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Crumbley C, Cepni AB, Taylor A, Thompson D, Moran NE, Olvera N, O'Connor DP, Johnston CA, Ledoux TA. Exploring Factors Associated With Accelerometer Validity Among Ethnically Diverse Toddlers. Pediatr Exerc Sci 2024; 36:66-74. [PMID: 37758263 DOI: 10.1123/pes.2022-0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 05/11/2023] [Accepted: 07/28/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Studying physical activity in toddlers using accelerometers is challenging due to noncompliance with wear time (WT) and activity log (AL) instructions. The aims of this study are to examine relationships between WT and AL completion and (1) demographic and socioeconomic variables, (2) parenting style, and (3) whether sedentary time differs by AL completion. METHODS Secondary analysis was performed using baseline data from a community wellness program randomized controlled trial for parents with toddlers (12-35 mo). Parents had toddlers wear ActiGraph wGT3x accelerometers and completed ALs. Valid days included ≥600-minute WT. Analysis of variance and chi-square analyses were used. RESULTS The sample (n = 50) comprised racial and ethnically diverse toddlers (mean age = 27 mo, 58% male) and parents (mean age = 31.7 y, 84% female). Twenty-eight families (56%) returned valid accelerometer data with ALs. Participants in relationships were more likely to complete ALs (P < .05). Toddler sedentary time did not differ between those with ALs and those without. CONCLUSIONS We found varied compliance with WT instructions and AL completion. Returned AL quality was poor, presenting challenges in correctly characterizing low-activity counts to improve internal validity of WT and physical activity measures. Support from marital partners may be important for adherence to study protocols.
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Affiliation(s)
- Christine Crumbley
- Department of Health and Human Performance, University of Houston, Houston, TX,USA
| | - Aliye B Cepni
- Department of Health and Human Performance, University of Houston, Houston, TX,USA
| | - Ashley Taylor
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX,USA
| | - Debbe Thompson
- USDA/ARS Children's Nutrition Research Center & Department of Pediatrics, Baylor College of Medicine, Houston, TX,USA
| | - Nancy E Moran
- USDA/ARS Children's Nutrition Research Center & Department of Pediatrics, Baylor College of Medicine, Houston, TX,USA
| | - Norma Olvera
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX,USA
- Latino Health Disparities Lab, University of Houston, Houston, TX,USA
| | - Daniel P O'Connor
- Department of Health and Human Performance, University of Houston, Houston, TX,USA
- HEALTH Research Institute, University of Houston, Houston, TX,USA
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX,USA
| | - Tracey A Ledoux
- Department of Health and Human Performance, University of Houston, Houston, TX,USA
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Huang HH, Chu YW, Chan AT, Chen CL. A pilot randomised controlled trial of ride-on cars and postural combinations of standing and sitting for mobility and social function in toddlers with motor delays. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38180348 DOI: 10.1080/17483107.2023.2299712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/21/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE Locomotor experiences in upright postures are essential for developing toddlers' mobility and social functions. This pilot randomised controlled trial aimed to examine the effectiveness of using a modified ride-on car (ROC) with postural combinations of standing and sitting on mobility and social function in toddlers with motor delays. MATERIALS AND METHODS Nineteen participants aged 1-3 years with mild, moderate or severe motor delays were randomly assigned to four ROC groups. The ROC groups had different combinations of standing and sitting, namely standing for 70 min (ROC-Stand70, five participants), standing for 45 min (ROC-Stand45, four participants), standing for 25 min (ROC-Stand25, five participants) and sitting for 70 min (ROC-Sit70, five participants). All participants participated in 2-h sessions twice a week for 12 weeks. The Pediatric Evaluation of Disability Inventory, Goal Attainment Scaling and Bayley-III tests were administered before and after the intervention, and after 12 weeks of follow-up. A mixed-model analysis of variance was used to compare inter- and intra-group differences. This trial was registered at ClinicalTrials.gov (NCT03707405). RESULTS All groups showed significantly improved mobility, social function and goal achievement at the post-test (p < .001). However, no significant changes were observed in Bayley scores. CONCLUSIONS Combining physical and social environmental modifications with active exploration is crucial for early power mobility training in toddlers with motor delays. To enhance the robustness and generalisability of our findings, future studies should include larger sample sizes, consider variations in motor delays, and measure energy expenditure during the intervention.Implications for rehabilitationProviding active exploratory experience using ride-on cars (ROCs) with various postural combinations can improve a child's mobility.The ROC training with various postural combinations can improve social function, and the degree of improvement may depend on the severity of motor delays.Setting goals with caregivers and incorporating their roles in the training process can empower them to interact with children more frequently and actively.
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Affiliation(s)
- Hsiang-Han Huang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Wen Chu
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Occupational Therapy, Hung Da Wei Rehabilitation Clinic, Taichung, Taiwan
| | - Ai-Tzu Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Chia-Ling Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Graduate Institute of Early Intervention, Chang Gung University, Taoyuan, Taiwan
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Boyd RN, Novak I, Morgan C, Bora S, Sakzewski L, Ware RS, Comans T, Fahey MC, Whittingham K, Trost S, Pannek K, Pagnozzi A, Mcintyre S, Badawi N, Smithers Sheedy H, Palmer KR, Burgess A, Keramat A, Bell K, Hines A, Benfer K, Gascoigne-Pees L, Leishman S, Oftedal S. School readiness of children at high risk of cerebral palsy randomised to early neuroprotection and neurorehabilitation: protocol for a follow-up study of participants from four randomised clinical trials. BMJ Open 2023; 13:e068675. [PMID: 36849209 PMCID: PMC9972445 DOI: 10.1136/bmjopen-2022-068675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
INTRODUCTION School readiness includes cognitive, socio-emotional, language and physical growth and development domains which share strong associations with life-course opportunities. Children with cerebral palsy (CP) are at increased risk of poor school readiness compared with their typically developing peers. Recently, earlier diagnosis of CP has allowed interventions to commence sooner, harnessing neuroplasticity. First, we hypothesise that early referral to intervention for children at-risk of CP will lead to improved school readiness at 4-6 years relative to placebo or care as usual. Second, we hypothesise that receipt of early diagnosis and early intervention will lead to cost-savings in the form of reduced healthcare utilisation. METHODS AND ANALYSIS Infants identified as at-risk of CP ≤6 months corrected age (n=425) recruited to four randomised trials of neuroprotectants (n=1), early neurorehabilitation (n=2) or early parenting support (n=1) will be re-recruited to one overarching follow-up study at age 4-6 years 3 months. A comprehensive battery of standardised assessments and questionnaires will be administered to assess all domains of school readiness and associated risk factors. Participants will be compared with a historical control group of children (n=245) who were diagnosed with CP in their second year of life. Mixed-effects regression models will be used to compare school readiness outcomes between those referred for early intervention versus placebo/care-as-usual. We will also compare health-resource use associated with early diagnosis and intervention versus later diagnosis and intervention. ETHICS AND DISSEMINATION The Children's Health Queensland Hospital and Health Service, The University of Queensland, University of Sydney, Monash University and Curtin University Human Research Ethics Committees have approved this study. Informed consent will be sought from the parent or legal guardian of every child invited to participate. Results will be disseminated in peer-reviewed journals, scientific conferences and professional organisations, and to people with lived experience of CP and their families. TRIAL REGISTRATION NUMBER ACTRN12621001253897.
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Affiliation(s)
- Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Iona Novak
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Catherine Morgan
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Samudragupta Bora
- Case Western Reserve University School of Medicine, University Hospitals Rainbow Babies & Children's Hospital, Cleveland, Ohio, USA
- Faculty of Medicine, Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Tracy Comans
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Michael Collingwood Fahey
- Paediatric Neurology, Monash Medical Centre Clayton, Clayton, Victoria, Australia
- Paediatrics, Monash University, Clayton, Victoria, Australia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Stewart Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kerstin Pannek
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australian Capital Territory, Australia
| | - Alex Pagnozzi
- The Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Canberra, Australian Capital Territory, Australia
| | - Sarah Mcintyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hayley Smithers Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten Rebecca Palmer
- Obstetrics and Gynaecology, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
| | - Andrea Burgess
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Afroz Keramat
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Kristie Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
- Dietetics and Food Services, Children's Health Queensland, South Brisbane, Queensland, Australia
| | - Ashleigh Hines
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Katherine Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Laura Gascoigne-Pees
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Shaneen Leishman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
| | - Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, South Brisbane, Queensland, Australia
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Dere T, Serel Arslan S, Alemdaroğlu-Gürbüz İ. Validity and reliability of the turkish version of the early activity scale for endurance in preschool children with cerebral palsy. Dev Neurorehabil 2023; 26:101-108. [PMID: 36628489 DOI: 10.1080/17518423.2023.2166616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study presented the Turkish translation of the Early Activity Scale for Endurance (T-EASE) which was developed to evaluate the endurance for physical activity of preschool children with Cerebral Palsy (CP), and its validity and reliability. Fifty-five children with CP aged between 2 and 5 years were included in the study. The Gross Motor Function Classification Scale (GMFCS) and Pediatric Outcomes Data Collection Instrument (PODCI) were used to determine motor function levels and quality of life of the study population. The T-EASE had good test-retest reliability (ICC = 0.996), internal consistency (α = 0.903), higher construct validity approved by confirmatory factor analysis, and criterion validity supported by the weak-to-strong correlations between T-EASE and GMFCS, and PODCI. The T-EASE scores were significantly different between GMFCS levels (p < .05). The T-EASE was found to be valid and reliable to determine the endurance for physical activity of Turkish pre-school children with CP with the sensitivity to changes in motor function levels.
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Affiliation(s)
- Tuğba Dere
- Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat Bozok University, Yozgat, Turkey
| | - Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Ruiz Brunner MDLM, Cuestas E, Heinen F, Schroeder AS. Growth in infants, children and adolescents with unilateral and bilateral cerebral palsy. Sci Rep 2022; 12:1879. [PMID: 35115566 PMCID: PMC8813947 DOI: 10.1038/s41598-022-05267-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 11/26/2021] [Indexed: 11/09/2022] Open
Abstract
To compare growth patterns during infancy, childhood and adolescence in children with unilateral and bilateral cerebral palsy (CP) phenotype and to assess the association with gross motor impairment, dysphagia and gestational age. We retrospectively studied 389 children with CP from a single center population in Munich, Germany. 1536 measurements of height and weight were tabulated and z-scored from 6 to 180 months of age. Generalized linear mixed model were used to examine the association between growth, GMFCS, dysphagia and gestational age by CP phenotype. Children with unilateral CP tend to grow similarly to their typically developed peers. In the main effect model, bilateral CP phenotype was significantly associated with decreased mean z-scores for height (β [95% CI] - 0.953 [- 1.145, - 0.761], p < 0.001), weight (- 0.999 [- 1.176, - 0.807], p < 0.001) and BMI (β [95% CI] - 0.437 [- 0.799, - 0.075]), compared with unilateral CP phenotype. This association remained significant in the interaction models. The height-for-age z-scores, weight-for-age decreased z-scores and BMI-for-age z-scores of children with bilateral CP and GMFCS III-V or dysphagia decreased more significantly than those of children with unilateral CP. Preterm birth was not significantly associated with decreased growth in height, weight and BMI. Reduced growth in children with bilateral CP was strongly associated with moderate to severe impairment in gross motor function (GMFCS III-V) and dysphagia.
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Affiliation(s)
- Maria de Las Mercedes Ruiz Brunner
- Instituto de Investigación en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas, Bv de la Reforma S/N, Pabellón de Biología Celular, Ciudad Universitaria, CP: 5016, Córdoba, Argentina.
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany.
| | - Eduardo Cuestas
- Instituto de Investigación en Ciencias de la Salud, Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas, Bv de la Reforma S/N, Pabellón de Biología Celular, Ciudad Universitaria, CP: 5016, Córdoba, Argentina
- Cátedra de Clínica Pediátrica, Hospital Nuestra Señora de la Misericordia, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Florian Heinen
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany
| | - Andreas Sebastian Schroeder
- Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University Hospital of Munich (LMU), Hauner Children's Hospital, Munich, Germany.
- Ludwig Maximilian University of Munich (LMU), Hauner Children's Hospital, Paediatric Neurology, Developmental Medicine, Lindwurmstr. 4, 80337, Munich, Germany.
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Rivares C, Vignaud A, Noort W, Koopmans B, Loos M, Kalinichev M, Jaspers RT. Glycine receptor subunit-ß -deficiency in a mouse model of spasticity results in attenuated physical performance, growth and muscle strength. Am J Physiol Regul Integr Comp Physiol 2022; 322:R368-R388. [PMID: 35108108 PMCID: PMC9054346 DOI: 10.1152/ajpregu.00242.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Spasticity is the most common neurological disorder associated with increased muscle contraction causing impaired movement and gait. The aim of this study was to characterize the physical performance, skeletal muscle function, and phenotype of mice with a hereditary spastic mutation (B6.Cg-Glrbspa/J). Motor function, gait, and physical activity of juvenile and adult spastic mice and the morphological, histological, and mechanical characteristics of their soleus and gastrocnemius medialis muscles were compared with those of their wild-type (WT) littermates. Spastic mice showed attenuated growth, impaired motor function, and low physical activity. Gait of spastic mice was characterized by a typical hopping pattern. Spastic mice showed lower muscle forces, which were related to the smaller physiological cross-sectional area of spastic muscles. The muscle-tendon complex length-force relationship of adult gastrocnemius medialis was shifted toward shorter lengths, which was explained by attenuated longitudinal tibia growth. Spastic gastrocnemius medialis was more fatigue resistant than WT gastrocnemius medialis. This was largely explained by a higher mitochondrial content in muscle fibers and relatively higher percentage of slow-type muscle fibers. Muscles of juvenile spastic mice showed similar differences compared with WT juvenile mice, but these were less pronounced than between adult mice. This study shows that in spastic mice, disturbed motor function and gait is likely to be the result of hyperactivity of skeletal muscle and impaired skeletal muscle growth, which progress with age.
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Affiliation(s)
- Cintia Rivares
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | | | - Wendy Noort
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | | | - Maarten Loos
- Sylics (Synaptologics BV), Amsterdam, the Netherlands
| | | | - Richard T Jaspers
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Bradbury M, O'Brien C, Giles N, Fenton S, Neilson S, Duda JL. Sedentary behaviour in non-ambulant children and young people with physical disabilities: a systematic search and review protocol. BMJ Open 2021; 11:e053077. [PMID: 34862293 PMCID: PMC8647535 DOI: 10.1136/bmjopen-2021-053077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Non-ambulant children and young people with physical disabilities are at high risk of experiencing negative health outcomes associated with sedentary time. A previous scoping review summarising evidence relating to sedentary behaviours of children with physical disabilities identified the need for validated methods of measuring physical activity of children who use wheelchairs and evaluation of interventions to reduce sedentary time. The scoping review did not assess the quality of evidence relating to this topic, therefore its validity remains unclear. No reviews focussing on non-ambulant children and young people up to the age of 25 years have been undertaken.The objectives of this systematic search and review are to:Identify all peer-reviewed articles relating to sedentary behaviour of non-ambulant children and young people.Categorise the articles according to study design and four subquestions relating to (i) measurement, (ii) patterns, (iii) associated risks and (iv) interventions to reduce sedentary time or behaviour.Critically appraise quality of the articles using established critical appraisal tools.Summarise the evidence for each subquestion. Describe its cumulative strength and identify knowledge gaps. METHODS AND ANALYSIS This protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The research questions, inclusion/exclusion criteria and search terms have been developed a priori using the 'Population, Concept and Context' framework. Online databases will be systematically searched to identify peer-reviewed articles published between 1996 and 2021. Two reviewers will screen, categorise and critically appraise the articles. Data extraction and analysis will be verified by the second reviewer.Results will be reported as a best evidence synthesis, with reference to the PRISMA checklist. ETHICS AND DISSEMINATION Ethical approval is not required. The review will be submitted to an appropriate peer-reviewed journal. REGISTRATION The review is registered on the Open Science Framework database. DOI: https://doi.org/10.17605/OSF.IO/SQXJB. Any protocol amendments will be recorded in the Open Science Framework database.
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Affiliation(s)
- Marilyn Bradbury
- Research and Innovation, Birmingham Community Healthcare NHS Foundation Trust, Aston, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Ciara O'Brien
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Nathan Giles
- Public and Patient Involvement Representative (Volunteer), Birmingham Community Healthcare NHS Foundation Trust, Aston, Birmingham, UK
| | - Sally Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Sue Neilson
- School of Nursing, University of Birmingham, Birmingham, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Xiong JSP, Reedman SE, Kho ME, Timmons BW, Verschuren O, Gorter JW. Operationalization, measurement, and health indicators of sedentary behavior in individuals with cerebral palsy: a scoping review. Disabil Rehabil 2021; 44:6070-6081. [PMID: 34334077 DOI: 10.1080/09638288.2021.1949050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the operationalization and measurement of sedentary behavior (SB) in individuals with cerebral palsy (CP). MATERIALS AND METHODS We searched five databases from 2011 to 2020 for primary studies of experimental, qualitative, longitudinal, or observational designs measuring SB or postures typically characterized as sedentary (sitting, reclining, lying). RESULTS We screened 1112 citations and selected 47 studies. SB was operationalized through muscle activation, energy expenditure or oxygen consumption in typically sedentary postures (n = 9), and through thresholds and postures used by accelerometers, activity monitors, and a questionnaire to measure time spent in SB (n = 25). Seven out of the eight studies that measured energy expenditure found ≤1.5 metabolic equivalents of task (METs) for sitting and lying. While different accelerometer thresholds were used to measure SB, the behavior (SB) was consistently operationalized as sitting and lying. Little consistency existed in the subpopulation, instruments and cut-points for studies on validity or reliability of tools for measuring SB (n = 19). CONCLUSIONS Sitting and lying are considered sedentary postures, which is defined as ≤1.5 METs in individuals with CP. There is variability in the tools used to measure SB in individuals with CP. Therefore, consensus on the definition and reporting of SB is needed.Implications for rehabilitationAlthough sedentary behavior (SB) is increased in individuals with cerebral palsy (CP) compared to the typically developing population, there is no standard definition for SB for these individuals; this makes it difficult to synthesize data across studies.Sitting and lying are ≤1.5 METs in individuals with CP, suggesting we only need to measure posture to show change in SB.The commonly used accelerometer cut-point in the typically developing population of ≤100 counts per minute generally has excellent reliability across multiple devices in ambulatory children with CP.
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Affiliation(s)
- Julia Shi-Peng Xiong
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Hamilton, Canada
| | - Sarah E Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - Michelle E Kho
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Hamilton, Canada.,Department of Physiotherapy, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Brian W Timmons
- Department of Pediatrics, Child Health and Exercise Medicine Program, McMaster University, Hamilton, Canada.,Department of Kinesiology, McMaster University, Hamilton, Canada
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation Medicine, Utrecht University, Utrecht and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Jan Willem Gorter
- Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Hamilton, Canada.,Department of Pediatrics, CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada.,Department of Pediatrics, McMaster University, Hamilton, Canada
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Ganz F, Wright V, Manns PJ, Pritchard L. Is Physical Activity-Related Self-Efficacy Associated with Moderate to Vigorous Physical Activity and Sedentary Behaviour among Ambulatory Children with Cerebral Palsy? Physiother Can 2021. [DOI: 10.3138/ptc-2020-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: To determine how physical activity-related self-efficacy is associated with physical activity and sedentary behaviour time among ambulatory children with cerebral palsy (CP). Method: Children with CP, Gross Motor Function Classification System (GMFCS) Levels I-III ( N = 26; aged 9–18 y), completed the task self-efficacy component of a self-efficacy scale and wore Actigraph GT3X+ accelerometers for 5 days. Correlations (Pearson and Spearman’s rank-order; a = 0.050) were conducted to evaluate the relationships among age, GMFCS level, self-efficacy, and both daily moderate-to-vigorous physical activity (MVPA) and sedentary time. Linear regression models were used to determine the relationships among the independent variables and MVPA and sedentary time. Results: Self-efficacy was positively associated with MVPA time ( r = 0.428, p = 0.015) and negatively correlated with sedentary time ( r = –0.332, p = 0.049). In our linear regression models, gross motor function (β = –0.462, p = 0.006), age (β = –0.344, p = 0.033), and self-efficacy (β = 0.281, p = 0.080) were associated with MVPA time ( R2 = 0.508), while GMFCS level (β = 0.439, p = 0.003) and age (β = 0.605, p < 0.001) were associated with sedentary time ( R2 = 0.584). Conclusions: This research suggests that self-efficacy, age, and gross motor function are associated with MVPA in children with CP. Additional research is needed to confirm these findings and further explore the influence of self-efficacy on sedentary behaviour.
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Affiliation(s)
- Felipe Ganz
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Virginia Wright
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Patricia J. Manns
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Kalleson R, Jahnsen R, Østensjø S. Exploring participation in family and recreational activities among children with cerebral palsy during early childhood: how does it relate to motor function and parental empowerment? Disabil Rehabil 2021; 44:1560-1570. [PMID: 33749471 DOI: 10.1080/09638288.2021.1894608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore participation in real-life activities during early childhood, compare children's participation based on motor function and investigate relationships between participation and parental empowerment. METHODS Data derived from the Cerebral Palsy Follow-up Program (CPOP) in Norway and the research registry Habilitation Trajectories, Interventions, and Services for Young Children with CP (CPHAB). Fifty-six children (12-56 months, GMFCS levels I-IV, MACS levels I-V) and their families were included. Frequency and enjoyment of participation were assessed by the Child Engagement in Daily Life Questionnaire and parental empowerment in family and service situations by the Family Empowerment Scale at least twice during the preschool years. Differences between groups based on motor function were explored by the Kruskal-Wallis tests. A linear mixed model was conducted to explore relationships between child participation and parental empowerment. RESULTS Similarities and differences in participation between children at different motor function levels varied between the activities explored. Fluctuations in frequency and stable enjoyment scores over time were most common. A statistically significant relationship was revealed between child participation and parental empowerment in family situations, but not in service situations. CONCLUSIONS Child participation appears as context-dependent and complexly influenced by both motor function and parental empowerment. This supports a focus on transactional processes when exploring and promoting child participation.Implications for RehabilitationFamily and recreational activities represent real-life contexts providing opportunities for interactions and experiences supporting development and learning.Children with CP appreciate a wide range of activities in the home and community, which emphasizes the importance of providing opportunities for such participation in order to fulfill their desires and interests.Child participation appears as complexly influenced by the unique activity setting, motor function and characteristics of the family environment, requiring attention to transactional processes when aiming to explore and promote participation.
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Affiliation(s)
- Runa Kalleson
- OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Reidun Jahnsen
- Oslo University Hospital (OUS), University of Oslo (UiO), Oslo, Norway
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11
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Ganz F, Hammam N, Pritchard L. Sedentary behavior and children with physical disabilities: a scoping review. Disabil Rehabil 2020; 43:2963-2975. [DOI: 10.1080/09638288.2020.1723720] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Felipe Ganz
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Nevin Hammam
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
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12
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Orlando JM, Pierce S, Mohan M, Skorup J, Paremski A, Bochnak M, Prosser LA. Physical activity in non-ambulatory toddlers with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 90:51-58. [PMID: 31063871 DOI: 10.1016/j.ridd.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/21/2018] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Children with cerebral palsy are less likely to be physically active than their peers, however there is limited evidence regarding self-initiated physical activity in toddlers who are not able, or who may never be able, to walk. AIMS The aim of this study was to measure self-initiated physical activity and its relationship to gross motor function and participation in non-ambulatory toddlers with cerebral palsy. METHODS AND PROCEDURES Participants were between the ages of 1-3 years. Physical activity during independent floor-play at home was recorded using a wearable tri-axial accelerometer worn on the child's thigh. The Gross Motor Function Measure-66 and the Child Engagement in Daily Life, a parent-reported questionnaire of participation, were administered. OUTCOMES AND RESULTS Data were analyzed from the twenty participants who recorded at least 90 min of floor-play (mean: 229 min), resulting in 4598 total floor-play minutes. The relationship between physical activity and gross motor function was not statistically significant (r = 0.20; p = 0.39), nor were the relationships between physical activity and participation (r = 0.05-0.09; p = 0.71-0.84). CONCLUSIONS AND IMPLICATIONS The results suggest physical activity during floor-play is not related to gross motor function or participation in non-ambulatory toddlers with cerebral palsy. Clinicians and researchers should independently measure physical activity, gross motor function, and participation.
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Affiliation(s)
- Julie M Orlando
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Samuel Pierce
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Mayumi Mohan
- University of Pennsylvania, School of Engineering and Applied Science, 220 S 33rd St, Philadelphia, PA 19104, United States
| | - Julie Skorup
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Athylia Paremski
- The Children's Hospital of Philadelphia, Division of Rehabilitation Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Megan Bochnak
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Laura A Prosser
- The Children's Hospital of Philadelphia, Division of Rehabilitation Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States; University of Pennsylvania, School of Medicine, Department of Pediatrics, 220 S 33rd St, Philadelphia, PA 19104, United States
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13
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Bjornson K, Fiss A, Avery L, Wentz E, Kerfeld C, Cicirello N, Hanna SE. Longitudinal trajectories of physical activity and walking performance by gross motor function classification system level for children with cerebral palsy. Disabil Rehabil 2019; 42:1705-1713. [PMID: 30616403 DOI: 10.1080/09638288.2018.1534995] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Purpose: This study aims to present developmental trajectories for physical activity (PA) and walking performance for children with cerebral palsy (CP).Materials and methods: Seventy-nine children with CP, 39 (49%) female, Gross Motor Functional Classification System levels I-V, and mean age 91.3 months (+/-27.7 SD) participated. Participants in levels I-V wore the Actigraph to capture PA and children in levels I-II also wore a StepWatch (SW) (n = 43) to measure walking performance. Trajectories for average PA counts/minute and number of minutes of moderate to vigorous PA were generated for levels I, II, and III/IV/V (aggregate). Single leg strides/day and average strides faster than 30 strides/min trajectories were generated for levels I-II.Results: Participants did not display plateaus in PA or walking performance based on functional level. Children in all levels showed a decrease in amount and intensity of PA from 3.0 to 12 years old, with participants in level I demonstrating the steepest decline. Children in level I decreased slightly, and level II increased slightly in both walking performance measures from 3.0 to 12 years old.Conclusions: Longitudinal curves demonstrate variations in PA and walking performance by functional level and provide prognostic information as to what changes may be anticipated for children with CP.Implications for rehabilitationLongitudinal developmental trajectories for physical activity and walking performance for children with cerebral palsy across functional levels are documented.Trajectories have potential to support collaborative intervention planning between therapists and families relative to physical activity and walking performance.
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Affiliation(s)
- Kristie Bjornson
- Department of Rehabilitation Medicine, Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - Alyssa Fiss
- Department of Physical Therapy, Mercer University, Atlanta, GA, USA
| | - Lisa Avery
- Avery Information Services Ltd., Orillia, Canada
| | - Erin Wentz
- Department of Physical Therapy, SUNY Upstate Medical University, Syracuse, NY, USA
| | | | | | - Steven E Hanna
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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14
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Relationship between habitual physical activity, motor capacity, and capability in children with cerebral palsy aged 4–5 years across all functional abilities. Disabil Health J 2018; 11:632-636. [DOI: 10.1016/j.dhjo.2018.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/21/2018] [Accepted: 03/26/2018] [Indexed: 11/20/2022]
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Ryan JM, Allen E, Gormley J, Hurvitz EA, Peterson MD. The risk, burden, and management of non-communicable diseases in cerebral palsy: a scoping review. Dev Med Child Neurol 2018; 60:753-764. [PMID: 29572812 DOI: 10.1111/dmcn.13737] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2018] [Indexed: 12/26/2022]
Abstract
AIM To examine the risk, burden, and management of non-communicable diseases (NCDs) among people with cerebral palsy (CP). METHOD Databases (Ovid MEDLINE, Embase Ovid, CINAHL Plus) were systematically searched up to August 2017. Data on the prevalence of risk factors for, and the burden and management of, cardiovascular diseases, diabetes, cancers, and respiratory diseases were extracted. RESULTS Thirty-six studies that examined the prevalence of risk factors among people with CP were identified. There was inconsistent evidence that people with CP had higher prevalence of metabolic risk factors such as hypertension, hyperlipidaemia, and obesity, but strong evidence that they participated in low levels of physical activity, compared with people without CP. Seven studies reported on the burden of NCDs. Adults with CP had a higher risk of NCDs, including stroke, chronic obstructive pulmonary disease, and other heart conditions, and death due to NCDs, including cancers, chronic obstructive pulmonary disease, stroke, and ischaemic heart disease, compared with the general population. Only one study reported on the management of NCD, specifically the uptake of breast cancer screening among females. INTERPRETATION The burden of NCDs is higher among adults with CP compared with the general population. Further research is required to determine the prevalence of metabolic risk factors and management of NCDs among people with CP. WHAT THIS PAPER ADDS Adults with cerebral palsy (CP) have an increased risk of non-communicable diseases (NCDs) and increased risk of death because of NCDs. Evidence is inconsistent about the elevated prevalence of metabolic risk factors for NCDs. Evidence is consistent that people with CP participate in reduced physical activity. Only one study reported on management of NCD among people with CP. Available evidence suggests people with CP are less likely to receive preventive medicine.
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Affiliation(s)
- Jennifer M Ryan
- College of Health and Life Sciences, Brunel University, London, UK.,Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Elizabeth Allen
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - John Gormley
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Edward A Hurvitz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
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Keawutan P, Bell KL, Oftedal S, Ware RS, Stevenson RD, Davies PSW, Boyd RN. Longitudinal physical activity and sedentary behaviour in preschool-aged children with cerebral palsy across all functional levels. Dev Med Child Neurol 2017; 59:852-857. [PMID: 28432680 DOI: 10.1111/dmcn.13439] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2017] [Indexed: 11/28/2022]
Abstract
AIM To investigate longitudinal changes of habitual physical activity (HPA) and sedentary time in children with cerebral palsy (CP) aged 1 year 6 months to 5 years across all functional abilities. METHOD At study entry, 95 children (62 males, 33 females) were classified using the Gross Motor Function Classification System (GMFCS) at levels I (50), II (9), III (16), IV (6), and V (14). Physical activity was recorded on a total of 159 occasions at four possible time points: 1 year 6 months to 2 years; 2 years 6 months to 3 years; 4 years; and 5 years using ActiGraph for 3 days. Mixed-effects regression models were used for analyses. RESULTS Participants classified at GMFCS levels I and II had stable HPA as they aged. HPA significantly decreased at 5 years in children classified at GMFCS levels III to V. Sedentary time significantly increased at 4 years and 5 years in all participants. Annual HPA significantly reduced in children classified at GMFCS levels III to V (-123 counts/min, 95% confidence interval [CI] -206 to -40) while annual sedentary time significantly increased in all participants (GMFCS levels I-II: 2.4%, 95% CI 0.7-4.1; GMFCS levels III-V: 6.9%, 95% CI 4.6-9.2). INTERPRETATION Children with CP at all GMFCS levels should be encouraged to be physically active from early childhood as HPA levels start to decline from 4 years. Breaks in sedentary time are required for all children with CP from the age of 3 years.
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Affiliation(s)
- Piyapa Keawutan
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.,Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
| | - Kristie L Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.,Dietetics and Food Services, Lady Cilento Children's Hospital, Children's Health Queensland, South Brisbane, Qld, Australia
| | - Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.,Children's Nutrition Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Brisbane, Qld, Australia
| | - Richard D Stevenson
- Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA
| | - Peter S W Davies
- Children's Nutrition Research Centre, The University of Queensland, Brisbane, Qld, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia
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Oftedal S, Davies PS, Boyd RN, Stevenson RD, Ware RS, Keawutan P, Benfer KA, Bell KL. Body composition, diet, and physical activity: a longitudinal cohort study in preschoolers with cerebral palsy. Am J Clin Nutr 2017; 105:369-378. [PMID: 28077375 DOI: 10.3945/ajcn.116.137810] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 11/07/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Altered body composition in children with cerebral palsy (CP) could be due to differences in energy intake, habitual physical activity (HPA), and sedentary time. OBJECTIVE We investigated the longitudinal relation between the weight-for-age z score (WZ), fat-free mass (FFM), percentage of body fat (%BF), and modifiable lifestyle factors for all Gross Motor Function Classification System (GMFCS) levels (I-V). DESIGN The study was a longitudinal population-based cohort study of children with CP who were aged 18-60 mo (364 assessments in 161 children; boys: 61%; mean ± SD recruitment age: 2.8 ± 0.9 y; GMFCS: I, 48%; II, 11%; III, 15%; IV, 11%; and V, 15%). A deuterium dilution technique or bioelectrical impedance analysis was used to estimate FFM, and the %BF was calculated. Energy intake, HPA, and sedentary time were measured with the use of a 3-d weighed food diary and accelerometer wear. Data were analyzed with the use of a mixed-model analysis. RESULTS Children in GMFCS group I did not differ from age- and sex-specific reference children with typical development for weight. Children in GMFCS group IV were lighter-for-age, and children in GMFCS group V had a lower FFM-for-height than those in GMFCS group I. Children in GMFCS groups II-V had a higher %BF than that of children in GMFCS group I, with the exception of orally fed children in GMFCS group V. The mean %BF of children with CP classified them as overfat or obese. There was a positive association between energy intake and FFM and also between HPA level and FFM for children in GMFCS group I. CONCLUSIONS Altered body composition was evident in preschool-age children with CP across functional capacities. Gross motor function, feeding method, energy intake, and HPA level in GMFCS I individuals are the strongest predictors of body composition in children with CP between the ages of 18 and 60 mo.
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Affiliation(s)
- Stina Oftedal
- Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center, .,Children's Nutrition Research Center, and
| | | | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center
| | - Richard D Stevenson
- Division of Developmental Pediatrics, Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA
| | - Robert S Ware
- School of Population Health, The University of Queensland, Brisbane, Australia
| | - Piyapa Keawutan
- Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.,Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand; and
| | - Katherine A Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center
| | - Kristie L Bell
- Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.,Dietetics and Food Services, Lady Cilento Children's Hospital, Children's Health Queensland, South Brisbane, Australia
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18
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Coker-Bolt P, Downey RJ, Connolly J, Hoover R, Shelton D, Seo NJ. Exploring the feasibility and use of accelerometers before, during, and after a camp-based CIMT program for children with cerebral palsy. J Pediatr Rehabil Med 2017; 10:27-36. [PMID: 28339408 DOI: 10.3233/prm-170408] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The aim of this pilot study was to determine the feasibility and use accelerometers before, during, and after a camp-based constraint-induced movement therapy (CIMT) program for children with hemiplegic cerebral palsy. METHODS A pre-test post-test design was used for 12 children with CP (mean = 4.9 yrs) who completed a 30-hour camp-based CIMT program. The accelerometer data were collected using ActiGraph GT9X Link. Children wore accelerometers on both wrists one day before and after the camp and on the affected limb during each camp day. Three developmental assessments were administered pre-post CIMT program. RESULTS Accelerometers were successfully worn before, during, and directly after the CIMT program to collect upper limb data. Affected upper limb accelerometer activity significantly increased during the CIMT camp compared to baseline (p< 0.05). Significant improvements were seen in all twelve children on all assessments of affected upper limb function (p< 0.05) measuring capacity and quality of affected upper limb functioning. CONCLUSION Accelerometers can be worn during high intensity pediatric CIMT programs to collect data about affected upper limb function. Further study is required to determine the relationship between accelerometer data, measure of motor capacity, and real-world performance post-CIMT.
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Affiliation(s)
- Patty Coker-Bolt
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA.,Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA
| | - Ryan J Downey
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA
| | - Jacqueline Connolly
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA
| | - Reagin Hoover
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel Shelton
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA
| | - Na Jin Seo
- Department of Health Professions, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC, USA.,Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA
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Habitual Physical Activity in Children With Cerebral Palsy Aged 4 to 5 Years Across All Functional Abilities. Pediatr Phys Ther 2017; 29:8-14. [PMID: 27984458 DOI: 10.1097/pep.0000000000000327] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare ambulatory status in children with cerebral palsy aged 4 to 5 years with their habitual physical activity and time spent sedentary, and to compare their activity with physical activity guidelines. METHODS Sixty-seven participants-independently ambulant, marginally ambulant, and nonambulant-wore accelerometers for 3 days. Time spent sedentary as a percentage of wear time and activity counts were compared between groups. RESULTS There were significant differences in time spent sedentary and activity counts between groups. Children who were independently ambulant were more likely to meet physical activity guidelines. CONCLUSION Children with cerebral palsy spent more than half of their waking hours in sedentary time. Interventions to reduce sedentary behavior and increase habitual physical activity are needed in children with cerebral palsy at age 4 to 5 years.
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