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Pediatric Physical Therapy:
doi: 10.1097/PEP.0000000000000047
Case Report

Estimating Energy Expenditure for Different Assistive Devices in the School Setting

Lephart, Kim PT, DPT, MBA, PCS; Utsey, Carolyn PT, PhD; Wild, Dana L. PT, PhD, PCS; Fisher, Steve R. PT, PhD

Supplemental Author Material
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Purpose: This case report describes a simple means of estimating energy costs for a child with cerebral palsy using different assistive devices within a school setting.

Key Points: A 9-year-old boy, Gross Motor Function Classification Scale level III, was assessed over 8 ambulation trials using a posterior walker and using forearm crutches. Each trial was followed by a fine motor accuracy task. An energy expenditure index (EEI) was calculated for each device. For the posterior walker, EEI was 47% higher overall compared with forearm crutches. Fine motor accuracy and task completion time were similar for both devices.

Conclusion: EEI was a straightforward method of estimating the energy costs of different assistive devices. Measurement procedures described in this case were time efficient in the field and provided a reasonable estimation of energy expenditure to help decide objectively which assistive device would best fit the needs of the student.

Video Abstract: For more insights from the authors, see Supplemental Digital Content 1, available at

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.


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