The energy cost of rickshaw pulling.
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Biomedical subjects
Publications and source records attributed to S R Datta.
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A partially age-related admission policy coupled with a "single-ward" scheme for treatment and rehabilitation was introduced by the Hull geriatric department in 1970. With rare exceptions, elderly patients needing hospital care have been admitted directly to the geriatric unit, and the proportion of the retired population admitted by the general physicians has been greatly reduced. The proportion of inpatients needing continuing care has been reduced to less than 20%, the mean length of inpatient stay has fallen to under 30 days, and separate long-stay wards are no longer needed. More than 91% of patients are admitted without preceding domiciliary assessment, and only 5-6% of admissions are transferred from other units within the area.
This study was undertaken to assess the effects of certain common modes of load carrying by hand in the BK amputee-PTB prosthesis system. The energy costs of a test group consisting of BK amputees using PTB prostheses were compared to those of a control group made up of normal able-bodied individuals and the difference between the two groups was observed to be more marked when walking was performed on the level with load in one hand only in comparison with the both-hand carrying conditions. Single handed load carrying by either hand did not seem to make any observable difference. Stair ascending with equal load in both hands did not produce any appreciable difference between the two groups. Indications were obtained that the BK amputee with a PTB prosthesis system is capable of performing industrial tasks of "moderate" grade.
The ergonomic approach to performance evaluation in orthopaedic rehabilitation presents problems because of the cumbersome and time-consuming measurement and test procedures involved. This paper describes a method of performance evaluation through graded load carrying tests which makes it possible to set up regression equations which can be used in routine clinical practice for prediction of the performance of below-knee amputees.
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Six healthy adult male Indian workers whose physical characteristics resembled those of the average worker from eastern India, were required to carry compact loads of 20, 30, 40, and 50 kg at a speed of 5 km/h on separate days. From observations on energy expenditures, of peak pulse rates, and of the patterns of recovery pulse rates, it was decided that for the average eastern Indian male worker the permissible weight of a compact load for manual carriage on a hard, level terrain should not ordinarily be more than 30 kg.
A below-knee amputee is generally known to achieve a close-to-normal performance level, with the patellar-tendon-bearing method of stump fitting. This was confirmed by an ergonomic investigation on ten below-knee amputees, fitted with PTB prostheses. The test group subjects were given two static tests, two dynamic tests and one exercise tolerance test, during which their oxygen consumptions, pulmonary ventilations, energy expenditures and peak heart rates were measured. The performance of the test subjects were compared with that of a control group consisting of sixteen normal, healthy, individuals. The percentage increases in the values of the biomechanical parameters of the test subjects, over those of the control group, were found to be justified and thus natural to the below-knee amputee-PTB prosthesis system. The ergonomic study has not yielded information regarding the biomechanical efficacy of the PTB prosthesis, but it has also shown that the amputees fitted with such prostheses can take up, without any undue extra effort and metabolic cost, industrial occupations of the moderately heavy kind.
Heart rate, which is an easily measurable biomechanical index, has been known to bear a definite relationship with the energy cost of any activity. An investigation undertaken on two groups of lower extremity rehabilitees and a group of normal, healthy, sedentary, adult males, when the subjects were administered with a battery of tests representing four common activities of daily living and working and a fifth test for exercise tolerance (as suitable), has confirmed that the relationship between peak heart rate (beats/min) and energy expenditure (kcal/min) is linear and can be represented by the equation E=0.068 PHR-4.59, thus making it possible to predict the energy cost of any activity from the peak heart rate value. This method is a more direct, simpler and more accurate one for the assessment of rehabilitation effectiveness in clinics than the more widely used direct measurement of energy cost by indirect calorimetry.
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