Skip to main content

Oxygen Consumption in Cerebral Palsy

  • Living reference work entry
  • First Online:
Book cover Handbook of Human Motion

Abstract

Oxygen consumption is a measure of aerobic fitness and the body’s ability to deliver oxygen for energy generation during exercise. Oxygen consumption can be measured directly or indirectly. To measure oxygen consumption, breath by breath measurements of the oxygen inspired and the carbon dioxide exhaled are measured by specialized equipment. For other indirect measures, heart rate or distance walked/ran during exercise are used in regression equations to estimate oxygen consumption. Examples of such measures of oxygen consumption and energy expenditure are shuttle runs/rides, stair climbing tests, 6 min walk tests, 1 min walking tests, and mechanical energy estimation. Regardless of age children, adolescents and adults diagnosed with cerebral palsy have decreased physical activity and increased energy, oxygen cost and oxygen consumption (measured with direct and indirect methods) when walking compared to able-bodied persons. Decreases in physical activity may increase the risk of cardiovascular and cardiopulmonary compromise in children and adults diagnosed with cerebral palsy and these impairments may contribute to further decreases in physical activities. However, surgical interventions (single event multi-level surgeries, and Rhizotomy) and therapy have been reported to increase walking distances and decrease energy expended when walking for persons diagnosed with cerebral palsy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  • Geoffrey E, Moore J, Larry Durstine, Patricia L, Painter American College of Sports Medicine ACMS’s exercise management for persons with chronic diseases and disabilities/American College of Sports Medicine. Champaign, IL: Human Kinetics; 2016

    Google Scholar 

  • Walter R, Thompson, Neil F, Gordon Linda S, Pescatello, American College of Sports Medicine ACSM’s guidelines for exercise testing and prescription/American College of Sports Medicine. Philadelphia: Wolters Kluwer Health/Lippincott Williams and Wilkins; 2014. p 480

    Google Scholar 

  • Augsburger S, Tylkowski C (2000) A comparison of volumetric oxygen consumption to gait mechanical energy in normal and pathological gait. In: Harris GF, Smith PA (eds) A new millennium in clinical care and motion analysis technology. Institute of Electical and Electronics Engineers, Piscataway, pp 109–115

    Google Scholar 

  • Bar-Haim S, Belokopytov M, Harries N, Frank A (2004) A stair-climbing test for ambulatory assessment of children with cerebral palsy. Gait Posture 20:183–188

    Article  Google Scholar 

  • Battley E (1995) The advantages and disadvantages of direct and indirect calorimetry. Thermochem Acta 250:337–352

    Article  Google Scholar 

  • Bowen TR, Lennon N, Castagno P et al (1998a) Variability of energy-consumption measures in children with cerebral palsy. J Pediatr Orthop 18:738–742

    Google Scholar 

  • Bowen TR, Cooley SR, Castagno PW et al (1998b) A method for normalization of oxygen cost and consumption in normal children while walking. J Pediatr Orthop 18:589–593

    Article  Google Scholar 

  • Carraro E, Zeme S, Ticcinelli V et al (2014) Multidimensional outcome measure of selective dorsal rhizotomy in spastic cerebral palsy. Eur J Paediatr Neurol 18:704–713

    Article  Google Scholar 

  • Chan SH, Yam KY, Yiu-Lau BP et al (2008) Selective dorsal rhizotomy in Hong Kong: multidimensional outcome measures. Pediatr Neurol 39:22–32

    Article  Google Scholar 

  • Cook CE, (2008) Clinimetrics Coroner: The Minimal Clinically Important Change Score (MCID): A Necessary Pretense. J Man Manip Ther 16(4): E82–E83

    Google Scholar 

  • Darter BJ, Rodriguez KM, Wilken JM (2013) Test-retest reliability and minimum detectable change using the K4b2: oxygen consumption, gait efficiency, and heart rate for healthy adults during submaximal walking. Res Q Exerc Sport 84:223–231

    Article  Google Scholar 

  • DeJaeger D, Willems PA, Heglund NC (2001) The energy cost of walking in children. Pflugers Arch 441:538–543

    Article  Google Scholar 

  • Fowler EG, Kolobe TH, Damiano DL et al (2007) Promotion of physical fitness and prevention of secondary conditions for children with cerebral palsy: section on pediatrics research summit proceedings. Phys Ther 87:1495–1510

    Article  Google Scholar 

  • Gorter H, Holty L, Rameckers EE et al (2009) Changes in endurance and walking ability through functional physical training in children with cerebral palsy. Pediatr Phys Ther 21:31–37

    Article  Google Scholar 

  • Hassani S, Krzak JJ, Johnson B et al (2014) One-Minute Walk and modified Timed Up and Go tests in children with cerebral palsy: performance and minimum clinically important differences. Dev Med Child Neurol 56:482–489

    Article  Google Scholar 

  • Johnston TE, Moore SE, Quinn LT, Smith BT (2004) Energy cost of walking in children with cerebral palsy: relation to the Gross Motor Function Classification System. Dev Med Child Neurol 46:34–38

    Article  Google Scholar 

  • Jones J, McLaughlin JF (1993) Mechanical efficiency of children with spastic cerebral palsy. Dev Med Child Neurol 35:614–620

    Article  Google Scholar 

  • Kamp FA, Lennon N, Holmes L et al (2014) Energy cost of walking in children with spastic cerebral palsy: relationship with age, body composition and mobility capacity. Gait Posture 40:209–214

    Article  Google Scholar 

  • Kay RM, Rethlefsen SA, Kelly JP, Wren TA (2004) Predictive value of the Duncan-Ely test in distal rectus femoris transfer. J Pediatr Orthop 24:59–62

    Article  Google Scholar 

  • Keefer DJ, Tseh W, Caputo JL et al (2004) Comparison of direct and indirect measures of walking energy expenditure in children with hemiplegic cerebral palsy. Dev Med Child Neurol 46:320–324

    Article  Google Scholar 

  • Kerr C, Parkes J, Stevenson M et al (2008) Energy efficiency in gait, activity, participation, and health status in children with cerebral palsy. Dev Med Child Neurol 50:204–210

    Article  Google Scholar 

  • Maher CA, Williams MT, Olds TS (2008) The six-minute walk test for children with cerebral palsy. Int J Rehabil Res 31:185–188

    Article  Google Scholar 

  • Maltais DB, Robitaille NM, Dumas F et al (2012) Measuring steady-state oxygen uptake during the 6-min walk test in adults with cerebral palsy: feasibility and construct validity. Int J Rehabil Res 35:181–183

    Article  Google Scholar 

  • Marconi V, Hachez H, Renders A et al (2014) Mechanical work and energy consumption in children with cerebral palsy after single-event multilevel surgery. Gait Posture 40:633–639

    Article  Google Scholar 

  • Mattsson E, Andersson C (1997) Oxygen cost, walking speed, and perceived exertion in children with cerebral palsy when walking with anterior and posterior walkers. Dev Med Child Neurol 39:671–676

    Article  Google Scholar 

  • McDowell BC, Kerr C, Parkes J, Cosgrove A (2005) Validity of a 1 minute walk test for children with cerebral palsy. Dev Med Child Neurol 47:744–748

    Article  Google Scholar 

  • McGinley JL, Dobson F, Ganeshalingam R et al (2012) Single-event multilevel surgery for children with cerebral palsy: a systematic review. Dev Med Child Neurol 54:117–128

    Article  Google Scholar 

  • McMulkin ML, Gordon AB, Caskey PM et al (2015) Outcomes of orthopaedic surgery with and without an external femoral derotational osteotomy in children with cerebral palsy. J Pediatr Orthop Gait and Posture 41:608–612

    Google Scholar 

  • Morris C (2007) Definition and classification of cerebral palsy: a historical perspective. Dev Med Child Neurol Suppl 109:3–7

    Article  Google Scholar 

  • Nene AV, Evans GA, Patrick JH (1993) Simultaneous multiple operations for spastic diplegia. Outcome and functional assessment of walking in 18 patients. J Bone Joint Surg Br 75:488–494

    Google Scholar 

  • Norman JF, Bossman S, Gardner P, Moen C (2004) Comparison of the energy expenditure index and oxygen consumption index during self-paced walking in children with spastic diplegia cerebral palsy and children without physical disabilities. Pediatr Phys Ther 16:206–211

    Article  Google Scholar 

  • Nsenga Leunkeu A, Shephard RJ, Ahmaidi S (2012) Six-minute walk test in children with cerebral palsy gross motor function classification system levels I and II: reproducibility, validity, and training effects. Arch Phys Med Rehabil 93:2333–2339

    Article  Google Scholar 

  • Oeffinger DJ, Tylkowski CM, Rayens MK, Davis RF, Gorton GE, D’Astous J, Nicholson DE, Damiano DL, Abel MF, BAgley AM, Luan J (2004) Developmental Medicine and Child Neurology 46:311–319

    Google Scholar 

  • Oeffinger D, Bagley A, Rogers S, Gorton G, Kryscio R, Abel M, Damiano D, Barnes D, Tylkowski C (2008) Outcome tools used for ambulatory children with cerebral palsy: responsiveness and minimum clinically important differences. Dev Med Child Neurol 50(12): 918–925

    Google Scholar 

  • Palisano RJ, Hanna SE, Rosenbaum PL et al (2000) Validation of a model of gross motor function for children with cerebral palsy. Phys Ther 80:974–985

    Google Scholar 

  • Park ES, Park CI, Kim JY (2001) Comparison of anterior and posterior walkers with respect to gait parameters and energy expenditure of children with spastic diplegic cerebral palsy. Yonsei Med J 42:180–184

    Article  Google Scholar 

  • Potter CR, Unnithan VB (2005) Interpretation and implementation of oxygen uptake kinetics studies in children with spastic cerebral palsy. Dev Med Child Neurol 47:353–357

    Article  Google Scholar 

  • Powers S, Howley E (2007) Exercise physiology: theory and application to fitness and performance. McGraw Hill, New York

    Google Scholar 

  • Provost B, Dieruf K, Burtner PA et al (2007) Endurance and gait in children with cerebral palsy after intensive body weight-supported treadmill training. Pediatr Phys Ther 19:2–10

    Article  Google Scholar 

  • Raja K, Joseph B, Benjamin S et al (2007) Physiological cost index in cerebral palsy: its role in evaluating the efficiency of ambulation. J Pediatr Orthop 27:130–136

    Article  Google Scholar 

  • Rodda JM, Graham HK, Nattrass GR et al (2006) Correction of severe crouch gait in patients with spastic diplegia with use of multilevel orthopaedic surgery. J Bone Joint Surg Am 88:2653–2664

    Google Scholar 

  • Rose J, Gamble JG, Medeiros J et al (1989) Energy cost of walking in normal children and in those with cerebral palsy: comparison of heart rate and oxygen uptake. J Pediatr Orthop 9:276–279

    Article  Google Scholar 

  • Rose J, Gamble JG, Burgos A et al (1990) Energy expenditure index of walking for normal children and for children with cerebral palsy. Dev Med Child Neurol 32:333–340

    Article  Google Scholar 

  • Rose J, Gamble JG, Lee J et al (1991) The energy expenditure index: a method to quantitate and compare walking energy expenditure for children and adolescents. J Pediatr Orthop 11:571–578

    Article  Google Scholar 

  • Russell D, Rosenbaum P, Gowland C et al (1993) Gross motor function measure manual. McMaster University, Hamilton

    Google Scholar 

  • Scholtes VA, Becher JG, Beelen A, Lankhorst GJ (2006) Clinical assessment of spasticity in children with cerebral palsy: a critical review of available instruments. Dev Med Child Neurol 48:64–73

    Article  Google Scholar 

  • Slaman J, Bussmann J, van der Slot WM et al (2013) Physical strain of walking relates to activity level in adults with cerebral palsy. Arch Phys Med Rehabil 94:896–901

    Article  Google Scholar 

  • Slaman J, Roebroeck M, van der Slot W et al (2014) Can a lifestyle intervention improve physical fitness in adolescents and young adults with spastic cerebral palsy? A randomized controlled trial. Arch Phys Med Rehabil 95:1646–1655

    Article  Google Scholar 

  • Stallings VA, Zemel BS, Davies JC et al (1996) Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model. Am J Clin Nutr 64:627–634

    Google Scholar 

  • Steinbok P (2007) Selective dorsal rhizotomy for spastic cerebral palsy: a review. Childs Nerv Syst 23:981–990

    Google Scholar 

  • Thomas SS, Buckon CE, Piatt JH et al (2004) A 2-year follow-up of outcomes following orthopedic surgery or selective dorsal rhizotomy in children with spastic diplegia. J Pediatr Orthop B 13:358–366

    Article  Google Scholar 

  • Thomason P, Rodda J, Sangeux M et al (2012) Management of children with ambulatory cerebral palsy: an evidence-based review. Commentary by Hugh Williamson Gait Laboratory staff. J Pediatr Orthop 32(Suppl 2):S182–S186

    Google Scholar 

  • Thompson P, Beath T, Bell J et al (2008) Test-retest reliability of the 10-metre fast walk test and 6-minute walk test in ambulatory school-aged children with cerebral palsy. Dev Med Child Neurol 50:370–376

    Article  Google Scholar 

  • Umberger BR, Augsburger S, Resig J et al (2013) Generation, absorption, and transfer of mechanical energy during walking in children. Med Eng Phys 35:644–651

    Article  Google Scholar 

  • Unnithan VB, Dowling JJ, Frost G, Bar-Or O (1996) Role of cocontraction in the O2 cost of walking in children with cerebral palsy. Med Sci Sports Exerc 28:1498–1504

    Article  Google Scholar 

  • Valle AC, Dionisio K, Pitskel NB et al (2007) Low and high frequency repetitive transcranial magnetic stimulation for the treatment of spasticity. Dev Med Child Neurol 49:534–538

    Article  Google Scholar 

  • Van de Walle P, Hallemans A, Schwartz M et al (2012a) Mechanical energy estimation during walking: validity and sensitivity in typical gait and in children with cerebral palsy. Gait Posture 35:231–237

    Article  Google Scholar 

  • Van de Walle P, Hallemans A, Truijen S et al (2012b) Increased mechanical cost of walking in children with diplegia: the role of the passenger unit cannot be neglected. Res Dev Disabil 33:1996–2003

    Article  Google Scholar 

  • van den Hecke A, Malghem C, Renders A et al (2007) Mechanical work, energetic cost, and gait efficiency in children with cerebral palsy. J Pediatr Orthop 27:643–647

    Article  Google Scholar 

  • Vargus-Adams JN, Majnemer A (2014) International Classification of Functioning, Disability and Health (ICF) as a framework for change: revolutionizing rehabilitation. J Child Neurol 29:1030–1035

    Article  Google Scholar 

  • Verrotti A, Greco R, Spalice A et al (2006) Pharmacotherapy of spasticity in children with cerebral palsy. Pediatr Neurol 34:1–6

    Article  Google Scholar 

  • Verschuren O, Bloemen M, Kruitwagen C, Takken T (2010) Reference values for aerobic fitness in children, adolescents, and young adults who have cerebral palsy and are ambulatory. Phys Ther 90:1148–1156

    Article  Google Scholar 

  • Verschuren O, Zwinkels M, Ketelaar M et al (2013) Reproducibility and validity of the 10-meter shuttle ride test in wheelchair-using children and adolescents with cerebral palsy. Phys Ther 93:967–974

    Article  Google Scholar 

  • Welch WA, Strath SJ, Swartz AM (2015) Congruent validity and reliability of two metabolic systems to measure resting metabolic rate. Int J Sports Med 36:414–418

    Article  Google Scholar 

  • Wood E, Rosenbaum P (2000) The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol 42:292–296

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hank White .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this entry

Cite this entry

White, H., Wallace, J.J., Augsburger, S. (2016). Oxygen Consumption in Cerebral Palsy. In: Müller, B., et al. Handbook of Human Motion. Springer, Cham. https://doi.org/10.1007/978-3-319-30808-1_41-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-30808-1_41-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-30808-1

  • eBook Packages: Springer Reference EngineeringReference Module Computer Science and Engineering

Publish with us

Policies and ethics