Participation in physical activities for children with cerebral palsy: feasibility and effectiveness of physical activity on prescription

Abstract

BackgroundChildren with cerebral palsy (CP) are less physically active and more sedentary than other children which implies risk factors for their physical and mental health. Physical activity on prescription (PAP) is an effective intervention to promote a lifestyle change towards increased physical activity in adults in general. Knowledge is lacking about the use of PAP in children with CP. Therefore, the aim of this study was to evaluate the feasibility of PAP for children with CP and its effectiveness on participation in physical activity and sedentary behaviour.MethodsEleven children with CP, aged 7-11 years, participated in PAP, consisting of a written agreement between each child, their parents and the physiotherapist and based on Motivational Interviewing (MI), Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS). Individual goals, gross motor function and physical activity were assessed at baseline, at 8 and/or 11 months using COPM, GAS, logbooks, Gross Motor Function Measure (GMFM-66), physical activity questionnaires, physical activity and heart rate monitors and time-use diaries. At 8 and 11 months the feasibility of the intervention and costs and time spent for the families and the physiotherapist were evaluated by questionnaires.ResultsThe intervention was feasible according to the feasibility questionnaire. Each child participated in 1-3 self-selected physical activities during 3-6 months with support from the physiotherapist, and clinically meaningful increases from baseline of COPM and GAS scores were recorded. Being physically active at moderate-vigorous levels varied between less than 30 and more than 240 minutes/day, and the median for the whole group was 84 minutes/day at baseline and 106 minutes/day at 8 months.ConclusionsThe intervention PAP seems to be feasible and effective for children with CP, involving both every day and organised physical activities to promote an active lifestyle through increased participation, motivation, and engagement in physical activities. Further research of PAP is needed, preferably in a long term randomised controlled trial and including health economic analysis to show costs and benefits.Trial Registration ISRCTN76366356, retrospectively registered.

Locomotion and cadence detection using a single trunk-fixed accelerometer: validity for children with cerebral palsy in daily life-like conditions

“…Treatment options include physiotherapy, orthoses, pharmacological interventions, orthopedic and neurosurgical interventions [2]. Physical therapy interventions for the ambulatory youth with CP often focus on activity-based strategies to promote functional mobility in daily-life contexts and participation in physical activity [3]. An important component of functional mobility in ambulatory subjects is locomotion activity in the context of everyday life.…”

Prevalence of metabolic syndrome and cardiovascular disease risk factors in adults with cerebral palsy

“…Participants' physical function level status was defined by the GMFCS 17,18 and the International Physical Activity Questionnaire -Short Form, 26 which has been used to examine physical activity in the CP population. 27 GMFCS levels and the International Physical Activity Questionnaire -Short Form was obtained from a comprehensive motor evaluation by a specialized team of physical therapists, researchers, and engineers. From the International Physical Activity Questionnaire -Short Form, metabolic equivalent of task was calculated.…”

An Observational Tool to Assess Activity Limitation in Ambulatory People with Cerebral Palsy When Performing Motor Skills

“…Lack of physical activity (PA) has been shown to be a serious concern for the whole population, but with special emphasis for people with disabilities who are at higher risk of suffering from health problems [5]. Even though people with disabilities are encouraged to practice more PA and sports, their participation rates are still low, particularly among the group with CP [6,7]. While active, performance-focused exercise with variable practice opportunities improves gross motor function in ambulant people with CP [8], developing healthy lifestyles when living with a disability can be a daunting task, as participation in PA requires minimum levels of strength, endurance, balance, and coordination [5].…”