Characteristics associated with physical activity among independently ambulant children and adolescents with unilateral cerebral palsy

Abstract

AIM This study aimed to quantify the contribution of physical, personal and environmental characteristics to physical activity among independently ambulant children with unilateral cerebral palsy (CP).METHOD One-hundred and two children with unilateral CP (52 males, 50 females; 52 right hemiplegia; mean age 11y 3mo, range 8-17y [SD 2y 4mo]) classified at Gross Motor Function Classification System (GMFCS) levels I = 44 and II = 58 participated. Physical activity was measured over 4 days using ActiGraph accelerometers recording as activity counts. GMFCS, functional strength, 6-minute walk test (6MWT), mobility limitations (MobQues28), age, sex, Assessment of Life-Habits recreation domain, Participation and Environment Measure for Children and Youth (PEM-CY) and environmental characteristics were considered for selection in a linear regression model. These served as independent variables which were determined using a backwards selection procedure. RESULTSYounger age, male sex, increased performance on the 6MWT, and increased participation in the home and community measured using the PEM-CY were significantly associated with activity counts (p<0.001). However, the model fit was somewhat weak (R 2 =0.32), indicating that much of the variation was unexplained. Older age and reduced community participation were associated with high inactivity (p<0.001).

Accelerometer-Assessed Physical Activity and Sedentary Time in Youth With Disabilities

“…In the PVI group, males had higher PA than females. This is in line with findings on youth with cerebral palsy (Mitchell, Ziviani, & Boyd, 2015a, 2015b, which is a diagnosis included in the PVI group. Moreover, males in the ID group were more physically active than females in this group, which has been noted in individuals with ID elsewhere (Phillips & Holland, 2011).…”

“…The influence of age on PA was large among youth with disabilities and in line with previous studies on youth with cerebral palsy (Mitchell et al, 2015a), Down syndrome (Esposito et al, 2012;Shields et al, 2009), visual impairment (Ayvazoglu, Oh, & Kozub, 2006;Kozub & Oh, 2004), ID (Kozub, 2003), ASDs (Pan & Frey, 2005, and on youth with TD (Riddoch et al, 2004;Trost et al, 2002). Particularly, time spent in intense PA (i.e., MVPA and meeting PA recommendations) decreased with age, whereas no influence of age was found on average PA or on time spent in less intense PA (i.e., LPA).…”

Characteristics associated with physical activity capacity and performance in children and adolescents with an acquired brain injury

“…Although trends emerged between higher activity counts and increased frequency of community participation and walking endurance in univariate analyses, these factors were not significant in the final model. This is in contrast to a previous study in children with CP where these factors were found to be significantly associated with activity counts [13]. Differences in intellectual functioning between children with CP and ABI may have influenced factors associated with physical activity performance [34].…”

“…This is consistent with literature in CP, which demonstrated a relationship between older age and high inactivity [13]. Typically developing sedentary children and adolescents are more likely to use technology more than three hours per day, be overweight and have sedentary parents [36].…”

“…In a cross-sectional study of 102 children with unilateral CP (classified as gross motor function classification system [GMFCS] level I or II), younger age, male sex, increased performance on the 6-minute walk test (6MWT) and increased participation in the home and community (as measured on the participation and environment scale for children and youth, PEM-CY) were significantly associated with higher levels of accelerometer average activity counts per minute, a measure of physical activity performance [13]. The study also found that older age and reduced community participation were associated with high inactivity (≥75% of time spent inactive) [13]. Whether these same characteristics are associated with physical activity performance in children who have had an ABI in the post-neonatal period has not been investigated.…”