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Anthropometric measurements of ambulant cerebral palsy subjects
Published posters / Gait & Posture 24S (2006) S98–S289
dren there were still a significant difference between boys and girls after normalization to body weight. After net nondimensional normalization metabolic parameters showed no longer significant differences between boys and girls.
6. Discussion Our results show differences between men and women for O2 rate in rest and during walking. In adults, normalization to body weight and normalization to dimensionless parameters eliminated the differences between genders. In children metabolic parameters were different for both sexes before net non-dimensional normalization although no significant differences in anthropometric data were found. The differences in children are probably due to differences in timing of maturation. We can conclude that in young adults it is not necessary to compare patients with their own gender. For clinical interpretation in children it is wise to compare with their own gender or use net non-dimensional normalization. Further investigation about the age at which differences between men and women disappear is necessary.
S285
2. Introduction Anthropometric studies of normal subjects have been conducted by many disciplines (i.e., medicine, biomechanics, ergonomics, sociology, etc.). These measurements are describing characteristics that can be related to various factors. It is always interesting to study common features and differences among various populations. The CP subjects constitute a special population with abnormalities in growth, resulting in various skeletal deformities. The aim of the study was to examine the anthropometric features of ambulant CP subjects in order to document deviations from the normal population.
3. Statement of clinical significance Documentation of deviations of body segment proportions of ambulant CP subjects can reveal the effect of cerebral palsy on body segments growth. Secondarily, it can also be documented weather these deviations are segment specific.
4. Methods References [1] Waters. Gait Posture 1999;9:207–31. [2] Waters. J Orthopaed Res 1988;6(2):215–22. [3] Schwarz, et al. Gait and clinical movement analysis society meeting. Lexington, USA; 2004.
doi:10.1016/j.gaitpost.2006.11.194 PP-128 Anthropometric measurements of ambulant cerebral palsy subjects Nikolaos Darras a,∗ , Dimitris a Tziomaki , Christos Nestoridis a
Pasparakis b , Magdalini
a
ELEPAP Gait Analysis Center, Athens, Greece 2nd Orthopaedic Department “Aglaia Kyriakou”, Children Hospital, Athens, Greece
A cross-sectional study was contacted using the data collected from CP subjects that were able to perform Gait Analysis. Height and weight measurements were combined with detailed 3D photogrammetric measurements of all body segments. The following segments were analysed: Head, Trunk, Arm, Forearm, Thigh and Shank. Two different normalization methods have been applied: (a) normalisation to body height and (b) normalisation to trunk length. Since CP subjects develop contractures that influence the subjects standing height, normalisation to the subject’s trunk length was conducted. Thirty-nine normal subjects, 83 Diplegics and 31 Quadriplegics were included in the study. Physical growth percentile analysis of height and weight was conducted for the CP subjects that were between 5 and 18 years of age, using the standard NCHS norms. Descriptive statistics and ANOVAs were used to test for differences among groups.
b
5. Results 1. Summary/conclusions Mean ambulant CP subject’s height was found to be decreased 17% compared to NCHS norms. Their weight was found to be 12% increased compared to the expected for their age and height values. Head and Trunk ratio to height was found to be significantly increased in CP subjects compared to normal subjects while Thigh and Shank ratios were found to be decreased. Non-significant differences were found between normal and CP subjects for Arm and Forearm ratios to height.
See Tables 1 and 2. ANOVA analysis showed the following significant differences CP Head CP Trunk CP Thigh CP Shank
Ratio to Height > normal Ratio to Height > normal Ratio to Height < normal Ratio to Height < normal
*** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001)
S286
Published posters / Gait & Posture 24S (2006) S98–S289
Table 1 Mean ± S.D. subject’s characteristics Normal Diplegics Quadriplegics CP = D+Q
n
Male
Female
39 83 30 113
33 41 16 57
6 42 14 56
Table 2 Mean ± S.D. CP subject’s physical growth percentiles (age 18) Diplegics Quadriplegics CP = D + Q
n
Height
Weight
60 21 81
36.4 ± 26.6 19.4 ± 23 32.7 ± 26.7
46.9 ± 33.6 38.7 ± 28.9 44.8 ± 32.5
Height (m)
26.7 ± 7.6 14.9 ± 7.2 14.6 + 6.9 14.8 + 7.1
1.75 1.47 1.43 1.45
± ± ± ±
0.11 0.18 0.19 0.19
Weight (kg) 73.6 44.1 42.9 42.3
± ± ± ±
13.1 17.4 14.7 18.1
PP-129 The impact of different normalization schemes on oxygen cost and oxygen consumption data in able-bodied children Sandra W. Dennis a,∗ , Susan Sienko Thomas b , K. Patrick Do a , Michael D. Aiona b , Tishya A.L. Wren a
and CP Head CP Trunk CP Forearm CP Thigh CP Shank
Age
Ratio to Trunk > normal Ratio to Trunk > normal Ratio to Trunk > normal Ratio to Trunk < normal Ratio to Trunk < normal
*** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001)
Non-significant differences were found between Diplegic and Quadriplegic subjects in any of the segment ratios to Height or Trunk.
6. Discussion From the physical growth percentile analysis it was documented that mean ambulant CP subjects height is shorter 17% than standard NCHS norms. Also their weight is 12% increased compared to the expected for their age and height. Strong significant differences were found between Normal and CP subject’s segment. It was documented that Head and Trunk ratios are increased in CP subjects while Thigh and Shank ratios are decreased. These results indicated that cerebral palsy has a negative effect on growth of the lower limp segments. Head, Trunk showed increased growth while upper limp segments did not show to be affected.
Further reading [1] Henderson RC, Gilbert SR, Clement ME, Abbas A, Worley G, Stevenson RD. Altered skeletal maturation in moderate to severe cerebral palsy. Dev Med Child Neurol 2005;47(April (4)):220. [2] Malina RM, Bouchard C. Growth maturation and physical activity. Hum Kinet 1991. [3] Trotter M, Gleser GC. Estimation of stature from long bones of American Whites and Negroes. Am J Phys Anthropol 1952;10:463–514.
doi:10.1016/j.gaitpost.2006.11.195
a b
Childrens Hospital Los Angeles, Los Angeles, CA, USA Shriners Hospitals for Children, Portland, OR, USA
1. Summary/conclusions In this study, mass and net non-dimensional (NN) normalization schemes demonstrated a similar dependence on subject mass, suggesting that NN normalization might not adjust for growth as previously believed. Comparison with mass or age-adjusted norms may be a more meaningful way to interpret oxygen (O2 ) cost and consumption data in children with gait pathology.
2. Introduction O2 cost and O2 consumption are used to evaluate the efficiency of walking and to assess changes in efficiency over time [1,2]. There are differing conclusions in the literature regarding the most meaningful parameters to use to evaluate this efficiency [3–7]. The purpose of this study was to evaluate the response of O2 data collected on able-bodied children to the mass and NN normalization schemes.
3. Statement of clinical significance Further investigation regarding the most meaningful measurements of the efficiency of walking will improve the interpretation of this data and help to make pre and post operative comparisons more meaningful.
4. Methods Energy consumption data from 53 able-bodied children from two different sites were used in this study. The test protocol consisted of 5–10 min resting quietly in a chair followed by a 5–10 min walk at a self-selected speed. The children
dren there were still a significant difference between boys and girls after normalization to body weight. After net nondimensional normalization metabolic parameters showed no longer significant differences between boys and girls.
6. Discussion Our results show differences between men and women for O2 rate in rest and during walking. In adults, normalization to body weight and normalization to dimensionless parameters eliminated the differences between genders. In children metabolic parameters were different for both sexes before net non-dimensional normalization although no significant differences in anthropometric data were found. The differences in children are probably due to differences in timing of maturation. We can conclude that in young adults it is not necessary to compare patients with their own gender. For clinical interpretation in children it is wise to compare with their own gender or use net non-dimensional normalization. Further investigation about the age at which differences between men and women disappear is necessary.
S285
2. Introduction Anthropometric studies of normal subjects have been conducted by many disciplines (i.e., medicine, biomechanics, ergonomics, sociology, etc.). These measurements are describing characteristics that can be related to various factors. It is always interesting to study common features and differences among various populations. The CP subjects constitute a special population with abnormalities in growth, resulting in various skeletal deformities. The aim of the study was to examine the anthropometric features of ambulant CP subjects in order to document deviations from the normal population.
3. Statement of clinical significance Documentation of deviations of body segment proportions of ambulant CP subjects can reveal the effect of cerebral palsy on body segments growth. Secondarily, it can also be documented weather these deviations are segment specific.
4. Methods References [1] Waters. Gait Posture 1999;9:207–31. [2] Waters. J Orthopaed Res 1988;6(2):215–22. [3] Schwarz, et al. Gait and clinical movement analysis society meeting. Lexington, USA; 2004.
doi:10.1016/j.gaitpost.2006.11.194 PP-128 Anthropometric measurements of ambulant cerebral palsy subjects Nikolaos Darras a,∗ , Dimitris a Tziomaki , Christos Nestoridis a
Pasparakis b , Magdalini
a
ELEPAP Gait Analysis Center, Athens, Greece 2nd Orthopaedic Department “Aglaia Kyriakou”, Children Hospital, Athens, Greece
A cross-sectional study was contacted using the data collected from CP subjects that were able to perform Gait Analysis. Height and weight measurements were combined with detailed 3D photogrammetric measurements of all body segments. The following segments were analysed: Head, Trunk, Arm, Forearm, Thigh and Shank. Two different normalization methods have been applied: (a) normalisation to body height and (b) normalisation to trunk length. Since CP subjects develop contractures that influence the subjects standing height, normalisation to the subject’s trunk length was conducted. Thirty-nine normal subjects, 83 Diplegics and 31 Quadriplegics were included in the study. Physical growth percentile analysis of height and weight was conducted for the CP subjects that were between 5 and 18 years of age, using the standard NCHS norms. Descriptive statistics and ANOVAs were used to test for differences among groups.
b
5. Results 1. Summary/conclusions Mean ambulant CP subject’s height was found to be decreased 17% compared to NCHS norms. Their weight was found to be 12% increased compared to the expected for their age and height values. Head and Trunk ratio to height was found to be significantly increased in CP subjects compared to normal subjects while Thigh and Shank ratios were found to be decreased. Non-significant differences were found between normal and CP subjects for Arm and Forearm ratios to height.
See Tables 1 and 2. ANOVA analysis showed the following significant differences CP Head CP Trunk CP Thigh CP Shank
Ratio to Height > normal Ratio to Height > normal Ratio to Height < normal Ratio to Height < normal
*** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001)
S286
Published posters / Gait & Posture 24S (2006) S98–S289
Table 1 Mean ± S.D. subject’s characteristics Normal Diplegics Quadriplegics CP = D+Q
n
Male
Female
39 83 30 113
33 41 16 57
6 42 14 56
Table 2 Mean ± S.D. CP subject’s physical growth percentiles (age 18) Diplegics Quadriplegics CP = D + Q
n
Height
Weight
60 21 81
36.4 ± 26.6 19.4 ± 23 32.7 ± 26.7
46.9 ± 33.6 38.7 ± 28.9 44.8 ± 32.5
Height (m)
26.7 ± 7.6 14.9 ± 7.2 14.6 + 6.9 14.8 + 7.1
1.75 1.47 1.43 1.45
± ± ± ±
0.11 0.18 0.19 0.19
Weight (kg) 73.6 44.1 42.9 42.3
± ± ± ±
13.1 17.4 14.7 18.1
PP-129 The impact of different normalization schemes on oxygen cost and oxygen consumption data in able-bodied children Sandra W. Dennis a,∗ , Susan Sienko Thomas b , K. Patrick Do a , Michael D. Aiona b , Tishya A.L. Wren a
and CP Head CP Trunk CP Forearm CP Thigh CP Shank
Age
Ratio to Trunk > normal Ratio to Trunk > normal Ratio to Trunk > normal Ratio to Trunk < normal Ratio to Trunk < normal
*** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001) *** (P 0.001)
Non-significant differences were found between Diplegic and Quadriplegic subjects in any of the segment ratios to Height or Trunk.
6. Discussion From the physical growth percentile analysis it was documented that mean ambulant CP subjects height is shorter 17% than standard NCHS norms. Also their weight is 12% increased compared to the expected for their age and height. Strong significant differences were found between Normal and CP subject’s segment. It was documented that Head and Trunk ratios are increased in CP subjects while Thigh and Shank ratios are decreased. These results indicated that cerebral palsy has a negative effect on growth of the lower limp segments. Head, Trunk showed increased growth while upper limp segments did not show to be affected.
Further reading [1] Henderson RC, Gilbert SR, Clement ME, Abbas A, Worley G, Stevenson RD. Altered skeletal maturation in moderate to severe cerebral palsy. Dev Med Child Neurol 2005;47(April (4)):220. [2] Malina RM, Bouchard C. Growth maturation and physical activity. Hum Kinet 1991. [3] Trotter M, Gleser GC. Estimation of stature from long bones of American Whites and Negroes. Am J Phys Anthropol 1952;10:463–514.
doi:10.1016/j.gaitpost.2006.11.195
a b
Childrens Hospital Los Angeles, Los Angeles, CA, USA Shriners Hospitals for Children, Portland, OR, USA
1. Summary/conclusions In this study, mass and net non-dimensional (NN) normalization schemes demonstrated a similar dependence on subject mass, suggesting that NN normalization might not adjust for growth as previously believed. Comparison with mass or age-adjusted norms may be a more meaningful way to interpret oxygen (O2 ) cost and consumption data in children with gait pathology.
2. Introduction O2 cost and O2 consumption are used to evaluate the efficiency of walking and to assess changes in efficiency over time [1,2]. There are differing conclusions in the literature regarding the most meaningful parameters to use to evaluate this efficiency [3–7]. The purpose of this study was to evaluate the response of O2 data collected on able-bodied children to the mass and NN normalization schemes.
3. Statement of clinical significance Further investigation regarding the most meaningful measurements of the efficiency of walking will improve the interpretation of this data and help to make pre and post operative comparisons more meaningful.
4. Methods Energy consumption data from 53 able-bodied children from two different sites were used in this study. The test protocol consisted of 5–10 min resting quietly in a chair followed by a 5–10 min walk at a self-selected speed. The children