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Accelerometer-measured physical activity, sedentary behavior, and sleep in children with cerebral palsy and their
Raquel Y Hulst1, Jan Willem Gorter1,2,3, Joyce Obeid4
1Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Insights
Children with cerebral palsy (CP) show low adherence to 24-hour activity guidelines for physical activity and sleep. These findings highlight the need for integrated approaches to promote healthy lifestyles in children with CP.
Area of Science:
- Pediatric physical therapy
- Movement science
- Child health and wellness
Background:
- Children with cerebral palsy (CP) face challenges in meeting physical activity and sleep recommendations.
- Understanding 24-hour activity patterns is crucial for managing CP and preventing secondary health issues.
Purpose of the Study:
- To measure and describe the 24-hour activity patterns (physical activity, sedentary behavior, sleep) in children with CP.
- To assess adherence to 24-hour activity guidelines among children with CP.
Main Methods:
- Actigraphy (hip- and wrist-worn accelerometers) was used to record 24-hour activities over 7 days in 54 children with CP (GMFCS levels I-III).
- Data analysis focused on time spent in light physical activity, moderate-to-vigorous physical activity, and sedentary behavior, alongside sleep duration.
Main Results:
- Children spent an average of 33.8% of time in light physical activity, 5.2% in moderate-to-vigorous physical activity, and 61.1% sedentary.
- Adherence to physical activity guidelines was 13%, and to sleep duration guidelines was 35%.
- Only 5.9% met both guidelines, with 0% in GMFCS level III meeting combined guidelines.
Conclusions:
- Adherence to 24-hour movement behavior guidelines is low in children with CP, particularly those with higher GMFCS levels.
- Interventions should address the full spectrum of movement behaviors to promote health and prevent adverse outcomes in this population.
Aim:
To measure and describe the 24-hour activities (i.e. physical activity, sedentary behavior, and sleep) and to examine adherence to the 24-hour activity guidelines among children with cerebral palsy (CP) using actigraphy.
Method:
Children's 24-hour activities were recorded over 7 days using hip- and wrist-worn ActiGraph wGT3X-BT accelerometers.
Results:
In total, 362 days and 340 nights from 54 children with CP (Gross Motor Function Classification System [GMFCS] levels I-III; 44% females; median age [range] 6 years 6 months [3-12 years]) were included. Mean (SD) daily wear time was 746.2 (48.9) minutes, of which children spent on average 33.8% in light physical activity (251.6 [58.7] minutes per day), 5.2% in moderate-to-vigorous physical activity (38.5 [20.1] minutes per day), and the remaining 61.1% being sedentary (456.1 [80.4] minutes per day). Physical activity decreased while sedentary behavior increased with increasing GMFCS level. In total, 13% of all children met the physical activity recommendations, and 35% met the age-appropriate sleep duration recommendation. The proportion of children meeting the combined 24-hour guidelines for physical activity and sleep was low (5.9%), especially in those classified in GMFCS level III (0%).
Interpretation:
The observed low 24-hour guideline adherence rates emphasize the importance of considering the entire continuum of movement behaviors in the care of children with CP, in efforts to promote healthy lifestyle behaviors and prevent negative health outcomes.
