Effect of Tonal Abnormality On Physiological Cost Index In Patients With Cerebral Palsy

Background:  Children with cerebral palsy (CP) have limited functional level due to primary and secondary functional impairments like movement difficulty, problem with balance and coordination. Physiological Cost Index (PCI) is a reliable clinical tool for measuring energy expenditure during walking. However presence of tonal abnormality may affect the PCI and subsequently the energy expenditure. Aim: To investigate the effect of tonal abnormality in lower limb muscles on PCI patients with CP. Methodology: After obtaining Institutional Ethical Committee approval, ambulatory patients with cerebral palsy were included with their parent consent. Patients were asked to walk a pathway of 50 meters with or without orthosis as a self-selected speed. Along with the demographic data, type of Tonal abnormality, muscles involved, Resting & Walking Heat Rate, Walking Speed & PCI were recorded. Spasticity in lower limb muscles was assessed with the help of Modified Tardieu scale. Result: In the present study, out of 30 patients there were 16 boys and 14 girls in the age group of 6-12 years. Patient were divided into 3 groups on the presence of spasticity in either Tendo Achilles(TA), Hamstring(H), and in both the muscle (TA+H). There was no significant difference among three groups for the parameters – Resting Heart Rate (RHR), Walking Heart Rate (WHR), Walking speed, Physiological Cost Index. (P value for RHR 0.4724, WHR-0.8936, WALKING SPEED-0.3379, PCI -0.4952). Conclusion: It is concluded from study that tonal abnormality in various muscle group does not affect Physiological Cost Index.