TY - JOUR
T1 - Fatigue-related gait adaptations in children with cerebral palsy
AU - Oudenhoven, Laura M
AU - Van Der Krogt, Marjolein M
AU - Ettema, Sanne
AU - Roeleveld, Karin
AU - Brehm, Merel A
AU - Buizer, Annemieke I
AU - van der Krogt, Marjolein M.
N1 - Funding Information: This work was supported by HandicapNL under grant no. R201605435; Phelps Stichting voor Spastici under grant no. 2017.015; Stichting Johanna Kinderfonds under grant no. 20170006; Cornelia‐Stichting; and Kinderrevalidatie Fonds Adriaanstichting, as part of the MOVING‐CP project. The authors thank all participating children and their parents. We generously thank Annet Dallmeijer for helping in designing the protocol and experimental set‐up. We also thank Kirsten Veerkamp for assisting with the measurement protocol, Eefje Muselaers and Eline Bolster for their help with data interpretation, and Jorinde Scholten and Julien Pronk (Cosmed) for their technical support. Publisher Copyright: © 2023 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.
PY - 2023/12
Y1 - 2023/12
N2 - Aim: To obtain insights into the effects of fatigue on the kinematics, kinetics, and energy cost of walking (ECoW) in children with cerebral palsy (CP). Method: In this prospective observational study, 12 children with CP (mean age 12 years 9 months, SD 2 years 7 months; four females, eight males) and 15 typically developing children (mean age 10 years 8 months, SD 2 years 4 months; seven females, eight males) followed a prolonged intensity-based walking protocol on an instrumented treadmill, combined with gas analysis measurements. The protocol consisted of consecutive stages, including a 6-minute walking exercise (6MW) at comfortable speed, 2 minutes of moderate-intensity walking (MIW) (with a heart rate > 70% of its predicted maximal), and 4 minutes walking after MIW. If necessary, the speed and slope were incremented to reach MIW. Outcomes were evaluated at the beginning and end of the 6MW and after MIW. Results: With prolonged walking, Gait Profile Scores deteriorated slightly for both groups (p < 0.01). Knee flexion increased during early stance (p = 0.004) and ankle dorsiflexion increased during late stance (p = 0.034) in children with CP only. Negligible effects were found for kinetics. No demonstrable change in ECoW was found in either group (p = 0.195). Interpretation: Kinematic deviations in children with CP are progressive with prolonged walking. The large variation in adaptations indicates that an individual approach is recommended to investigate the effects of physical fatigue on gait in clinical practice.
AB - Aim: To obtain insights into the effects of fatigue on the kinematics, kinetics, and energy cost of walking (ECoW) in children with cerebral palsy (CP). Method: In this prospective observational study, 12 children with CP (mean age 12 years 9 months, SD 2 years 7 months; four females, eight males) and 15 typically developing children (mean age 10 years 8 months, SD 2 years 4 months; seven females, eight males) followed a prolonged intensity-based walking protocol on an instrumented treadmill, combined with gas analysis measurements. The protocol consisted of consecutive stages, including a 6-minute walking exercise (6MW) at comfortable speed, 2 minutes of moderate-intensity walking (MIW) (with a heart rate > 70% of its predicted maximal), and 4 minutes walking after MIW. If necessary, the speed and slope were incremented to reach MIW. Outcomes were evaluated at the beginning and end of the 6MW and after MIW. Results: With prolonged walking, Gait Profile Scores deteriorated slightly for both groups (p < 0.01). Knee flexion increased during early stance (p = 0.004) and ankle dorsiflexion increased during late stance (p = 0.034) in children with CP only. Negligible effects were found for kinetics. No demonstrable change in ECoW was found in either group (p = 0.195). Interpretation: Kinematic deviations in children with CP are progressive with prolonged walking. The large variation in adaptations indicates that an individual approach is recommended to investigate the effects of physical fatigue on gait in clinical practice.
UR - http://www.scopus.com/inward/record.url?scp=85160854380&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/dmcn.15660
DO - https://doi.org/10.1111/dmcn.15660
M3 - Article
C2 - 37243486
SN - 0012-1622
VL - 65
SP - 1629
EP - 1638
JO - Developmental Medicine and Child Neurology
JF - Developmental Medicine and Child Neurology
IS - 12
ER -