Ongoing
Fatigue is one of the most prevalent problems in ambulant children with cerebral palsy (CP). However, most diagnostic methods ignore its effects when assessing gait problems. Within this research project, we aim to incorporate the effects of fatigue within clinical gait analysis, by performing extended gait analysis on an instrumented treadmill, using a fatigue-inducing protocol.

Through a combination of extended gait analysis with breath-by-breath energy consumption, we aim to improve insight into underlying mechanisms related to daily-life fatigue problems. ost prevalent problems in ambulant children with cerebral palsy (CP). However, most diagnostic methods ignore its effects when assessing gait problems. Within this research project, we aim to incorporate the effects of fatigue within clinical gait analysis, by performing extended gait analysis on an instrumented treadmill, using a fatigue-inducing protocol. Through combination of extended gait analysis with breath-by-breath energy consumption, we aim to improve insight into underlying mechanisms related to daily-life fatigue problems.

Many children with cerebral palsy (CP), encounter difficulties in daily-life activities such as walking.  Most children have complaints about fatigue, occurring in an earlier state when compared to their peers. This is related to fall events, pain, and a decrease in walking speed and distance. The underlying problems leading to complaints during longer walking can be different for each child.

Parents often explain that the gait pattern worsens when their child becomes fatigued, after walking for a longer period. A problem with regular clinical gait analysis, which is commonly used for gait diagnostics, is that it only evaluates gait for a short period.

Sometimes, children with CP are able to deliberately present a nice pattern for a short distance in the gait lab (‘the doctors walk’), but this is not always representative for daily life. Therefore, problems might be underestimated by the physician evaluating the gait analysis.

Within the MOVING-CP project, we investigate the effects of fatigue on gait problems in children with CP, using a recently developed protocol on a treadmill to evoke effects of fatigue, based on intensity. Measurements are performed on a instrumented treadmill with virtual-reality (GRAIL-system) combined with 3D kinematics, kinetics, electromyography, heart rate and breath-by-breath oxygen uptake. Assessments are used within clinical practice, to improve precision diagnostics in this patient group, as well as to unravel the interaction of fatigue and gait problems at group level.  This project is one of the research projects in the Amsterdam UMC national Center of Expertise for Cerebral Palsy.

Researchers involved in this project

  • Laura Oudenhoven, PhD candidate Amsterdam UMC, location VUmc.