Article

Many ambulatory children with Spina Bifida (SB) experience functional
decline in ambulation despite stable or even improving motor exams. Improving or
maintaining low energy cost of locomotion during childhood and throughout the
teenage years, could be an important goal for children and adolescents with SB.
Purpose of this study was to determine reproducibility of energy expenditure
measures during gait in ambulatory children with SB. DESIGN: Reproducibility
study. SETTING: Child Development and Exercise Center of the University
Children's Hospital in Utrecht, the Netherlands. PARTICIPANTS: Fourteen
ambulatory children (6 boys/8 girls) with SB. Mean age was 10.8 years (+ or -
3.4). INTERVENTIONS: Net and gross energy expenditure measures during locomotion
were determined during a six-minute walking test. These measures consisted of
energy consumption (ECS), expressed in J/kg/min, and energy cost (EC), expressed
in J/kg/m. For reliability, the intra-class coefficient (ICC) was determined. For
agreement, the smallest detectable difference (SDD) was calculated. RESULTS: ICCs
vary from 0.86 to 0.96 for both EC and ECS. The SDD ranges from 18-24% for gross
measures, up to over 30% for net values. CONCLUSION: Reproducibility of energy
expenditure during ambulation in children with SB should be considered carefully
when using these measures in the evaluation of gait. High reliability of energy
expenditure measurements makes these measurements appropriate to use as
discriminative tools in children with SB, while agreement of only gross EC seems
acceptable to use as a evaluative tool in children with SB. Overall, measures of
reliability and agreement seem higher in young children when compared to
adolescents. Further research is recommended to determine clinically relevant
changes in energy expenditure in children with SB.
CI - Copyright 2009 Elsevier B.V. All rights reserved.

Langue : ANGLAIS