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Ambulatory activity of children with cerebral palsy: which characteristics are important?
Leontien van Wely1, Jules G Becher, Astrid C J Balemans
1Department of Rehabilitation Medicine, EMGO+ Institute for Health and Care Research, Research Institute MOVE, VU University Medical Center, Amsterdam, the Netherlands.
Insights
Children with cerebral palsy (CP) are less active on weekends. Interventions should target increasing physical activity for children with bilateral spastic CP on weekends.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Movement Science
Background:
- Cerebral palsy (CP) significantly impacts motor function and daily activity levels in children.
- Assessing ambulatory activity is crucial for understanding functional limitations and planning interventions.
Purpose of the Study:
- To evaluate the daily ambulatory activity patterns of children with spastic cerebral palsy (CP).
- To identify personal and environmental factors associated with varying levels of physical activity in this population.
Main Methods:
- Sixty-two children with spastic CP (GMFCS I-III) wore a StepWatch activity monitor for one week.
- Linear regression analysis identified factors associated with daily step counts and time at medium/high step rates.
Main Results:
- Children with CP took fewer steps on weekend days compared to school days.
- Higher Gross Motor Function Classification System (GMFCS) level, bilateral CP, and older age were linked to reduced activity, particularly on school days.
- Bilateral CP, older age, and lack of sports club participation were associated with lower weekend activity.
Conclusions:
- Physical activity levels in children with CP differ significantly between school and weekend days.
- Targeted interventions are needed to boost weekend physical activity, especially for children with bilateral spastic CP.
Aim:
To assess ambulatory activity of children with cerebral palsy (CP), aged 7 to 13 years, and identify associated characteristics.
Method:
Sixty-two children with spastic CP (39 males, 23 females; mean age 10y 1mo, SD 1y 8mo; age range 7-13y), classified as Gross Motor Function Classification System (GMFCS) levels I to III, participated. Ambulatory activity was measured during 1 week with a StepWatch activity monitor as steps per day, and time spent at medium and high step rates. Multiple linear regression analyses were performed following a backward selection procedure until only independent variables with p<0.05 remained in the model. Ambulatory activity outcome parameters served as dependent variables, and disease, personal, and environmental characteristics as independent variables. Ambulatory activity was corrected for body height.
Results:
Children took more steps during school days (5169 steps, SD 1641) than during weekend days (4158 steps, SD 2048; p<0.001). Higher GMFCS level, bilateral CP, and higher age were associated with lower ambulatory activity on school days (R(2) ranged from 43-53%), whereas bilateral CP, higher age, and no sport club participation were associated with lower ambulatory activity in the weekend (R(2) ranged from 21-42%). Correcting for body height decreased the association with age.
Interpretation:
Interventions should focus at increasing physical activity at the weekend for children with bilateral spastic CP.
