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The effect of corrective surgery on energy expenditure during ambulation in children with cerebral palsy
Insights
Corrective surgery improved mechanical efficiency in children with cerebral palsy, reducing oxygen consumption during walking. Physical fitness levels remained unchanged, indicating a biomechanical enhancement post-surgery.
Area of Science:
- Biomechanical Engineering
- Pediatric Rehabilitation
- Movement Science
Background:
- Children with cerebral palsy often exhibit altered gait mechanics.
- Assessing the impact of corrective surgery on walking efficiency is crucial for rehabilitation.
Purpose of the Study:
- To evaluate the effects of corrective surgery on mechanical efficiency and physiological responses during treadmill walking in children with cerebral palsy.
Main Methods:
- Six children with cerebral palsy underwent treadmill tests before and after corrective surgery.
- Measurements included oxygen consumption, heart rate, and blood lactate during level and inclined walking.
- Subjects utilized a handrail for stability.
Main Results:
- A 5% reduction in oxygen consumption per kg body mass was observed during level walking post-surgery.
- Physical fitness, estimated by oxygen pulse, did not change significantly.
- Exhaustion during inclined walking appeared related to local factors, not systemic anaerobic threshold.
Conclusions:
- Corrective surgery leads to biomechanical improvements in walking efficiency for children with cerebral palsy.
- Further investigation is needed to understand factors contributing to exhaustion during challenging inclines.
Abstract:
Mechanical efficiency, heart rate, blood lactate, and some other variables were studied in six children with cerebral palsy who walked on a treadmill before and after corrective surgery. During each test, conducted at each child's naturally selected speed, two situations were studied: steady state level walking for 9 min, and then walking at an increasing inclination up to 20% for another 10 min. During the test the subjects were allowed to hold on to a handrail to eliminate the risk of falling off the treadmill. The corrective surgery resulted in a 5% reduction in oxygen consumption per kg body mass during level walking. The subjects' levels of physical fitness, as estimated from oxygen pulse, however, were unchanged. These results are indicative of a biomechanical improvement due to the corrective surgery. While walking at a 20% inclination the subjects off loaded themselves to different degrees on the handrail which influenced the results. Their feeling of exhaustion at this load was probably due to local factors, since heart rate was well below maximal values, and blood lactate, respiratory exchange ratio and ventilatory equivalent also indicated that they were below their anaerobic thresholds (50-60% of maximal oxygen uptake).
