Habitual Physical Activity of Independently Ambulant Children and Adolescents With Cerebral Palsy: Are They Doing Enough?

Abstract

Background Despite the health benefits of regular physical activity, children with cerebral palsy (CP) are thought to participate in reduced levels of physical activity. Objective The study objective was to assess physical activity and determine the proportion adhering to the recommended 60 minutes of moderate-to-vigorous physical activity (MVPA) daily in independently ambulant children and adolescents with unilateral CP. Design This was a cross-sectional study. Method Children (N=102; 52 boys, 50 girls; mean age=11 years 3 months, SD=2 years 4 months) with spastic hemiplegia classified at Gross Motor Function Classification System (GMFCS) levels I (n=44) and II (n=58) recorded physical activity over 4 days using an accelerometer. Activity counts were converted to daily and hourly time spent inactive and in light physical activity or MVPA using uniaxial cutpoints (inactive: ≤100 vertical counts·min−1, light: 101 to 2,295 vertical counts·min−1, MVPA: ≥2,296 vertical counts·min−1) and recorded step counts. Differences between groups were examined using t tests. Results Of a potential 396 days, 341 days (86%) were recorded. The average wear time was 11:44 (SD=1:56) hours. On a typical day, participants recorded 438 (SD=234) counts·min−1, took 7,541 (SD=3,894) steps, spent 8:36 (SD=1:09) hours inactive, spent 2:38 (SD=0:51) hours in light activity, and spent 0:44 (SD=0:26) hours in MVPA. Only 25% of participants met the recommended level of MVPA on at least one day. Physical activity was highest in boys (versus girls), in children (versus adolescents), and on weekdays (versus weekends). Limitations Participants were limited to children with unilateral spasticity who were classified at GMFCS levels I and II. Conclusions The majority of independently ambulant children with unilateral CP did not perform sufficient physical activity to meet public health recommendations.