Katherine A. KONOP, Kelly M. B. STRIFLING, Mei WANG, Kevin CAO, Daniel EASTWOOD, Scott JACKSON, Jeffrey ACKMAN, Haluk ALTIOK, Jeffrey SCHWAB, Gerald F HARRIS

Beyin felçli çocuklarda yürüteç kullanımı sırasında üst ekstremite kinetikleri ve enerji tüketimi

Amaç: Çalışmada, spastik diplejik beyin felçli çocuklarda, ön ve arka yürüteç kullanımı sırasında üst ekstremite (ÜE) kinetik verileri ile enerji tüketim indeksi arasındaki ilişkiler araştırıldı. Çalışma planı: Yürüteçle yürüyebilen, spastik diplejik beyin felçli 10 çocukta (3 erkek, 7 kız; ort. yaş 12.1; dağılım 8-18) ÜE kinematiği ve kinetiği ile ilgili yürüme analizleri yapıldı. Üst ekstremite kinetiği ile ilgili veriler yürüteç tutacaklarına yerleştirilen donanım ile elde edildi. Enerji tüketim indeksi, kalp hızı yöntemiyle (ETİKH), yürüme sırasındaki kalp hızından dinlenme anındaki kalp hızının çıkarılması ve sonucun yürüyüş hızına bölünmesiyle hesaplandı. Kinetik değişkenler ile ETİKH ve yürümenin zamansal ve adım parametreleri arasındaki korelasyonlar araştırıldı. Sonuçlar: Genel olarak, ön yürüteç kullanmada ETİKH’nin daha yüksek olduğu görüldü. Birçok kinetik değişken, yürümenin zamansal ve adım parametreleri ve ETİKH ile korelasyon gösterdi. Anlamlı korelasyonların tümü (r>0.80; p

Anahtar Kelimeler:

Enerji metabolizması, Yürüme bozuklukları, nörolojik, Kalp hızı, Yürüteç, Kas spastisitesi, Yürüme, Kinetik, Çocuk, Biyomekanik, Beyin felci, Üst ekstremite, Ergen

Upper extremity kinetics and energy expenditure during walker-assisted gait in children with cerebral palsy

Objectives: We evaluated the relationships between upper extremity (UE) kinetics and the energy expenditure index during anterior and posterior walker-assisted gait in children with spastic diplegic cerebral palsy (CP). Methods: Ten children (3 boys, 7 girls; mean age 12.1 years; range 8 to 18 years) with spastic diplegic CP, who ambulated with a walker underwent gait analyses that included UE kinematics and kinetics. Upper extremity kinetics were obtained using instrumented walker handles. Energy expenditure index was obtained using the heart rate method (EEIHR) by subtracting resting heart rate from walking heart rate, and dividing by the walking speed. Correlations were sought between the kinetic variables and the EEIHR and temporal and stride parameters. Results: In general, anterior walker use was associated with a higher EEIHR. Several kinetic variables correlated well with temporal and stride parameters, as well as the EEIHR. All of the signiﬁcant correlations (r>0.80; p<0.005) occurred during anterior walker use and involved joint reaction forces (JRF) rather than moments. Some variables showed multiple strong correlations during anterior walker use, including the medial JRF in the wrist, the posterior JRF in the elbow, and the inferior and superior JRFs in the shoulder. Conclusion: The observed correlations may indicate a relationship between the force used to advance the body forward within the walker frame and an increased EEIHR. More work is needed to reﬁne the correlations, and to explore relationships with other variables, including the joint kinematics.

Keywords:

Energy Metabolism, Gait Disorders, Neurologic, Heart Rate, Walkers, Muscle Spasticity, Walking, Kinetics, Child, Biomechanics, Cerebral Palsy, Upper Extremity, Adolescent,

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