Activity-related energy expenditure during lower limb cast immobilization in children.
Physical inactivity, which may result from immobilization, is recognized as a risk factor for the development of obesity. We aimed to quantify the decrease in activity-related energy expenditure (AEE) because of lower limb cast immobilization. We carried out a longitudinal matched case-control study: 34 adolescents with a first episode of lower limb fracture and 34 healthy cases. Physical activity was assessed during cast immobilization by an accelerometer from which we calculated the decrease in AEE. AEE in adolescents with lower limb fractures was estimated to be 16.0% lower than healthy controls. When converted into kcal per mean participants' weight, the difference in AEE amounted to 125 kcal/day, which corresponds to 5.2 h of slow walking. A significant reduction of AEE in adolescents with lower limb fractures may lead to a significantly positive energy balance as there is usually no compensatory reduction of energy intake. An increase of walking seems unrealistic in this situation and patients should be advised at the emergency unit to reduce their energy intake during the immobilization period.


METHODS
Level III, prospective case-control study.
aPediatric Sport Medicine and Obesity Care Program bPediatric Orthopedic Service, Department of Child and Adolescent, University Hospitals of Geneva, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Albane B
AB
Maggio
Xavier E
XE
Martin
Dimitri
D
Ceroni
D000054:Acceleration; D000293:Adolescent; D000886:Anthropometry; D016022:Case-Control Studies; D002370:Casts, Surgical; D002648:Child; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D015444:Exercise; D005121:Extremities / Q000473:pathology*; D005260:Female; D050723:Fractures, Bone; D006801:Humans; D008137:Longitudinal Studies; D035002:Lower Extremity; D008297:Male; D011446:Prospective Studies; D016138:Walking