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Santana CAS, Rosenbaum P, van der Kemp J, de Campos AC. Looking beyond Body Structure and Function: ICF Foci and Who Is Being Assessed in Research about Adolescents and Young Adults with Cerebral Palsy-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:670. [PMID: 38928917 PMCID: PMC11203594 DOI: 10.3390/ijerph21060670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE The purpose of this study is to summarize the ICF foci, looking beyond body structures and function, and to analyze who has been assessed in research about adolescents and young adults (AYAs) with CP in the phase of transition to adulthood. METHOD Medline, EMBASE, PsycINFO, and CINAHL databases were searched using terms related to cerebral palsy, adolescents/young adults, health development, participation, and independence. Studies including youth with CP (13-30 years old) published in English from 2014 to 2021 were considered. The methods of assessment reported in the included studies were used to identify the ICF foci and who was assessed. RESULTS In this study, 86 studies were reviewed. The main ICF foci are activity and participation (51% of the studies), personal factors (23%), ICF not covered (14%), ICF not defined (9%), with environmental factors being the least focused ICF component (3%). Most studies assessed AYAs directly (49% of studies). CONCLUSIONS Activity- and participation-related constructs are the leading research focus of studies, and more attention is needed concerning environmental factors. AYAs are the main source of information, and the perspectives of other key figures are also being valued. To bridge the gap between child and adult health care, a broader view of health development and approaches to explore AYA developmental issues must be taken.
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Affiliation(s)
- Camila Araújo Santos Santana
- Physiotherapy Department, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jet van der Kemp
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, 3584 Utrecht, The Netherlands
| | - Ana Carolina de Campos
- Physiotherapy Department, Child Development Analysis Laboratory (LADI), Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
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Petersen BA, Erickson KI, Kurowski BG, Boninger ML, Treble-Barna A. Emerging methods for measuring physical activity using accelerometry in children and adolescents with neuromotor disorders: a narrative review. J Neuroeng Rehabil 2024; 21:31. [PMID: 38419099 PMCID: PMC10903036 DOI: 10.1186/s12984-024-01327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Children and adolescents with neuromotor disorders need regular physical activity to maintain optimal health and functional independence throughout their development. To this end, reliable measures of physical activity are integral to both assessing habitual physical activity and testing the efficacy of the many interventions designed to increase physical activity in these children. Wearable accelerometers have been used for children with neuromotor disorders for decades; however, studies most often use disorder-specific cut points to categorize physical activity intensity, which lack generalizability to a free-living environment. No reviews of accelerometer data processing methods have discussed the novel use of machine learning techniques for monitoring physical activity in children with neuromotor disorders. METHODS In this narrative review, we discuss traditional measures of physical activity (including questionnaires and objective accelerometry measures), the limitations of standard analysis for accelerometry in this unique population, and the potential benefits of applying machine learning approaches. We also provide recommendations for using machine learning approaches to monitor physical activity. CONCLUSIONS While wearable accelerometers provided a much-needed method to quantify physical activity, standard cut point analyses have limitations in children with neuromotor disorders. Machine learning models are a more robust method of analyzing accelerometer data in pediatric neuromotor disorders and using these methods over disorder-specific cut points is likely to improve accuracy of classifying both type and intensity of physical activity. Notably, there remains a critical need for further development of classifiers for children with more severe motor impairments, preschool aged children, and children in hospital settings.
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Affiliation(s)
- Bailey A Petersen
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kirk I Erickson
- AdventHealth Research Institute Department of Neuroscience, AdventHealth, Orlando, FL, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brad G Kurowski
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - M L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Treble-Barna
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
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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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Eun IS, Goh TS, Kim DS, Choi M, Lee JS. Comparison of Korean Body Image Questionnaires in Adolescent Idiopathic Scoliosis. Asian Spine J 2023; 17:47-60. [PMID: 35527533 PMCID: PMC9977971 DOI: 10.31616/asj.2021.0460] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/08/2022] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN A prospective study. PURPOSE To obtain the results of four body image questionnaires analyzed for validity in Korean and compare them to radiographic findings and quality of life scores. OVERVIEW OF LITERATURE Each of the four body image questionnaires has been studied, but comparative studies of each other are rare. METHODS Adolescent idiopathic scoliosis (AIS) patients ages 10 to 19 years completed the Korean version of the Quality of Life Profile for Spinal Deformities (K-QLPSD), the Scoliosis Research Society-22 self-image subscale (K-SRS-22-si), Korean version of the Spinal Appearance Questionnaire (K-SAQ), Korean version of the Body Image Disturbance Questionnaire-Scoliosis (K-BIDQ-S), and Korean version of the Italian Spine Youth Quality of Life (K-ISYQOL). Four body image questionnaires were compared with K-ISYQOL and radiographic major curve magnitude, coronal balance, and sagittal balance. Spearman's correlation was performed to compare the four body image questionnaires. RESULTS The study included 84 AIS patients, with a mean age of 12.6 years and a major Cobb angle of 29.4°. The four surveys were correlated with major curve magnitude and K-ISYQOL. K-SAQ and K-BIDQ-S were correlated better than K-QLPSD, and K-SRS-22-si was correlated with K-ISYQOL. The four surveys were moderately correlated with major curve magnitude, but there was no correlation with age, coronal balance, and sagittal balance. CONCLUSIONS K-SAQ and K-BIDQ-S correlate better with K-ISYQOL than K-QLPSD and K-SRS-22-si.
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Affiliation(s)
- Il-Soo Eun
- Department of Orthopaedic Surgery, Good Samsun Hospital, Busan,
Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Biomedical Research Institute, Busan National University Hospital, Busan National University School of Medicine, Busan,
Korea
| | - Dong Suk Kim
- Department of Orthopaedic Surgery, Biomedical Research Institute, Busan National University Hospital, Busan National University School of Medicine, Busan,
Korea
| | - Minjun Choi
- Department of Orthopaedic Surgery, Biomedical Research Institute, Busan National University Hospital, Busan National University School of Medicine, Busan,
Korea
| | - Jung Sub Lee
- Department of Orthopaedic Surgery, Biomedical Research Institute, Busan National University Hospital, Busan National University School of Medicine, Busan,
Korea
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Heath GW, Levine D. Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10436. [PMID: 36012074 PMCID: PMC9408065 DOI: 10.3390/ijerph191610436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to promote health and prevent disease among people with disabilities. Addressing the core function of assessment, current physical activity epidemiology, and surveillance among people with disabilities across the globe highlights the paucity of surveillance systems that include physical activity estimates among people with disabilities. The status of valid and reliable physical activity measures among people with condition-specific disabilities is explored, including self-report measures along with wearable devices, and deficiencies in measurement of physical activity. The core functions of policy development and assurance are described in the context of community-based intervention strategies to promote physical activity among people with disabilities. The identification of research gaps in health behavior change, policy, and environmental approaches to promoting physical activity among people with disabilities is explored, along with recommendations based on the principles of inclusive and engaged research partnerships between investigators and the members of the disability community.
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Affiliation(s)
- Gregory W. Heath
- Public Health Program, Department of Health and Human Performance, University of Tennessee, Chattanooga, TN 37403, USA
- University of Tennessee Health Science Center College of Medicine Chattanooga, Chattanooga, TN 37403, USA
| | - David Levine
- Department of Physical Therapy, The University of Tennessee, Chattanooga, TN 37403, USA
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Scott KS, Barbosa GO, Pan J, Heathcock JC. Using the PODCI to Measure Motor Function and Parent Expectations in Children With Cerebral Palsy. Phys Ther 2021; 101:pzab215. [PMID: 34529078 PMCID: PMC8651067 DOI: 10.1093/ptj/pzab215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 07/12/2021] [Accepted: 07/31/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Involving parents in the evaluation of their child with cerebral palsy (CP) is associated with enhanced neurodevelopmental outcomes. The pediatric outcomes data collection instrument (PODCI) is a patient-reported outcome measure primarily used to assess motor function following orthopedic surgical intervention or for older children with more independent motor function. The PODCI expectations scale has infrequently been reported in previous studies. This study aims to determine the relationship between parent-reported motor performance using the PODCI and motor capacity assessed by pediatric therapists for young children with CP across all ability levels and to explore the use of the PODCI expectations scale for quantifying therapy-related parent expectations. METHODS This prospective cohort study included 108 participants with CP, 2 to 8 years of age, gross motor function classification systems (GMFCS) levels I to V. Measures included the PODCI, gross motor function measure (GMFM), and GMFCS. RESULTS There were moderate (r = 0.513) to large (r = 0.885) relationships between PODCI and GMFM scores. PODCI scores were significantly different across GMFCS levels. Weak, significant relationships (r = -0.28) were found between function expectations scores and measures of function. CONCLUSION The PODCI, GMFM, and GMFCS provide different, but strongly related, information about the abilities of young children. The GMFM measures motor capacity. Parents report daily function and health-related quality of life for their child using the PODCI. Parent expectations for intervention outcomes may relate to a child's motor function. IMPACT These study results are consistent with those for older children with greater independent mobility, indicating an opportunity for expanded use of the PODCI for measuring motor performance for younger children with CP across all ability levels. A strategy is provided for using the PODCI expectations scale to quantify parent therapy-related expectations in future research and clinical settings. Therapy-related expectations may relate to child outcomes.
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Affiliation(s)
- Kimberley S Scott
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Gardenia O Barbosa
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Jeff Pan
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
| | - Jill C Heathcock
- Pediatric and Rehabilitation Laboratory, School of Health and Rehabilitation Sciences, Division of Physical Therapy, The Ohio State University, Columbus, Ohio, USA
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Eun IS, Park SH, Goh TS, Son SM, Kim DS, Lee JS. Effect of bisphosphonates on ankylosing spondylitis: A meta-analysis. J Clin Neurosci 2021; 92:153-158. [PMID: 34509243 DOI: 10.1016/j.jocn.2021.08.016] [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] [Received: 05/11/2020] [Revised: 06/16/2021] [Accepted: 08/15/2021] [Indexed: 12/01/2022]
Abstract
This study aimed to compare outcomes between ankylosing spondylitis (AS) treated with and without bisphosphonate (BP; non-BP) through a meta-analysis. The Medline (via PubMed), Cochrane, Scopus, and Embase databases were searched for studies that evaluated the outcomes of AS, including patient age, disease duration, disease activity, and bone mineral density (BMD), published between January 2000 and March 2020. Two authors extracted the data independently. Any discrepancies were resolved by a consensus. Six comparative studies were identified. No significant differences were found between the BP and non-BP groups in terms of demographic characteristics, disease activity, and BMD, except for follow-up erythrocyte sedimentation rate (ESR). The follow-up ESR was higher in the BP than in the non-BP group. A literature review identified six comparative studies reporting the outcomes of BP and non-BP treatments for AS. Despite the heterogeneity, a limited number of meta-analyses reported that BP treatment was not clearly better than non-BP treatment. Hence, further large-scale multicenter studies are required to validate our results.
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Affiliation(s)
- Il-Soo Eun
- Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, Republic of Korea
| | - Shi Hwan Park
- Department of Orthopaedic Surgery, Gupo Sungshim Hospital, Busan, Republic of Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Seung Min Son
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Suk Kim
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jung Sub Lee
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
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Park SH, Goh TS, Son SM, Kim DS, Lee JS. Validation of the Italian spine youth quality of life (ISYQOL) in Korean population. J Clin Neurosci 2021; 92:165-168. [PMID: 34509245 DOI: 10.1016/j.jocn.2021.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/16/2021] [Accepted: 08/15/2021] [Indexed: 11/28/2022]
Abstract
We aimed to evaluate the reliability and validity of the adapted Korean version of the Italian Spine Youth Quality of Life (ISYQOL) questionnaire. Translation/retranslation of the English version of ISYQOL was conducted, and all steps of the cross-cultural adaptation process were performed. The Korean version of the ISYQOL and the previously validated Scoliosis Research Society-22 (SRS-22) questionnaire were mailed to 120 consecutive idiopathic scoliosis patients wearing brace. Factor analysis and reliability assessment by kappa statistics of agreement for each item, the intraclass correlation coefficient (ICC) and Cronbach's α were conducted. Construct validity was also evaluated by comparing the responses of ISYQOL with the responses of SRS-22 by using Pearson's correlation coefficient. Factor analysis extracted 2 factors. All items had a kappa statistics of agreement greater than 0.6. The ISYQOL showed good test/re-test reliability (ICC = 0.812). Internal consistency of Cronbach's α was found to be very good (α = 0.873). The Korean version of ISYQOL showed good significant correlation with SRS-22 total score and with single SRS-22 domains scores. The adapted Korean version of the ISYQOL was successfully translated and showed acceptable measurement properties, and as such, is considered suitable for outcome assessments in the Korean speaking patients with idiopathic scoliosis.
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Affiliation(s)
- Shi Hwan Park
- Department of Orthopaedic Surgery, Gupo Sungshim Hospital, Busan, Republic of Korea
| | - Tae Sik Goh
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Seung Min Son
- Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Dong Suk Kim
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Jung Sub Lee
- Department of Orthopaedic Surgery, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.
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A Study on Physical Exercise and General Mobility in People with Cerebral Palsy: Health through Costless Routines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179179. [PMID: 34501769 PMCID: PMC8430775 DOI: 10.3390/ijerph18179179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 12/16/2022]
Abstract
Sedentary behavior (SB) is a common problem that may produce health issues in people with cerebral palsy (CP). When added to a progressive reduction in motor functions over time, SB can lead to higher percentages of body fat, muscle stiffness and associated health issues in this population. Regular physical activity (RPA) may prevent the loss of motor skills and reduce health risks. In this work, we analyzed data collected from 40 people (20 children and teenagers, and 20 adults) who attend two specialist centers in Seville to obtain an up-to-date picture regarding the practice of RPA in people with CP. Roughly 60% of the participants showed mostly mid/severe mobility difficulties, while 38% also had communicative issues. Most of the participants performed light-intensity physical activity (PA) at least once or twice a week and, in the majority of cases, had a neutral or positive attitude to exercising. In the Asociación Sevillana de Parálisis Cerebral (ASPACE) sample test, the higher the International Classification of Functioning, Disability and Health (ICF), the higher the percentage of negative responses to doing exercise. Conversely, in the Centro Específico de Educación Especial Mercedes Sanromá (CEEEMS), people likes PA but slightly higher ratios of positive responses were found at Gross Motor Function Classification System (GMFCS) levels V and II, agreeing with the higher personal engagement of people at those levels. We have also performed a literature review regarding RPA in CP and the use of low-cost equipment. As a conclusion, we found that RPA produces enormous benefits for health and motor functions, whatever its intensity and duration. Costless activities such as walking, running or playing sports; exercises requiring low-cost equipment such as elastic bands, certain smartwatches or video-games; or therapies with animals, among many others, have all demonstrated their suitability for such a purpose.
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Suk MH, Park IK, Yoo S, Kwon JY. The association between motor capacity and motor performance in school-aged children with cerebral palsy: An observational study. J Exerc Sci Fit 2021; 19:223-228. [PMID: 34447440 PMCID: PMC8361183 DOI: 10.1016/j.jesf.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 12/18/2022] Open
Abstract
Background This study aimed to investigate the association between motor capacity and motor performance in children with cerebral palsy (CP) aged 6–12 years with Gross Motor Function Classification System (GMFCS) levels I to III. Methods Forty-six children with CP (24 boys and 22 girls) classified as GMFCS levels Ⅰ, Ⅱ, or Ⅲ were included. Motor capacity was measured by the Gross motor function measure (GMFM), Pediatric balance scale (PBS), Timed up and go (TUG), and 6-min walk test (6MWT). Motor performance was measured by triaxial accelerometers. Estimations of physical activity energy expenditure (PAEE) (kcal/kg/day), percentage of time spent on physical activity (% sedentary physical activity; %SPA; % light physical activity, %LPA; % moderate physical activity, %MPA; % vigorous physical activity %VPA; and moderate-to-vigorous physical activity, %MVPA), and activity counts (counts/minute) were obtained. Results Children with GMFCS level I showed a significantly higher motor capacity (GMFM-66, GMFM-88, D-dimension and E-dimension, PBS and 6MWT) than those with level II or III. Children with GMFCS level II and/or III had significantly lower physical activity (PAEE, % MPA, % VPA, %MVPA, and activity counts) than children with GMFCS level I. Multiple linear regression analysis (dependent variable, GMFM-66) showed that %MVPA was positively associated with GMFM-66 in the GMFCS level II & III children but not in GMFCS level I children. Conclusions These findings highlight the importance of increasing %MVPA in children with CP, especially GMFCS levels II and III.
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Affiliation(s)
- Min-Hwa Suk
- Department of Physical Education, Seoul National University of Education, Seoul, Republic of Korea
| | - In-Kyeong Park
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Soojin Yoo
- Department of Health and Human Performance, University of Texas, Rio Grande Valley, Edinburg, TX, USA
| | - Jeong-Yi Kwon
- Dept. of Physical & Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
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Changes in physical activity and risk of fracture: a Korean nationwide population-based cohort study. Sci Rep 2020; 10:16266. [PMID: 33004986 PMCID: PMC7531000 DOI: 10.1038/s41598-020-73495-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/11/2020] [Indexed: 12/04/2022] Open
Abstract
Physical activity (PA) is one of the most important modifiable factors associated with fracture risk. However, the association between interval changes in PA and the risk of fracture remains unknown. We investigated the risk of fracture development according to interval changes in PA in middle aged and older individuals. In this nationwide cohort study of adults aged ≥ 40 years, more than 4.9 million individuals without fractures within the last year who underwent two consecutive national health screenings in Korea from 2009 to 2012 were identified. The risk of fracture between 2013 and 2016 according to interval changes in regular PA was prospectively analyzed. Compared to individuals with a continuous lack of PA, those with a decrease in PA (0.41/1000 person-years (PY) decrease in incidence rate (IR); adjusted hazard ratio (aHR) 0.975; 95% confidence interval (CI) 0.964–0.987), increase in PA (1.8/1000 PY decrease in IR; aHR 0.948; 95% CI 0.937–0.959), and continuous PA (3.58/1000 PY decrease in IR; aHR 0.888; 95% CI 0.875–0.901) had a significantly reduced risk of fracture. Interval changes in regular PA were associated with risk of fracture. Individuals who engaged in continuous regular PA exhibited the maximum protective benefit against fracture.
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