Quantifying Energetic Demands of Walking for People With Cerebral Palsy
The purpose of this study is to examine the underlying mechanisms that contribute to high energy costs for people with cerebral palsy (CP) as they walk.
The investigators will characterize the cost landscape of children with CP, quantifying the magnitude of cost (net nondimensional oxygen consumption) associated with walking and common sub-tasks of walking, such as supporting and stabilizing the body.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Children with CP use large amounts of energy to walk and move, leading to fatigue and limiting participation. For people with CP the energetic cost of walking is on average over two times higher than typically-developing (TD) peers. This means that for people with CP, walking is as tiring as jogging or climbing stairs. An energetic cost of this magnitude restricts activities of daily living (ADL) and causes exhaustion.
While the investigators and many others have sought to reduce these energetic costs through surgical interventions, rehabilitation, orthotics, or other assistive devices, these strategies have failed to result in meaningful reductions in energy. To design strategies that successfully reduce walking costs, the investigators must first understand the underlying mechanisms contributing to elevated cost in people with CP. This basic-science research will provide the foundation to create evidence-based strategies to decrease energy costs, minimize fatigue, and increase quality of life for people with CP and other neurologic injuries.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Michael Schwartz, PhD
- Phone Number: 651-229-1745
- Email: mschwartz@gillettechildrens.com
Study Contact Backup
- Name: Marissa Thill, MS
- Phone Number: 651-229-1748
- Email: marissajthill@gillettechildrens.com
Study Locations
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Minnesota
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Saint Paul, Minnesota, United States, 55101
- Gillette Children's Specialty Healthcare
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria for Cases:
- 8-17 years old
- Diagnosed with bilateral cerebral palsy
- Gross Motor Function Classification System II
- No surgery within the last 9 months
- No current baclofen pump or explantation in the last 2 months
- No botulinum toxin or phenol injections in the last 2 months
- Had a prior gait and motion analysis at Gillette Children's Specialty Healthcare
- Participant and caregiver able to speak and read English
- Ability to follow instructions
Inclusion Criteria for Controls:
- 8-17 years old
- Participant and caregiver able to speak and read English
- Ability to follow instructions
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Children with Cerebral Palsy (Cases)
Children meeting inclusion/exclusion criteria with a diagnosis of cerebral palsy.
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Participants will complete a standard gait and motion analysis at varying levels of harness support and stabilization (low, moderate, and high levels).
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Other: Typically Developing Children (Controls)
Children meeting inclusion/exclusion criteria without a diagnosis of cerebral palsy or other condition.
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Participants will complete a standard gait and motion analysis at varying levels of harness support and stabilization (low, moderate, and high levels).
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Net Nondimensional Oxygen Cost
Time Frame: Baseline walking trial with harness on (5-minutes) and support walking trials with vertical or lateral support in harness system (5-minutes)
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Steady-state net nondimensional oxygen consumption while walking on a treadmill.
Percent change in oxygen consumption was evaluated between baseline without support and with vertical and lateral support.
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Baseline walking trial with harness on (5-minutes) and support walking trials with vertical or lateral support in harness system (5-minutes)
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Three-dimensional Gait Kinematics (Baseline)
Time Frame: Initial trial without support (5-minutes)
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Five features describing kinematics during gait in the harness system without vertical or lateral support collected from marker-based motion capture.
Since the harness system differed between vertical and lateral support, baseline kinematics are reported separately for each system in the rows below.
The features include (1) median pelvic tilt during the stance phase, (2) peak hip extension, (3) peak knee extension, (4) peak ankle plantarflexion, and (5) the foot progression angle relative to fore-aft direction.
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Initial trial without support (5-minutes)
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Three-dimensional Gait Kinematics (Support)
Time Frame: Trial with maximum support (5-minutes)
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Five features describing kinematics during gait in the harness system with vertical and lateral support.
The features include (1) median pelvic tilt during the stance phase, (2) peak hip extension, (3) peak knee extension, (4) peak ankle plantarflexion, and (5) the foot progression angle relative to fore-aft direction.
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Trial with maximum support (5-minutes)
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Three-dimensional Gait Kinetics (Baseline)
Time Frame: Initial trial without support (5-minutes)
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Three features describing kinetics during gait in the harness system without vertical or lateral support collected from marker-based motion capture and instrumented treadmill for ground reaction forces.
Since the harness system differed between vertical and lateral support, baseline kinematics are reported separately for each system in the rows below.
The features include (1) peak hip extensor moment, (2) peak knee extensor moment, and (3) peak ankle plantarflexor moment.
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Initial trial without support (5-minutes)
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Three-dimensional Gait Kinetics (Support)
Time Frame: Trial with maximum support (5-minutes)
|
Three features describing kinetics during gait in the harness system with vertical and lateral support. .
Since the harness system differed between vertical and lateral support, baseline kinematics are reported separately for each system in the rows below.
The features include (1) peak hip extensor moment, (2) peak knee extensor moment, and (3) peak ankle plantarflexor moment.
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Trial with maximum support (5-minutes)
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Passive Joint Range of Motion
Time Frame: One-time research visit (15 minutes)
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Compare passive joint range of motion (degrees) measured by lower extremity physical exam
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One-time research visit (15 minutes)
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Selective Motor Control
Time Frame: One-time research visit (15 minutes)
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Selective motor control (0 patterned movement - 2 complete isolated movement)
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One-time research visit (15 minutes)
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Lower Extremity Strength
Time Frame: One-time research visit (15 minutes)
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Lower extremity strength measures by the manual muscle test (0 no muscle contraction - 5 typical muscle function)
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One-time research visit (15 minutes)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Michael Schwartz, PhD, Gillette Children's Specialty Healthcare
- Principal Investigator: Katherine Steele, PhD, University of Washington
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- STUDY00014591
- R21HD104112 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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