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Physical strain of comfortable walking in children with mild cerebral palsy
Annet J Dallmeijer1, Merel-Anne Brehm
1Department of Rehabilitation Medicine, EMGO Institute for Health and Care Research and Research Institute MOVE, VU University Medical Center, Amsterdam, The Netherlands. a.dallmeijer@vumc.nl
Insights
Children with mild cerebral palsy (CP) experience greater physical strain during walking than typically developing children. This increased exertion may contribute to fatigue and highlights the need for targeted aerobic training programs for pediatric CP patients.
Area of Science:
- Pediatric physical therapy
- Neuromuscular disorders
- Exercise physiology
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, impacting daily activities.
- Children with mild CP often face challenges with physical exertion and fatigue during ambulation.
- Understanding the physiological demands of walking is crucial for managing CP and improving quality of life.
Purpose of the Study:
- To quantify and compare the physical strain experienced by children with mild CP during comfortable walking versus typically developing (TD) children.
- To define physical strain as the ratio of oxygen uptake during walking (VO2walk) to maximal aerobic capacity (VO2peak).
Main Methods:
- Eighteen children (8-16 years), including 8 with mild CP and 10 TD controls, participated.
- Oxygen uptake during walking (VO2walk) was measured during a 5-minute indoor walk at a comfortable pace.
- Maximal aerobic capacity (VO2peak) was assessed using a shuttle run test.
Main Results:
- Children with mild CP exhibited significantly higher VO2walk (19.7 ml/kg/min) compared to TD children (16.8 ml/kg/min).
- Maximal aerobic capacity (VO2peak) was significantly lower in children with CP (37.2 ml/kg/min) versus TD children (45.0 ml/kg/min).
- Consequently, the physical strain during walking was substantially higher in children with CP (52%) compared to TD children (36%).
Conclusions:
- Children with mild CP experience significantly greater physiological strain during comfortable walking than their typically developing peers.
- This increased physical demand may underlie reported issues of fatigue in pediatric CP populations.
- Findings suggest the importance of incorporating physical aerobic training programs to improve endurance and functional capacity in children with mild CP.
Purpose:
To evaluate the physical strain of comfortable walking in children with mild cerebral palsy (CP) in comparison to typically developing (TD) children. Physical strain was defined as the oxygen uptake during walking (VO(2walk)) expressed as a percentage of their maximal aerobic capacity (VO(2peak)).
Method:
Eighteen children (aged 8-16 years) participated, including eight ambulant children (four girls, four boys) with mild spastic CP (three hemiplegia, five diplegia, GMFCS I: n = 7 and II: n = 1) and 10 TD children. VO(2walk) was measured during 5 min of walking on an indoor track at comfortable walking speed. VO(2peak) was measured in a shuttle run test.
Results:
VO(2walk) was significantly higher in CP (19.7 (2.8) ml/kg/min) compared to TD (16.8 (3.6) ml/kg/min, p = 0.033), while walking speed did not differ significantly between groups. VO(2peak) was significantly lower in CP (37.2 (2.2) ml/kg/min) compared to TD (45.0 (5.3) ml/kg/min, p = 0.001). Consequently, the physical strain during walking was significantly higher in CP (52 (7.7) %) compared to TD (36 (8.4) %, p = 0.001).
Conclusions:
The higher physical strain during comfortable walking of children with mild CP compared to TD children may be related to reported problems with fatigue in this population, and suggest a need for physical aerobic training programmes.
