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Gross motor function is an important predictor of daily physical activity in young people with bilateral spastic
Theofani A Bania1, Nicholas F Taylor1, Richard J Baker2
1Faculty of Health Sciences, La Trobe University, Bundoora, Melbourne, Vic., Australia.
Insights
Adolescents and young adults with bilateral spastic cerebral palsy (CP) exhibit low daily physical activity. Gross Motor Function Measure Dimension-E (GMFM-E) significantly predicts activity levels in this population.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pediatrics
Background:
- Bilateral spastic cerebral palsy (CP) significantly impacts motor function and daily life.
- Understanding physical activity levels is crucial for managing health in adolescents and young adults with CP.
- Previous research has not fully elucidated the predictors of physical activity in this specific demographic.
Purpose of the Study:
- To quantify daily physical activity in adolescents and young adults with bilateral spastic CP.
- To identify demographic and physical factors that predict daily physical activity levels.
- To establish baseline activity data for targeted interventions.
Main Methods:
- 45 participants with bilateral spastic CP (GMFCS levels II-III) wore accelerometers to measure daily physical activity.
- Predictor variables included age, sex, weight, gross motor function (GMFM), lower limb strength, and 6-minute walk distance.
- Statistical analysis employed the Akaike information criterion (AIC) and linear regression.
Main Results:
- Daily physical activity levels were notably lower than established norms for the general population.
- Gross Motor Function Measure Dimension-E (GMFM-E; assessing walking, running, jumping) was a consistent predictor across models for energy expenditure, step count, and sedentary time.
- GMFM Dimension-D (standing ability) and bilateral reverse leg press strength also contributed to predicting overall daily physical activity.
Conclusions:
- Adolescents and young adults with bilateral spastic CP and mild-to-moderate walking impairments demonstrate significantly low daily physical activity.
- GMFM-E emerged as a key predictor, highlighting the importance of functional mobility in determining activity levels.
- These findings underscore the need for interventions to enhance physical activity in this population.
Aim:
The aim of the study was to describe daily physical activity levels of adolescents and young adults with bilateral spastic cerebral palsy (CP) and to identify factors that help predict these levels.
Method:
Daily physical activity was measured using an accelerometer-based activity monitor in 45 young people with bilateral spastic CP (23 males, 22 females; mean age 18y 6mo [SD 2y 5mo] range 16y 1mo-20y 11mo); classified as Gross Motor Function Classification System (GMFCS) level II or III and with contractures of <20° at hip and knee. Predictor variables included demographic characteristics (age, sex, weight) and physical characteristics (gross motor function, lower limb muscle strength, 6min walk distance). Data were analyzed using the information-theoretic approach, using the Akaike information criterion (AIC) and linear regression.
Results:
Daily activity levels were low compared with published norms. Gross Motor Function Measure Dimension-E (GMFM-E; walking, running, and jumping) was the only common predictor variable in models that best predicted energy expenditure, number of steps, and time spent sitting/lying. GMFM Dimension-D (standing) and bilateral reverse leg press strength contributed to the models that predicted daily physical activity.
Interpretation:
Adolescents and young adults with bilateral spastic CP and mild to moderate walking disabilities have low levels of daily activity. The GMFM-E was an important predictor of daily physical activity.
