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Physical Activity in Pre-Ambulatory Children with Cerebral Palsy: An Exploratory Validation Study to Distinguish
Julie M Orlando1, Beth A Smith2,3,4, Jocelyn F Hafer5
1Division of Rehabilitation Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Insights
This study validates using wearable inertial sensors to measure physical activity in young children with cerebral palsy. Raw sensor data shows potential for accurately quantifying active and sedentary time.
Area of Science:
- Biomedical Engineering
- Pediatric Physical Therapy
- Rehabilitation Technology
Background:
- Wearable inertial sensors offer promising methods for monitoring physical activity in natural settings.
- Validating these sensors is crucial for accurate interpretation of data, especially in pediatric populations.
- Children with cerebral palsy often have altered movement patterns requiring specialized assessment tools.
Purpose of the Study:
- To develop and validate a method for quantifying active and sedentary physical activity using inertial sensors.
- To establish criterion validity for sensor-based activity measurement in pre-ambulatory children with cerebral palsy.
- To explore the utility of raw sensor data versus activity counts for this population.
Main Methods:
- Ten pre-ambulatory children with cerebral palsy participated in 30-minute physical therapy sessions.
- Video recordings were used for behavioral coding to determine criterion active and sedentary time.
- A receiver operating characteristic (ROC) curve analysis identified the optimal acceleration threshold (0.417 m/s²).
Main Results:
- The developed method achieved high accuracy, with 92.2% true positives and 89.7% true negatives upon validation.
- The optimal threshold effectively distinguished between active and sedentary periods.
- Raw acceleration data proved a reliable metric for activity quantification.
Conclusions:
- Inertial sensor technology holds significant potential for quantifying physical activity in pre-ambulatory children with physical disabilities.
- Raw acceleration data from inertial sensors may offer greater generalizability compared to sensor-specific activity counts.
- This validated method can aid in objective assessment and intervention planning for pediatric rehabilitation.
Abstract:
Wearable inertial sensor technology affords opportunities to record the physical activity of young children in their natural environments. The interpretation of these data, however, requires validation. The purpose of this study was to develop and establish the criterion validity of a method of quantifying active and sedentary physical activity using an inertial sensor for pre-ambulatory children with cerebral palsy. Ten participants were video recorded during 30 min physical therapy sessions that encouraged gross motor play activities, and the video recording was behaviorally coded to identify active and sedentary time. A receiver operating characteristic curve identified the optimal threshold to maximize true positive and minimize false positive active time for eight participants in the development dataset. The threshold was 0.417 m/s2 and was then validated with the remaining two participants; the percent of true positives and true negatives was 92.2 and 89.7%, respectively. We conclude that there is potential for raw sensor data to be used to quantify active and sedentary time in pre-ambulatory children with physical disability, and raw acceleration data may be more generalizable than the sensor-specific activity counts commonly reported in the literature.
