{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:14:35Z","timestamp":1792721675227,"version":"4.5.0"},"reference-count":54,"publisher":"Journal of Rehabilitation Research & Development","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rehabil Res Dev"],"published-print":{"date-parts":[[2015]]},"DOI":"10.1682\/jrrd.2014.02.0060","type":"journal-article","created":{"date-parts":[[2015,6,17]],"date-time":"2015-06-17T14:27:47Z","timestamp":1434551267000},"page":"147-158","source":"Crossref","is-referenced-by-count":127,"title":["Heart rate and oxygen demand of powered exoskeleton-assisted walking in persons with paraplegia"],"prefix":"10.1682","volume":"52","author":[{"given":"Pierre","family":"Asselin","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Knezevic","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Kornfeld","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cirnigliaro","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Agranova-Breyter","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, James J. Peters VA Medical Center, Bronx, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Bauman","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,Departments of Medicine and Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann M.","family":"Spungen","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs (VA) Rehabilitation Research and Development National Center of Excellence for the Medical Consequences of Spinal Cord Injury,Departments of Medicine and Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"737","reference":[{"issue":"9","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r1","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1038\/sc.1996.94","article-title":"Paraplegic locomotion: A review","volume":"34","author":"Nene","year":"1996","journal-title":"Spinal Cord"},{"issue":"2","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r2","first-page":"116","article-title":"Energy cost of paraplegic locomotion using the ParaWalker\u2014electrical stimulation \u201chybrid\u201d orthosis","volume":"71","author":"Nene","year":"1990","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r3","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/sc.1989.2","article-title":"Energy cost of paraplegic locomotion with the ORLAU ParaWalker","volume":"27","author":"Nene","year":"1989"},{"issue":"3","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r4","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3109\/03093649609164441","article-title":"Objective measurement of use of the reciprocating gait orthosis (RGO) and the electrically augmented RGO in adult patients with spinal cord lesions","volume":"20","author":"Sykes","year":"1996","journal-title":"Prosthet Orthot Int"},{"issue":"8","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r5","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1038\/sj.sc.3101916","article-title":"Effect of lesion level on the orthotic gait performance in individuals with complete paraplegia","volume":"44","author":"Kawashima","year":"2006","journal-title":"Spinal Cord"},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r6","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/sj.sc.3100564","article-title":"Walking with the advanced reciprocating gait orthosis (ARGO) in thoracic paraplegic patients: Energy expenditure and cardiorespiratory performance","volume":"36","author":"Massucci","year":"1998","journal-title":"Spinal Cord"},{"issue":"7","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r7","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1080\/01616412.2000.11740743","article-title":"Stochastically-modulated stimulation to slow down muscle fatigue at stimulated sites in paraplegics using functional electrical stimulation for leg extension","volume":"22","author":"Graupe","year":"2000","journal-title":"Neurol Res"},{"issue":"10","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r8","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.3928\/0147-7447-19891001-06","article-title":"The RGO Generation II: Muscle stimulation powered orthosis as a practical walking system for thoracic paraplegics","volume":"12","author":"Solomonow","year":"1989","journal-title":"Orthopedics"},{"issue":"3","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r9","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3109\/09638289609166028","article-title":"Energy expenditure and fatiguability in paraplegic ambulation using reciprocating gait orthosis and electric stimulation","volume":"18","author":"Hirokawa","year":"1996","journal-title":"Disabil Rehabil"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r10","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1038\/sc.1987.10","article-title":"Augmentation of the Oswestry Parawalker orthosis by means of surface electrical stimulation: Gait analysis of three patients","volume":"25","author":"McClelland","year":"1987"},{"issue":"11","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r11","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1016\/0003-9993(91)90007-6","article-title":"Physiologic costs of computer-controlled walking in persons with paraplegia using a reciprocating-gait orthosis","volume":"72","author":"Petrofsky","year":"1991","journal-title":"Arch Phys Med Rehabil"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r12","doi-asserted-by":"crossref","unstructured":"Durfee WK, Rivard A. Preliminary design and simulation of a pneumatic, stored-energy, hybrid orthosis for gait restoration. Proceedings of the ASME 2004 International Mechanical Engineering Congress and Exposition; 2004 Nov 13\u201319; Anaheim, CA.","DOI":"10.1115\/IMECE2004-60075"},{"issue":"6","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r13","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1115\/1.2050652","article-title":"Design and simulation of a pneumatic, stored-energy, hybrid orthosis for gait restoration","volume":"127","author":"Durfee","year":"2005","journal-title":"J Biomech Eng"},{"issue":"3","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r14","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1109\/TNSRE.2003.816873","article-title":"Preliminary evaluation of a controlled-brake orthosis for FES-aided gait.","volume":"11","author":"Goldfarb","year":"2003","journal-title":"IEEE Transactions on Neural Systems and Rehabilitation Engineering."},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r15","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1038\/sc.1971.31","article-title":"Powered lower limb orthotics in paraplegia","volume":"9","author":"Hughes","year":"1972","journal-title":"Paraplegia"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r16","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1007\/BF02629836","article-title":"Development of active anthropomorphic exoskeletons","volume":"12","author":"Vukobratovic","year":"1974"},{"issue":"11","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r17","doi-asserted-by":"publisher","first-page":"S217","DOI":"10.1097\/PHM.0b013e31826bce18","article-title":"Robotic-assisted gait training and restoration","volume":"91","author":"Esquenazi","year":"2012","journal-title":"Am J Phys Med Rehabil"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r18","doi-asserted-by":"crossref","unstructured":"Zabaleta H, Bureau M, Eizmendi G, Olaiz E, Medina J, Perez M, editors. Exoskeleton design for functional rehabilitation in patients with neurological disorders and stroke. Proceedings of the IEEE 10th International Conference on Rehabilitation Robotics 2007 Jun 13\u201315; Noordwijk, the Netherlands.","DOI":"10.1109\/ICORR.2007.4428415"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r19","doi-asserted-by":"crossref","unstructured":"Zeilig. G, Weingarden. H, Zwecker. M, Bloch. A. , Levy A, Esquenazi A. Safety and tolerance of the ReWalk\n                      TM\n                      exoskeleton suit for ambulation by people with complete spinal cord injury: A pilot study. J Spinal Cord Med. 2012;35(2):96\u2013101. [PMID:22333043] http:\/\/dx.doi.org\/10.1179\/2045772312Y.0000000003","DOI":"10.1179\/2045772312Y.0000000003"},{"issue":"11","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r20","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1097\/PHM.0b013e318269d9a3","article-title":"The ReWalk powered exoskeleton to restore ambulatory function to individuals with thoracic-level motor-complete spinal cord injury","volume":"91","author":"Esquenazi","year":"2012","journal-title":"Am J Phys Med Rehabil"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r21","first-page":"144","article-title":"Lower extremity exoskeletons and active orthoses: Challenges and state-of-the-art. Robotics","volume":"24","author":"Dollar","year":"2008","journal-title":"IEEE Transactions on."},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r22","doi-asserted-by":"crossref","unstructured":"Farris RJ, Quintero HA, Goldfarb M. Performance evaluation of a lower limb exoskeleton for stair ascent and descent with paraplegia. Proceedings of the 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2012 Aug 28\u2013Sep 1; San Diego, CA.","DOI":"10.1109\/EMBC.2012.6346326"},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r23","doi-asserted-by":"publisher","first-page":"0410031","DOI":"10.1115\/1.4007181","article-title":"A method for the autonomous control of lower limb exoskeletons for persons with paraplegia","volume":"6","author":"Quintero","year":"2012","journal-title":"J Med Device"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r24","unstructured":"Spungen A, Asselin P, Fineberg D, Kornfeld S, Harel N. Exoskeletal-assisted walking for persons with motor-complete paraplegia. North Atlantic Treaty Organization (NATO), Research and Technology Organization, Human Factors and Medicine Panel, HFM-228 Symposium; April 15, 2013 Apr 15; Italy."},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r25","unstructured":"ReWalk\u2013Rehabilitation [Internet].Marlborough (MA): ReWalk Robotics; 2014 [cited 2014 May 29]. Available from: http:\/\/rewalk.com\/products\/rewalk-rehabilitation\/."},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r26","first-page":"111","article-title":"Use of the robot assisted gait therapy in rehabilitation of patients with stroke and spinal cord injury","volume":"48","author":"Sale","year":"2012","journal-title":"Eur J Phys Rehabil Med"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r27","unstructured":"Goffer A, Tivon K, inventors. Gait-locomotor apparatus. United States patent US 7,153,242. 2003 May 24."},{"issue":"10","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r28","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1016\/j.apmr.2005.06.001","article-title":"Bone mineral density after spinal cord injury: A reliable method for knee measurement","volume":"86","author":"Shields","year":"2005","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r29","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1179\/2045772313Y.0000000126","article-title":"Vertical ground reaction force-based analysis of powered exoskeleton-assisted walking in persons with motor-complete paraplegia","volume":"36","author":"Fineberg","year":"2013","journal-title":"J Spinal Cord Med"},{"issue":"5","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r30","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r31","first-page":"307","article-title":"The effects of training on heart rate; a longitudinal study","volume":"35","author":"Karvonen","year":"1957","journal-title":"."},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r32","unstructured":"Heyward V. Assessing cardiorespiratory fitness. In: Heyward VH, editor. Advanced fitness assessment & exercise prescription. 6\n                      th\n                      ed. Champaign (IL): Human Kinetics; 2010."},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r33","doi-asserted-by":"publisher","first-page":"226","DOI":"10.2165\/00007256-199520040-00003","article-title":"Spinal cord injury, exercise and quality of life","volume":"20","author":"Noreau","year":"1995","journal-title":"Sports Med"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r34","unstructured":"Whaley MH, Brubaker PH, Otto RM, Armstrong LE. ACSM\u2019s guidelines for exercise testing and prescription. Philadelphia (PA): Lippincott Williams & Wilkins; 2006."},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r35","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1136\/bjsm.25.1.38","article-title":"Effect of exercise intensity on postexercise energy expenditure in women","volume":"25","author":"Sedlock","year":"1991","journal-title":"Br J Sports Med"},{"issue":"5","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r36","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1007\/s00421-006-0141-9","article-title":"Effect of a 12-month physical conditioning programme on the metabolic cost of walking in healthy older adults","volume":"100","author":"Mian","year":"2007","journal-title":"Eur J Appl Physiol"},{"issue":"6","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r37","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1097\/00005768-199806000-00032","article-title":": The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults","volume":"30","author":"Pollock","year":"1998","journal-title":"Med Sci Sports Exerc"},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r38","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1080\/10790268.2001.11753584","article-title":"Carbohydrate and lipid metabolism in chronic spinal cord injury","volume":"24","author":"Bauman","year":"2001","journal-title":"J Spinal Cord Med"},{"issue":"6","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r39","doi-asserted-by":"publisher","first-page":"2398","DOI":"10.1152\/japplphysiol.00729.2002","article-title":"Factors influencing body composition in persons with spinal cord injury: A cross-sectional study","volume":"95","author":"Spungen","year":"2003","journal-title":"J Appl Physiol"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r40","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/sj.sc.3101389","article-title":"Long-term exercise training in persons with spinal cord injury: Effects on strength, arm ergometry performance and psychological well-being","volume":"41","author":"Hicks","year":"2003","journal-title":"Spinal Cord"},{"issue":"10","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r41","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/sj.sc.3100917","article-title":"High density lipoprotein cholesterol in individuals with spinal cord injury: The potential role of physical activity","volume":"37","author":"Washburn","year":"1999","journal-title":"Spinal Cord"},{"issue":"8","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r42","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1038\/sj.sc.3101487","article-title":"Maintenance of exercise participation in individuals with spinal cord injury: Effects on quality of life, stress and pain","volume":"41","author":"Ditor","year":"2003","journal-title":"Spinal Cord"},{"issue":"4","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r43","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1310\/sci1204-76","article-title":"Exercise to reduce obesity in SCI","volume":"12","author":"Nash","year":"2007","journal-title":"Top Spinal Cord Inj Rehabil"},{"issue":"5","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r44","first-page":"8","article-title":"Beneficial changes in body composition after exoskeletal-assisted walking: Implications for improved metabolic function","volume":"19","author":"Spungen","year":"2013","journal-title":"Top Spinal Cord Inj Rehabil"},{"issue":"2","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r45","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3109\/03093649309164364","article-title":"A comparison of paraplegic gait performance using two types of reciprocating gait orthoses","volume":"17","author":"Winchester","year":"1993","journal-title":"Prosthet Orthot Int"},{"issue":"7","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r46","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1038\/sc.1995.91","article-title":"The efficiency of walking of paraplegic patients using a reciprocating gait orthosis","volume":"33","author":"Bernardi","year":"1995"},{"issue":"6","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r47","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1038\/sj.sc.3100403","article-title":"Rehabilitation of walking for paraplegic patients by means of a treadmill","volume":"35","author":"Felici","year":"1997","journal-title":"Spinal Cord"},{"issue":"9","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r48","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1016\/S0003-9993(99)90054-0","article-title":"Validity and reproducibility of crutch force and heart rate measurements to assess energy expenditure of paraplegic gait","volume":"80","author":"Ijzerman","year":"1999","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r49","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1038\/sj.sc.3100946","article-title":"Paraplegic adaptation to assisted-walking: Energy expenditure during wheelchair versus orthosis use","volume":"38","author":"Merati","year":"2000","journal-title":"Spinal Cord"},{"issue":"12","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r50","first-page":"595","article-title":"Energy cost of ambulation in paraplegic patients using Craig-Scott braces","volume":"60","author":"Huang","year":"1979","journal-title":"Arch Phys Med Rehabil"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r51","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1152\/jappl.1961.16.6.977","article-title":"Maximal oxygen uptake and heart rate in various types of muscular activity","volume":"16","author":"Astrand","year":"1961","journal-title":"J Appl Physiol"},{"issue":"2","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r52","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1152\/jappl.1976.41.2.191","article-title":"Maximal oxygen uptake during exercise with various combinations of arm and leg work","volume":"41","author":"Bergh","year":"1976","journal-title":"J Appl Physiol"},{"key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r53","doi-asserted-by":"crossref","unstructured":"Vokac Z, Bell H, Bautz-Holter E, Rodahl K. Oxygen uptake\/heart rate relationship in leg and arm exercise, sitting and standing. J Appl Physiol. 1975;39(1):54\u201359.","DOI":"10.1152\/jappl.1975.39.1.54"},{"issue":"1","key":"key-10.1682\/JRRD.2014.02.0060-201506171349-r54","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1310\/sci1401-16","article-title":"Locomotor Training with Incremental Changes in Velocity: Muscle and Metabolic Responses","volume":"14","author":"Forrest","year":"2008","journal-title":"Top Spinal Cord Inj Rehabil"}],"container-title":["Journal of Rehabilitation Research and Development"],"original-title":[],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:01:53Z","timestamp":1781089313000},"score":1,"resource":{"primary":{"URL":"https:\/\/web.archive.org\/web\/20200805222754\/http:\/\/www.rehab.research.va.gov\/jour\/2015\/522\/pdf\/JRRD-2014-02-0060.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015]]},"references-count":54,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2015]]}},"URL":"https:\/\/doi.org\/10.1682\/jrrd.2014.02.0060","relation":{},"ISSN":["0748-7711","1938-1352"],"issn-type":[{"value":"0748-7711","type":"print"},{"value":"1938-1352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015]]}}}