Cerebral Palsy Energetics

Movement requires energy! How much energy an activity takes often dictates how often and how much we choose to engage. For individuals with cerebral palsy, the energetic cost of many activities of daily living are elevated due to changes in neuromuscular and musculoskeletal function. For walking, the average child with cerebral palsy requires over two-times as much energy to walk compared to peers. These elevated costs can contribute to exhaustion, lower activity levels, and reduced participation in daily activities. At our partner hospital, Gillette Children’s 92% of children with cerebral palsy report that fatigue significantly impacts their daily activities. Nationally, seven of the top ten research priorities identified by the CP community are related to fatigue or energy.

The energetic costs of movement have been well characterized, but not for people with cerebral palsy. Using a combination of biomechanical modeling and experimental studies, researchers have identified the factors that drive the energetics of walking for nondisabled adults. This prior research has provided fundamental insight into walking energetics, enabling the development of exoskeletons and other assistive devices that can reduce energetic costs. Whether these principles extend to individuals with cerebral palsy remains unknown.

In partnership with Mike Schwartz & Andy Ries from Gillette Children’s and Max Donelan from Simon Fraser University, the goal of this research is to perform the basic science experiments to quantify and understand walking energetics in cerebral palsy. Over the next two years we will be performing fundamental biomechanical experiments to interrogate the factors that contribute to elevated walking costs.

Experimental paradigm used to perturb walking while a participant walks on a treadmill and we monitor energetic cost. We've plotted our best guess at results - these are hypothetical results which are experiments will either support or disprove. We hypothesize that individuals with CP have a greater energetic cost to support the body.

Funding

This work is supported by the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development under Grant Number R21HD104112. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Institutes of Health.

News & Publications

Journal Article in PLOS ONE: Causal inference is inherently ambiguous since we cannot observe multiple realizations of the same person ...
Journal Article in Developmental Medicine & Child Neurology: This retrospective analysis demonstrated that energy consumption is not reduced after rhizotomy when ...
Congratulations to Nicole Zaino for being awarded the ESMAC (European Society of Movement Analysis for Adults and Children) Best Paper ...
Congratulations to Nicole Zaino and our colleague Mike Schwartz at Gillette Children's Specialty Healthcare for both being nominated as finalists ...
Scatter plot illustrating that there is not a significant correlation between minimum knee flexion angle during stance and oxygen consumption.
Journal article in Journal of Biomechanics: Does energy consumption during walking increase with crouch severity among children with cerebral palsy? ...
Kat Steele presents at Biomedical Engineering Society and is awarded Outstanding Presentation, Neural Engineering Track: Predicting metabolic costs of pathologic ...