WORKING CAPACITY IN PATIENTS WITH ORTHOPEDIC HANDICAPS FROM POLIOMYELITIS

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Abstract
The energy expenditures of 2 poliomyelitis patients, one clinically completely recovered from paralysis (E. B.) the other one with an almost atrophic right leg (J. D.), were compared to those of 2 normal subjects during walking on a treadmill at different speeds and grades. E. B.''s energy expenditure, expressed as excess Cal./m distance/kg. body wt., coincided with the normal values at all variations of speed and grade up to 3.5 m.p.h. with a slight tendency to higher values at 4.0 m.p.h. J. D.''s energy expenditure when walking with braces exceeded the normal values (1.5 to 2.6 times) at all variations investigated (up to 3 m.p.h.), but the relative increase was higher in horizontal than in grade walking; a part of the energy waste in horizontal walking could be utilized for climbing. Without braces, J. D.''s energy expenditure was considerably higher than it was with braces. E. B. was not able to maintain a steady state at 3.5 m.p.h., 7.5% and 10% grade, and 4 m.p.h. at all grades. The normal subjects were able to maintain a steady state at least up to 30 mins. at these variations. The respiratory efficiency (ml. O2 consumption/100 ml. pulmonary ventilation) of J. D. was definitely lower than that of the other subjects at all variations; a pronounced drop of the respiratory efficiency occurred in both J. D. and E. B. at the higher speeds and grades. The O2 debt of E. B. and J. D. followed a similar trend with the energy expenditure to that observed in normal subjects, but was comparatively low. The work pulse rate tended to be high in both E. B. and J. D. at all levels of energy expenditure above 5 to 6 times the basal metabolic rate. The rate of steps increased, as in normal subjects, with the speed but was independent of the grade. An attempt is made to discuss the data with a view of evaluation of working capacity in persons with orthopedic handicaps.

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