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Influence of age on step activity patterns in children with cerebral palsy and typically developing children
Sandra L Stevens1, Elizabeth A Holbrook, Dana K Fuller
1Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, USA. sstevens@tnstate.edu
Insights
Older children with cerebral palsy (CP) exhibit significantly lower daily step activity and higher inactivity levels compared to younger children with CP and typically developing (TD) peers. Targeted interventions are crucial for promoting physical activity in adolescents with CP.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Movement Science
Background:
- Children with cerebral palsy (CP) often experience reduced physical activity, impacting their health and quality of life.
- Age-related changes in physical activity patterns are not well-documented in children with CP compared to typically developing (TD) peers.
Purpose of the Study:
- To investigate the influence of age on step activity patterns in children with CP.
- To compare step activity patterns between younger and older children with CP and age-matched TD children.
Main Methods:
- A cross-sectional study involving 54 children (27 with CP, 27 TD), stratified into younger (<10 years) and older (10-18 years) groups.
- Free-living daily step activity was monitored using accelerometers, recording data in 1-minute epochs.
- Analysis included daily steps, inactivity time, and time spent in low-, moderate-, and high-intensity activity.
Main Results:
- Significant interactions between age and condition (CP vs. TD) were found for daily step activity, inactivity, and low/high-intensity activity.
- Older children with CP showed significantly fewer daily steps, more inactivity, and less high-intensity activity compared to older TD children.
- Older children with CP also exhibited lower daily step activity and higher inactivity compared to younger children with CP.
Conclusions:
- Older youth with CP demonstrate reduced physical activity and increased inactivity compared to younger counterparts and TD peers.
- Interventions should focus on providing age-appropriate physical activities to enhance mobility, health, and quality of life for adolescents with CP.
Objective:
To document the influence of age on step activity patterns in children with cerebral palsy (CP) and typically developing (TD) children.
Design:
Cross-sectional.
Setting:
All step activity data were collected in free-living environments.
Participants:
Children with CP (n=27; age, 4-18y; 22 boys, 5 girls; Gross Motor Function Classification System levels I and II) and 27 age- and sex-matched TD children were recruited through public advertisements and contacts with local clinicians. CP and TD participants were stratified into younger (<10y; n=14) and older (10-18y; n=13) age groups.
Intervention:
Daily step activity was monitored using a step activity monitor that was individually programmed to account for the gait characteristics of each participant. Step activity data were collected in 1-minute epochs during waking hours on 3 weekdays and 1 weekend day. Stored data were analyzed to yield average values of daily step activity, percentage of inactive time (0 steps) over the entire day, and percentage of total daily active time spent in low step activity (1-15 steps/min), medium step activity (16-40 steps/min), and high step activity (>40 steps/min).
Main Outcome Measures:
Daily step activity, percentage of inactive time, and percentage of active time spent in low-, moderate-, and high-intensity step activity.
Results:
A significant (P<.05) interaction was observed between age (younger, older) and condition (CP, TD) for daily step activity, percentage of inactive time, and percentage of active time spent in low- and high-intensity step activity. The main effect of age was significant for each physical activity measure except for relative high-intensity step activity, and the main effect of condition was significant for all physical activity measures. Follow-up analyses (P<.025) revealed that older children with CP took fewer daily steps and displayed higher relative levels of inactivity and low-intensity activity and lower relative levels of high-intensity activity compared with older TD children. Older children with CP also exhibited lower daily step activity, demonstrated higher relative levels of inactivity and low-intensity activity, and displayed lower relative levels of moderate-intensity activity compared with younger children with CP.
Conclusions:
Compared with younger children with CP and age- and sex-matched TD youth, older youth with CP generally displayed step activity patterns typified by lower levels of physical activity and a greater degree of inactivity. These findings highlight the need to provide multiple opportunities for adolescents with CP to engage in a variety of physical activities that are appropriate to their needs, abilities, and preferences and that can aid in maintaining functional mobility, health, and quality of life.
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