",isbn:"978-1-83969-452-3",printIsbn:"978-1-83969-451-6",pdfIsbn:"978-1-83969-453-0",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,hash:"a6e1a11c05ff8853c529750ddfac6c11",bookSignature:"Dr. René Mauricio Barría",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/10734.jpg",keywords:"Neonatal Intensive Unit, Neonatal Diagnostic Techniques, Neonatal Nurses, Neonatologists, Newborn Diseases, Premature Diseases, Breast Feeding, Kangaroo-Mother Care Method, Neonatal Survival, Limit of Viability, Minimal Handling, Neonatal Stress",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 5th 2021",dateEndSecondStepPublish:"March 5th 2021",dateEndThirdStepPublish:"May 4th 2021",dateEndFourthStepPublish:"July 23rd 2021",dateEndFifthStepPublish:"September 21st 2021",remainingDaysToSecondStep:"2 days",secondStepPassed:!1,currentStepOfPublishingProcess:2,editedByType:null,kuFlag:!1,biosketch:"The principal investigator and academic expert in epidemiological methods and evidence-based health with an emphasis on children's health. His research interests lie in the areas of Maternal-Child Health, Neonatal Care, and Environmental Health. From 2010 until 2017 he was Director of the Evidence-Based Health Office and currently serves as Director of the Nursing Institute at the Universidad Austral de Chile.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"88861",title:"Dr.",name:"R. Mauricio",middleName:null,surname:"Barría",slug:"r.-mauricio-barria",fullName:"R. Mauricio Barría",profilePictureURL:"https://mts.intechopen.com/storage/users/88861/images/system/88861.jpg",biography:"R. Mauricio Barría, DrPH, is a Principal Investigator and Associate Professor at the Faculty of Medicine at Universidad Austral de Chile. He was trained as an epidemiologist and received his MSc in Clinical Epidemiology from Universidad de la Frontera in Temuco, Chile, and his DrPH from Universidad de Chile in Santiago, Chile. His research interests lie in the areas of Maternal-Child Health, Neonatal Care and Environmental Health. He is skilled in epidemiological studies designs with special interest in cohort studies and clinical trials. Since 2010 until 2017 he was Director of the Evidence-Based Health Office and currently serves as Director of the Nursing Institute at the Universidad Austral de Chile. 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1. Introduction
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Multidimensional assessment in cerebral palsy (CP) is very important for the determination of the fundamental problems of children, to select the most appropriate therapy approaches for these problems and to reveal the changes occurring during time with the therapy. The assessment should provide information on the primary, secondary, and tertiary problems, functional capacity of the children, and the expectations of the children and families. Although various scales and tests prepared for children with CP can be used, observation, photographs, video records, or computer-supported complicated assessment methods can be used as well.
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While selecting the outcome measures, psychometric properties should be considered; however, there is no clear information about how the outcome measures will be selected to reveal the function and health of children ideally [1]. In the selection of the assessment methods, it may be beneficial to consider the dimensions of the International Classification of Functioning, Disability and Health Child and Youth Version (ICF-CY) [2], which is a classification system established by World Health Organization (WHO). When considered in the ICF-CY framework, there are instruments assessing body structures and functions such as problems of muscle tone, muscle strength, and selective motor control; instruments assessing activities and participation such as activities of daily life (ADL) and quality of life; and instruments assessing environmental factors such as impact of the family or the environment. Among these tools, the mostly required ones should be determined for the children. This way, a general opinion can be gathered about the children without much detail. Furthermore, the concerned physicians can examine ultrasound, magnetic resonance (MR), or radiographs as a part of neurologic or orthopedic examination and their results can be combined with the physiotherapy assessments. All of these assessments are crucial not only for establishing a physiotherapy program or to determine the efficiency of the program but also for clarifying the surgical or medical interventions that need to be carried out for the children.
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In this chapter, the assessment methods most frequently used by physiotherapists for children with CP are discussed.
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2. History and observation
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Detailed information should be received from the family or caretakers in all issues related to the children including family history, prenatal, natal and postnatal period, chronologic and corrected age, other accompanying problems, developmental story, adaptive equipment used, therapy approaches applied, medication taken, and educational status of the family [3, 4].
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Observational analysis is crucial to determine children’s functional skills, spontaneous motions and motion strategies, and the underlying fundamental problems. Thus, it can be decided in which field detailed assessment needs to be carried out. Observational analysis prepared by a specialized physiotherapist completes the standardized tests. During observational analysis, children must be in a setting they can be with their family, and they can feel comfortable and safe. There should be various toys and materials in the setting to reveal the children’s capacity and to draw their attention. The assessment room should not be crowded and noisy [3]. Observations provide a general idea to physiotherapists about the general state of the children, quality of movements, capacity and motor strategies developed by the children, protective reactions, and upper and lower extremity functions. Video recordings during observation are rather beneficial as well.
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3. Assessment of reflexes and reactions
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Observation of reflexes is important to illustrate the severity of the influence in the nervous system, and observation of balance and protective reactions is important to support motor developmental process. When these assessments are carried out, the corrected age of the children should be considered. It is known that primitive reflexes continue insistently or disappear later than normal or never occur in children with CP [5]. It can be observed that symmetric tonic and asymmetric tonic neck reflexes still continue in adolescent stage in a case diagnosed with dyskinetic-type CP. Insistence of these reflexes can complicate the therapy. It may be necessary to make various adaptations in the treatment program when the primitive reflexes continue in advanced ages. For example, in a case whose asymmetric tonic neck reflexes continues, orientation of the head and extremities in the midline may be the fundamental target of the therapy. At the same time, the assessment of protective reactions is important for determining a treatment program.
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4. Assessment of functional level and motor development
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Although CP is a nonprogressive central nervous system problem, emerging physical impairment and functional limitations change with the therapy approaches applied to the children during growth and with the effect of the environmental conditions. It is crucial to assess motor development, functional skills, and activity limitations for determining the current state of the children, and there are frequently used test batteries for this purpose. Gross Motor Function Measurement (GMFM) [6] is a standardized measurement instrument frequently used to measure the change in gross motor function. This tool consists of five different dimensions, and all skills of the children during supine/prone position, sitting, crawling, standing up, and walking are assessed in detail. GMFM, with versions consisting of 88 items and 66 items, is accepted worldwide. Items 48 and 50 from GMFM 88 version are shown in Figures 1 and 2.
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Figure 1.
GMFM-88, Item 48.
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Figure 2.
GMFM-88, Item 50.
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Gross Motor Function Classification System [7] is the most frequently used classification system interdisciplinary and intradisciplinary to define motor level in children with CP. This classification system categorizes the functional skills of children during their daily life under five levels. In addition, for assessing functional level and motor development various scales are used as well including Activities Scale for Kids [8], Child Health Questionnaire [9], Gillette Functional Assessment Questionnaire [10], Functional Mobility Scale [11], Pediatric Evaluation of Disability Inventory [12], Pediatric Outcomes Data Collection Instrument [13], and Functional Independence Measure for Children [14].
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5. Assessment of muscle tone
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Spastic type is the most common one among CP types. Therefore, spasticity is the major problem encountered most frequently by pediatric physiotherapists. Spasticity makes the voluntary and selective motor control more difficult, increases energy consumption, and causes the formation of secondary musculoskeletal system problems observed in CP [15]. Various physiotherapy methods can be effective in mild tone problems; however, medical or surgical interventions are needed for severe increase in tone persisting for a long time. In this context, it is crucial to determine the changes occurred in muscle tone.
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The most affected muscles from spasticity in children with CP are gastroc-soleus, hamstrings, rectus femoris, hip adductors and psoas in lower extremities, and shoulder external rotators, elbow, wrist and finger flexors, and forearm pronators in upper extremities [16].
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There are various clinical scales, biomechanical assessment tools, and neurophysiologic assessment methods to assess spasticity; however, there is no consensus about the best assessment. The most frequently used clinical scales are Ashworth/Modified Ashworth (MAS) and Tardieu/Modified Tardieu (MTS) scales. MTS grades muscle spasticity in three different velocities and goniometric measurements also included for all velocities [17, 18]. According to a study by Numanoğlu et al. [19], the administration of MAS is easier and takes less time than MTS, but MTS gives valuable information about muscle length and dynamic contracture and has better intraobserver reliability [19]. Assessment of knee flexor muscle spasticity with MTS is shown in Figure 3.
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Figure 3.
Assessment of knee flexor spasticity with MTS.
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In addition to these, there are scales such as Spasticity Grading, Modified Composite Spasticity Index, Duncan Ely Test, New York University Tone Scale, and the Hypertonia Assessment Tool [20–22].
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Myotonometer, sensors, Wartenberg Pendulum Test, dynamometer, goniometric measurement, and robot-supported assessment instruments are used as biomechanical assessment tools [21, 23–27]. In the neurophysiologic assessment of spasticity, Hoffman H reflex occurring with low-threshold electric stimulation, tendon reflex occurring with tendon tap, and M-wave generated by high-intensity stimulation of peripheral nerve are used. However, overlapping of the values of healthy muscles with those of spastic muscles decreases the diagnostic value of these measurements. Furthermore, electromyography methods are also used in spasticity assessment [21, 28–30].
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In the long term spasticity; intrinsic structure of the muscles changes and this leads to muscle stiffness. In a study, an increase in the extracellular matrix collagen density of muscle fiber bundle in spastic hamstrings was reported to be the reason for an increased passive stiffness of muscle, and indicated that this situation can develop even before 3 years of age in children with CP [31–33]. From this perspective, it is important to assess not only neural mechanisms of hypertonus but also nonneural mechanism. In recent years, elastography is benefited in the assessment of muscle stiffness in children with CP [34, 35].
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In addition to tone increase in children with CP, hypotonia and muscle fluctuations are observed as well. There are tools to assess dystonia such as the Burke-Fahn-Marsden Rating Scale [36] and Unified Dystonia Rating Scale [37]. There is no tool used routinely by the clinicians to assess hypotonia; it is generally categorized as mild, moderate, and severe.
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6. Assessment of muscle strength
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One of the primary problems observed in CP is muscle weakness. This situation occurs due to reasons including central nervous system impairment, inactivation, learned nonuse, and inadequate selective motor control. Muscle weakness can be observed in all subtypes of CP, and it is seen that muscular forces of children with CP are less than those of their peers who developed typically. Moreover, children with CP have slower sequential force generation in force application and have influenced motor planning [38, 39].
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Many publications show that strength trainings improve functional capacity without causing any problems in children with CP [40, 41]. In this respect, assessment of muscular force is significant.
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Muscular force can be assessed as isometric, isotonic, and isokinetic. For muscle strength assessment, the patients should cooperate with the assessor and the target muscle group must contract maximum; however, it could become difficult due to increased co-contractions in agonist-antagonists and due to cognitive limitations [42]. In the assessment of muscular force, manual muscle testing, testing with handheld dynamometer, and isokinetic dynamometer or the measurement of maximum repetition of functional exercises are used frequently [43].
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Usage of handheld dynamometers is suggested in the assessment of upper extremity and lower extremity isometric muscular force and grasping in children with CP [43–46]. A systematic review about this issue suggested that Jamar dynamometer can be used to measure grasping force and handheld dynamometer can be used to measure the force of other upper extremity muscles. It is also reported that manual muscle testing can be used to measure the total upper extremity force or hand wrist force in children who have very limited muscular force [47].
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7. Assessment of musculoskeletal system deformities
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Children with CP are prone to develop musculoskeletal system deformities. In addition to the major problems generated by central nervous system lesion in CP, secondary problems also exist. The development of musculoskeletal system in children with CP can be affected negatively due to the reasons including muscle weakness, postural problems, and muscle tone problems [50]. Musculoskeletal system should be assessed in detail to detect and to prevent from deformities at an early stage. For this purpose, various measurements should be made such as the measurement of muscular force, range of motion, extremity length, and muscle length.
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Figure 4.
X-ray of a child with quadriparetic CP, age 13, GMFCS Level 5.
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Numerous problems concerned with hips can occur in individuals with CP related to aging. Many children with CP are born with a healthy hip; however, scores of problems cause insufficiencies in femur and acetabulum development. These problems are physical inactivity, severe mental retardation, flexion and adduction contractures, pelvic obliquity, sitting in “W” position, excessive tone increase in hip flexor, adductor, and internal rotator muscles, muscular imbalance, and insufficiency in weight bearing [48–50]. Coxavalga, increased femoral anteversion, and acetabular dysplasia are the major problems of hip. Hip subluxation rate in CP is reported to be 75% [51, 52]. Walking ability is the key point in the development of hip problems. Dynamic compressive forces generated during walking are required for the development of the required depth in acetabulum [53]. Hemiparetic and diparetic children, who could walk independently at the age of 30 months, have the lowest risk for hip dislocation [54]. Hip subluxation was reported to be 11% in ambulatory children and 57% in nonambulatory children [49]. Deterioration of motor level affects hip development directly; it was reported that there was 90% hip displacement in children at GMFCS level V [55]. In Figure 4, hip X-ray of a 13-year-old child with quadriparetic CP, who was classified in GMFCS level 5, is shown.
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Hip surveillance is important for the determination of hip dislocation. Routine radiographic hip assessment is one of the most significant parts of hip follow-up. It was reported that imaging as a part of orthopedic assessment should be carried out at 12–18 months and should be repeated every 6 months [56]. Reimer’s Migration Percentage and acetabular index are assessments suggested for radiologic hip monitoring [54]. Children whose Reimer’s Migration Percentage is greater than 33% or whose acetabular index is greater than 30% are at risk and they should be monitored closely [48, 54, 57]. For hip surveillance, the hip abduction range of motion at flexion and extension position, presence of contractures, pelvic obliquity, femoral anteversion angle, and spinal deformities should also be assessed [49].
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8. Assessment of physical fitness
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Due to physical impairments, individuals with CP have more reduced physical fitness in comparison to their peers who develop typically. Tone disorders, muscle weakness, emotional problems, and unfavorable environmental conditions push individuals with CP to move much less in comparison to their peers during the day and to develop sedentary lifestyle [58]. These risks increase in children who are affected bilaterally or have low GMFCS level. In a study conducted on this matter, it was reported that individuals with CP engage in physical activities 13–53% less in comparison to their peers who developed typically and the time spent sedentarily is twofolds higher than that suggested normally [59]. As the age advances, this situation becomes more serious due to the occurrence of musculoskeletal system deformities and the increase of body weight. Because of the abovementioned reasons, children with CP may face many undesired health conditions such as metabolic dysfunction, cardiovascular illness, and decrease in bone mineral density. There are various measurement methods used to assess physical activity. Maintaining an activity journal may help the assessment. Many surveys such as Activity Scales for Kids [60], Physical Activity Questionnaire for Adolescents [61], Children’s Assessment of Participation and Enjoyment [62], Canada Fitness Survey [63], and the Early Activity Scale for Endurance [64] are benefited for this purpose [65, 66].
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General physical endurance can be assessed by a 6-Min Walk Test [67, 68]. In addition to the surveys, equipment such as step counters, heart rate meters, and accelerometers can be used or more complicated assessment methods such as The Doubly Labelled Water Technique can be applied [69, 70].
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9. Assessment of gait
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Ensuring independent locomotion is one of the basic goals of many physiotherapists and families of children with CP. Children with unilateral CP almost always develop independent locomotion; however, a part of children with bilateral CP walk independently, some of them walk with aids, and some cannot achieve this function during their lifetime. Numerous gait problems such as equinus, crouch gait, jump gait, and scissoring gait are observed in children with CP who can walk independently.
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Gait assessment can be used as an outcome measure to determine the reason of the problem in children and to determine the effects of the interventions [71].
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Gait assessment in children with CP can be made by observational gait scale-combined video records, time-distance characteristics, and instrumented gait analyses. Instrumented gait analyses made by measuring electromyography activity, three-dimensional joint kinetic, and kinematic values in laboratory setting present an objective assessment of the patients; however, they are not appropriate for routine clinical purposes. These systems require trained personnel, appropriate setting and the evaluation and interpretation of the results lasts for 3–6 h. In this context, observational gait assessment emerges as an important and useful tool for clinicians. Simple gait scales can be used to determine the quantity of the changes in gait pattern, and deviations from normal gait in the stance and swing phases. In these assessments, clinicians record the walking pattern by video and evaluate walking abnormalities in different joints and planes according to the existing scales. Furthermore, there are computer-supported video analysis programs to be used for this purpose. Among the observational gait assessment tools, there are Gillette Functional Assessment Questionnaire [10], Physician Rating Scale [72], Observational Gait Scale [73], Visual Gait Score, Salford Gait Tool, Edinburgh Visual Gait Scale [74], Observational Gait Analysis, and Visual Gait Assessment Scale [71, 75]. According to Günel et al., GMFM’s gait domain can also be used as a gait assessment [76]. Among these gait scales, Edinburgh Visual Gait Scale is suggested because it consists of information in each of the three planes for foot, knee, hip, pelvis, and trunk for both stance and swing phases and have good reliability and concurrent validity. It is reported that any of these scales is not equivalent to instrumented gait analyses [71].
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10. Assessment of balance
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Muscle tone impairments and abnormal postural control in children with CP affect balance capacity negatively. It is known that static and dynamic balance reactions of children with CP are insufficient when compared with their normally developed peers [77]. Pediatric Reach Test [78], Pediatric Balance Scale [79], Timed Up and Go Test [80], Pediatric Clinical Test of Sensory Interaction for Balance [81], Heel-to-Toe Stand, Timed One-Leg Stance, and Timed Up and Down Stairs are frequently used balance assessments in children with CP. Special equipment such as Wii-Fit and Biodex Balance System can be benefited as well [82–84].
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11. Assessment of trunk impairment
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Problems concerned with the trunk are observed frequently in children with CP and these problems affect both upper and lower extremity functions negatively. There are different methods for assessment of the trunk impairment. Assessment of postural control at the sitting position can be used to determine the weakness of the trunk muscles. Moreover, the affected trunk control leads to insufficient balance and therefore instruments assessing postural control and balance during sitting can be benefited to assess the trunk impairment [85].
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In the literature, there are limited number of instruments providing information about postural control during sitting and most of the measurements are developed for adults [86]. Some of the scales that could be used to assess trunk impairment in children with CP are listed below:
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Spinal Alignment and Range-of-Motion Measure assessing spinal alignment and range of motion [87].
Segmental Assessment of Trunk Control assessing static, active, and reactive sitting balance and control level [88].
Seated Postural Control Measure assessing sitting function and alignment [89].
Trunk Control Measurement Scale (TCMS) assessing static and dynamic sitting balance and dynamic reaching [90].
Level of Sitting Scale classifying sitting ability [91].
Assessment & Coding of Postural and Behavioral Observations assessing head control during sitting, grasping, reaching, eating, and drinking activities [92].
Sitting Assessment for Children with Neuromotor Dysfunction assessing static and dynamic postural control during sitting [93].
Seated Posture Control Measurement assessing postural alignment [94].
Sitting Assessment Scale assessing sitting posture and control with video records [95].
Chailey Levels of Ability assessing sitting, reaching, and standing ability [96].
Trunk Impairment Scale assessing static and dynamic sitting balance of trunk coordination [97, 98].
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Furthermore, scales such as Pediatric Balance Scale, Pediatric Reach Test, Modified Posture Assessment Scale, and Gross Motor Function Measurement provides information about the trunk although they do not assess trunk impairment directly [78, 84, 86, 99].
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Among the scales indicated above, Trunk Control Measurement Scale (TCMS) [90] can be preferred because it has good inter-rater reliability, does not require equipment other than simple materials such as a measuring tape and a ruler, does not require researcher training, and can be used easily in clinical setting. Item 8 of TCMS is shown in Figures 5 and 6 [84, 86, 100].
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Figure 5.
TCMS, Item 8.
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Figure 6.
TCMS, Item 8.
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12. Assessment of health-related quality of life
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Although motor function problems are the major problems in children with CP, with the accompanying sensory, cognitive, and mental problems, activities of daily life and functional independence of the children are influenced as well. Not only children but those of the individuals taking care of them are also affected negatively. It was reported that children with CP experience emotional and behavioral problems fourfolds more than their peers. Quality of life should be self-reported by the person if possible due to its personal nature. However, this may not be possible in children with CP who have severe cognitive impairment; therefore, surveys assessing quality of life need to be answered by family or caretakers [101–103]. Surveys answered by families are used more in children who are under 18 years of age and have difficulty in communication. For children who have no communication problem and can express themselves, child reports should be used. For this purpose, questionnaires such as Pediatric Outcomes Data Collection Instrument and Child Health Questionnaire [13] are the most used ones. Child Health Questionnaire-Parent Form 50 [9], Lifestyle Assessment Questionnaire [104], KIDSCREEN [105], Cerebral Palsy Quality of Life-Child, the Caregiver Priorities and Child Health Index of Life with Disabilities [106], the Pediatric Quality-of-life Inventory CP Module [107], and the DISABKIDS CP Module [108] that are scored by families are used. According to a systematic review, for children with CP who are at school age, Cerebral Palsy Quality of Life-Child Survey is recommended due to its strongest psychometric properties and clinical utility [3, 101, 109–111].
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13. Assessment of activities of daily life
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Activities of daily life (ADL) are vital tasks of persons in their school, home, and social environment. According to ICF-CY, these activities are included in the Activity and Participation dimension, including activities such as personal care, nutrition, cleaning, etc. Motor, sensory, perception, cognition, communication, and behavioral problems existing in children with CP can affect ADL performance [112]. Children with CP have difficulty in performing activities of daily life and generally need adaptive equipment or family assistance. Therefore, activities of daily life should be assessed and attempts should be made to develop these activities. According to a systematic review, ADL scales that could be used in children with CP at the age of 5–18 are ABILHAND-Kids [113], Assessment of Motor and Process Skills [114], Children’s Hand-use Experience Questionnaire [115], Klein-Bell Activities of Daily Living [116], Functional Independence Measure for Children [14], Pediatric Evaluation of Disability Inventory [12], School Function Assessment, and Vineland Adaptive Behavior Scales [117]. Among these scales, Pediatric Evaluation of Disability Inventory was reported to be the best assessment instrument for children at an elementary school age because of its psychometric properties and personal ADL items. Children’s Hand-use Experience Questionnaire, Vineland Adaptive Behavior Scale, and Functional Independence Measure for Children were reported to be appropriate for adolescent age. Assessment of Motor and Process Skills scale was reported to be the best scale assessing ADL in adolescent children with CP regardless of age [112].
\n
\n
14. Assessments of upper extremity
\n
The upper extremity problems are observed in children with unilateral or bilateral CP but these problems can be more important for the children with unilateral involvement because the lower extremity functions are managed in this group more easily.
\n
Motor planning, sensory motor integration, and bimanual coordination problems are observed frequently in the upper extremities [118]. Manual Ability Classification System (MACS) [119] classifying the upper extremity function at five levels is used frequently. This system examines the bilateral skills of the extremities during daily life activities. Assisting Hand Assessment scale [120] assesses the use of the affected extremity during bilateral activities. Many different scales such as Melbourne Assessment of Unilateral Upper Limb Function [121], Jebsen Taylor Hand Function Test [122], Zancolli Hand Deformity Classification, Shriners Hospital Upper Extremity Evaluation [123], Upper Extremity Rating Scale, ABILHAND-Kids Questionnaire [113], Bimanual Fine Motor Function, the Quality of Upper Extremity Skills Test [124], and the Canadian Occupational Performance Measure [125] are used to assess the upper extremity function in children with CP [126]. Two items from the Quality of Upper Extremity Skills Test are shown in Figures 7 and 8. Also, musculoskeletal evaluation methods, which are mentioned above, can be specified for upper extremities.
\n
Figure 7.
An item from The Quality of Upper Extremity Skills Test.
\n
A systematic review reported that any of the scales listed above did not reveal all ICF dimensions in detail on their own and different assessment methods should be combined to assess the upper extremity performance and function in children with CP [127].
\n
Figure 8.
An item from The Quality of Upper Extremity Skills Test.
\n
\n
15. Infant assessment
\n
Today, the number of preterm and low birth weight infants is increasing gradually. These infants can present motor impairment findings ranging from developmental coordination disorder to CP in the later stages of development [128]. It may be necessary to wait until 2–3 years of age to diagnose with CP in many countries. In a study conducted in Denmark, it was reported that although CP diagnosis was made at month 11 on an average, the children were not recorded in CP registry system until 4–6 years old for finalizing that the situation is not progressive [129].
\n
However, prior to diagnosis, various assessments should be carried out and motor development should be monitored in especially risky groups. It is suggested that age-appropriate neuromotor assessments of infants with low birth weight and premature infants are made during the first year of life [130]. These assessments are crucial to ensure the differentiation of the infants with motor dysfunction and typically developing, to predict which infants will have motor influence in the future by considering their current performance and to determine the changes occurring in time [131]. Therapy approaches give the best results at this stage when brain development continues rapidly. In this context, infant neuromotor assessments are made to determine infants with motor impairment and to start the early intervention program promptly.
\n
The commonly used assessment instruments for this purpose were reported as Alberta Infant Motor Scale (AIMS) [132], Bayley Scale of Infant and Toddler Development [133], Peabody Developmental Motor Scales [134], Denver Developmental Screening Test [135], Prechtl’s Assessment of General Movements (GMs) [136], Motion Assessment of Infants, Test of Infant Motor Performance (TIMP) [137], Infant Motor Profile [138], and the Neurological Sensory Motor Developmental Assessment (NSMDA) [139] [5, 131].
\n
Among these assessment methods, some of them such as GMs assess spontaneous movements of infants without any handling and some scales assess both spontaneous behavior and motor behavior occurring with minimal handling. Only TIMP and GMs among the abovementioned tests are appropriate to be used before the term stage. In a systematic review, it was reported that GMs have the best predictive validity for CP during the early infancy stage and AIMS and NSMDA are the best scales for motor development prediction in the later months. The authors of this review suggest that more than one scale should be used in infants. They discuss that the utilization of GMS and TIMP in the preterm phase and their use along with AIMS and NDSMA will give best results in terms of predictive, discriminative, and evaluative assessments. Better results can be obtained with the repetition of the assessments in infants in certain intervals [131].
\n
\n
16. Other assessment methods
\n
In addition to all of these assessments discussed above, it may be necessary to assess other accompanying problems as well. Sleep quality in children with CP can be assessed with Children’s Sleep Habits Questionnaire [140], global mental functions can be assessed with Leiter International Performance Scale [141], global psychosocial functions with Self-perception Profile for Children and Self-perception Profile for Adolescents [142], attention functions with Behaviour Rating Inventory of Executive Function [143], communication skills with Preschool Language Scale [144] and Communication Function Classification System [145], voluntary motion control with Selective Control Assessment of the Lower Extremity [146], eating and drinking function with Eating and Drinking Ability Classification System [147], and saliva control can be assessed with Drool Severity Score [145].
\n
Pain is one of the frequently observed problems in especially advanced ages in children with CP; scores of factors can be discussed causing pain such as contractures, hip dislocation, patella alta, equines deformity, dysphagia, gastroesophageal reflux, gastrointestinal tube feeding, and constipation. Also, pain can develop originating from the used adaptive equipment and orthosis or as a result of physiotherapy, serial casting, and surgical interventions. Whereas information about pain can be assessed simply by asking the children and families or can be assessed with scales such as Non-Communicating Children’s Pain Checklist [148] and Pediatric Pain Profile (PPP) [149]. For children who have communication problems, parent proxy reports can be used. However, monitoring of findings including spontaneous motions, facial expression, breathing pattern, sweating, or blushing also provides opinion about pain.
\n
Children with CP have numerous motor, sensorial, and behavioral problems as discussed in detail above. Moreover, these problems may give different findings along with growth. Application of protective methods is necessary before the generation of many problems. In this sense, assessments are crucial. The current state of children and changes occurred with treatments can be observed in detail when the most appropriate assessment is selected from the assessments discussed above by considering ICF dimensions. Thus, both body structure and functions and activity and participation of children with CP can be improved, and inclusion of them in a society as healthier and happier individuals can be assisted.
\n
\n\n',keywords:"cerebral palsy, assessment, measurement, evaluation, physiotherapy",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/51622.pdf",chapterXML:"https://mts.intechopen.com/source/xml/51622.xml",downloadPdfUrl:"/chapter/pdf-download/51622",previewPdfUrl:"/chapter/pdf-preview/51622",totalDownloads:3784,totalViews:3546,totalCrossrefCites:3,totalDimensionsCites:3,hasAltmetrics:1,dateSubmitted:"November 26th 2015",dateReviewed:"May 16th 2016",datePrePublished:null,datePublished:"September 21st 2016",dateFinished:null,readingETA:"0",abstract:"In cerebral palsy (CP), numerous primary problems are observed including muscle tone problems, muscle weakness, insufficient selective motor control, postural control, and balance problems. In the persistence of these problems for a long period, secondary problems including torsional deformities, joint contractures, scoliosis, and hip dysplasia can occur in time, and strategies formed by children to cope with these problems make up the tertiary problems. Hence, the most accurate and brief assessment of all of these problems mentioned above is crucial to determine an effective and precise physiotherapy program. In the assessment of children with CP, it is very important to receive a detailed story consisting of the birth story, to question underlying medical situations and to carry out physical assessment. In clinics, gross motor function, muscle tone, muscle length, muscle strength, and joint range of motion assessments are the most preferred ones.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/51622",risUrl:"/chapter/ris/51622",book:{slug:"cerebral-palsy-current-steps"},signatures:"Ayşe Numanoğlu Akbaş",authors:[{id:"181610",title:"Dr.",name:"Ayşe",middleName:null,surname:"Numanoğlu Akbaş",fullName:"Ayşe Numanoğlu Akbaş",slug:"ayse-numanoglu-akbas",email:"aysenumanoglu@gmail.com",position:null,institution:{name:"Abant Izzet Baysal University",institutionURL:null,country:{name:"Turkey"}}}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. History and observation",level:"1"},{id:"sec_3",title:"3. Assessment of reflexes and reactions",level:"1"},{id:"sec_4",title:"4. Assessment of functional level and motor development",level:"1"},{id:"sec_5",title:"5. Assessment of muscle tone",level:"1"},{id:"sec_6",title:"6. Assessment of muscle strength",level:"1"},{id:"sec_7",title:"7. Assessment of musculoskeletal system deformities",level:"1"},{id:"sec_8",title:"8. Assessment of physical fitness",level:"1"},{id:"sec_9",title:"9. Assessment of gait",level:"1"},{id:"sec_10",title:"10. Assessment of balance",level:"1"},{id:"sec_11",title:"11. Assessment of trunk impairment",level:"1"},{id:"sec_12",title:"12. Assessment of health-related quality of life",level:"1"},{id:"sec_13",title:"13. Assessment of activities of daily life",level:"1"},{id:"sec_14",title:"14. Assessments of upper extremity",level:"1"},{id:"sec_15",title:"15. Infant assessment",level:"1"},{id:"sec_16",title:"16. Other assessment methods",level:"1"}],chapterReferences:[{id:"B1",body:'Schiariti, V., et al., Comparing contents of outcome measures in cerebral palsy using the international classification of functioning (ICF-CY): a systematic review. 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Research in Developmental Disabilities, 2011. 32(2): pp. 727–739.'},{id:"B98",body:'Verheyden, G., et al., The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clinical Rehabilitation, 2004. 18(3): pp. 326–334.'},{id:"B99",body:'Chen, C.-l., et al., Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy. Research in Developmental Disabilities, 2013. 34(3): pp. 916–922.'},{id:"B100",body:'Bañas, B.B. and E.J.R. Gorgon, Clinimetric properties of sitting balance measures for children with cerebral palsy: a systematic review. Physical & Occupational Therapy in Pediatrics, 2014. 34(4): pp. 313–334.'},{id:"B101",body:'Gilson, K.-M., et al., Quality of life in children with cerebral palsy implications for practice. Journal of Child Neurology, 2014. 29(8): pp. 1134–1140.'},{id:"B102",body:'Glenn, S., et al., Maternal parenting stress and its correlates in families with a young child with cerebral palsy. Child: Care, Health and Development, 2009. 35(1): pp. 71–78.'},{id:"B103",body:'Sigurdardottir, S., et al., Behavioural and emotional symptoms of preschool children with cerebral palsy: a population‐based study. Developmental Medicine & Child Neurology, 2010. 52(11): pp. 1056–1061.'},{id:"B104",body:'Mackie, P., E. Jessen, and S. Jarvis, The lifestyle assessment questionnaire: an instrument to measure the impact of disability on the lives of children with cerebral palsy and their families. Child: Care, Health and Development, 1998. 24(6): pp. 473–486.'},{id:"B105",body:'Ravens-Sieberer, U., et al., KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Review of Pharmacoeconomics & Outcomes Research, 2005. 5(3): pp. 353–364.'},{id:"B106",body:'Narayanan, U., et al., Caregiver priorities & child health index of life with disabilities: initial development and validation of an outcome measure of health status and well-being in children with severe cerebral palsy. Developmental Medicine and Child Neurology, 2006. 48: pp. 804–812.'},{id:"B107",body:'Varni, J.W., M. Seid, and C.A. Rode, The PedsQL™: measurement model for the pediatric quality of life inventory. Medical Care, 1999. 37(2): pp. 126–139.'},{id:"B108",body:'Baars, R.M., et al., The European DISABKIDS project: development of seven condition-specific modules to measure health related quality of life in children and adolescents. Health and Quality of Life Outcomes, 2005. 3(1): p. 1.'},{id:"B109",body:'Schneider, J.W., et al., Health-related quality of life and functional outcome measures for children with cerebral palsy. Developmental Medicine & Child Neurology, 2001. 43(09): pp. 601–608.'},{id:"B110",body:'Waters, E., et al., Psychometric properties of the quality of life questionnaire for children with CP. Developmental Medicine & Child Neurology, 2007. 49(1): pp. 49–55.'},{id:"B111",body:'Carlon, S., et al., A systematic review of the psychometric properties of Quality of Life measures for school aged children with cerebral palsy. BMC Pediatrics, 2010. 10(1): p. 1.'},{id:"B112",body:'James, S., J. Ziviani, and R. Boyd, A systematic review of activities of daily living measures for children and adolescents with cerebral palsy. Developmental Medicine & Child Neurology, 2014. 56(3): pp. 233–244.'},{id:"B113",body:'Arnould, C., et al., ABILHAND-Kids A measure of manual ability in children with cerebral palsy. Neurology, 2004. 63(6): pp. 1045–1052.'},{id:"B114",body:'Fisher, A.G. and K.B. Jones, Assessment of Motor and Process Skills. Vol. 375. 1999: Three Star Press Fort Collins, CO.'},{id:"B115",body:'Sköld, A., et al., Development and evidence of validity for the Children’s Hand‐use Experience Questionnaire (CHEQ). Developmental Medicine & Child Neurology, 2011. 53(5): pp. 436–442.'},{id:"B116",body:'Law, M. and P. Usher, Validation of the Klein-Bell activities of daily living scale for children. Canadian Journal of Occupational Therapy, 1988. 55(2): pp. 63–68.'},{id:"B117",body:'Sparrow, S.S., Vineland Adaptive Behavior Scales. 2011: Springer. New York, USA.'},{id:"B118",body:'Gordon, A.M., Y. Bleyenheuft, and B. Steenbergen, Pathophysiology of impaired hand function in children with unilateral cerebral palsy. Developmental Medicine & Child Neurology, 2013. 55(s4): pp. 32–37.'},{id:"B119",body:'Eliasson, A.-C., et al., The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental Medicine & Child Neurology, 2006. 48(07): pp. 549–554.'},{id:"B120",body:'Krumlinde‐Sundholm, L., et al., The Assisting Hand Assessment: current evidence of validity, reliability, and responsiveness to change. Developmental Medicine & Child Neurology, 2007. 49(4): pp. 259–264.'},{id:"B121",body:'Randall, M., et al., Reliability of the Melbourne assessment of unilateral upper limb function. Developmental Medicine & Child Neurology, 2001. 43(11): pp. 761–767.'},{id:"B122",body:'Lynch, K.B. and M.J. Bridle, Validity of the Jebsen-Taylor Hand Function Test in predicting activities of daily living. OTJR, 1989. 9(5): p. 316.'},{id:"B123",body:'Davids, J.R., et al., Validation of the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) for children with hemiplegic cerebral palsy. Journal of Bone and Joint Surgery. American Volume, 2006. 88(2): pp. 326–333.'},{id:"B124",body:'DeMatteo, C., et al., The reliability and validity of the quality of upper extremity skills test. Physical & Occupational Therapy in Pediatrics, 1993. 13(2): pp. 1–18.'},{id:"B125",body:'Law, M., et al., The Canadian occupational performance measure: an outcome measure for occupational therapy. Canadian Journal of Occupational Therapy, 1990. 57(2): pp. 82–87.'},{id:"B126",body:'Gilmore, R., L. Sakzewski, and R. Boyd, Upper limb activity measures for 5‐to 16‐year‐old children with congenital hemiplegia: a systematic review. Developmental Medicine & Child Neurology, 2010. 52(1): pp. 14–21.'},{id:"B127",body:'Wagner, L.V. and J.R. Davids, Assessment tools and classification systems used for the upper extremity in children with cerebral palsy. Clinical Orthopaedics and Related Research®, 2012. 470(5): pp. 1257–1271.'},{id:"B128",body:'Bracewell, M. and N. Marlow, Patterns of motor disability in very preterm children. Mental Retardation and Developmental Disabilities Research Reviews, 2002. 8(4): pp. 241–248.'},{id:"B129",body:'Granild‐Jensen, J.B., et al., Predictors for early diagnosis of cerebral palsy from national registry data. Developmental Medicine & Child Neurology, 2015. 57(10): pp. 931–935.'},{id:"B130",body:'Wang, C.J., et al., Quality-of-care indicators for the neurodevelopmental follow-up of very low birth weight children: results of an expert panel process. Pediatrics, 2006. 117(6): pp. 2080–2092.'},{id:"B131",body:'Spittle, A.J., L.W. Doyle, and R.N. Boyd, A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life. Developmental Medicine & Child Neurology, 2008. 50(4): pp. 254–266.'},{id:"B132",body:'Piper, M.C. and J. Darrah, Alberta Infant Motor Scale (AIMS). 1994: Philadelphia: Saunders.'},{id:"B133",body:'Bayley, N., Bayley Scales of Infant Development: Manual. 1993: Psychological Corporation, San Antonio, USA.'},{id:"B134",body:'Folio, M.R. and R.R. Fewell, Peabody Developmental Motor Scales: Examiner’s Manual. 2000: Pro-ed Press. San Antonio, USA.'},{id:"B135",body:'Frankenburg, W.K. and J.B. Dodds, The Denver developmental screening test. The Journal of Pediatrics, 1967. 71(2): pp. 181–191.'},{id:"B136",body:'Einspieler, C. and H.F. Prechtl, Prechtl’s assessment of general movements: a diagnostic tool for the functional assessment of the young nervous system. Mental Retardation and Developmental Disabilities Research Reviews, 2005. 11(1): pp. 61–67.'},{id:"B137",body:'Campbell, S., et al., Development of the test of infant motor performance. Physical Medicine and Rehabilitation Clinics of North America, 1993. 4: pp. 541–541.'},{id:"B138",body:'Heineman, K.R., A.F. Bos, and M. Hadders‐Algra, The Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy. Developmental Medicine & Child Neurology, 2008. 50(4): pp. 275–282.'},{id:"B139",body:'BURNS, Y.R., R.M. ENSBEY, and M.A. NORRIE, The neuro-sensory motor developmental assessment part 1: development and administration of the test. Australian Journal of Physiotherapy, 1989. 35(3): pp. 141–149.'},{id:"B140",body:'Owens, J.A., A. Spirito, and M. McGuinn, The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep New York, 2000. 23(8): pp. 1043–1052.'},{id:"B141",body:'Roid, G.H. and L.J. Miller, Leiter International Performance Scale-Revised (Leiter-R). 2011: Madrid: Psymtec.'},{id:"B142",body:'Harter, S., Self-Perception Profile for Children. 1983: University of Denver Press. Denver, ABD.'},{id:"B143",body:'Donders, J., D. DenBraber, and L. Vos, Construct and criterion validity of the Behaviour Rating Inventory of Executive Function (BRIEF) in children referred for neuropsychological assessment after paediatric traumatic brain injury. Journal of Neuropsychology, 2010. 4(2): pp. 197–209.'},{id:"B144",body:'Zimmerman, I.L., V.G. Steiner, and R.E. Pond, PLS-3: Preschool Language Scale-3. 1992: 2 Psychological Corporation. San Antonio, USA.'},{id:"B145",body:'Hidecker, M.J.C., et al., Developing and validating the Communication Function Classification System for individuals with cerebral palsy. Developmental Medicine & Child Neurology, 2011. 53(8): pp. 704–710.'},{id:"B146",body:'Fowler, E.G., et al., Selective Control Assessment of the Lower Extremity (SCALE): development, validation, and interrater reliability of a clinical tool for patients with cerebral palsy. Developmental Medicine & Child Neurology, 2009. 51(8): pp. 607–614.'},{id:"B147",body:'Sellers, D., et al., Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy. Developmental Medicine & Child Neurology, 2014. 56(3): pp. 245–251.'},{id:"B148",body:'Breau, L.M., et al., Psychometric properties of the non-communicating children’s pain checklist-revised. Pain, 2002. 99(1): pp. 349–357.'},{id:"B149",body:'Swiggum, M., et al., Pain in children with cerebral palsy: implications for pediatric physical therapy. Pediatric Physical Therapy, 2010. 22(1): pp. 86–92.'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Ayşe Numanoğlu Akbaş",address:"aysenumanoglu@gmail.com",affiliation:'
Department of Physical Therapy and Rehabilitation, Abant İzzet Baysal University, Bolu, Turkey
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\n
1. Introduction
\n
The LNG shipping industry had been tremendously cautious in choosing the propulsion system, and the steam turbine had been practically an exclusive option for LNG carriers over the last several decades. Influencing factors including economic consideration, environmental regulation, as well as safety issues made a profound impact on the technology developments implemented on LNG carrier propulsion systems. Since 2004 many LNG carrier projects with propulsion other than steam turbine have been under construction, such as dual-fuel diesel electric propulsion and two-stroke diesel engine propulsion with reliquefaction plant. Steam turbine domination in the LNG carrier sector has been gradually broken. So far there is no standard propulsion system that applicable to all types of LNG carriers [1, 2].
\n
The development history of the propulsion system for LNG carriers is presented in Figure 1. Steam turbine has been the dominating propulsion plant used on LNG carriers since 1960. Because it offers dual fuel burning capability, low maintenance cost and high reliability. However, in order to improve operational efficiency, reduce engine room size and increase cargo capacity, a number of alternative propulsion options have been developed in the industry. In 2004, the four-stroke dual fuel engine broke the domination of the steam turbine and started to be used on LNG carriers as a part of dual fuel diesel electric propulsion system. After 2010, two-stroke dual fuel technology has made a breakthrough and has been applied to LNG carriers, including both the high pressure and low pressure gas injection concept. The two-stroke dual fuel engines can offer substantial efficiency advantages over both the DFDE and steam turbines. So they become a popular propulsion system choice for LNG carriers.
\n
Figure 1.
LNGC fleet and order book by propulsion type (as of May 2017).
\n
The driving factors for the development of the propulsion system come from the following three aspects [3]:
Change of trade pattern. Traditionally, LNG was almost exclusively traded under inflexible long-term contracts and the vessels are operating on fixed sailing routes. However, the proportion of short-term contracts and even spot cargoes has increased substantially since 2000. So this change requires a more flexible and efficient propulsion system to accommodate various operating profiles.
Upgrading of emission regulation. The NOx emission limits and the Energy Efficiency Design Index (EEDI) are getting more and more stringent. In order to comply with the stricter regulation, the propulsion plant has to improve its emission performance and fuel efficiency.
Improvement on insulation technology. The boil off rate is significantly reduced due to the improvement in LNG tank insulation. This results in the insufficient BOG to fuel the propulsion plant and leads to the development of alternative more fuel efficient propulsion systems.
\n
After an exhaustive review of works related to propulsion systems of LNG carriers, an extensive variety of systems installed on board has been found, ranging from turbines to internal combustion engines with endless variants. Therefore, the purpose of this chapter is to investigate the various LNG carrier propulsion systems, taking into account the latest technology progress and innovation in this field.
\n
\n
\n
2. Characteristics of LNG carriers
\n
\n
2.1 Size of LNG carriers
\n
The size of an LNG carrier is based on its obtainable volumetric capacity of liquid natural gas in m3. The most common size of LNG carriers delivered or on order is between 120,000 and 180,000 m3, and often referred to as conventional type [4]. The demand for lower LNG transportation costs is most effectively met by increasing the LNG capacity of the LNG carriers. Thus, the LNG carriers to and from Qatar ordered over the last few years are of the large sizes of approx. 210,000 and 265,000 m3, and referred to as Q-flex and Q-max, respectively. The LNG carrier classes often used today can therefore be referred to as listed in Table 1.
\n
\n
\n
\n
\n\n
\n
LNG carrier classes
\n
Dimensions
\n
Ship size—LNG capacity
\n
\n\n\n
\n
Small
\n
B: up to 40 m, LOA: up to 250 m
\n
Up to 90,000 m3
\n
\n
\n
Small conventional
\n
B: 41–49 m, LOA: 270–298 m
\n
120,000–149,999 m3
\n
\n
\n
Large conventional
\n
B: 43–46 m, LOA: 285–295 m
\n
150,000–180,000 m3
\n
\n
\n
Q-flex
\n
B: approx. 50 m, LOA: approx. 315 m
\n
200,000–220,000 m3
\n
\n
\n
Q-max
\n
B: 53–55 m, LOA: approx. 345 m
\n
More than 260,000 m3
\n
\n\n
Table 1.
LNG carrier classes.
\n
\n
\n
2.2 Trade mode changes
\n
The traditional LNG trade mode is based on long term shipping contracts and dedicated fleets of ships sailing on the fixed routes and schedules between LNG terminals in the world. The LNG supply chain does not have much buffering capacity and it is very important that the cargo is delivered on time. However, due to the increasing demand and supply of LNG the number of short-term contracts and even spot trade has increased significantly.
\n
From the shipping point of view this means that the operators are bound to look for ships with more operational flexibility and efficiency in response to varying contractual situations. Primarily this calls for a flexible and efficient propulsion plant able to accommodate different ship speeds and alternative operating profiles [3].
\n
\n
\n
2.3 Boil-off gas problem
\n
Most of LNG carriers have the boil-off gas problem which takes place during storage, loading or discharging and the ship’s voyage. LNG carriers are designed to carry natural gas in liquid form at a temperature below its boiling temperature point. Despite tank insulation designed to limit the admission of external heat, even a small amount of it will cause slight evaporation of the cargo, known as boil-off gas (BOG). The amount of liquid that is evaporating from cargo due to heat leakage and expressed in % of total liquid volume per unit time. Typical values are 0.15%/day or below, recent projected LNG carriers are offered with a boil off rate close to 0.1%.
\n
The BOG result from natural evaporation is unavoidable and has to be removed from the tanks in order to maintain the cargo tank pressure. To relieve the pressure in LNG tanks, BOG can be re-liquefied, used as fuel or burned in a combustion unit. Reliquefaction occurs when evaporated LNG is cooled and reverted back to its liquid state. Excess gas can also be led to the engines which have a capability of burning gas fuel. Another alternative is to burn the unwanted gas in a combustion unit, but this results in wastage of materials and valuable energy.
\n
\n
\n
2.4 Evolution on containment system
\n
Categorization of containment systems for LNG carriers is shown in Figure 2. The IGC code categorizes cargo tanks into two main types: integral tanks and independent tanks. In addition, the integral tanks are mainly of membrane type and the independent tanks can be further classified into three subcategories, which are referred to as Type A, Type B and Type C. For small-scale LNG carriers and LNG fuelled ships other than LNG carriers, we typically use type C tank. On large-scale carriers, type B and membrane tanks are mainly used. From the fleet breakdown by containment system, we found that over 70% of the active fleet had a membrane tank. This is most likely because prismatic membrane tanks utilize the hull shape more efficiently, and thus have less void space between the cargo tanks and ballast tanks. However, self-supporting type B tanks are more robust and have greater resistance to sloshing forces.
\n
Figure 2.
Categorization of containment systems for LNG carriers.
\n
\n
\n
2.5 Regulatory framework
\n
The safety requirements for the propulsion system are specified by the international code and classification rules and the regulatory framework is constantly improving along with the development of the propulsion system. Since the dual fuel engines are extensively used on LNG carriers, the revised IGC code has included the gas-fuelled engines. IACS proposed new Unified Requirement to cover the low pressure gas engines. Classifications also issued dedicated rules or guidelines for propulsion system applied on LNG carriers. ABS (American Bureau of Shipping) has issued guide for propulsion systems for LNG carriers, and CCS (China Classification Society) has released guidelines for design, installation and testing of gas engines on LNG carriers [5, 6].
\n
\n
\n
\n
3. Propulsion options for LNG carriers
\n
The propulsion system for LNG vessels is closely related with the generation and consumption of the BOG [7]. There are various proposed propulsion systems being used and considered by the industry. From the categorization of propulsion systems for LNG carriers as shown in Figure 3, we can see that the prime movers include steam turbine, gas turbine, diesel engine, dual fuel engine. Based on the prime movers and their combinations, we have six propulsion system options, including steam turbine propulsion, dual fuel diesel electric propulsion, slow speed dual fuel engine propulsion, gas turbine propulsion, slow speed diesel engine propulsion with re-liquefaction plant, and hybrid propulsion system based on steam turbine and gas engine.
\n
Figure 3.
Categorization of propulsion systems for LNG carriers.
\n
\n
3.1 Steam turbines
\n
Figure 4 shows a simplified schematic of a typical steam propulsion system. A steam turbine based propulsion system usually comprises two gas/HFO fuelled boilers supplying overheated high pressure steam, typically at a pressure of 60–70 bar at 520°C, to the high and low pressure turbines driving a single propeller via a reduction gearbox [8, 9]. The steam is also used to feed turbo generators which provide electric power for auxiliary services (e.g., hotel load, powering pumps). Two turbo generators are installed to guarantee the redundancy, and each one has a power capacity capable of covering the peak load demand which is normally during full rate cargo discharge. Two auxiliary diesel engines are installed as well, with a combined capacity equal to one of the turbo generator sets, as a safety requirement to supply sufficient power during black outs. The excessive BOG generated in situations when the steam turbine is out of service or at low load is also burned in the boilers, and the steam generated is dumped in the condenser to dissipate the energy to the sea. Through this simple philosophy it is able to stabilize the tank pressure, eliminating the need for a gas combustion unit (GCU).
\n
Figure 4.
Simplified schematic of a steam propulsion system [9].
\n
The boilers can burn the heavy fuel oil (HFO) and boil-off gas (BOG) simultaneously at any liquid/gas ratio, thus offering a very easy method to handle the BOG. In addition, the steam turbine propulsion is also featured with ease of use, intrinsic reliability, and reduced maintenance costs. However, the steam turbine has the lowest overall efficiency of the propulsion system available, approximately 35% at full load and the efficiency becomes lower as the turbine load goes down, which directly led to high fuel cost and the resulting high CO2 emissions. Another disadvantage is the steam turbine is not space efficient, so in the case of Q-Flex/Q-Max ships with twin screw designs, it is very difficult to arrange side by side steam turbine machinery in the engine rooms. Therefore, steam turbine propulsion is not a feasible solution for Q-Flex/Q-Max ships.
\n
\n
\n
3.2. Dual fuel diesel electric
\n
The other big group of vessels with non-steam propulsion is featured with Dual Fuel Diesel Electric plants (DFDE). The DFDE configuration provides a more straightforward and simple layout of the propulsion system. The DFDE propulsion system employs multiple engines of the same type, typically four or five, coupled to electrical generators to supply energy to the entire ship including propulsion, which is driven by means of electric motors [10]. The schematic of a four-stroke DFDE propulsion system is shown in Figure 5.
\n
Figure 5.
Schematic main machinery of a four-stroke DFDE plant [10].
\n
Dual fuel engines can operate on BOG, MDO or HFO. Duel fuel engines have different operation modes depending on the fuel to be used. When gas is burned as fuel (gas mode), the engine adopts the concept of the lean Otto cycle. On the contrary, if MDO or HFO are used, the engine operates at diesel cycle (diesel mode). In Gas Mode, the BOG is injected to the air intake before each cylinder individually through a gas admission valve, where it is mixed with the charged air before entry to the combustion chamber. The mechanism enables the compressing and injecting of the BOG at a relatively low pressure, approximately 5–6 bar, which reduce the complexity of the fuel gas supply system and thus the risks using methane at high pressure in the engine room. A small amount (approx. 1%) of MDO is also required as a pilot fuel when operating on gas, giving a high-energy ignition source for the main fuel gas charge in the combustion chamber. In diesel mode, the DF-engine works resemble any diesel engine, utilizing traditional jerk pump fuel injection system. Switching between the two operating modes can be conducted stably without interruption in power supply. Gas mode and diesel mode follow the different operating principles, and as a result they have different operating features. The diesel mode performances better in terms of thermal efficiency and dynamic response, while the Gas mode has advantages in terms of fuel cost and exhaust emissions.
\n
The combustion control system is an important issue that must be taken into account in DF engines. In gas mode following Otto cycle, as the engine load increased along with the mean effective pressure, the operating window between misfiring and knocking becomes narrower. To stay within the operating window and have optimal performance for all cylinders regarding safety, efficiency and emissions in all conditions, it requires a system to control the combustion process each cylinder individually and precisely.
\n
The largest dual fuel engines available can develop 950–1000 kW per cylinder and are configured as L-type of 6–9 cylinders or V-type of 12–18 cylinders. The number of engines and configuration of cylinder are selected so as to provide as near optimal loading as possible for the engines required to be operated during the various working conditions of the vessel. With a multi-engine configuration, the DFDE propulsion system provides a superior performance in terms of redundancy and safety.
\n
If there is more BOG available than the power required for the propulsion or electric load, then the excess BOG is sent to the gas combustion unit (GCU). The installed capacity of GCU is usually sized to handle the total BOG capacity on a typical laden journey.
\n
In the DFDE concept, since the power demand for propulsion and cargo handling are in different operating time phase the installed power of the ship can be considerably reduced compared with other mechanical propulsion system, which is a notable advantage. The drawback of this propulsion system is the high investment and maintenance costs, resulting from the dual fuel engines and the increased amount of equipment comprised in the electric propulsion system.
\n
\n
\n
3.3 Two-stroke slow speed diesel engine with re-liquefaction plant
\n
Two-stroke slow speed diesel engines are predominant propulsion plant in merchant shipping, which is benefit from its high efficiency, capability of burning low-quality low cost fuels, and low maintenance costs. Since the two-stroke slow speed engine is a single fuelled (HFO) propulsion plant without a BOG burning capability, the natural BOG from cargo tanks shall be liquefied and sent back to cargo tanks. With the increase in LNG carrier’s dimension to approximately 210,000 and 265,000 m3, referred to as Q-flex and Q-max respectively, the volume of BOG of the tanks has increased significantly and is now within the capacity range of re-liquefaction plant. In this context, the two-stroke slow speed diesel engines with re-liquefaction plant turn into a feasible and attractive option for the ship owners. For this kind of propulsion concept, the abbreviation SSDR is typically used for reference.
\n
The schematic main machinery of a two-stroke diesel engine powered LNG carrier with re-liquefaction plant is illustrated in Figure 6. The main machinery of SSDR based LNG carrier of Q-flex/Q-max size typically comprises two low speed diesel engines for propulsion in twin screw format, and four auxiliary generator sets for electric power generation. The re-liquefaction plant is used for re-liquefying the BOG generated in cargo tanks and returning it to into a liquid state, maintaining a proper pressure in cargo tanks, and moreover avoiding any wastage of the LNG being transported. Besides, a GCU is also equipped to burn the BOG generated which, in case of re-liquefaction plant failures, would be impossible to treat, avoiding the pressure increase in the tanks and could cause great damage.
\n
Figure 6.
Schematic main machinery of a two-stroke LNG carrier with re-liquefaction plant [10].
\n
The BOG re-liquefaction principal is based on a closed cycle using nitrogen as a refrigerant, absorbing the heat from BOG. In this cycle, cargo boil off is suctioned from the LNG tanks and compressed to 5 bar by a low duty compressor, and then the vapor is cryogenically cooled to −160°C in a heat exchanger. This ensures condensation of all hydrocarbons in the BOG so they can be converted back to LNG, while the nitrogen and other non-condensable remain at gaseous state. These gas impurities are finally removed in a gas-liquid separator where the LNG is separated and delivered back to the cargo tanks with the nitrogen-rich non-condensable gases either discharged to the atmosphere or burnt in the GCU.
\n
The operation of a re-liquefaction plant requires a high electric power supply by auxiliary generators composed of either 3 or 4 power generators. Taking the case of a 149,000 m3 LNG vessel, the re-liquefaction plant has a consumption of 3.5-7 MW depending on the BOG generated in the cargo tanks. The vessel’s net auxiliary power is therefore increased to the order of 14 and 16 MW. Considering the overall performance of the system, the tremendous power consumption of the re-liquefaction plant substantially diminishes the efficiency advantages provided by the two-stroke slow speed diesel engines.
\n
\n
\n
3.4 Slow speed dual fuel engine
\n
The propulsion system of choice for the majority of LNGC new buildings was the four-stroke engine based DFDE option, from around 2002 until 2012. In December 2012, the slow speed two-stroke dual fuel engines received the first orders for a pair of gas fuelled container vessels, marked the beginning of the two-stroke dual-fuel power train era. Dual fuel engines of two-stroke low-speed types offer major propulsive efficiency advantages over both the DFDE and steam turbines, the most popular propulsion system options during the early stages of development for LNG carriers. Distinct technical routes have been adopted by the two main manufacturers. MAN Diesel & Turbine utilize the high pressure concept while Wartsila focuses on the low pressure concept.
\n
Initial LNG ship owner interest in two-stroke, dual-fuel propulsion was focused primarily on the MDT high-pressure plant, known as its Mechanically operated, Electronically controlled, Gas Injection (ME-GI) diesel engine. In recent years, the WinGD low pressure X-DF two-stroke engines have also undergone substantial development and application [11].
\n
\n
3.4.1 High pressure
\n
Figure 7 shows the schematic main machinery of a ME-GI propulsion plant. The ME-GI high pressure gas engines operate on the diesel cycle. The BOG is pressurized through the fuel gas supply system (FGSS), and then directly injected at high pressure (250–300 bar) into the cylinder after the diesel pilot fuel has ignited near the top dead center. It is claimed that this concept would have significant advantages compared with the premixed Otto cycle gas process, i.e. eliminates the risk of knocking and capable of burning gas from any source irrespective of the methane number, due to the fact that the fuel gas is not involved in the compression stroke. This concept makes it possible to utilize high compression ratio designs, thereby offering higher energy efficiency. For a LNG carrier with a capacity of 145,000 m3 or larger, double ME-GI engine solution is the most attractive option, providing the redundancy in terms of propulsion.
\n
Figure 7.
Schematic main machinery of a ME-GI propulsion plant (high-pressure gas).
\n
The high pressure FGSS for ME-GI engines have two basic system configurations. One system where a piston compressor feeds the ME-GI with high-pressure fuel gas, and one system where an LNG pump and a vaporizer feed the ME-GI with high pressure gas [12, 13]. Besides, a combined option based on the compressor and the LNG pump solution also offers a feasible configuration. For dealing with the BOG exceeds the capability of FGSS or the demand of the engines, a full or partial re-liquefaction system can be installed on board.
\n
The high pressure gas is supplied from the FGSS to the engine room through a double wall piping system, where the gas fuel is contained in the inner pipe and space between the gas fuel piping and the wall of the outer pipe or duct shall be equipped with mechanical underpressure ventilation. This specific arrangement secures that the engine room is regarded as an ordinary engine room rather than a hazardous area, which complies with requirement of “inherently gas safe machinery spaces” specified in the IMO IGF code.
\n
In terms of emissions, the high pressure two-stroke engines reduce the NOx emissions by 40% compared to HFO without exhaust gas treatment, which fulfills the IMO Tier II NOx limits. To achieve Tier III limits, ME-GI engine requires equipping with an EGR or SCR system. Furthermore, the CO2 emissions are reduced by approximately 24% and methane emissions are at a very low level.
\n
\n
\n
3.4.2 Low pressure
\n
Figure 8 shows the schematic main machinery of an X-DF propulsion plant. The low pressure X-DF technology is based on the lean-burn Otto cycle, in which fuel and air are premixed and burned at a relatively high air-to-fuel ratio. When gas admission in the cylinder occurs, the piston is at about mid stroke of the compression phase and therefore the pressure in the combustion chamber is low. This allows the gas to be injected at low pressure, ranging from 5 to 16 bar. With the low-pressure gas injection, the gas-air mixtures need an ignition source to start the combustion. The most common ignition method is using a fuel oil pilot injection, with the amount of fuel as low as 0.5% of the total injected fuel [14].
\n
Figure 8.
Schematic main machinery of a X-DF propulsion plant (low-pressure gas).
\n
The low pressure concept offers the possibility of applying a simple FGSS, since the fuel gas is mixed with the scavenge air at about mid stroke position, the required gas injection pressure is below 16 bar at any operating point. It is claimed that the FGSS is relatively simple, reliable and well-proven. In addition, low pressure gas supply means wider selection of system vendors and installation of less auxiliary engine power, thereby lowering the investment and operating costs.
\n
The most significant advantage of the low-pressure X-DF engine is the low level of emissions of any exhaust gas element. As the low-pressure X-DF engine has a pre-mixed homogeneous lean mixture of gas and air in the combustion chamber, the flame temperatures are relatively low. This results in low levels of NOx production without any after treatment system, approximately 50% of the IMO Tier III limits. Besides, the weighted average of relative methane emission is about 3 g/kWh.
\n
\n
\n
3.4.3 Comparison of the two options
\n
Since WinGD X-DF and MAN ME-GI use distinct technical routes, each option has its own advantages and disadvantages in terms of power performance, emission and economy, as the comparison shown in Table 2. The low pressure engines have certain advantages in terms of NOx emissions, gas fuel supply systems and investment costs, while high pressure engines perform better in terms of power, thermal efficiency, gas compatibility and methane slip [15].
\n
\n
\n
\n
\n\n
\n
\n
Low pressure (WinGD X-DF)
\n
High pressure (MAN ME-GI)
\n
\n\n\n
\n
Power performance
\n
\n
BMEP: 17.3 bar
Output: approx. 17% lower than the diesel engine counterpart
Dynamic response: poorer than diesel engine
\n
\n
\n
BMEP 21 bar
Output: comparable with the diesel engine counterpart
Dynamic response: comparable with diesel engine
\n
\n
\n
\n
Thermal efficiency
\n
Approx. 47%
\n
Approx. 50%
\n
\n
\n
NOx emission
\n
IMO Tier III
\n
IMO Tier II
\n
\n
\n
CH4 slip
\n
3 g/kWh
\n
0.2 g/kWh
\n
\n
\n
Methane Number (MN)
\n
MN ≥ 65 (DCC technology)
\n
Adapt to various MN
\n
\n
\n
Gas consumption
\n
140–142 g/kWh @100%MCR
\n
136–138 g/kWh @100%MCR
\n
\n
\n
Pilot fuel consumption
\n
\n
0.8 g/kWh@100%MCR
2.7 g/kWh@30%MCR
\n
\n
\n
5 g/kWh@100%MCR
12 g/kWh@30%MCR
\n
\n
\n
\n
Fuel gas supply system
\n
\n
LNG pump: centrifugal pump, with simple structure and low maintenance requirement
Low pressure gas compressor: a large variety of products, small size and weight, low energy consumption
Low pressure vaporizer: low cost and mature technology
\n
\n
\n
Low pressure vaporizer: low cost and mature technology
High pressure gas compressor: few products, large size and heavy weight, high energy consumption
\n
\n
\n
\n
CAPEX
\n
\n
For LNG fuelled vessels, the CAPEX of high pressure fuel and gas supply system is approx. 15% higher.
For LNG carriers, the CAPEX of high pressure fuel and gas supply system is approx. 40% higher.
\n
\n
\n
\n
OPEX
\n
The two options are comparable
\n
\n\n
Table 2.
Comparison of the low pressure system and high pressure system.
\n
\n
\n
\n
3.5 COGES propulsion
\n
Aircraft derivative gas turbine has been used as propulsion machinery for navy ships and electric power generator combined with steam or diesel generators for cruise vessels. The gas turbine is an innovative option introduced on LNG vessels because of their dual fuel (gas and diesel oil) burning capability, high reliability derived from the aeronautical industry, high power/weight ratio, and excellent emission performance [16]. However, the relative low thermal efficiency along with the requirement of using MGO as a backup fuel which with a relative high price, hampers the gas turbines to be an attractive option to be applied on LNG carriers. The gas turbines combined with a steam turbine cycle for waste heat recovery, referred to as Combined Gas turbine Electric & Steam system (COGES), enable the overall efficiency increase to 40%.
\n
With the COGES system, the gas turbine drives the generator, which feeds into the main switchboard in turn and provides the electric power and propulsion demand. The propeller is driven by a frequency-controlled electric motor. The exhaust gases from the gas turbine are used to raise steam in a heat recovery steam generator (HRSG). This steam drives the steam turbine generator in turn, which also feeds into the main switchboard.
\n
The schematic main machinery of a COGES propulsion plant (Rolls-Royce) is illustrated in Figure 9. The COGES designed by the manufacturer Rolls-Royce has two GTs with different powers, one of 36 MW and another of 5 MW. In addition, a 10 MW steam turbine is coupled with a HRSG. During sailing, only the main GT, HSRG, and steam turbine would be in service, providing the electric power and propulsion demand. The purpose of the less powerful turbine (5 MW) is to generate power at port, hence avoiding running the main GT at high fuel consumption.
\n
Figure 9.
Schematic main machinery of a COGES propulsion plant (Rolls-Royce).
\n
Another COGES configuration is designed by the manufacturer General Electric. The schematic main machinery of this COGES propulsion plant (General Electric) is illustrated in Figure 10. The COGES system has two 20 MW gas turbines, thereby increasing the reliability because the system could guarantee 50% of the electric power supply to continue with the voyage in case of a GT failures. However, as it does not have a low power auxiliary generator as in the case of the Rolls-Royce design, this will result in high consumption while at port. This system requires installing a more powerful steam turbine, approximately 15 MW, to meet the larger demand of waste heat recovery.
\n
Figure 10.
Schematic main machinery of a COGES propulsion plant (General Electric) [20].
\n
The primary disadvantage of gas turbines is the relatively high capital cost, stemming from the fact that the overall drive system is more complex and expensive than mechanical drives. For a 20–30 MW class gas turbine, its capital cost is approximately 15–20% higher than its diesel engine counterpart. Besides, gas turbines do not have their line-up of engine types for the customer’s selection upon various power demands like diesel engines.
\n
\n
\n
3.6 STaGE propulsion
\n
STaGE is an abbreviation for Steam Turbine and Gas Engine, which is a hybrid propulsion system that comprises an ultra-steam turbine (UST) plant on the port side and a combination of a dual-fuel engine and a propulsion electric motor (DFE-PEM plant) on the starboard side [17]. The dual-fuel engine can work on both gas and oil. The configuration of a STaGE propulsion plant is shown in Figure 11.
\n
Figure 11.
Schematic main machinery of a STaGE propulsion plant (Mitsubishi Heavy Industries) [17].
\n
By using a waste heat recovery system of STaGE plant, the exhaust gas and jacket waste heat from the dual-fuel engine are recovered to heat the feed water going toward the UST plant, achieving significant improvement in fuel efficiency. In the UST plant, the heated feed water flows to the boiler to generate steam to be used to drive the turbine. The electricity generated by the dual-fuel engine drives the propulsion electric motor. Typically, a huge amount of waste heat from the dual-fuel engine is dumped into the exhaust-gas and jacket cooling water. But the STaGE plant uses the waste heat to heat the boiler feedwater, enhancing the total efficiency of the propulsion plant. The waste heat from the dual-fuel engine is also recycled to generate auxiliary steam as well as the drive steam for the main turbine, also enhancing total efficiency. Instead of a turbine generator used in conventional steam turbine plants, the power generator of the dual-fuel engine supplies power to the ship, achieving a simpler plant configuration and higher efficiency. As such, the STaGE plant achieves significant efficiency enhancement by combining two different propulsion engines and by optimizing the waste heat energy.
\n
A typical LNG carrier equipped with STaGE plant emits about 40% less CO2 per cargo unit than conventional LNG carriers with a cargo capacity of 147,000 m3 propulsed by a conventional turbine plant. Furthermore, gas burning is available in all operation modes, including in harbors, achieving high environmental performance that meets the IMO Tier III emission regulations implemented in the global ECA. The STaGE plant gains high-reliability by combining the proven turbine plant and DFE-PEM plant and high-redundancy by using different propulsion systems on both port and starboard sides.
\n
\n
\n
\n
4. Comparison and evaluations
\n
\n
4.1 Economic factors
\n
Figure 12 indicates the trends of investment cost and delivery schedule of LNG carriers of different propulsion system. During the 2000s, the average construction cost of LNG carrier kept within a narrow scope. The swift increase in demand for vessels using new propulsion technologies starting from 2014, particularly DFDE propulsion based vessels, pushed average construction costs to rise from $1300/m3 in 2005 to $1770/ m3 in 2014. This increase was mainly due to the icebreaker vessels in Yamal LNG project. Nevertheless, the costs for TFDE and ME-GI vessels in 2017 reduced to $1072/m3 and $1082/m3, respectively [18].
\n
Figure 12.
Trends of investment cost and delivery schedule [18].
\n
In most cases, it takes 30–50 months to complete the construction of a vessel after the order is confirmed. However, the different type of propulsion system also affects the delivery schedule of the vessels. For example, when DFDE vessels were first ordered in the early 2000s, it takes longer time to delivery as shipyards need longer time to apply the new propulsion technology. The delivery time of DFDE carriers between 2006 and 2010 reached an average length of 50 months, but cut down to 37 months after 2010. If a sister ship is ordered, the delivery time can be reduced to within 24 months, because few modifications are required in design.
\n
Trends of LNG spot charter rates are illustrated in Figure 13. During the most of 2017, spot charter rates kept a low level, approximately $23,500/day for conventional steam carriers and $37,000/day for DFDE carriers. The gap between charter rates for conventional steam carriers and DFDE carriers has remained because the larger and more fuel-efficient carriers are more preferred by the charterers. The charter rates of vessels equipped with ME-GI and X-DF propulsion systems are even higher than that of DFDE carriers as the newer technologies can offer increased efficiency. Remarkably, toward the end of the year, there was a significant increase in the charter rates. For conventional steam carriers, the charter rates reached an average $44,300/day, while the charter rates for DFDE carriers reached an average $81,700/day.
\n
Figure 13.
Trends of LNG spot charter rates [18].
\n
\n
\n
4.2 Propulsion efficiency
\n
The propulsion efficiency is calculated based on the thermal efficiency of the engine and the transmission efficiency of the components, as shown in Table 3. LSDF can achieve the efficiency nearly 50% owing to the high efficiency of 2-Stroke DF Engine and direct mechanical driving. The propulsion efficiency of UST, SSDR, DFDE and COGES has almost similar performance, ranging from 40 to 42%. The efficiency of SSD is reduced mainly due to extra power consumed by the re-liquefaction plant.
\n
Table 3.
Propulsion efficiency of different propulsion options.
\n
\n
\n
4.3 Emission performance
\n
The comparison of emission performance of different propulsion system is illustrated in Figure 14 and Table 4. In terms of SOx emission, SSDR and ST have higher SOx emission since they burn the HFO purely and partially, respectively. DF engine’s SOx emissions are from sulfur in the pilot fuel and hence are much lower than SSDR and ST.
\n
Figure 14.
Emission performance of different propulsion options.
\n
\n
\n
\n
\n
\n
\n
\n\n
\n
Fuel
\n
DFDE
\n
ME-GI
\n
X-DF
\n
COGES
\n
STaGE
\n
\n\n\n
\n
LNG
\n
IMO Tier III
\n
IMO Tier II
\n
IMO Tier III
\n
IMO Tier III
\n
IMO Tier III
\n
\n
\n
MGO
\n
IMO Tier II
\n
IMO Tier II
\n
IMO Tier II
\n
IMO Tier III
\n
IMO Tier II
\n
\n\n
Table 4.
Comparison of emission performance of different propulsion options [20].
\n
In term of NOx emission, SSDR and LSDF-HP have relatively higher NOx emission. DFDE, ST and COGES release lower NOx missions. GT produces approx. 2–3 times NOx in comparison to ST. COGES can comply with Tier III in both gas and MGO mode [19].
\n
\n
\n
4.4 Development trends
\n
By comparing the order book and the active fleet, as shown in Figure 15, we can see that the orderbook reflects a variety of new propulsion systems, including LSDF(HP), LSDF(LP), UST and STaGE. The preferred option is shifted from DFDE to slow speed dual fuel engine, LSDF accounting for 57% of the orders while DFDE accounting for 28%. MAN ME-GI high pressure engines have evolved into a popular propulsion choice. WinGD X-DF low pressure technology has been gradually gaining ground recently. Improved steam propulsion, including UST and StaGE, have entered into the commercial arena.
\n
Figure 15.
Development trends of propulsion system.
\n
\n
\n
\n
5. Conclusion
\n
The economic market trends as well as global emission regulations are leading to diversified development of propulsion systems for LNG carriers.
The UST, improved based on the conventional ST, substantially increase the thermal efficiency and emission performance (approx. 15%).
LSDF(HP) featured with high fuel efficiency, free of knocking risk and negligible methane slip remains a popular propulsion option.
LSDF(LP) can offer relatively less capital cost and Tier III compliance, and thus has been gaining ground recently.
COGES can offer excellent emission performance and design & arrangement flexibility, the high capital cost, however, makes this technology being awaiting the first order.
STaGE, as a hybrid propulsion system combining UST and DFDE and providing high reliability and improve efficiency, has entered into the commercial arena.
\n
In conclusion, there is not a unique optimum solution for the propulsion of LNG carriers. Each option has its advantages and disadvantages that must be evaluated before the selection of the propulsion plant for a specific project. Therefore, the decision for which propulsion system to be utilized, must be examined case by case, based on the specific size of the vessel, the operating profile (speed, trade mode and distance, use of natural BOG and forced BOG or BOG and fuel oil as add-on, or fuel oil only and BOG re-liquefaction, etc.), the fuel oil and LNG price trends and the availability of bunkers of the correct grade in the operating route, the initial cost and maintenance cost, the emission regulation compliance, the crew availability and so on.
\n
\n
\n
Nomenclature
\n
\n\n\nABS\n\n
American Bureau of Shipping
\n\n\n\nBOG\n\n
boil-off gas
\n\n\n\nBMEP\n\n
brake mean effective pressure
\n\n\n\nCCS\n\n
China Classification Society
\n\n\n\nCOGES\n\n
combined gas turbine electric & steam system
\n\n\n\nCST\n\n
conventional steam turbine
\n\n\n\nDFDE\n\n
dual fuel (medium-speed) diesel electric propulsion
\n\n\n\nEEDI\n\n
energy efficiency design index
\n\n\n\nEGR\n\n
exhaust gas recirculation
\n\n\n\nFGSS\n\n
fuel gas supply system
\n\n\n\nGCU\n\n
gas combustion unit
\n\n\n\nGT\n\n
gas turbine
\n\n\n\nHFO\n\n
heavy fuel oil
\n\n\n\nHP\n\n
high pressure
\n\n\n\nHRSG\n\n
heat recovery steam generator
\n\n\n\nIACS\n\n
International Association of Classification Societies
\n\n\n\nIGC Code\n\n
international code for the construction and equipment of ships carrying liquefied gases in bulk
\n\n\n\nLNG\n\n
liquefied natural gas
\n\n\n\nLNGC\n\n
liquefied natural gas carrier
\n\n\n\nLOA\n\n
length over all
\n\n\n\nLP\n\n
low pressure
\n\n\n\nLSDF\n\n
low speed dual fuel
\n\n\n\nMDO\n\n
marine diesel oil
\n\n\n\nMN\n\n
methane number
\n\n\n\nSCR\n\n
selective catalytic reduction
\n\n\n\nSSDR\n\n
slow speed diesel with re-liquefaction plant
\n\n\n\nST\n\n
steam turbine
\n\n\n\nSTaGE\n\n
steam turbine and gas engine
\n\n\n\nTFDE\n\n
tri-fuel diesel electric propulsion
\n\n\n\nUST\n\n
ultra steam turbine
\n\n\n
\n
\n\n',keywords:"LNG carrier, propulsion system, steam turbine, gas turbine, dual fuel diesel electric propulsion, slow speed dual fuel engine",chapterPDFUrl:"https://cdn.intechopen.com/pdfs/64509.pdf",chapterXML:"https://mts.intechopen.com/source/xml/64509.xml",downloadPdfUrl:"/chapter/pdf-download/64509",previewPdfUrl:"/chapter/pdf-preview/64509",totalDownloads:3087,totalViews:0,totalCrossrefCites:2,dateSubmitted:"July 3rd 2018",dateReviewed:"October 21st 2018",datePrePublished:"February 14th 2019",datePublished:"October 7th 2019",dateFinished:null,readingETA:"0",abstract:"The LNG carriers are undergoing a period of rapid and profound change, with much larger size ships and novel propulsion systems emerging for fulfilling the market trends of LNG shipping industry. There are various proposed propulsion solutions for LNG carriers, ranging from the conventional steam turbine and dual fuel diesel electric propulsion, until more innovative ideas such as slow speed dual fuel diesel engine, combined gas turbine electric & steam system, and hybrid propulsion based on steam turbine and gas engine. Since propulsion system significantly influenced the ship’s capital, emission regulation compliance and navigation safety, the selection of a proper propulsion option with technical feasibility and economic viability for LNG carriers is currently a major concern from the shipping industry and thus must be comprehensively assessed. In this context, this chapter investigated the main characteristics of these propulsion options in terms of BOG treatment, fuel consumption, emission standards compliance, and plant reliability. Furthermore, comparisons among different propulsion system were also carried out and related evaluation was presented.",reviewType:"peer-reviewed",bibtexUrl:"/chapter/bibtex/64509",risUrl:"/chapter/ris/64509",signatures:"Tu Huan, Fan Hongjun, Lei Wei and Zhou Guoqiang",book:{id:"7198",title:"Propulsion Systems",subtitle:null,fullTitle:"Propulsion Systems",slug:"propulsion-systems",publishedDate:"October 7th 2019",bookSignature:"Alessandro Serpi and Mario Porru",coverURL:"https://cdn.intechopen.com/books/images_new/7198.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"217145",title:"Dr.",name:"Alessandro",middleName:null,surname:"Serpi",slug:"alessandro-serpi",fullName:"Alessandro Serpi"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}},authors:[{id:"265951",title:"Mr.",name:"Huan",middleName:null,surname:"Tu",fullName:"Huan Tu",slug:"huan-tu",email:"tuhuan2011@126.com",position:null,institution:null}],sections:[{id:"sec_1",title:"1. Introduction",level:"1"},{id:"sec_2",title:"2. Characteristics of LNG carriers",level:"1"},{id:"sec_2_2",title:"2.1 Size of LNG carriers",level:"2"},{id:"sec_3_2",title:"2.2 Trade mode changes",level:"2"},{id:"sec_4_2",title:"2.3 Boil-off gas problem",level:"2"},{id:"sec_5_2",title:"2.4 Evolution on containment system",level:"2"},{id:"sec_6_2",title:"2.5 Regulatory framework",level:"2"},{id:"sec_8",title:"3. Propulsion options for LNG carriers",level:"1"},{id:"sec_8_2",title:"3.1 Steam turbines",level:"2"},{id:"sec_9_2",title:"3.2. Dual fuel diesel electric",level:"2"},{id:"sec_10_2",title:"3.3 Two-stroke slow speed diesel engine with re-liquefaction plant",level:"2"},{id:"sec_11_2",title:"3.4 Slow speed dual fuel engine",level:"2"},{id:"sec_11_3",title:"3.4.1 High pressure",level:"3"},{id:"sec_12_3",title:"3.4.2 Low pressure",level:"3"},{id:"sec_13_3",title:"Table 2.",level:"3"},{id:"sec_15_2",title:"3.5 COGES propulsion",level:"2"},{id:"sec_16_2",title:"3.6 STaGE propulsion",level:"2"},{id:"sec_18",title:"4. Comparison and evaluations",level:"1"},{id:"sec_18_2",title:"4.1 Economic factors",level:"2"},{id:"sec_19_2",title:"4.2 Propulsion efficiency",level:"2"},{id:"sec_20_2",title:"4.3 Emission performance",level:"2"},{id:"sec_21_2",title:"4.4 Development trends",level:"2"},{id:"sec_23",title:"5. Conclusion",level:"1"},{id:"sec_24",title:"Nomenclature",level:"1"}],chapterReferences:[{id:"B1",body:'Fernández IA, Gómez MR, Gómez JR, et al. Review of propulsion systems on LNG carriers. Renewable and Sustainable Energy Reviews. 2017;67:1395-1411'},{id:"B2",body:'Attah EE, Bucknall R. An analysis of the energy efficiency of LNG ships powering options using the EEDI. Ocean Engineering. 2015;110:62-74'},{id:"B3",body:'Kosomaa J. The DF-electric LNG carrier concept. In: GASTECH. 2002'},{id:"B4",body:'MAN Diesel and Turbo. Propulsion Trends in LNG Carriers. Available from: https://www.mandieselturbo.com/docs/default-source/shopwaredocuments/propulsion-trends-in-lngb395958927f2417aa98957b04cbb684a.pdf?sfvrsn=4'},{id:"B5",body:'ABS (American Bureau of Shipping). Guide for Propulsion Systems for LNG Carriers. Houston: ABS Plaza; 2005'},{id:"B6",body:'CCS (China Classification Society). Guidelines for Design and Installation of Gas Fuelled Engines on Liquefied Gases Carriers. Beijing: China Communications Press; 2018'},{id:"B7",body:'Chang D, Rhee T, Nam K, et al. A study on availability and safety of new propulsion systems for LNG carriers. Reliability Engineering & System Safety. 2008;93(12):1877-1885'},{id:"B8",body:'Sinha RP, Nik WMNW. Investigation of propulsion system for large LNG ships. IOP Conference Series: Materials Science and Engineering. 2012;36(1):012004'},{id:"B9",body:'Class NK. Guidelines for Dual Fuel Diesel Engines. Chiba: Nippon Kaiji Kyokai; 2008'},{id:"B10",body:'Michael Wenninger and Sokrates Tolgos. LNG Carrier Power: Total Fuel Flexibility & Maintainability with 51/60DF Electric Propulsion. Augsburg, Germany: MAN Diesel SE; 2008. Available from: https://marine.mandieselturbo.com/docs/librariesprovider6/technical-papers/lng-carrier-power.pdf?sfvrsn=6'},{id:"B11",body:'LNG World Shipping. More LNG owners choose low-pressure, two-stroke engines. March/April 2018. Available from: https://www.lngworldshipping.com/news/view,lng-owners-choose-lowpressure-twostroke-engines_50482.htm'},{id:"B12",body:'Juliussen L. MAN B & W ME-GI engines recent research & results. In: ISME KOBE. 2011'},{id:"B13",body:'MAN Diesel and Turbo. LNG Carriers with ME-GI Engine and High Pressure Gas Supply System. Available from: https://marine.mandieselturbo.com/docs/librariesprovider6/technical-papers/lng-carriers-with-high-pressure-gas-supply-system.pdf?sfvrsn=16'},{id:"B14",body:'Nylund I, Alder R. The 2-stroke low-pressure dual-fuel technology: From concept to reality. In: CIMAC PAPER No. 233; CIMAC Congress; Helsinki. 2016'},{id:"B15",body:'Winterthur Gas & Diesel. Low- and High-Pressure Dual-Fuel Technology Evaluation Process. Interlaken: WinGD Low-Speed Engines Licensees Conference; 2015'},{id:"B16",body:'Marine propulsion & auxiliary machinery. Gas turbines bide their LNG carrier time. April/May 2018:33-34'},{id:"B17",body:'Hiramatsu SAI, Kuwahata K, Hirota K, et al. SAYARINGO STaGE-next generation MOSS-type LNG carrier with hybrid propulsion plant. Mitsubishi Heavy Industries Technical Review. 2016;53(2):3'},{id:"B18",body:'International Gas Union. 2018 World LNG Report; 2018'},{id:"B19",body:'Waney WS et al. A natural evolution of the modern LNG carriers—The application of gas turbines for LNG carrier propulsion systems. In: GASTECH. 2005'},{id:"B20",body:'General Electric Company. COGES for LNG Carrier; Shanghai: Power point provided by General Electric Company’s branch; 2018'}],footnotes:[],contributors:[{corresp:"yes",contributorFullName:"Tu Huan",address:"htu@ccs.org.cn",affiliation:'
Wuhan Rules and Research Institute, China Classification Society, Wuhan, China
Wuhan Rules and Research Institute, China Classification Society, Wuhan, China
'}],corrections:null},book:{id:"7198",title:"Propulsion Systems",subtitle:null,fullTitle:"Propulsion Systems",slug:"propulsion-systems",publishedDate:"October 7th 2019",bookSignature:"Alessandro Serpi and Mario Porru",coverURL:"https://cdn.intechopen.com/books/images_new/7198.jpg",licenceType:"CC BY 3.0",editedByType:"Edited by",editors:[{id:"217145",title:"Dr.",name:"Alessandro",middleName:null,surname:"Serpi",slug:"alessandro-serpi",fullName:"Alessandro Serpi"}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"}}},profile:{item:{id:"213975",title:"Ph.D.",name:"Ru",middleName:null,surname:"Ji",email:"jiru@ustb.edu.cn",fullName:"Ru Ji",slug:"ru-ji",position:null,biography:null,institutionString:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",totalCites:0,totalChapterViews:"0",outsideEditionCount:0,totalAuthoredChapters:"1",totalEditedBooks:"0",personalWebsiteURL:null,twitterURL:null,linkedinURL:null,institution:{name:"University of Science and Technology Beijing",institutionURL:null,country:{name:"China"}}},booksEdited:[],chaptersAuthored:[{title:"Preparation and Numerical Modelling of Ceramic Foam Insulation for Energy Saving in Buildings",slug:"preparation-and-numerical-modelling-of-ceramic-foam-insulation-for-energy-saving-in-buildings",abstract:"For the purpose of energy saving in buildings, a foam ceramic insulation (FCI) was prepared by using fly ash (FA) and ceramic waste (CW) as the main raw materials for its matrix part and foam part, respectively. The effects of the sintering temperature and the additive agent on the macroscopic performances were systematically measured and investigated. The experiment results indicate that for the matrix sample 5% quartz addition makes the rupture modulus at 1200°C reach high to 34.28 MPa, while the corresponding water absorption capacity is only 0.83%. In addition, for the foam sample with 1 wt% silicon carbide, the lowest measured bulk density and thermal conductivity at 1200°C are 0.471 g/cm3 and 0.1184 W/(m•K), respectively. Furthermore, the proposed simulation model predicts that the effective thermal conductivity of FCI decreases with the decrease of the bulk density. Moreover, the simulation results calculated by EnergyPlus software indicate that the synthetic FCI can efficiently reduce the building’s heating and cooling loads and exerts excellent energy conservation effect.",signatures:"Ru Ji, Xidong Wang and Yang He",authors:[{id:"213968",title:"Prof.",name:"Xidong",surname:"Wang",fullName:"Xidong Wang",slug:"xidong-wang",email:"xidong@pku.edu.cn"},{id:"213975",title:"Ph.D.",name:"Ru",surname:"Ji",fullName:"Ru Ji",slug:"ru-ji",email:"jiru@ustb.edu.cn"},{id:"221381",title:"Mr.",name:"Yang",surname:"He",fullName:"Yang He",slug:"yang-he",email:"hey@mails.cneic.com.cn"}],book:{title:"Recent Advances in Porous Ceramics",slug:"recent-advances-in-porous-ceramics",productType:{id:"1",title:"Edited Volume"}}}],collaborators:[{id:"174059",title:"Dr.",name:"Denis",surname:"Dowling",slug:"denis-dowling",fullName:"Denis Dowling",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"206210",title:"Dr.",name:"Takeshi",surname:"Yabutsuka",slug:"takeshi-yabutsuka",fullName:"Takeshi Yabutsuka",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Kyoto University",institutionURL:null,country:{name:"Japan"}}},{id:"206960",title:"Dr.",name:"Hongliang",surname:"He",slug:"hongliang-he",fullName:"Hongliang He",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"207382",title:"Dr.",name:"Emmanuel",surname:"Ekoi",slug:"emmanuel-ekoi",fullName:"Emmanuel Ekoi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University College Dublin",institutionURL:null,country:{name:"Ireland"}}},{id:"212233",title:"Dr.",name:"Yibran",surname:"Perera-Mercado",slug:"yibran-perera-mercado",fullName:"Yibran Perera-Mercado",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"213846",title:"Associate Prof.",name:"Xiaojian",surname:"Mao",slug:"xiaojian-mao",fullName:"Xiaojian Mao",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Shanghai Institute of Ceramics",institutionURL:null,country:{name:"China"}}},{id:"213858",title:"Dr.",name:"Tamara",surname:"Ivetić",slug:"tamara-ivetic",fullName:"Tamara Ivetić",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"University of Novi Sad",institutionURL:null,country:{name:"Serbia"}}},{id:"213968",title:"Prof.",name:"Xidong",surname:"Wang",slug:"xidong-wang",fullName:"Xidong Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Peking University",institutionURL:null,country:{name:"China"}}},{id:"221381",title:"Mr.",name:"Yang",surname:"He",slug:"yang-he",fullName:"Yang He",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null},{id:"221480",title:"Dr.",name:"Muhammad",surname:"Awais",slug:"muhammad-awais",fullName:"Muhammad Awais",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:null}]},generic:{page:{slug:"open-access-funding-funders-list",title:"List of Funders by Country",intro:"
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I am also a member of the team in charge for the supervision of Ph.D. students in the fields of development of silicon based planar waveguide sensor devices, study of inelastic electron tunnelling in planar tunnelling nanostructures for sensing applications and development of organotellurium(IV) compounds for semiconductor applications. I am a specialist in data analysis techniques and nanosurface structure. 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