Evaluation of energy expenditure in children with cerebral palsy using a multi-sensor accelerometer.

摘要

AIM: The aim of this paper was to evaluate the validity and reliability of a multisensor accelerometer, the Intelligent Device for Energy Expenditure and Activity (IDEEA, MiniSun, CA), for measuring energy expenditure in children with cerebral palsy (CP). Twenty-one children with CP, age range 4-10 years, with varying degrees of impairment, were recruited for the study. In addition, 7 children with normal development, age range 5.67-8.5 years, were also tested. METHODS: Children were connected to a portable metabolic cart (Cosmed, Rome, Italy) and to the IDEEA by five sensors. Children were asked to perform a series of activities simulating everyday activity, walk on a treadmill for 4 min and climb a staircase for 4 min. During all activities oxygen consumption values were measured and converted to energy units. Energy expenditure as measured by the IDEEA was also recorded. RESULTS: During the simulation of daily activities and during walking at a comfortable speed the IDEEA significantly overestimated the energy expenditure. However significant and relatively high positive correlations (0.70-0.97) were found between the two instruments. Inconsistent results were obtained during walking at increased speed. During a step test similar means were found by the two instruments for children with normal development and children with CP with good correlations between the values measured by the two instruments. Energy expenditure measurement in children with CP were found to be very reliable, with a correlation of 0.998 for repeated measurements during treadmill walking. CONCLUSION: It seems IDEEA, with its present conversion equations, is not suitable for exact evaluation of energy expenditure in children with CP or in young children with normal development. However, in light of the good correlation with the standard method of evaluating energy expenditure and the high test-retest reliability of the IDEEA's measurements, It is suggested that IDEEA may be a valuable tool for clinical follow-up of children with CP for quantitative evaluation of the efficacy of treatment interventions. The establishment of population specific conversion equations is expected to significantly increase the accuracy of energy expenditure evaluation by the IDEEA.