Accelerometer-measured habitual physical activity and sedentary time in pediatric concussion: A controlled cohort study

Abstract

Objectives: To characterize and quantify differences in accelerometer-measured physical activity and sedentary time between children with concussion (within the first month of injury) and 1:1 matched healthy controls. Methods: Secondary analysis of accelerometer data collected on 60 children with concussion and 60 healthy controls matched for age, sex, and season of accelerometer wear. Daily and hourly sedentary time, light physical activity (LPA), moderate physical activity (MPA), and vigorous physical activity (VPA) were compared between groups per independent samples t-tests. Results: Children with concussion (12.74 ± 2.85 years, 31 females) were significantly more sedentary than controls (12.43 ± 2.71 years, 31 females; mean difference [MD], 38.3 minutes/day, p=0.006), and spent less time performing LPA (MD, -19.5 minutes/day, p=0.008), MPA (MD, -9.8 minutes/day, p<0.001), and VPA(MD, -12.0 minutes/day, p<0.001); hour-by-hour analyses showed that these differences were observed from 8:00AM to 9:00PM. Sex-specific analyses identified that girls with concussion were less active and more sedentary than both boys with concussion (MD, 50.8 minutes/day; p=0.010) and healthy girls (MD, 51.1 minutes/day; p<0.010). Days post-injury significantly predicted MPA (β=0.071, p=0.032) and VPA (β=0.095, p=0.004), but not LPA or sedentariness in children with concussion. Conclusion: Clinical management should continue to advise against prolonged rest following pediatric concussion, given the activity debt observed within the first-month of injury. Currently, clinical management of concussion is shifting towards prescribing a single bout of daily sub-maximal aerobic exercise. Interventions aimed at reducing overall sedentary time and increasing habitual physical activity in pediatric concussion also warrant study.