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Variability of energy-consumption measures in children with cerebral palsy
T R Bowen1, N Lennon, P Castagno
1Alfred I. duPont Institute, DE 19899, USA.
Insights
Oxygen cost measurements are reliable for assessing gait efficiency in children with cerebral palsy (CP). This study found oxygen cost to be the most sensitive and consistent measure compared to oxygen consumption and physiological cost index.
Area of Science:
- Biomechanics
- Pediatric Rehabilitation
- Exercise Physiology
Background:
- Children with cerebral palsy (CP) often exhibit altered gait patterns, impacting their energy expenditure during locomotion.
- Accurate and reliable measurement of metabolic cost is crucial for evaluating interventions aimed at improving gait efficiency in this population.
- Previous research has explored various metrics, but their reliability in children with CP requires further investigation.
Purpose of the Study:
- To compare the reliability of oxygen cost, oxygen consumption, and physiological cost index (PCI) as measures of gait efficiency in children with CP.
- To determine the most sensitive and consistent metric for assessing changes in gait efficiency in this population.
Main Methods:
- Oxygen consumption was measured using the Cosmed K2 system during free-walking velocity in five children with CP and five non-disabled children.
- Repeated tests were conducted to assess the variability of oxygen cost, oxygen consumption, and PCI.
- Statistical analysis focused on the percentage of variability for each measurement between the two groups.
Main Results:
- No statistically significant differences in the variability of oxygen cost, oxygen consumption, or PCI were found between children with CP and non-disabled children.
- Oxygen cost demonstrated the lowest percentage of variability (13.2% in CP, 13.9% in non-disabled), indicating higher reliability.
- Physiological cost index exhibited the highest variability (20.3% in CP, 20.5% in non-disabled), suggesting lower reliability.
Conclusions:
- Oxygen cost is the most reliable and sensitive measurement for assessing gait efficiency in children, including those with cerebral palsy.
- The low variability of oxygen cost makes it a suitable metric for detecting subtle changes in gait efficiency following interventions.
- Physiological cost index is less reliable and may not be as sensitive for evaluating gait efficiency in this pediatric population.
Abstract:
Oxygen consumption measurements made on five repeated tests from five children with cerebral palsy (CP) and five nondisabled children of similar age and size were collected using the Cosmed K2 (Cosmed, Rome, Italy) oxygen-analysis system at free-walking velocity. Oxygen cost, oxygen consumption, and physiological cost index (PCI) were measured. There were no statistically significant differences in the percentage of variability of oxygen cost, oxygen consumption, or PCI between the disabled and nondisabled populations. Oxygen cost was the most reliable oxygen-use measurement with an average percentage of variability of 13.2% for the CP population and 13.9% for the nondisabled population. Physiological cost index was found be the least reliable measurement with the average percentages of variabilities of the disabled and nondisabled populations of 20.3 and 20.5%, respectively. Thus because of oxygen cost's relatively low variability, it was the most sensitive measurement of change in gait efficiency.