Physical strain: a new perspective on walking in cerebral palsy

Abstract Objective The objectives of this study in children and adolescents with cerebral palsy (CP) were to 1) describe physical strain of walking, 2) describe the proportion of participants walking above the anaerobic threshold and 3) describe 4 phenotypes of physical strain of walking based on deviations in aerobic capacity and walking energy cost (EC). Design Cohort Setting Academic medical center Participants Thirty-seven participants (13y5mo(4y0mo)) with CP (Gross Motor Function Classification System (GMFCS) levels I[n=13], II[N=17] and III[N=7]) and 20 typically developing participants (TD) (11y8mo(3y5mo)). Interventions Not applicable Main Outcome Measure(s) Oxygen consumption (VO2walk ), speed and EC were determined during walking at comfortable speed. Peak oxygen uptake (VO2peak ) and anaerobic threshold were measured during a maximal cycling exercise test. Aerobic capacity was decreased if 3SD’s. Physical strain was defined as [VO2walk /VO2peak ]*100. Results Participants with CP had a higher physical strain (GMFCS levels I:55±12%, II:62±17% and III:78±14%) than TD (40±11%, p