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Original article| Volume 89, ISSUE 12, P2302-2308, December 2008

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

      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

      List of Abbreviations:

      CP (cerebral palsy), PCI (Physiological Cost Index), THBI (Total Heart Beat Index), V̇o2 (oxygen uptake)
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