Movement Behaviors on Days With and Without Structured Activities in Children With Cerebral Palsy: A Within- and...

A structured day can positively impact movement behaviorsphysical activity, sedentary time, and sleep among children with cerebral palsy. This study aims to describe and examine the between- and within-person associations of movement behaviors on days with and without structured activities among children with cerebral palsy.

A cross-sectional study was conducted with 17 children with cerebral palsy. Inclusion criteria were children aged 3-10 years, diagnosed with cerebral palsy, and classified as levels I to III according to the Gross Motor Function Classification System. Movement behaviors were objectively measured using accelerometers over 7 consecutive days. A daily activity log documented the structure of the children's activities. Two-level multilevel linear mixed-effects models were fitted to analyze associations.

A total of 119 days were included in the analyses. Recommendations for sleep, sedentary time (ie, screen time), and physical activity were met on 30.2%, 9.2%, and 6.7% of the days, respectively. More favorable behaviors occurred on days with structured activities compared with days without. Adjusted within-person effects revealed that on days with more structured activities compared with their average days, children accumulated an additional 4.3 minutes of moderate to vigorous physical activity, took 648 more steps, and spent 24.8 fewer minutes on screen time.

The within-person analysis highlights day-to-day patterns and provides a contextual perspective on promoting movement behaviors, regardless of the child's level of impairment. Informing caregivers and families about the benefits of structured activities can support strategies to enhance movement behaviors in children with cerebral palsy.