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Longitudinal Trajectories of Sedentary Time and Physical Activity in Children With Cerebral Palsy: Time to Move
Ineke Verreydt1, Olaf Verschuren2, Marieke De Craemer3
1Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Insights
Sedentary time increases and light physical activity decreases in children with cerebral palsy (CP) as they age. Tailored advice is crucial for optimizing activity levels in children with CP.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Movement Science
Background:
- Children with cerebral palsy (CP) exhibit reduced mobility, leading to decreased physical activity (PA) and increased sedentary behavior.
- Longitudinal studies examining age-related changes in sedentary behavior and PA levels in children with CP are lacking.
Purpose of the Study:
- To longitudinally investigate the effects of increasing age on sedentary behavior and different intensities of physical activity (PA) in children with CP.
- To compare these changes with typically developing peers.
Main Methods:
- A longitudinal study involving 45 ambulant children with spastic CP (aged 2-11 years) with 108 total assessments.
- ActiGraph accelerometers measured PA and sedentary behavior.
- Linear mixed-effects models analyzed age-related changes, with comparisons to cross-sectional data from typically developing children.
Main Results:
- Sedentary time increased by 0.79%/year, light PA decreased by 1.17%/year, and moderate-to-vigorous PA increased by 0.33%/year in children with CP.
- Children with Gross Motor Function Classification System (GMFCS) levels II/III showed higher sedentary time and lower PA than GMFCS I from age 2.
- Children with CP exhibited significantly lower PA, higher sedentary time, and more sleep problems than typically developing peers.
Conclusions:
- Light PA declines with age in children with CP, accompanied by a greater increase in sedentary time relative to moderate-to-vigorous PA.
- Individual differences in developmental trajectories underscore the need for personalized interventions to manage sedentary time and promote PA in children with CP as they grow.
Background:
Children with cerebral palsy (CP) have reduced movement abilities, limiting physical activity (PA) and increasing sedentary behavior. No study so far applied a longitudinal design to examine changes in sedentary behavior and different levels of PA in relation to increasing age.
Methods:
Forty-five ambulant children with spastic CP, aged 2-11 years, participated in this longitudinal study, totaling 108 assessments (2-4 assessments/child). PA and sedentary behavior were measured using ActiGraph wGT3X-BT triaxial accelerometers, placed on the right hip. Linear mixed-effects models fitted effect of age on sedentary time and PA, for the total sample and Gross Motor Function Classification System (GMFCS) subgroups. Results were compared with cross-sectional data of 49 typically developing peers including data on sleep problems.
Results:
Based on linear mixed-effects models, sedentary time increased with 0.79%/year (P = .0094), light PA decreased with 1.17%/year (P < .0001), and moderate-to-vigorous PA increased with 0.33%/year (P = .0003) in the total sample of children with CP. Children with GMFCS levels II/III presented with more sedentary time and less PA than children with GMFCS I, already at the age of 2 years old. Significant lower levels of light and moderate-to-vigorous PA, more sedentary time, and more sleep problems (P < .05) were seen for the CP compared with the typically developing group.
Conclusions:
The unique longitudinal results indicate that with increasing age, light PA decreases, along with a greater increase in sedentary time compared with moderate-to-vigorous PA. The variability in individual trajectories highlights the importance of patient-tailored advice to optimize how children with CP spend their waking hours, especially with increasing age.
