Dear members,
Some weeks ago i sent the following message :

" As agent for Cosmed, manufacturer of the K4 - a portable O2/CO2 analyser - I
am looking for information for one of my customer :
He intends to buy a K4 to measure the oxygen consumption in CP children
conditions. The manufacturer has implemented a database for predicted values for
normal subject and we (my customer and myself) would like to adapt it to CP
Children values.
Does anyone has ever made this measurements yet and could you help me to solve
this problem."

I received very few answers and I wonder if this technique has already found an
echo among the clinician community. It seems obvious to me and to some of my
contacts that this methodology gives an immediate answer to the question : what
is the improvement of my patient capacities after surgery or rehabilitation. The
K4, being portable and accurate, gives, in real conditions, the energy
expenditure value without modifying the subject's performances. (Correct me if I
am wrong) .
However, here is the summary of the answers I received :

>From Dan India
----------------------
I believe the duPont Childrens lab has just presented papers on 02 and
CP children with Cosmed. Pat Castagno 302-651-4615
e-mail chestnut@udel.edu

They integrated it a Motion Analysis Gait System. Do you or your
client need info on Motion Analysis as well?

Dan India
Biosales@macorp.com

>From Kathy Hinderer, M.S., M.P.T., P.T.
------------------------------------------------------------

I would also be interested in the K4 portable O2/CO2 analyser if you are
able to adapt it to include predicted values for individuals with
myelodysplasia (spina bifida). The energy expenditure for walking and
wheelchair use was examined in the myelodysplasia population and compared
to able-bodied peers in the following study.

Williams, LV, Anderson, AD, Campbell, J, Thomas, L, Feiwell, E, Walker,
JM. (1983). Energy cost of walking and of wheelchair propulsion by
children with myelodysplasia: Comparison with normal children.
Developmental Medicine & Child Neurology, 25, 617-624.

Please keep me informed if you are able to adapt your values for this
population. Thank you.

Kathy Hinderer, M.S., M.P.T., P.T.
Doctoral student, Department of Movement Science
Division of Kinesiology, University of Michigan
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From: SCOTT MALONE/CGS
To: Martin van den Berg
Subject: Re: O2 consumption and CP children

I am interested in your machine that measures o2 consumption. I also
work with children with CP. Could you please send me info on your k4.
thanks in advance.
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From: Patrick Castagno
To: Martin van den Berg
Subject: Re: O2 consumption and CP children

Martin,
........ The variables that we
typically use are variables that we take from cosmed and manipulate
ourselves. We are using the k2 system, not the k4 so do not have access
to CO2 values. We look at the following variables for a pre walk state
of 2 minutes sitting rest- then an exercise (walking) steady state value
which consists of an average of 6 - 10 samples (30-40 seconds of 5 second
samples) - then finally a recovery segment which is averaged at approx
1-2 minutes of sitting rest after the walk (walk is usually 5-9 minutes
depending on childs involvement and what it takes for child to reach
steady state). The variables we analyze in these aformentioned 3
positions are VO2/ml/kg/min, heart rate, volume of expired air (liters),
and oxygen cost (VO2 normalized for walking velocity), also - we
calculate an average velocity of walk over the entire walk duration.

We have not published this information other than the abstract
that came out in Gait and Posture journal for the 1995 and 1996 gait
conferences. Specific references for these I will have to get back on
that with you. Reply with any additional questions........


Sincerely,

Patrick

Thanks all for your help and do not hesitate to post me your comments

Martin
---------------------------------

Martin van den Berg
Cosmed distributor for Benelux and France
Voice : 32-10-41.79.82
Fax : 32-10.41.77.86
EMail : 100335.1043@compuserve.com