Fatigue-related gait adaptations in children with cerebral palsy.
Study Goal
The researchers aimed to investigate the effects of fatigue on walking kinematics, kinetics, and energy cost in children with cerebral palsy (CP) compared to typically developing children.
Results Summary
Prolonged walking led to slight deterioration in gait kinematics for both groups, with specific changes in knee and ankle flexion in children with CP. No significant changes were observed in kinetics or energy cost of walking.
Population
12 children with CP (mean age 12 years 9 months) and 15 typically developing children (mean age 10 years 8 months).
Effective Dosage
6-minute walking exercise at comfortable speed, 2 minutes of moderate-intensity walking, and 4 minutes walking after moderate-intensity walking.
Duration
Single session with stages totaling approximately 12 minutes of walking.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
prolonged walking | decrease | Gait Profile Scores | children with cerebral palsy and typically developing children | - | deteriorated slightly | #1 |
prolonged walking | increase | knee flexion during early stance | children with cerebral palsy | - | increased | #2 |
prolonged walking | increase | ankle dorsiflexion during late stance | children with cerebral palsy | - | increased | #3 |
prolonged walking | no change | kinetics | children with cerebral palsy and typically developing children | - | negligible effects were found | #4 |
prolonged walking | no change | energy cost of walking (ECoW) | children with cerebral palsy and typically developing children | - | no demonstrable change | #5 |
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.