Ambulatory activity of children with cerebral palsy: which characteristics are important?

Abstract

Aim To assess ambulatory activity of children with cerebral palsy (CP), aged 7 to 13 years, and identify associated characteristics. Method Sixty‐two children with spastic CP (39 males, 23 females; mean age 10y 1mo, SD 1y 8mo; age range 7–13y), classified as Gross Motor Function Classification System (GMFCS) levels I to III, participated. Ambulatory activity was measured during 1 week with a StepWatch activity monitor as steps per day, and time spent at medium and high step rates. Multiple linear regression analyses were performed following a backward selection procedure until only independent variables with p<0.05 remained in the model. Ambulatory activity outcome parameters served as dependent variables, and disease, personal, and environmental characteristics as independent variables. Ambulatory activity was corrected for body height. Results Children took more steps during school days (5169 steps, SD 1641) than during weekend days (4158 steps, SD 2048; p<0.001). Higher GMFCS level, bilateral CP, and higher age were associated with lower ambulatory activity on school days (R2 ranged from 43–53%), whereas bilateral CP, higher age, and no sport club participation were associated with lower ambulatory activity in the weekend (R2 ranged from 21–42%). Correcting for body height decreased the association with age. Interpretation Interventions should focus at increasing physical activity at the weekend for children with bilateral spastic CP.

The effects of progressive resistance training on daily physical activity in young people with cerebral palsy: a randomised controlled trial

“…Daily physical activity levels of people with cerebral palsy (CP) are low [1,2]. Like the rest of the population, low levels of physical activity increases the risk of people with CP developing secondary health problems such as cardiovascular diseases, obesity or osteoporosis [3].…”

Are Results After Single-event Multilevel Surgery in Cerebral Palsy Durable?

“…Management of gait dysfunction in patients with cerebral palsy may include nonoperative measures, such as physiotherapy [45], orthotics [5], casting [19], and injections of botulinum toxin type A [17]. Despite appropriate nonoperative management, however, the majority of patients with spastic diplegia will have fixed contractures and bony deformities develop which require surgical correction to maintain gait or even sitting functions.…”

Physical Activity Among Adolescents with Cerebral Palsy: An Integrative Review

“…The descriptive literature supports a social model, studying the person in the context of environment, versus a medical model, which focuses on the context of disability (Colver et al, 2012;Palisano et al, 2009;van Wely, Balemans, Becher, & Dallmeijer, 2014). Study findings reported that environmental variables (accessibility, attitude, adaptations) were found to be as effective for improving self-help skills and mobility as conventional therapeutic interventions focused on changing the child (Colver et al, 2012).…”

“…Virtual reality systems also hold interest and motivate longer sessions of physical activity (Bryanton et al, 2006). Barriers to physical activity include a variety of factors such as physical (inaccessibility), programmatic (lack of knowledgeable staff), attitudinal (over-emphasis on competition and winning), as well as a lack of understanding for personal and environmental factors (Colver et al, 2012;Donkervoort et al, 2006;van Wely, Becher, Balemans, & Dallmeijer, 2012). Several investigators recommend these areas as targets for change.…”

“…Children with cerebral palsy were found to experience more activity during school days than when they are not in school (van Wely et al, 2012). However, little research was found that explored daily physical activity of teens with cerebral palsy at home, in school, or in the community (Fowler et al, 2007).…”