Mechanical energy patterns in gait of cerebral palsied children with hemiplegia.

The mechanical energy costs of walking were studied in 10 cerebral palsied children with hemiplegia to determine whether their values were substantially different from normal and, if so, to discover the movements that were responsible. A two-dimensional, sagittal-plane cinematographic analysis of the subjects' normal walking was undertaken. This technique provided continuous information about the mechanical energy costs of the whole body and each of its parts, the energy types involved, and the amounts of energy conserved. In most cases, the energy costs were above normal and were attributable to poor patterns of exchange between the potential and kinetic energy types of the head, arms, and trunk segment; to very low levels of kinetic energy that precluded exchange; or to both. We concluded that attention should be directed to restoring the sinusoidal pattern of motion and to the fluctuating speeds during each gait cycle when energy costs are a therapeutic consideration.