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Abstract
Background Upper limb fractures and subsequent cast immobilisation constitute a potential cause of reduction in childhood levels of physical activity (PA), with subsequent decrease of energy consumption. The main objective of this study was thus to quantify the decrease of activity-related energy expenditure (AEE) due to upper limb cast immobilisation .
Methods We conducted a longitudinal matched case-control study that included 35 children and teenagers with a first episode of upper limb fracture and 35 healthy cases. PA was assessed during cast immobilisation by accelerometer. AEE was the calculated using an equation based on the total counts per day measured by accelerometers.
Results AEE in children and teenagers with upper limb fractures was estimated to be 7.4 % lower than healthy controls. The mean difference corresponded to 1.35 kcal/kg per mean valid recorded time (750 min), that is, the waking hours. When converted in kcal per mean subjects’ weight, the difference in AEE amounted 63.5 kcal/day, which corresponds approximately to 26 min of walking at a speed of 4 km/hours. In comparison with the mean AEE in healthy controls (18.2 kcal/kg), the noted decrease (1.35 kcal/kg) represents only 7.4 % of AEE.
Conclusion Reduction of AEE in children and teenagers with upper limb fractures may lead to a slight positive energy balance, as there is usually no compensatory reduction of energy intake. An increase of light PA has to be counselled in this situation or patients should be advised to reduce their energy intake during the immobilisation period.
Level of evidence Level I: high-quality prospective study (all patients were enrolled at the same point in their disease with ≥80 % follow-up of enrolled patients).
- physical activity
- fracture
- upper extremity
- energy expenditure
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Footnotes
Contributors DC: participated in the design, conception and coordination of the study, collected and treated the patients and revised the article for important intellectual content. XEM: participated in study’s coordination, performed the CSA investigation, collected the data, realised data’s interpretation and revised the article for important intellectual content. CD: performed the data analysis and the statistic alanalysis and revised the article for important intellectual content. ABRM: performed the CSA analysis and drafted the manuscript. AT-F: participated in drafting and revising critically the article for important intellectual content. All authors read and approved the final version of the manuscript to be submitted.
Funding This work was supported by grants from the Swiss National Science Foundation (SNSF #405340-104611).
Competing interests None declared.
Patient consent Obtained.
Ethics approval The protocol was approved by the institutional ethics committee (protocol # 04–057, ped 04–002), ethics committee of Geneva.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement There is no available additional unpublished data from the study.