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Longitudinal assessment of oxygen cost and velocity in children with myelomeningocele: comparison of the hip-knee-ankle-foot orthosis and the reciprocating gait orthosis.

Abstract
Oxygen consumption and cost and velocity were evaluated over time in 23 children with myelomeningocele to determine whether differences exist when children walk with hip-knee-ankle-foot orthoses (HKAFOs) versus reciprocating gait orthoses (RGOs). Children using HKAFOs had similar oxygen cost as children using RGOs while achieving a faster velocity. Children walking with HKAFOs into adolescence had a faster velocity and lower oxygen cost than children who discontinued use of their HKAFOs. No significant differences in velocity or oxygen cost were found between children who continued to walk with RGOs and those who discontinued use of their RGOs. Upright ambulation may progress from ambulation with an RGO, when the child's upper extremity strength to mass ratio is low, to an HKAFO when upper extremity strength improves and velocity or keeping up with peers is of concern. Wheelchair mobility should be offered when speed and an energy-efficient method of community mobility are desired.
AuthorsS S Thomas, C E Buckon, J Melchionni, M Magnusson, M D Aiona
JournalJournal of pediatric orthopedics (J Pediatr Orthop) 2001 Nov-Dec Vol. 21 Issue 6 Pg. 798-803 ISSN: 0271-6798 [Print] United States
PMID11675558 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adolescent
  • Analysis of Variance
  • Biomechanical Phenomena
  • Child
  • Child, Preschool
  • Energy Metabolism
  • Female
  • Gait (physiology)
  • Humans
  • Longitudinal Studies
  • Male
  • Meningomyelocele (metabolism, physiopathology)
  • Orthotic Devices (standards)
  • Oxygen Consumption (physiology)

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