Physiological Cost Index Research Articles

Physiological cost index: comparison between repaired congenital heart disease and healthy children

Children with congenital heart disease (CHD) have compromised physiological function compared to normal with the same age and anthropometric measure. Physiologic cost index (PCI) calculated the energy expenditure and gives an idea about the same during walking. So the present observational study calculates the energy expenditure in repaired congenital heart disease patient and provides the baseline for a goal to achieve during any rehabilitation program by comparing with the normal. To compare the PCI between repaired congenital heart disease patients and healthy children. The study design is observational. Total 40 participants were selected as per the criteria for inclusion and exclusion i.e. 20 healthy children and 20 with repaired congenital heart disease. Duration of the study will be for six months. The six-minute walk was performed according to guidelines, and PCI was calculated using the Macgregor’s formula. In all the variables found of 6MWT, statically significant difference was seen. The mean values for PCI for repaired CHD group was 13.84 and for normal children it was 8.6 using the unpaired T test p value was found to be p=0.0001 which is statically significant. We can conclude that the energy expenditure in children with repaired congenital heart disease is more as compared to the normal children with similar age group. PCI can be used as an effective tool for a physiotherapist in assessment and evaluation of functional performance and provide the baseline for repaired CHD children

Effect of long-distance load marching on physiological responses at desert environment

AIM: The present study was undertaken to examine the effect of long-distance load marching on the physiological responses, walking efficiency, and mobility of soldiers at sandy desert environment. METHODS: A total of nine physically fit soldiers (age, 30.00 [SE 0.9] years; height, 175.56 [SE 1.18] cm; and weight, 77.83 [SE 1.37] kg) volunteered for long-distance (6 km) load marching by self-selected speed when carrying 22 kg (28.27% of body weight [BW]) load and no load (NL). Heart rate (HR), respiratory frequency (RF), and core body temperature (CBT) were recorded. Relative workload (RWL) and Physiological Cost Index (PCI) were calculated to assess the work intensity and mobility. RESULTS: It was observed that HR (P = 0.01), RWL (P = 0.01), and PCI (P = 0.01) were significantly increased by 23.79, 39.71, and 77.73%, respectively, and mobility was significantly reduced (P = 0.01) by 18.56% during marching with 22 kg load as compared to NL. CONCLUSION: It may be that marching without external load at speed of 4.85 ± 0.54 km/h should not be continued for more than 2 h, whereas marching with load of 28.27% of BW at speed of 3.95 ± 0.55 km/h should be restricted to maximum 30 min. This combination of load, speed, and duration provides information about soldiers' routine load carriage tasks, which may help in optimizing the load carriage task to reduce the chances of cumulative carriage-related injuries and, therefore, may contribute to improved soldiers' operational readiness and mobility.

Effect of Pursed Lip Breathing on Physiological Cost Index and Functional Exercise Capacity in Patients with Chronic Obstructive Pulmonary Disease

Background: Pursed lip breathing (PLB) is known to improve oxygenation by controlled ventilation. In COPD, PLB is adopted as a compensatory mechanism to maintain the patency of airways by creating a back pressure in airways. Objective: To find the effectiveness of Pursed lip breathing (PLB) on Physiological cost index (PCI) and functional exercise capacity in patients having COPD. Study design: This experimental study was carried out with one group pre test - post test design. Procedure: Thirty patients aged above 45 years and diagnosed as having mild and moderate COPD (as per GOLD staging) were assessed for their PCI and functional exercise capacity by six- minute walk test after their informed written consent. They were given 30 minutes of PLB training for 5 consecutive days. The post-interventional PCI and functional exercise capacity were reassessed. Results: The pre and post-intervention data of outcome measures was statistically analyzed using paired-t test. The results showed significant improvement in PCI and the functional exercise capacity. Conclusion: Pursed lip breathing was found to be more effective in improving Physiological Cost Index and six-minute walk performance in patients with mild to moderate COPD. Hence, it has been suggested to train pursed lip breathing voluntarily at early stages of COPD before the patient adopts it as compensatory mechanism on advanced stages

Efficacy of Wearable Device Gait Training on Parkinson's Disease: A Randomized Controlled Open-label Pilot Study.

Objective To investigate the efficacy of home-based gait training using the wearable Stride Management Assist (SMA) exoskeleton in people with moderately advanced Parkinson's disease. Methods This was a single-center, open-label, parallel, randomized controlled trial. We included outpatients with idiopathic Parkinson's disease who were capable of walking independently with or without walk aids and had Hoehn and Yahr stage 2-4 in the ON state. Patients were randomly assigned (1:1 ratio) to receive either SMA gait training (SMA group) or control gait training (control group). All participants underwent gait training for approximately 30 min. These training sessions were conducted 10 times for 3 months. We measured clinical outcomes at baseline and post-intervention. The between-group difference of distance in the three-minute walk test was the primary outcome. Results Of the 15 randomly assigned participants, 12 (five in the SMA group) completed this study. The between-group difference was a mean of 13.7 meters (standard error of the mean: 7.8) in the 3-minute walk test (p=0.109). The distance traversed increased from 141.4 m to 154.7 m in the SMA group (p=0.023), whereas there was no marked change in the control group. In addition, although there was a decrease in the physiological cost index from 0.29 to 0.13 in the SMA group (p=0.046), it remained unchanged in the control group. Conclusion These findings suggest that home-based SMA gait training may increase the exercise endurance in people with moderately advanced Parkinson's disease.

Physiological Cost Index of Walking among Non Smokers, Smokers and Smokers with Chronic Obstructive Pulmonary DiseaseAn Observational Study

Introduction: Most of the Chronic Obstructive Pulmonary Disease (COPD) patients are smokers and their disease progresses with increasing age. The energy cost of walking has strong association with aging and cigarette smoking. Its implication in COPD remains unclear. Aim: To evaluate the Physiological Cost Index (PCI) of walking among non smokers, smokers and smokers with COPD and to find its association with age and duration of cigarette smoking. Materials and Methods: The cross-sectional study was carried out in the Department of Physical medicine and Rehabilitation (PMR) at Rajah Muthiah Medical College and Hospital, Annamalai University at Chidambaram, Tamil Nadu, India, from November 2019 to February 2020. The PCI was carried out in 77 males, aged between 50-75 years with body mass index between 18.5-24.9 kg/m2 . There were 24 smokers with COPD, 27 were smokers and 26 were non smokers. The evaluation of six minute walk distance, resting, and post walk heart rate was applied in MacGregor's equation to estimate the PCI. Results: The mean PCI of smokers with COPD was 0.67±0.3 which was significantly (p-value=0.001) higher than those of smokers (0.22±0.07) and non smokers (0.14±0.04). The smokers and non smokers had no significant variation in PCI (p-value=0.122). Age had no association with PCI (p-value=0.213) whereas the duration of smoking years was found to have significant association (p=0.014). Conclusion: The PCI was found to be significantly higher in smokers with COPD and a significant association was established with years of smoking rather than age.

Physiological Cost Index among Individuals with Mild to Moderate Chronic Obstructive Pulmonary Disease and their Compliance with Pulmonary Rehabilitation

Background: Chronic obstructive pulmonary disease is currently one of the top three causes of mortality globally,with poor and middle income nations accounting for 90% of all deaths. The physiological cost index is a techniquefor calculating the energy cost using the measurement of heart rate.Aim: To evaluate Physiological cost index among patients with chronic obstructive pulmonary disease and tocheck their compliance with pulmonary rehabilitation protocol and to rate their exertion using modified Borgscale.Methodology: A total of 30 participants were included in this study. Subjects were asked to walk for 6 mins atcomfortable walking speed and Physiological cost index was calculated by using the walking heart rate. ThePhysiological cost index were studied on two occasions, before and after performing the given exercises, includedupper and lower mobility exercises along with breathing exercises.Results: Data was analyzed using statistical software R software version 4.1.2. P-value less than equal to 0.05 wasstatistically significant.Conclusion: This study found that the Physiological Cost Index of subjects with Chronic Obstructive PulmonaryDisease was seen to decrease after performing the prescribed exercises, suggesting a favorable reduction in energyconsumption and improving their functional performance.

Effect of Walking Speed on Gait Parameters and Energy Expenditure in Individuals with Unilateral Trans-tibial Amputatio

Background and Objectives: Analysis of gait parameters and energy expenditure in different walking speeds in trans-tibial amputees has been less investigated. This may provide an insight into how they respond to it. The main aim of this study was to investigate the effect of walking speed changes on gait parameters and metabolic energy consumption in unilateral trans-tibial amputees using the prosthesis. Methods: Thirty trans-tibial amputees fulfilling inclusion criteria were investigated for gait parameters using a ten-meter walk test while these subjects walked with three different walking speeds (comfortable, fast, and slow). Temporal-spatial gait parameters, such as step length, stride length, velocity and cadence, and Physiological Cost Index (PCI) for metabolic energy consumption were analyzed by repeated-measures ANOVA. Results: Step length of a prosthetic side in the fast walking speed (0.67±0.10 m) was higher than the normal comfortable speed (0.56±0.13 m) and least in slow walking (0.42±0.06 m). A similar trend was observed for all gait parameters. PCI (beats/m) was least in normal comfortable speed (0.08±0.09), followed by fast walking speed (0.11±0.08). It was highest when patients walked at a slow speed (0.18±0.12). There was a significant difference in all temporal-spatial gait parameters and PCI in three walking speed conditions (p<0.05). Conclusion: Walking speed significantly affected all temporal-spatial and energy parameters in unilateral trans-tibial amputees.

Physiological Cost Index of Walking in Stroke Patients and their Functional Ambulation Category

Background: Mobility, defined as the ability to walk safely and independently, is integral to theperformance of basic activities of daily living.An interruption in the normal gait cycle and the energyconserving characteristics of the trunk and limb motion results in an increased energy expenditure.Objective: The objective of the study was to compare the Physiological Cost Index(PCI) of walking instroke survivors with their Functional Ambulation Category(FAC).Design:Cross Sectional StudyMethods: 30 participants meeting the inclusion and exclusion criteria were included in the study. Theparticipants were graded on FAC. Their heart rate(HR) was recorded pre- and post- 6-Minute-Walk-Test(6MWT). The distance walked was measured and recorded. The PCI was calculated and the datawas subjected to statistical analysis.Results: The mean PCI of all the participants was 0.72(±0.68). A moderate negative correlation existedbetween the PCI and FAC. The category of FAC increased as the patients PCI of walking decreased.Conclusion: Increased PCI values could imply lower functional mobility scores on FAC. Therapeuticinterventions that alter PCI values and interventions that effectively reduce energy consumption couldbe identified for better rehabilitation outcomes.

A Study to Compare Physiological Cost Index (PCI) of Walking on Treadmill with and without Holding the Hand Rails

Treadmill walking is commonly used for fitness testing and training. Purpose of present study was to determine whether holding the front hand rails makes any significant change in energy expenditure during treadmill walking or not. Thirty volunteers (17 male and 13 female) participated in the study. Subjects were asked to walk on treadmill at speed of 1.0 to 6.0 mph with and without holding the front hand rails for 6 minutes. Physiological cost index was measured for two different positions and compared for statistically significant difference. Results showed that there was no significant difference (p > 0.05) in Physiological cost index measured for two different positions. Hence, present study concludes that, holding the front hand rails does not make any significant difference in energy expenditure while walking on treadmill. Keywords: Treadmill walking, Physiological cost index, Hand rail.

Effect of 12-week Rebound Training Exercise on energy consumption and body mass index of Patients with Spinal Cord Injury

Background: Energy consumption and body mass index are two of the most important complications associated with Spinal Cord Injury (SCI) that can be improved by exercise rehabilitation. The aim of this study was to evaluate the efficiency of using rebound therapy (exercise on a trampoline) on energy consumption and body mass index of SCI individuals'. Methods: Sixteen SCI people (ASIA classification: A=6, B=6, C=2, D=2) were selected and randomly divided in two group (an experimental (rebound exercise) group or a control group). The experimental (rebound exercise) group were done exercise program by means of a modified trampoline for 12 weeks (10-30 minutes three sessions a week). Energy consumption (by the physiological cost index (PCI)) and body mass index (by standard formula) were assessed before and after the exercise intervention. Data were analyzed by RM-ANOVA in SPSS software. Results: The mean values of energy consumption were 0.5±0.02 and 0.31±0.01 before and after the exercise, respectively, in the rebound group. Furthermore, these values were 0.38±0.05 and 0.39±0.03 before and after the 12 week, respectively. The results of RM-ANOVA were shown significant interaction in this criteria (P<0.05). The body mass was the other parameter measured in this study. It was 24.6±2.06 kg/m2 before and 23.8±2.09 kg/m2 after exercise in the rebound group. The body mass value in the control group changed from 23.3±2.2 kg/m2 to 23.7±2.3 kg/m2. Table 2 also demonstrates that interactions were significant in this parameter. It means that the control group had no progress, while the experimental group made a significant improvement. Discussion: The results of this study confirmed that rebound therapy could improve the BMI and energy consumption of SCI patients. It suggests that rebound exercise is a useful complementary method for SCI. Due to some limitations associated with this study, it is recommended that the same study be repeated with a big number of subjects and also with separated groups of SCI individuals with complete and incomplete paralysis. Conflict of interest: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.

Motor performance after treatment of pilocytic astrocytoma in the posterior fossa in childhood.

BackgroundPilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and treated mainly with surgery. These tumours have low mortality, but knowledge concerning its long‐term outcome is sparse.AimsThe aim was to investigate if patients treated for pilocytic astrocytoma in the posterior fossa had motor complications, including balance, motor and process skills.Methods and ResultsThis descriptive single‐centre study includes eight children and 12 adults, treated for pilocytic astrocytoma as children. Motor performance was investigated with Bruininks–Oseretsky Test of Motor Proficiency, Second Edition, and dynamic balance with the mini‐balance evaluation systems test. Physiological cost index, six‐minute walk test, hand grip strength and assessment of motor and process skills were also evaluated. Ten patients reported motor difficulties, mainly from the upper limbs. The motor performance test showed results within normal limits except for manual dexterity, which was significantly below mean (p = .008). In the dynamic balance test patients had significantly lower results compared with controls (p = .036). Physiological cost index, six‐minute walk tests and hand grip strength showed results within normal limits. In the Assessment of Motor and Process Skills, patients over 16 years had significantly lower results compared with test norms for motor activities of daily living (ADL) and 30% of all patients scored below the cut‐off level for difficulties with motor skills.ConclusionsMotor performance for patients treated for pilocytic astrocytoma in the posterior fossa in childhood is satisfactory but some patients display difficulties with balance, manual dexterity and ADL motor skills. Thus, it is important to identify those in need of motor follow‐up and training.

Effectiveness of robotic exoskeletons for improving gait in children with cerebral palsy: A systematic review

The Hybrid Assistive Limb® (HAL®, CYBERDYNE) is a wearable robot that provides assistance to a patient while they are walking, standing, and performing leg movements based on the wearer’s intended movement. The effect of robot-assisted training using HAL® for cerebral palsy (CP) is unknown. Therefore, we assessed the effect of robot-assisted training using HAL® on patients with CP, and compared walking and gross motor abilities between pre-intervention and post-intervention.Six subjects with CP were included (mean age: 16.8 years; range: 13–24 years; Gross Motor Function Classification System levels II–IV: n = 1, 4, 1). Robot-assisted training using HAL® were performed 2–4 sessions per week, 20 min per session, within a 4 weeks period, 12 times in total. Outcome measures included gait speed, step length, cadence, single-leg support per gait cycle, hip and knee joint angle in stance, and swing phase per gait cycle, 6-minute walking distance (6 MD), physiological cost index (PCI), knee-extension strength, and Gross Motor Function Measure (GMFM).There were significant increases in self-selected walking speed (SWS), cadence during SWS and maximum walking speed (MWS), single-leg support per gait cycle, hip joint angle in the swing phase, 6 MD, and GMFM. In contrast, gait speed during MWS, step length during SWS and MWS, hip and knee joint angle in the stance phase, knee joint angle in the swing phase, PCI, and knee-extension strength generally improved, but not significantly.Robot-assisted training using HAL® may improve walking and gross motor abilities of patients with CP.

Structured pain-free exercise progressively improves ankle-brachial index and walking ability in patients with claudication and compressible arteries: an observational study

In patients with peripheral artery disease (PAD), supervised exercise at near-moderate pain improves walking ability but not ankle-brachial index (ABI) values. In a retrospective observational study, we determined vascular and functional effects of a 6-month structured pain-free exercise program in patients with claudication and compressible vessels. Four-hundred and fifty-nine consecutive patients were studied. Segmental limb pressures were measured and ABI calculated during circa-monthly hospital visits. The 6-min (6MWD) and the pain-free walking distance (PFWD) during the 6-min walking test were determined. Two daily 8-min sessions of slow–moderate in-home walking at increasing metronome-paced speed were prescribed. After excluding patients with unmeasurable ABI or incompletion of the program, 239 patients were studied. Safe and satisfactory (88%) execution of the prescribed training sessions was reported. During the visits, bilateral ABI improved (+ 0.07; p < 0.001) as well as the segmental pressures in the more impaired limb, with changes already significant after 5 weeks of slow walking. Both systolic and diastolic blood pressure decreased overtime (F = 46.52; p < 0.001; F = 5.52; p < 0.001, respectively). 6MWD and PFWD improved (41[0‒73]m p < 0.001 and 107[42‒190]m p < 0.001, respectively) with associated decrease of walking heart rate (F = 15.91; p < 0.001) and Physiological Cost Index (F = 235.93; p < 0.001). The variations of most parameters at different visits correlated to the training load calculated. In a regression model, the PFWD variations directly correlated with rate sessions completed, training load and ABI change and inversely with the baseline value (R2 = 0.27; p < 0.001). In the PAD population studied, moderate pain-free exercise improved ABI with associated progressive functional and cardiovascular changes occurring regardless of subjects characteristics.

Impact of prostheses on quality of life and functional status of transfemoral amputees in Tanzania.

BackgroundThe rise of diabetes and traumatic injury has increased limb loss-related morbidity in low- and middle-income countries (LMICs). Despite this, the majority of amputees in LMICs have no access to prosthetic devices, and the magnitude of prosthesis impact on quality of life (QOL ) and function has not been quantified.ObjectivesQuantify the impact of prostheses on QOL and function in Tanzanian transfemoral amputees.MethodA prospective cohort study was conducted. Transfemoral amputees at Muhimbili Orthopaedic Institute were assessed twice before and three times after prosthetic fitting using EuroQol-5D-3L (EQ-5D-3L), Prosthetic Limb Users Survey of Mobility (PLUS-M), 2-minute walk test (2MWT) and Physiologic Cost Index (PCI). Data were analysed for change over time. Subgroup analysis was performed for amputation aetiology (vascular or non-vascular) and prosthesis use.ResultsAmongst 30 patients, EQ-5D, PLUS-M and 2MWT improved after prosthesis provision (p < 0.001). EuroQol-5D increased from 0.48 to 0.85 at 1 year (p < 0.001). EuroQol-5D and 2MWT were higher in non-vascular subgroup (p < 0.030). At 1-year, 84% of non-vascular and 44% of vascular subgroups reported using their prosthesis (p = 0.068).ConclusionProsthesis provision to transfemoral amputees in an LMIC improved QOL and function. This benefit was greater for non-vascular amputation aetiologies. Quality of life and function returned to pre-prosthesis levels with discontinued use of prosthesis.

Exploring relationships between inspiratory muscle strength and functional capacity in childhood cancer survivors: a pilot study

Childhood cancer survivors (CCS) experience short- and long-term side effects from cancer treatment that often impair functional capacity. Inspiratory muscle weakness is a potential mechanism for reduced functional capacity. The objective of this pilot study was to examine the relationship between inspiratory muscle strength and functional capacity in 10 CCS. Inspiratory muscle strength was measured by maximal inspiratory pressure (MIP) while functional capacity was measured by the two-minute walk test (2MWT), the physiological cost index and hemodynamic response to exercise according to changes in heart rate, blood pressure and rate-pressure product (RPP). Overall, MIP and 2MWT distance were below predicted values. Hemodynamic responses to the 2MWT were consistent with little variation, except for elevated diastolic blood pressure (DBP) response. MIP had significant relationships with resting DBP (Spearman’s rank correlation coefficient [rs ] = −0.70; p = 0.03) and DBP response (rs = 0.72; p = 0.02). Time since completion of cancer treatment had a significant positive relationship with RPP response (rs = 0.67; p = 0.03). Inspiratory muscle weakness in childhood cancer could be an indicator of skeletal muscle dysfunction and should be considered when symptoms of dyspnea or poor functional capacity arise. Inspiratory muscle strength was found to be related to changes in blood pressure in CCS. Future studies should further investigate these relationships and the impact of inspiratory muscle training on hemodynamics and functional capacity in CCS.

A STUDY PROTOCOL “PHYSIOLOGICAL COST INDEX: COMPARISON BETWEEN REPAIRED CONGENITAL HEART DISEASE AND HEALTHY CHILDREN

Congenital Heart Disease is a condition present since birth having malformed heart structure and function. The malfunction of the heart hemodynamics requires palliative, supportive and corrective surgery. Children with congenital heart disease have compromised physiological function compared to normal with the same age and anthropometric measures. The energy consumption for a given submaximal work would be more in CHD patients compared to normal. The physiologic cost index calculated the energy expenditure and gives an idea about the same during walking. PCI can be used as an outcome measure to plan and tailor a rehabilitation exercise program. So the present observational study calculates the energy expenditure in repaired congenital heart disease patient and provides the baseline for a goal to achieve during any rehabilitation program by comparing with the normal. To compare the physiological cost index (PCI) between repaired congenital heart disease patients and healthy children. The study design is observational. Total 40 participants will be selected as per the criteria for inclusion and exclusion i.e. 20 healthy children and 20 with repaired congenital heart disease. The duration of the study will be for six months.The six-minute walk will be performed according to guidelines, and PCI will be calculated using MacGregor’s formula. From the data will be calculated using PCI formula while performing 6MWT. PCI can be used as an effective tool for a physiotherapist in the assessment and evaluation of functional performance and provide the baseline for repaired CHD children. Many studies have evaluated functional performance in patients with coronary artery disease and there is the a paucity of studies in repaired congenital heart disease, so the present study aims at evaluation and comparison of PCI in repaired CHD and healthy children.

Spring-Loaded Dynamic Foot: An Act of Product Development in Economically Developing Country

ABSTRACT Introduction There is a need for a new prosthetic foot in economically developing countries that is technically simple yet functionally more equivalent to the dynamic response foot. Objectives The aim of this study is to develop and clinically evaluate a new prosthetic foot with a simple technical design that is as energy efficient as a dynamic response foot. Study Design This study is a crossover repeated measures study design comparing the new prosthetic foot to the participant's conventional high-end or low-end prosthetic foot. Methods Twenty-meter and 2-minute walk tests were performed to measure gait speed, and energy expenditure was estimated using the physiological cost index (PCI) for both the conventional prosthetic foot and the new spring-loaded dynamic (SLD) foot. Results The gait speed with the SLD foot was on average 0.27 m/s faster than conventional low-end foot (P &lt; 0.0001), but −0.18 m/s slower than conventional high-end prosthetic foot (P &lt; 0.0001). The PCI was similar across all three prosthetic feet technologies (P = 0.276). Conclusions The mobility function of the SLD foot was nearer to the dynamic response foot as compared with the low-end prosthetic foot. Given its technical simplicity and cost-effectiveness, the SLD foot may be considered as a true alternative to the existing dynamic response foot in economically developing countries. This article describes a new design of prosthetic foot that is simple in design, cost-effective, and made from readily available local material, yet shows clinical features that are nearer to the dynamic response foot. With further immaculate clinical and mechanical testing, it can be integrated to prosthetic users in developing countries.

Comparison of the Efficacy of Two Different Medial Linkage Mechanisms in Knee-Ankle-Foot Orthoses on Walking Ability in Subjects with Spinal Cord Injury

ABSTRACT Introduction This study evaluated the efficacy of two different medial linkage mechanisms (sliding mechanism [SM] and medial linkage mechanism associated with reciprocating gait motion (MLRGM), used within otherwise identical knee-ankle-foot orthoses (KAFOs) on patients with spinal cord injury (SCI). Methods Three volunteer subjects with SCI were fitted with a KAFO equipped with 1) an SM and 2) a medial linkage mechanism (MLRGM). Subjects walked at their self-selected speed along a flat walkway to enable a comparison of walking speed, endurance, and the resulting physiological cost index to be performed. Results The use of a KAFO fitted with the MLRGM resulted in improvements in walking speed, distance walked, and energy costs when compared with the more standard SM. However, the time required to don the KAFO increased with use of the MLRGM, but doffing time was approximately equal for both types. Conclusions This study demonstrated that the use of a KAFO with an MLRGM could provide significant benefits for patients with SCI when compared with a KAFO with a standard SM.

Body composition in children with cerebral palsy and its relationship with dynamic muscle strength, balance and energy cost of ambulation

Cerebral palsy (CP) causes walking disability in children which could lead to profound changes in body composition. This study assessed relationship between body composition and each of dynamic muscle strength, mobility and energy cost of ambulation (ECA) among children with CP. The cross sectional survey, recruited participants from a secondary and a tertiary hospitals in Kano. Body composition was assessed with BMI for age charts and skin fold calipher. Dynamic muscle strength, balance and ECA were assessed with step-up test, time-up-and-go test and physiological cost index respectively. Data was analysed with Pearson Product Moment Correlation and unpaired t test at alpha level of P&lt;0.05 using SPSS version 20 and Microsof excel. Twenty four children took part in the study, 13 (54.2%) females and 11(45.8%) males. Their mean age was 10.0 ± 4.6 years. Majority of them 17 (70.8%) were underweight. The mean percent body fat score was 11.78±3.85, with females having significantly higher amount of body fat than males (t=-3.37; P=0.003). There were no significant correlations between body compositon and each of dynamic muscle strength, balance and ECA (p&gt;0.05). It was concluded that about two-thirds of the children with CP in the study are underweight and having low percent body fat. Body composition may not have significant influence on the muscle strength, stability and the energy expended during walking function. Paediatricians and physiotherapists should encourage caregivers of children with CP to feed them with balanced diet in order to avoid diseases associated with malnutrition.

Effect of Abdominal Binder on Physiological Cost Index in Chronic Obstructive Pulmonary Disease.

Effect of Abdominal Binder on Physiological Cost Index in Chronic Obstructive Pulmonary Disease.