Thomas S S, Buckon C E, Melchionni J, Magnusson M, Aiona M D
Shriners Hospitals for Children-Portland, Portland, Oregon 97201, USA.
J Pediatr Orthop. 2001 Nov-Dec;21(6):798-803.
Oxygen consumption and cost and velocity were evaluated over time in 23 children with myelomeningocele to determine whether differences exist when children walk with hip-knee-ankle-foot orthoses (HKAFOs) versus reciprocating gait orthoses (RGOs). Children using HKAFOs had similar oxygen cost as children using RGOs while achieving a faster velocity. Children walking with HKAFOs into adolescence had a faster velocity and lower oxygen cost than children who discontinued use of their HKAFOs. No significant differences in velocity or oxygen cost were found between children who continued to walk with RGOs and those who discontinued use of their RGOs. Upright ambulation may progress from ambulation with an RGO, when the child's upper extremity strength to mass ratio is low, to an HKAFO when upper extremity strength improves and velocity or keeping up with peers is of concern. Wheelchair mobility should be offered when speed and an energy-efficient method of community mobility are desired.
对23名患有脊髓脊膜膨出的儿童的氧气消耗量、成本和速度进行了长期评估，以确定儿童使用髋-膝-踝-足矫形器（HKAFO）与往复式步态矫形器（RGO）行走时是否存在差异。使用HKAFO的儿童与使用RGO的儿童氧气成本相似，但速度更快。使用HKAFO步入青春期的儿童比停止使用HKAFO的儿童速度更快且氧气成本更低。继续使用RGO行走的儿童与停止使用RGO的儿童在速度或氧气成本方面未发现显著差异。当儿童上肢力量与质量比低时，直立行走可能从使用RGO行走开始，随着上肢力量的改善以及对速度或跟上同龄人有要求时，转变为使用HKAFO行走。当需要速度和节能的社区移动方式时，应提供轮椅移动。
