AEROBIC AND ANAEROBIC METABOLISM DURING LOCOMOTION WITH TWO DIFFERENT WHEELCHAIR TYPES

Abstract

Wheelchair design is extremely important in order to improve efficiency of locomotion and reduce physical stress in subjects whose muscular and cardiopulmonary fitness are impaired. Purpose of this study was to evaluate the effect of different wheelchair design on the aerobic and anaerobic metabolism during locomotion at different speeds in paraplegic subjects. The experiments were carried out on a group of 5 male paraplegic subjects (25 ±3 years; body weight 65±7kg) during locomotion on a roller ergometer (Sopur, Ergotronic mod.) at 3-4 different speeds from 2 to 9 km/h. At each speed oxygen consumption and heart rate were determined after at least 6 min of exercise. Lactic acid (LA) venous blood concentration was evaluated before and at the 5th min of recovery and lactate production was calculated. The oxygen equivalent of LA was assumed to be 3.15ml O2 per kg body weight for an increase of blood LA of 1 mmol/L. For each subject the test was repeated using two different types of daily use active wheelchairs: type A., foldable, 13.95kg; type B, demountable, 13.35kg. The main difference in size was in the horizontal location of the wheel axle, in seat height and in handrim diameter. Results indicate that: a) oxygen consumption increased linearly with speed being 2050±350ml/min and 1780±270ml/min at 9km/h for wheelchair type A and B, respectively; b)lactic acid concentrations were significantly higher, at a given speed, while using wheelchair type A than B (at 9km/h; 7.4±1.5 mmol/l and 6.0±1.6 mmol/l, respectively),c) the total energy required , aerobic and anaerobic, increased linearly with speed and was 15-20% higher with wheelchair type A than B at all speeds; d) the energy cost of locomotion at a given speed was in the 15-25% range higher for wheelchair A than B; e) at corresponding oxygen uptake, heart rate and pulmonary ventilation were not different with the two wheelchair types. The main results of this study concern the large difference existing in the energy cost of locomotion and in the lactate production in the same subject when two different wheelchairs, even if apparently similar are used. In particular the much higher lactate production suggests that wheelchair design affects the limb and trunk movements in such a way that the metabolism of some muscle group requires a greater participation of anaerobic mechanism of energy supply, this leading to early onset of muscular fatigue. Further studies, in particular the combined biomechanical analysis of user and wheelchair during locomotion are required to increase the optimum fitting of wheelchair –user interface.