Oxygen cost, walking speed, and perceived exertion in children with cerebral palsy when walking with anterior and posterior walkers.

Walkers with the frame positioned behind the child have been advocated recently, mainly because they may allow a more upright and therefore more normal ambulation and perhaps encourage favourable neuromuscular development. The purpose of this study was to estimate and compare speed, energy cost, and perceived exertion during walking with an anterior walker and a posterior walker. Ten children with spastic diplegia, average age 11 years, who were familiar with both types of walker participated in the study. Spasticity was measured according to the modified Ashworth scale. Oxygen cost was determined by the argon-diluted method using a mixing box mounted on a backpack, and the perceived exertion was graded. The results of the study showed that there are no differences in the measured variables in walking between the anterior and the posterior walker in children familiar with both walkers and also that most of the children preferred the posterior walker.