SUMMARY The energy expenditure of cerebral‐palsied children ambulating with bilateral quad canes and wheeled walkers was estimated, using average heart rate and speed of walking. An energy cost index (average number of heart rates per unit distance walked) was derived to allow for varying speeds among patients. Children were then categorized into those who had a lower energy cost index when using quad canes and those who had a lower index when using walkers. This made it possible to offer treatment recommendations based on objective data. RÉSUMÉ Index de coût énergétique comme estimation de la dépense énergétique d'enfants IMC durant une déambulation assistée La dépense d'énergie d'enfants IMC se déplacant avec Cannes quadripodes bilatérales a été appréciée en mesurant le rythme cardiaque moyen et la vitesse de déplacement. Un index de coût énergétique (nombre moyen de battements cardiaques par unité de distance franchie) a étéétabli pour des vitesses variées parmi les sujets étudiés. Les sujets ont alors été classés entre ceux qui avaient un index de coût énergétique plus bas lorsqu'ils utilisaient des quadripodes et ceux qui avaient un index plus bas en utilisant des fauteuils. Ceci a permis d'établir des conseils de traitement basés sur des données objectives. ZUSAMMENFASSUNG Energiebedarfsindex als Schätzwert des Energieverbrauchs bei Kindern mit Cerebralparese während assistierter Bewegung Bei Kindern mit Cerebralparese, die sich mit beidseitigen Gehstützen und Rollstuhlen fortbewegten, wurde anhand der durchschnittlichen Herzfrequenz und der Bewegungsgeschwindigkeit der Energieverbrauch bestimmt. Der Energiebedarfsindex (durchschnittliche Anzahl der Herzschläge pro zurückgelegter Gehstrecke) wurde ermittelt, urn die unterschiedlichen Geschwindigkeiten der Patienten zu berüchsichtigen. Die Probanden wurden dann eingeteilt in solche, die einen niedrigeren Energieverbrauchsindex beim Gehen mit Gehstützen und solche, die einen niedrigeren Energieverbrauchsindex beim Rollstuhlfahren hatten. Dadurch war man in der Lage, anhand objektiver Daten Behandlungsvorschläge zu machen. RESUMEN Indice de coste de energía como estimación del gasto de energía en niños con parálisis cérébral durante la deambulación asistida Se evaluó el gasto energético en niños con parálisis cerebral andando con muletas bilaterales o con andadores con ruedas, observando el promedio de frecuencia cardíaca y la velocidad de la marcha. Se dedujo un indice de gasto de energía (promedio de frecuencia cardíaca por unidad de distancia andada) para ser aplicado a diversas velocidades de marcha según los pacientes. Los pacientes se categorizaron en los que tenian un bajo indice de gasto energético al andar con muletas y los que lo tenían al usar andores con ruedas. Esto hizo posible ofrecer tratamientos recomendados en base a datos objetivos.

Four men isometrically trained their stronger leg for 19 weeks (attempted knee extension against a restraining strap incrementally increasing to 30 brief maximal contractions X 6 wk-1). Five others similarly trained dynamically (repeated knee extension against a 63 N resistance force, incrementally increasing to 300 extensions X 6 wk-1). Before, at regular intervals during training and after de-training (between 7-11 weeks) measurements were made using trained and control legs of: Maximum Voluntary Isometric Contraction (M.V.C.), Endurance at 60% M.V.C., Knee Extension Performance Test (K.E.P.T.) and One-legged Work Test. Isometric training produced a 30% (p less than 0.01) increase in M.V.C. with a 15% (p less than 0.05) increase in the control leg. These changes persisted with some deterioration after the de-training period. Endurance at 60% M.V.C. remained unchanged, even though M.V.C. was increasing in both trained and control legs. There was some evidence that isometric training improved the cardio-vascular response to one-legged exercise. Dynamic training did not result in changes in M.V.C., Endurance at 60% M.V.C. or the One-legged work Test, but K.E.P.T. (time taken for 50 knee extensions at a comfortable pace against 63 N resistance) improved by 33% (p less than 0.01) and 28% (p less than 0.01) in the trained and control legs respectively. Isometric training resulted in similar improvements in performance of K.E.P.T. (28%, p less than 0.05, trained leg; 18%, p less than 0.05 control leg). For similar time spent in training, isometric work appeared more effective than dynamic work in improving the parameters of muscle function, these improvements appeared to be both centrally (C.N.S.) and locally mediated.

Physiological parameters and activity were recorded monthly on 19 men wintering at a polar base. A comparison was made between those in their first Antarctic winter (Group A, n = 13) and those in their second consecutive Antarctic winter (Group B, n = 6). Group A were more active (p less than 0.001) and spent more time outside (p less than 0.001) during the summer months than during the darker and colder winter period. Combined data showed no correlation between total activity and meteorological conditions, but a clear (p less than 0.001) negative correlation with time spent outside and wind speed. In the first part of the year group A became fitter (as shown by a lower heart rate at a VO2 1.51 min-1), increased basal oxygen uptake under standard conditions and put on body and fat mass. These changes were not demonstrated in group B living and working under identical conditions. Lean body mass of both groups rose throughout the year (A, p less than 0.001; B, p less than 0.05). These data suggested that the changes in physiological parameters in group A were in response to the life style and activity of a polar base, rather than to the Antarctic climate per se.

As clinicians become more involved in preventative screening, assessment, and treatment of newborns and infants, an increasing need exists for quantitative, normal joint range-of-motion data for this population. We used a goniometer to assess in 40 healthy, full-term newborns the following passive ranges of motion: hip extension, knee extension, ankle plantar flexion, ankle dorsiflexion, and the popliteal angle. Every infant except one lacked full extension at both the hip and the knee. Plantar flexion was generally limited, but dorsiflexion was unlimited. Popliteal angle measurements showed the greatest amount of variation among the infants. Pearson correlation coefficients indicated that those infants with greater dorsiflexion tended to have less plantar flexion, and those with a greater limitation of knee extension measured with the hip extended tended also to have a smaller popliteal angle. Intrauterine position and newborn flexor tone are discussed as possible contributing factors to the results obtained in this study.