Piyapa Keawutan1,2, Kristie L Bell1,3, Stina Oftedal1,4, Robert S Ware5,6, Richard D Stevenson7, Peter S W Davies4, Roslyn N Boyd1. 1. Queensland Cerebral Palsy and Rehabilitation Research Centre, UQ Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia. 2. Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand. 3. Dietetics and Food Services, Lady Cilento Children's Hospital, Children's Health Queensland, South Brisbane, Qld, Australia. 4. Children's Nutrition Research Centre, The University of Queensland, Brisbane, Qld, Australia. 5. Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia. 6. Queensland Centre for Intellectual and Developmental Disability, The University of Queensland, Brisbane, Qld, Australia. 7. Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia, Charlottesville, VA, USA.
Abstract
AIM: To investigate longitudinal changes of habitual physical activity (HPA) and sedentary time in children with cerebral palsy (CP) aged 1 year 6 months to 5 years across all functional abilities. METHOD: At study entry, 95 children (62 males, 33 females) were classified using the Gross Motor Function Classification System (GMFCS) at levels I (50), II (9), III (16), IV (6), and V (14). Physical activity was recorded on a total of 159 occasions at four possible time points: 1 year 6 months to 2 years; 2 years 6 months to 3 years; 4 years; and 5 years using ActiGraph for 3 days. Mixed-effects regression models were used for analyses. RESULTS: Participants classified at GMFCS levels I and II had stable HPA as they aged. HPA significantly decreased at 5 years in children classified at GMFCS levels III to V. Sedentary time significantly increased at 4 years and 5 years in all participants. Annual HPA significantly reduced in children classified at GMFCS levels III to V (-123 counts/min, 95% confidence interval [CI] -206 to -40) while annual sedentary time significantly increased in all participants (GMFCS levels I-II: 2.4%, 95% CI 0.7-4.1; GMFCS levels III-V: 6.9%, 95% CI 4.6-9.2). INTERPRETATION: Children with CP at all GMFCS levels should be encouraged to be physically active from early childhood as HPA levels start to decline from 4 years. Breaks in sedentary time are required for all children with CP from the age of 3 years.
AIM: To investigate longitudinal changes of habitual physical activity (HPA) and sedentary time in children with cerebral palsy (CP) aged 1 year 6 months to 5 years across all functional abilities. METHOD: At study entry, 95 children (62 males, 33 females) were classified using the Gross Motor Function Classification System (GMFCS) at levels I (50), II (9), III (16), IV (6), and V (14). Physical activity was recorded on a total of 159 occasions at four possible time points: 1 year 6 months to 2 years; 2 years 6 months to 3 years; 4 years; and 5 years using ActiGraph for 3 days. Mixed-effects regression models were used for analyses. RESULTS:Participants classified at GMFCS levels I and II had stable HPA as they aged. HPA significantly decreased at 5 years in children classified at GMFCS levels III to V. Sedentary time significantly increased at 4 years and 5 years in all participants. Annual HPA significantly reduced in children classified at GMFCS levels III to V (-123 counts/min, 95% confidence interval [CI] -206 to -40) while annual sedentary time significantly increased in all participants (GMFCS levels I-II: 2.4%, 95% CI 0.7-4.1; GMFCS levels III-V: 6.9%, 95% CI 4.6-9.2). INTERPRETATION:Children with CP at all GMFCS levels should be encouraged to be physically active from early childhood as HPA levels start to decline from 4 years. Breaks in sedentary time are required for all children with CP from the age of 3 years.
Authors: Jakub S Gąsior; Antonio Roberto Zamunér; Luiz Eduardo Virgilio Silva; Craig A Williams; Rafał Baranowski; Jerzy Sacha; Paulina Machura; Wacław Kochman; Bożena Werner Journal: J Clin Med Date: 2020-04-16 Impact factor: 4.241