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The Clinical Assessment of Energy
Expenditure in Pathological Gait
The studies presented in this thesis were carried out at the department of
Rehabilitation Medicine of the VU University Medical Center Amsterdam,
The Netherlands, and the department of Orthopaedics at Gillette Children’s
Speciality Healthcare St Paul, USA.
The work was part of the research programme Musculoskeletal Disorders of
the EMGO institute, and it was supported by grants from the Anna Fonds
(02/07), ZonMw (014-32-031), and the Ter Meulen fonds, The Netherlands.
QBriks BV, Noppe Orthopedie BV, Kamer Orthopedie, Livit Orthopedie,
ISPO Nederland, Basko Healthcare, Ipsen Farmaceutica BV, Biometrics
Almere, and the Anna Fonds supported the printing of this thesis. Their
financial support is gratefully acknowledged.
ISBN:
Cover design:
Printed by:
978-90-6464-139-8
Arne Brans, QBriks BV, Amsterdam, www.qbriks.nl
Ponsen & Looijen BV, Wageningen
© Copyright M.A. Brehm, 2007
All rights reserved. No part of this book may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronically,
mechanical, photocopying, recording, or otherwise, without the prior written
permission of the holder of the copyright.
VRIJE UNIVERSITEIT
The Clinical Assessment of Energy
Expenditure in Pathological Gait
ACADEMISCH PROEFSCHRIFT
ter verkrijging van de graad Doctor aan
de Vrije Universiteit Amsterdam,
op gezag van de rector magnificus
prof.dr. L.M. Bouter,
in het openbaar te verdedigen
ten overstaan van de promotiecommissie
van de faculteit der Geneeskunde
op donderdag 21 juni 2007 om 10.45 uur
in de aula van de universiteit,
De Boelelaan 1105
door
Merel-Anne Brehm
geboren te Eindhoven
promotoren:
copromotor:
prof.dr. F. Nollet
prof.dr. G.J. Lankhorst
dr.ir. J. Harlaar
Contents
Chapter 1
Chapter 2
Chapter 3
General introduction
The validation of the portable VmaxST
system for oxygen-uptake measurement
7
27
Energy demands of walking in persons
45
with postpoliomyelitis syndrome: relationship with
muscle strength and reproducibility
Reproducibility evaluation of gross and
net walking efficiency in children with cerebral
palsy
Methodological considerations for
improving the reproducibility of walking
efficiency outcomes
The effect of ankle-foot orthoses on
walking efficiency and gait in children
with cerebral palsy
The effect of knee-ankle-foot orthoses on
walking efficiency and gait in former polio
patients
General discussion
Summary
Samenvatting
List of abbreviations
Dankwoord
About the author
61
Chapter 4
Chapter 5
73
Chapter 6
89
Chapter 7
107
Chapter 8
129
149
161
175
176
180

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