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Different Postures and Energy Expenditure in Children with Cerebral Palsy

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cpResearch was published comparing the muscle activation and energy expenditure of different postures in children and adolescents with cerebral palsy.   Energy-expenditure and muscle activity were measured during lying supine, sitting with support, sitting without support, and standing in 19 subjects with cerebral palsy (GMFCS- E&R Levels I-V).  Using indirect calorimetry and surface electromyography, the following results were recorded:
1.  mean energy expenditure was >1.5 METs (sedentary behavior is 1.5 METs or less) during standing for all GMFCS-E&R levels
2.  a nonsignificant trend for greater muscle activation was recorded for all postures with less support
3.  a standing posture resulted in significantly greater muscle activation compared to resting but only in the children classified at GMFCS-E&R level III.
The researchers concluded that across all GMFCS-E&R levels, children and adolescents with cerebral palsy had elevated energy expenditure during standing that exceeded the sedentary threshold of 1.5 METs. The researchers findings suggest that changing a child’s position to standing may help to increase light activity time and decrease long periods of sedentary behavior.
Reference:  Verschuren O, Peterson MD, Leferink S, Darrah J.  Muscle Activation and Energy-Requirements for Varying Postures in Children and Adolescents with
Cerebral Palsy. J Pediatr. 2014 Aug 20. pii: S0022-3476(14)00651-9. doi: 10.1016/j.jpeds.2014.07.027. [Epub ahead of print]
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