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Gait and Energy Expenditure in Children With Lower Limb Amputation (MAPEDE)
Sponsor: Rennes University Hospital
Summary
In lower limb amputation, prosthetic gait has been shown to be particularly energy-intensive. While energy expenditure has been the focus of many studies in adult amputees, this area of research is less developed for paediatric amputees. However, the increase in energy expenditure has implications for the physical, gait, and balance abilities of amputees of all ages. Combined with physical deconditioning, it exposes the patient to a greater risk of a sedentary lifestyle and weight gain, which is detrimental to their prosthetic training, autonomy, and length of hospital stay. However, this increased expenditure and deconditioning is not currently the subject of systematic evaluation in routine clinical practice for this population. In contrast to adults, the gait pattern of children amputees is poorly described, and the relation between energy expenditure and gait is rarely discussed. Oxygen consumption is the most widely used outcome to assess energy expenditure in studies. The main aim of this study was to identify the kinematic gait parameters obtained by quantified gait analysis associated with oxygen consumption during a 6-minute test in children with lower-limb amputations aged 7 years or older. This study also makes it possible to evaluate with the child's physician and rehabilitators the usefulness of measuring energy expenditure to guide medical decisions and rehabilitative care. Finally, it will allow the validation of a tool for this population for measuring energy expenditure that has been presented as more easily applicable in clinical routine than the measurement of oxygen consumption, the Physiological Cost Index (PCI). The validity and reliability of the PCI will therefore be evaluated. This study will therefore facilitate the assessment and monitoring of child amputees and provide guidance for the provision of an evidence-based rehabilitation program.
Official title: Relation Between Kinematic Gait Parameters and Energy Expenditure in Children With Unilateral Lower Limb Amputation
Key Details
Gender
All
Age Range
7 Years - 17 Years
Study Type
OBSERVATIONAL
Enrollment
48
Start Date
2025-09-01
Completion Date
2028-03-01
Last Updated
2025-07-22
Healthy Volunteers
No
Interventions
Gait and energy expenditure
SESSION 1: Physiotherapy assessment: clinical parameters, length of limb segments, range of motion of the lower limbs, muscle strength of each lower limb joint and trunk. Measurement of energy expenditure: 6-minute walking test with prosthesis, at a constant submaximal speed, with portable gas exchange analyzer to measure oxygen consumption and a connected device to calculate the Physiological Cost Index. * During test: recording of heart rate at the start, each minute, at the end then 5 minutes after the end, recording of the effort perceived by the child each minute (Borg scale) * At the end : questionnaire to assess child level of acceptability regarding the measurement of the O2 (Oxygen) consumption SESSION 2: Measurement of kinematic parameters by gait analysis: the child will be requested to walk with their prosthesis and shoes at spontaneous speed and at maximal gait speed. The second measurement of energy expenditure will be conducted using the same procedure as the first.
Locations (5)
Centre 02 - CHU Brest, Hôpital Morvan
Brest, France
Centre 04 - Hospices Civils de Lyon, Hôpital Mère Enfant Groupement Hospitalier Est
Bron, France
Centre 03 - CHU Dijon, Hôpital Le Bocage
Dijon, France
Centre 01 - CHU de RENNES, Hôpital Pontchaillou
Rennes, France
Hôpitaux Paris Est Val-de-Marne, Hôpital Saint-Maurice
Saint-Maurice, France