Movement Behaviors on Days With and Without Structured Activities in Children With Cerebral Palsy: A Within- and
Rafael Tassitano1, Clarice Maria de Lucena Martins2, Tracy Bowden1
1Department of Health and Kinesiology, University of Illinois, Urbana-Champaign, IL, USA.
Insights
Structured activities significantly improve movement behaviors in children with cerebral palsy. Days with more structure led to increased physical activity and steps, and reduced screen time.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Movement Science
Background:
- Children with cerebral palsy (CP) can benefit from structured daily routines impacting physical activity, sedentary time, and sleep.
- Understanding movement behavior patterns on days with and without structured activities is crucial for this population.
Purpose of the Study:
- To describe and examine associations of movement behaviors (physical activity, sedentary time, sleep) on days with and without structured activities in children with CP.
- To investigate both between-person and within-person variations in movement behaviors related to daily structure.
Main Methods:
- A cross-sectional study involving 17 children with CP (aged 3-10 years, GMFCS levels I-III).
- Objective measurement of movement behaviors using accelerometers over 7 days, supplemented by daily activity logs.
- Analysis using two-level multilevel linear mixed-effects models.
Main Results:
- Analysis included 119 days; sleep, sedentary time, and physical activity recommendations were met on 30.2%, 9.2%, and 6.7% of days, respectively.
- Favorable movement behaviors were observed on days with structured activities compared to unstructured days.
- Within-person analysis showed structured days correlated with an extra 4.3 min of moderate-to-vigorous physical activity, 648 more steps, and 24.8 fewer minutes of screen time.
Conclusions:
- Within-person analysis reveals day-to-day variability and highlights structured activities as a key factor for enhancing movement behaviors in children with CP.
- Educating caregivers on the benefits of structured activities can aid in developing effective strategies to improve movement behaviors, irrespective of the child's impairment level.
Background:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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