Reduced physical fitness in children with cerebral palsy (CP) has received little attention. The 600 Yard Walk-Run Test is easy to perform and has been used to measure walking endurance and speed in children without disability. A correlation between this test and cardiorespiratory fitness in children with cognitive disabilities has been demonstrated (Fernhall et al., 1998). The Gross Motor Functional Classification System (GMFCS) classifies the level of assistance required for independent mobility in the community (Palisano et al., 1997). This study examined: 1) the ability of children with CP to walk 600 yards and 2) differences in walking speeds between GMFCS Levels I, II and III.
Number of Subjects:
This study included 46 subjects with the spastic diplegic form of CP (22 males, 24 females) aged seven to 17 years.
Subjects were categorized as GMFCS Level I, II or III. During the 600 Yard Walk-Run Test, subjects used the assistive devices they required for community ambulation. They walked and/or ran as fast as they could without stopping until completing a distance of 600 yards along a circular path. Subjects were encouraged to walk or run at a pace sustainable for the entire distance. They could slow down but if they stopped for more than five seconds the examiner ended the test. If the subject stopped walking prior to 600 yards, the distance completed and the time were recorded. If the subject did not complete the distance within 15 minutes, the test ended and the distance was recorded. Statistical tests consisted of a One-way ANOVA with Tukey HSD post hoc analyses to examine the difference between GMFCS Level and walk-run times obtained for subjects who were able to walk the entire 600 yards.
Of the 46 subjects tested, 13 were Level I, 10 were Level II, and 23 were Level III. Only five subjects were unable to walk 600 yards in less than 15 minutes. Of this subset, four were classified as GMFCS III and one as II. Based on Tukey HSD, post-hoc analyses found statistically significant differences between all three GMFCS Levels on walking times, P < 0.05. Mean times for completion were 289.282.3 seconds (s), 412.064.2 s and 519.4136.1 s for GMFCS Levels I, II, and III, respectively. As all subjects walked the same distance, lower times indicate higher walking speeds.
The 600 Yard Walk-Run Test appears to be an appropriate tool for assessment of walking speed and endurance in children with CP. The majority of the children completed the test. Those with less mobility impairment, based on GMFCS classification, demonstrated faster walking speeds.
Children with CP exhibit decreased cardiorespiratory fitness compared to non-disabled peers. Tests of walking endurance and speed are important to assess the need for intervention and monitor change in children with CP.
Funding For This Project Was Provided By The Foundation For Physical Therapy As Part Of Ptclinresnet.