walking circuit at a university campus.
Participants: Volunteer, convenience sample of 20 subjects consisting of un
iversity students and staff without cardiovascular, respiratory, or orthope
dic conditions.
Intervention: Subjects used a three-point, NWB gait with forearm crutches s
et to length using conventional guidelines, and at 2.5cm above and below th
is value.
Main Outcome Measures: Oxygen consumption, carbon dioxide production, heart
rate, speed of ambulation, and perceived exertion under steady-state condi
tions.
Results: In terms of oxygen cost, ambulation with crutches set to the lengt
h recommended in conventional guidelines was not significantly more energy
efficient than ambulation with either the longer or shorter crutches. Using
crutches set 2.5cm longer than conventional guidelines produced the lowest
respiratory exchange ratio ((V) over dot CO2/(V) over dot O-2) and the low
est ratings of perceived exertion. However, none of these differences reach
ed statistical significance.
Conclusion: Since exact crutch length was not critical in terms of oxygen c
ost, walking speed, or perceived exertion during NWB ambulation, the import
ance of rigidly adhering to specific guidelines for setting crutch length w
as not substantiated in this study. Clinically consideration of patient pre
ference regarding crutch length (within 2.5cm) can be advocated.