ArticlesFeasibility of the physiological cost index as an outcome measure for the assessment of energy expenditure during walking☆,☆☆,★,★★,♢
Section snippets
Participants
Twelve children with CP participated in this study. Exclusion criteria were cardiovascular abnormalities, breathing difficulties, and surgery during the previous year. Eight children had hemiplegia and 4 had diplegia. The children were able to walk both barefoot and with shoes on for at least 10 minutes, with or without the use of a walker. All of these children understood the instructions given to them. Written permission from their parents to participate in this study was obtained. The local
Results
All subjects were able to walk at a comfortable speed with and without shoes for 8 minutes. During the first session, some children were anxious about wearing the facemask, but that improved during the second and the third sessions. All subjects were able to enter a steady state in approximately 4 minutes. The V̇O2 recording of 1 child during the first test was not reliable. We used the last recording (with shoes) as an estimate of walking with shoes instead.
Table 1 summarizes the crude data
Discussion
Although some articles have addressed the relation between heart rate and energy expenditure during walking, our study focused particularly on the feasibility of the PCI as an outcome measure in clinical trials. The PCI was considered feasible if the differences in energy requirements that have to be detected actually can be detected with sufficient statistical power. These topics are discussed later using our data, previously published data of a study in patients with SCI, and a literature
Conclusions
From the present study and a review of the literature, we concluded that reproducibility of the PCI and the ability to show small differences in EO2 is moderate. Subtracting HRbaseline when calculating the PCI is probably not useful because it does not improve the ability to detect differences, whereas it increases the within-subject variability. The calculated effect sizes were small, in particular because most of the differences in clinical trials were between 0% and 20%. If these small
Acknowledgements
We express our gratitude to Margit Schlecht, PT, Elles Stijnen, MSc, Miranda Velthuis, MSc, and Jans Ties, PT, for their valuable assistance and cooperation in the assessments.
References (28)
- et al.
Between-day and within-day variability in the relation between heart rate and oxygen consumption: effect on the estimation of energy expenditure by heart-rate monitoring
Am J Clin Nutr
(1997) - et al.
Validity and reproducibility of crutch force and heart rate measurements to assess energy expenditure of paraplegic gait
Arch Phys Med Rehabil
(1999) - et al.
Relation among indices of effort and oxygen uptake in below-knee amputee and able-bodied children
Arch Phys Med Rehabil
(1994) - et al.
A methodological framework for assessing health indices
J Chronic Dis
(1985) - et al.
Methods for assessing responsiveness: a critical review and recommendations
J Clin Epidemiol
(2000) Gait analysis: normal and pathological function
- et al.
High- or low-technology measurements of energy expenditure in clinical gait analysis?
Dev Med Child Neurol
(1999) - et al.
Validity of heart rate, pedometry, and accelerometry for predicting the energy cost of children's activities
J Appl Physiol
(1998) The objective measurement of physical performance with long-term ambulatory physiological surveillance equipment. In: Proceedings of 3rd international symposium on ambulatory monitoring
- et al.
Clinical decision making with the aid of ambulatory monitoring of heart rate
Prosthet Orthot Int
(1980)
Textbook of work physiology: physiological bases of exercise
The physiological cost of gait (PCG): a new technique for evaluating nonsteroidal anti-inflammatory drugs in rheumatoid arthritis
Br J Rheumatol
Physiological cost index of walking in able bodied adolescents and adults
Clin Rehabil
Physiological Cost Index of walking for normal children and its use as an indicator of physical handicap
Dev Med Child Neurol
Cited by (54)
Robot-assisted training using Hybrid Assistive Limb® for cerebral palsy
2018, Brain and DevelopmentImpact of loaded sit-to-stand exercises at different speeds on the physiological cost of walking in children with spastic diplegia: A single-blind randomized clinical trial
2016, Research in Developmental DisabilitiesCitation Excerpt :The PCI (beats/m) was calculated by dividing the increment of heart rate during walking by walking speed; higher values represent lower energy efficiency. The PCI has acceptable test–retest reliability (ICC = 0.81) and interrater reliability (ICC = 0.73) for children with CP (Ijzerman & Nene, 2002; Liu et al., 2004). Baseline measurements of heart rate were taken while the subject sat in a chair for at least 5 min until we were confident that a steady state was achieved.
Comparison of energy cost in transtibial amputees using " prosthesis" and " crutches without prosthesis" for walking activities
2012, Annals of Physical and Rehabilitation MedicineCitation Excerpt :Cette méthode comporte d’autres inconvénients, tels que l’impossibilité d’obtenir des données en continu, et par conséquent d’étudier des changements rapides de ventilation ou de VO2, ou encore la consommation en temps de, la méthode à cause des conditions de prélèvement des échantillons et de leur analyse après recueil [14]. De nombreuses études anciennes ont utilisé le calcul de l’indice de coût physiologique (ICP) comme l’une des méthodes d’évaluation du coût d’énergie métabolique, mais il existe une controverse sur la validité et la fiabilité de l’ICP comme mesure des données pour l’évaluation de la DE [3,14]. Il y a donc un vrai besoin d’analyse exacte de la quantification de DE entre « prothèse » et « béquilles sans prothèse » chez des sujets présentant peu de variations d’âge et de conditions cliniques.
Evaluation of Muscle Oxygen Dynamics in Children’s Gait and Its Relationship with the Physiological Cost Index
2023, Healthcare (Switzerland)Non-oncological outcomes following limb salvage surgery in patients with knee sarcoma: a scoping review
2022, Disability and Rehabilitation
- ☆
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
- ☆☆
Reprint requests to Maarten J. IJzerman, PhD, Roessingh Research and Development, PO Box 310, 7500 AH Enschede, The Netherlands, e-mail: [email protected].
- ★
Suppliers
- ★★
a. Erich Jaeger, Benelux BV, Breda, the Netherlands.
- ♢
b. PE3000; Polar Electro Oy, Professorintie 5, FIN-90440 Kempele, Finland.