Article

OBJECTIVES: To describe (1) physical strain of walking, (2) the proportion of
participants walking above the anaerobic threshold,
and (3) 4 phenotypes of
physical strain of walking on the basis of deviations in aerobic capacity and
walking energy cost (EC) in children and adolescents with cerebral palsy (CP).
SETTING: Academic medical center. PARTICIPANTS: A sample
(N=57) of participants (n=37; mean age, 13.5+/-4.0y) with CP (Gross Motor
Function Classification System [GMFCS] levels I [n=13], II [n=17], and III [n=7])
and typically developing (TD) participants (n=20; mean age, 11.8+/-3.5y).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Oxygen consumption
(Vo2walk), speed, and EC were determined during walking at a comfortable speed.
Peak oxygen consumption (Vo2peak) and anaerobic threshold were measured during a
maximal cycling exercise test. Aerobic capacity was reduced if lower than the
10th percentile, and EC was increased if higher than 3SD. Physical strain was
defined as follows: (Vo2walk/Vo2peak)x100. RESULTS: Participants with CP had a
higher physical strain (GMFCS level I, 55%+/-12% GMFCS level II, 62%+/-17%; GMFCS
level III, 78%+/-14%) than did TD participants (40%+/-11%) (P<.001). Forty-three
percent of participants with CP showed a Vo2walk at or above their anaerobic
threshold as compared with 10% of TD participants (P=.007). Phenotypes showed
that a reduced Vo2peak (n=9) or an increased EC (n=9) lead to an 18% to 20%
higher physical strain, whereas a combination (n=12) leads to a 40% increase.
CONCLUSIONS: Children and adolescents with CP walk at a high physical strain,
approximating intense exercise and a considerable proportion walks close to or
above their anaerobic threshold, probably explaining fatigue and reduced walking
distance. Both an increased EC and a reduced Vo2peak contribute to high physical
strain in children or adolescents with CP. The different causes of high physical
strain in individuals with CP require different intervention strategies.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS