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Repeatability of net mechanical efficiency during stair climbing in children with cerebral palsy
Simona Bar-Haim1, Netta Harries, Saleh Al-Oraibi
1Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Insights
A stair-climbing test can detect changes in net mechanical efficiency (MEnet) for children with cerebral palsy (CP). An increase over 13.4% suggests improved motor function after interventions.
Area of Science:
- Biomedical Engineering
- Pediatric Rehabilitation
- Movement Science
Background:
- Cerebral palsy (CP) significantly impacts motor function in children.
- Assessing changes in energy expenditure during movement is crucial for rehabilitation.
- Net mechanical efficiency (MEnet) is a key metric for evaluating motor performance.
Purpose of the Study:
- To establish the minimal detectable change in MEnet using a stair-climbing test.
- To assess the reliability of MEnet measurements in children with CP and typical development.
- To differentiate MEnet between Gross Motor Function Classification System (GMFCS) levels.
Main Methods:
- 51 children with diplegic CP (GMFCS II-III) and 9 typically developing children underwent two stair-climbing tests (T1, T2) with >30 min rest.
- MEnet was calculated for each participant.
- Statistical analysis compared T1 and T2 MEnet values and differences between GMFCS levels.
Main Results:
- MEnet measurements demonstrated good reliability, with T2 vs. T1 slope values not significantly differing from 1.00.
- MEnet was significantly higher in GMFCS level II (7.0%) compared to GMFCS level III (1.2%).
- For children with CP, the mean percentage difference in MEnet between tests was 7.8% (95% CI: -39% to +54%).
Conclusions:
- A change greater than 13.4% in MEnet score indicates a significant improvement in motor status.
- The stair-climbing test is a viable tool for monitoring intervention effects on MEnet in children with CP.
- Findings support the use of MEnet changes to track rehabilitation progress in pediatric CP.
Purpose:
To determine the smallest significant change in mechanical efficiency (MEnet) measured by a stair-climbing test.
Methods:
Duplicate stair-climbing tests (T1 and T2), with more than a 30-minute rest between, were performed by 51 children with diplegic cerebral palsy (CP) at levels II and III of Gross Motor Function Classification System (GMFCS) and 9 children with typical development, aged 5.5 to 13.0 years.
Results:
The T2 versus T1 slope values of MEnet for CP and typical development did not significantly differ from 1.00. MEnet was significantly higher for GMFCS level II (7.0%) than level III (1.2%). The mean percentage of difference was 7.8% (T2 > T1) for the children with CP, with a 95% confidence interval of -39% to +54%. The 95% confidence interval for MEnet scores computed from the standard error of the mean (SEM) of the percentage of differences was 4.0 to 4.5 for CP.
Conclusions:
An increase of >13.4% in MEnet score (eg, mean increase from 4.0% to 4.5%) can indicate improved motor status resulting from interventions.
