Influence of Age on Step Activity Patterns in Children With Cerebral Palsy and Typically Developing Children

Abstract

Objective-To document the influence of age on step activity patterns in children with cerebral palsy (CP) and typically-developing (TD) children. Design-Cross-sectionalSetting-All step activity data were collected in free-living environments.Participants-Children with CP (n=27; 4 -18 years; 22 boys, 5 girls, Gross Motor Function Classification System Levels I and II) and 27 age-and sex-matched TD children were recruited through public advertisements and contacts with local clinicians. CP and TD participants were stratified into younger (< 10 years; n = 14) and older (10-18 years; n = 13) age groups.Intervention-Daily step activity was monitored using a StepWatch Activity Monitor that was individually programmed to account for the gait characteristics of each participant.Step activity data were collected in 1-min epochs during waking hours on three weekdays and one weekend day. Stored data were analyzed to yield average values of daily step activity, percentage of inactive time (0 steps) over the entire day, and percentage of total daily active time spent in low step activity (1-15 steps/min), medium step activity (16-40 steps/min), and high step activity (> 40 steps/min).Main Outcome Measures-Daily step activity, percentage of inactive time, and percentage of active time spent in low-, moderate-, and high-intensity step activity.Results-A significant (p < .05) interaction was observed between age (younger, older) and condition (CP, TD) for daily step activity, percentage of inactive time, and percentage of active time spent in low-and high-intensity step activity. The main effect of age was significant for each physical activity measure except for relative high-intensity step activity and the main effect of condition was significant for all physical activity measures. Followup analyses (p < .025) revealed that older children with CP took fewer daily steps and displayed higher relative levels of inactivity © 2010 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.Correspondence to Sandy Stevens, MS, 4711 Timberhill Ct, Nashville, TN 37211, sstevens@tnstate.edu. Reprints are not available from the author. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Presented to the American Academy for Cerebral Palsy and Developmental Medicine, September 17-20, 2008, Atlanta, GA. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. and low-intensity activity and lower rel...

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“…Some evidence exists, however, which suggests that young children with developmental delays may have similar levels of physical activity as children without developmental delays, but differences between groups become more apparent as children become older (Stevens, Holbrook, Fuller, & Morgan, 2010 ). Stevens et al ( 2010 ) assessed daily step activity and percentage of active time among children with cerebral palsy ages 4-18 years ( n = 27) as compared with ageand sex-matched children without developmental delays ( n = 27).…”

“…Stevens et al ( 2010 ) assessed daily step activity and percentage of active time among children with cerebral palsy ages 4-18 years ( n = 27) as compared with ageand sex-matched children without developmental delays ( n = 27). Orthocare SAM activity monitors were given to participants to be worn on the right ankle during 3 weekdays and 1 weekend day.…”

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“…[17][18][19][20][21][22] These devices provide date-time stamped information about the acceleration of the body during human motion, allowing end significantly higher step counts on weekdays than on weekend days and that younger children with CP (< 10 years) have higher step counts than older children with CP. 30,34 Studies using the ActiGraph accelerometer to measure PA in youth with CP found that they accumulated approximately 90 minutes of light-intensity PA and 30 minutes of moderate to vigorous intensity PA daily. 28 Results of another study with youth with CP at GMFCS levels I and II showed that, on average, youth participated in 158 minutes of light intensity PA daily, and 44 minutes of MVPA daily.…”

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“…Stevens et al, showed that only 5% of the active time of a child with CP is spent in the high activity range, and 67% and 28% of the time is spent in the low and moderate activity [13] such as walking. Comparison of the time it takes to pressurize, activate and deactivate the PAM suggests that the moderate activity range (16 to 40 steps per minute) may be achieved.…”