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Energy cost of ambulation in healthy and disabled Filipino children
O B Luna-Reyes1, T M Reyes, F Y So
1Santo Tomas University Hospital, Manila, Phillipines.
Insights
Disabled children expend significantly more energy to ambulate than their non-disabled peers. Locomotion efficiency varied by mobility aid, with braces being the most efficient for disabled children.
Area of Science:
- Rehabilitation Medicine
- Pediatric Physical Therapy
- Biomechanical Engineering
Background:
- Locomotion is a fundamental activity impacting quality of life.
- Understanding energy expenditure in disabled children is crucial for developing effective mobility strategies.
- Previous research has not comprehensively compared energy costs across various assistive devices in Filipino children.
Purpose of the Study:
- To compare the energy expenditures (Ee) for locomotion in non-disabled and disabled Filipino children aged 7-13.
- To quantify the energy cost of different ambulation methods used by children with lower extremity poliomyelitis.
- To assess the impact of assistive devices on the efficiency of locomotion.
Main Methods:
- Indirect calorimetry was used to measure energy expenditure during ambulation.
- Participants included 41 non-disabled children and 16 children with lower extremity poliomyelitis.
- Disabled children ambulated using wheelchair propulsion, bilateral axillary crutches, unilateral orthoses (AFO/KAFO), or unassisted.
Main Results:
- Disabled children expended significantly more energy (p<0.05) than non-disabled children across all mobility methods.
- Wheelchair propulsion increased energy cost by 16%, crutch ambulation by 41%, and unassisted ambulation without braces by 109% compared to controls.
- Children using unilateral braces achieved near-normal energy expenditure at the cost of reduced speed.
Conclusions:
- Locomotion is energetically more demanding for disabled children, irrespective of their mobility aid.
- Assistive devices significantly influence energy expenditure, with unilateral braces offering the most energy-efficient ambulation among disabled participants.
- Energy expenditure (kcal x 10(-3)/kg/m) serves as a key indicator of locomotion efficiency in children.
Abstract:
The energy expenditures (Ee) for locomotion by nondisabled and disabled Filipino children aged 7 to 13 were determined and compared using indirect calorimetry. Forty-one controls (20 boys and 21 girls) ambulated at a comfortable pace; 16 children (eight boys and eight girls) with lower extremity poliomyelitis of varying severity ambulated by (1) wheelchair propulsion, (2) bilateral axillary crutches, (3) unilateral lower extremity ankle-foot orthoses or knee-ankle-foot orthoses, and (4) unassisted. Disabled children, regardless of their mode of ambulation, had to expend significantly more energy to ambulate than normal children (p less than 0.05). Wheelchair propulsion cost 16% more energy than the normal gait; crutch ambulation cost 41% more than the control. Children using unilateral braces sacrificed speed to attain near-normal Ee. When they ambulated without orthoses, their Ee increased by 109% over the control. In ascending order, the least energy was expanded by normal ambulation followed by disabled ambulation with unilateral brace, disabled propelling a wheelchair, disabled ambulation with bilateral axillary crutches, and disabled ambulation without brace. Efficiency of locomotion was reflected in the values obtained for Ee in terms of kcal x 10(-3)/kg/m, as demonstrated by the lower Ee but slower ambulation of children with braces, as compared to the nondisabled children.