Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2302-2308, December 2008

The Effect of Simulating Weight Gain on the Energy Cost of Walking in Unimpaired Children and Children With Cerebral Palsy

Presented to the European Society for Movement Analysis in Adults and Children, September 27–29, 2007, Athens, Greece.

  • Frank Plasschaert, MD

      Affiliations

    • Movement Analysis Laboratory, University Hospital, Ghent, Belgium
    • Corresponding Author InformationCorrespondence to Frank Plasschaert, MD, Department of Orthopedics & Traumatology, University Hospital Ghent, De Pintelaan 185, 9000 Gent, Belgium
    • ,
  • Kim Jones, PhD, MCSP

      Affiliations

    • Movement Analysis Laboratory, University Hospital, Ghent, Belgium
    • ,
  • Malcolm Forward, PhD, CEng

      Affiliations

    • Movement Analysis Laboratory, University Hospital, Ghent, Belgium
    • Faculty of Engineering, Institute of Biomedical Technology, University of Ghent, Ghent, Belgium

Abstract 

Plasschaert F, Jones K, Forward M. The effect of simulating weight gain on the energy cost of walking in unimpaired children and children with cerebral palsy.

Objective

To examine the effect of simulating weight gain on the energy cost of walking in children with cerebral palsy (CP) compared with unimpaired children.

Design

Repeated measures, matched subjects, controlled.

Setting

University hospital clinical gait and movement analysis laboratory.

Participants

Children (n=42) with CP and unimpaired children (n=42).

Interventions

Addition of 10% of body mass in weight belt.

Main Outcome Measures

Energy cost of walking parameters consisting of walking speed, Physiological Cost Index, Total Heart Beat Index, oxygen uptake (V̇o2), gross oxygen cost, nondimensional net oxygen cost, and net oxygen cost with speed normalized to height were measured by using a breath-by-breath gas analysis system (K4b2) and a light beam timing gate system arranged around a figure 8 track. Two walking trials were performed in random order, with and the other without wearing a weighted belt.

Results

Children with CP and their unimpaired counterparts responded in fundamentally different ways to weight gain. The unimpaired population maintained speed and V̇o2 but the children with CP trended toward a drop in their speed and an increase in their V̇o2. The oxygen consumption of children with CP showed a greater dependence on mass than the unimpaired group (P=.043).

Conclusions

An increase of a relatively small percentage in body mass began to significantly impact the energy cost of walking in children with CP. This result highlights the need for weight control to sustain the level of functional walking in these children.

Key Words: Cerebral palsy, Energy cost, Gait, Rehabilitation, Walking, Weight gain

List of Abbreviations: CP, cerebral palsy, PCI, Physiological Cost Index, THBI, Total Heart Beat Index, V̇o2, oxygen uptake

 

 Supported by Research Fellowship Funding, Robert Jones & Agnes Hunt Orthopedic Hospital Oswestry, Shropshire, UK.

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the authors.

PII: S0003-9993(08)00841-1

doi:10.1016/j.apmr.2008.05.023

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 12 , Pages 2302-2308, December 2008

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