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Energy expenditure during standing in children with cerebral palsy: A brief report1
Shikha Saxena1, Senthil Kumaran2, Bhamini K Rao2
1McGill University, Montreal, Canada.
Insights
Children with bilateral spastic cerebral palsy (BSCP) use 1.4 times more energy standing than typically developing children. This highlights the increased energy demand for maintaining a static standing posture in BSCP.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Disorders
- Human Physiology
Background:
- Bilateral spastic cerebral palsy (BSCP) significantly impacts motor function.
- Understanding energy expenditure in children with BSCP is crucial for effective rehabilitation strategies.
- Quiet standing is a fundamental functional task with measurable energy demands.
Purpose of the Study:
- To quantify and compare energy expenditure (EE) during quiet standing in children with BSCP versus typically developing (TD) children.
- To investigate the additional physiological load imposed by static standing in ambulant children with BSCP.
- To provide data informing physical therapy and rehabilitation interventions for children with BSCP.
Main Methods:
- An observational, cross-sectional study design was employed.
- Participants included 30 children with BSCP (GMFCS levels II-III) and 30 TD children.
- Energy expenditure was measured using a Cosmed K4b2 gas analyzer, assessing peak oxygen consumption (VO2 max).
Main Results:
- Children with BSCP exhibited significantly higher energy expenditure during quiet standing compared to TD children (1.4 times greater, p < 0.0001).
- This finding indicates a substantial additional energy cost for maintaining a static standing posture in this population.
- The results underscore the physiological challenge of standing for children with BSCP.
Conclusions:
- Standing imposes a significant additional energy demand on ambulant children with BSCP.
- Both dependent and independent ambulant children with BSCP may require greater effort to maintain a stable standing position.
- Clinicians should assess standing posture, balance control, and energy expenditure to optimize physical therapy and rehabilitation efficacy for children with BSCP.
Purpose:
The aim of the study was to estimate the energy expenditure (EE) during a quiet standing task in children with bilateral spastic CP (BSCP) in comparison with typically developing (TD) children, using gas analyzer.
Methods:
The study was an observational cross-sectional study of children with BSCP (Gross Motor Function Classification System [GMFCS] levels II and III; n = 30; 10 males, 20 females; mean weight 27.46 kgs; mean age 10 years) and TD children (n = 30; 16 males, 14 females; mean weight 25.35 kgs; mean age 9 years, 9 months). The energy expenditure during quiet standing task was measured by using Cosmed K4b2 gas analyzer and expressed in terms of peak oxygen consumption (VO2 max, ml/kg body weight/min).
Results:
Children with BSCP expended 1.4 times higher energy during standing than TD children (p< 0.0001).
Conclusion:
We identified that standing puts an additional energy demand in ambulant children with BSCP. Findings suggest that both dependant and independent ambulating children with BSCP might need to exert more effort to maintain a static standing position. Therefore, clinicians must evaluate standing position for balance control and energy expenditure to evaluate the efficiency of physical therapy and rehabilitation.
