Energetics of walking in individuals with cerebral palsy and typical development, across severity and age: A systematic review and meta-analysis.

Cerebral palsy Energetics Oxygen consumption Oxygen cost Walking

Journal

Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830

Informations de publication

Date de publication:
10 2021
Historique:
received: 14 04 2021
revised: 25 08 2021
accepted: 19 09 2021
pubmed: 27 9 2021
medline: 15 12 2021
entrez: 26 9 2021
Statut: ppublish

Résumé

Individuals with cerebral palsy (CP) report physical fatigue as a main cause of limitation, deterioration and eventually cessation of their walking ability. A consequence of higher level of fatigue in individuals with CP leads to a less efficient and long-distance walking ability. This systematic review investigates the difference in 1) walking energy expenditure between individuals with CP and age-matched typically developing (TD) individuals; and 2) energetics of walking across Gross Motor Function Classification System (GMFCS) levels and age. Five electronic databases (PubMed, Web of Science, CINAHL, ScienceDirect and Scopus) were searched using search terms related to CP and energetics of walking. Forty-one studies met inclusion criteria. Thirty-one studies compared energy expenditure between CP and age-matched controls. Twelve studies correlated energy expenditure and oxygen cost across GMFCS levels. Three studies investigated the walking efficiency across different ages or over a time period. A significant increase of energy expenditure and oxygen cost was found in individuals with CP compared to TD age-matched individuals, with a strong relationship across GMFCS levels. Despite significant differences between individuals with CP compared to TD peers, variability in methods and testing protocols may play a confounding role. Analysis suggests oxygen cost being the preferred/unbiased physiological parameter to assess walking efficacy in CP. To date, there is a knowledge gap on age-related changes of walking efficiency across GMFCS levels and wider span of age ranges. Further systematic research looking at longitudinal age-related changes of energetics of walking in this population is warranted.

Sections du résumé

BACKGROUND
Individuals with cerebral palsy (CP) report physical fatigue as a main cause of limitation, deterioration and eventually cessation of their walking ability. A consequence of higher level of fatigue in individuals with CP leads to a less efficient and long-distance walking ability.
RESEARCH QUESTION
This systematic review investigates the difference in 1) walking energy expenditure between individuals with CP and age-matched typically developing (TD) individuals; and 2) energetics of walking across Gross Motor Function Classification System (GMFCS) levels and age.
METHODS
Five electronic databases (PubMed, Web of Science, CINAHL, ScienceDirect and Scopus) were searched using search terms related to CP and energetics of walking.
RESULTS
Forty-one studies met inclusion criteria. Thirty-one studies compared energy expenditure between CP and age-matched controls. Twelve studies correlated energy expenditure and oxygen cost across GMFCS levels. Three studies investigated the walking efficiency across different ages or over a time period. A significant increase of energy expenditure and oxygen cost was found in individuals with CP compared to TD age-matched individuals, with a strong relationship across GMFCS levels.
SIGNIFICANCE
Despite significant differences between individuals with CP compared to TD peers, variability in methods and testing protocols may play a confounding role. Analysis suggests oxygen cost being the preferred/unbiased physiological parameter to assess walking efficacy in CP. To date, there is a knowledge gap on age-related changes of walking efficiency across GMFCS levels and wider span of age ranges. Further systematic research looking at longitudinal age-related changes of energetics of walking in this population is warranted.

Identifiants

pubmed: 34564011
pii: S0966-6362(21)00500-2
doi: 10.1016/j.gaitpost.2021.09.190
pii:
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

388-407

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Mauro Nardon (M)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Federico Ruzzante (F)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Leslie O'Donnell (L)

Shirley Ryan AbilityLab, Chicago, IL, USA.

Alessandra Adami (A)

Department of Kinesiology, University of Rhode Island, Kingston, RI, USA.

Sudarshan Dayanidhi (S)

Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Department of Physical Therapy and Human Movement Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Matteo Bertucco (M)

Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. Electronic address: matteo.bertucco@univr.it.

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Classifications MeSH