Energy cost of ambulation in health and disability: a literature review.

The literature concerning ambulation of normal and disabled persons--amputees, hemiplegics, and paraplegics--is reviewed. Also reviewed are studies of the energy cost of ambulating with assistive devices and of wheelchair locomotion. According to an average of the results available from the literature, a normal expenditure (Ee) of 0.063 kcal/min/kg and 0.00764 kcal/meter/kg. The disabled person walks more slowly, to avoid incurring an increase in Ec/minute. The more disabled the person, the more determinants of gait lost; thus, the more slowly he walks and the less efficient he becomes in terms of Ee/kcal/unit distance. The importance of a common terminology when measuring the energy cost of ambulation and the need to allow subjects to walk at their own most comfortable walking speed are stressed.