Gait efficiency in children with cerebral palsy is usually quantified by metabolic energy expenditure. Mechanical energy estimations, however, can be a valuable supplement as they can be assessed during gait analysis and plotted over the gait cycle, thus revealing information on timing and sources of increases in energy expenditure. Unfortunately, little information on validity and sensitivity exists. Three mechanical estimation approaches: (1) centre of mass (CoM) approach, (2) sum of segmental energies (SSE) approach and (3) integrated joint power approach, were validated against oxygen consumption and each other. Sensitivity was assessed in typical gait and in children with diplegia. CoM approach underestimated total energy expenditure and showed poor sensitivity. SSE approach overestimated energy expenditure and showed acceptable sensitivity. Validity and sensitivity were best in the integrated joint power approach. This method is therefore preferred for mechanical energy estimation in children with diplegia. However, mechanical energy should supplement, not replace metabolic energy, as total energy expended is not captured in any mechanical approach.
Bibliographical noteFunding Information:
This study was supported by grant ( HA-G827 ) of the Artesis University College of Antwerp .The authors like to thank the colleagues of the Clinical Motion Analysis Laboratory for their contribution to data collection and all the subjects for their willingness to participate! Conflict of interest statement
- Cerebral palsy
- Mechanical energy
- Metabolic energy