Axillary crutch walking: effects of three training programs.

This study compared the effects of three different training programs on physiologic and perceptual responses during axillary crutch walking (ACW) for a distance of 1 km at self-selected speeds in healthy women. Forty subjects completed 18 training sessions in six weeks according to one of the following regimens: (1) 20 minutes of aerobic arm ergometer training at 50% of peak oxygen consumption determined during arm ergometry; (2) isotonic strength and endurance training of the upper extremities with free weights; or (3) axillary crutching at self-selected speeds for 20 minutes on a rectangular indoor course. In comparison with a control group that did not do any systematic training, all three training groups significantly increased their self-selected ACW speeds after training. This also resulted in a significant increase in their heart rates during ambulation. However, no significant changes were observed in oxygen consumption at the faster ACW speeds, suggesting that the training regimens were effective in improving the metabolic efficiency of ACW. Ratings of perceived exertion were significantly lowered for the three training groups even though cardiorespiratory stress was significantly elevated. No significant differences were observed between the three training programs for any of the variables examined. Since heart rate is a reliable indicator of myocardial oxygen uptake, it was recommended that (1) individuals should be screened for cardiovascular problems before axillary crutches are prescribed as a mode of ambulation, and (2) they should be advised to reduce the speed of ambulation because of the high degree of cardiovascular stress associated with this activity.