title: [Upper extremity kinetics and energy expenditure during walker-assisted gait in children with cerebral palsy].
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Marquette Universitesi, Biyomedikal Mühendislik Bölümü, Milwaukee, WI, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Konop
authors.forename: Kelly M B
authors.initials: KM
authors.lastname: Strifling
authors.forename: Mei
authors.initials: M
authors.lastname: Wang
authors.forename: Kevin
authors.initials: K
authors.lastname: Cao
authors.forename: Daniel
authors.initials: D
authors.lastname: Eastwood
authors.forename: Scott
authors.initials: S
authors.lastname: Jackson
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ackman
authors.forename: Haluk
authors.initials: H
authors.lastname: Altiok
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schwab
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000378:metabolism* / Q000628:therapy; D002648:Child; D004734:Energy Metabolism; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007700:Kinetics; D008297:Male; D034941:Upper Extremity / Q000502:physiology*; D014853:Walkers