Accelerometry: A Feasible Method to Quantify Physical Activity in Ambulatory and Nonambulatory Adolescents with Cerebral Palsy

Abstract

Objective. To determine the feasibility of physical activity monitoring in adolescents with cerebral palsy (CP). Methods. A convenience sample of ambulatory and non-ambulatory adolescents (N = 23; 17 males, 6 females; mean age 13.5 y, SD 2.6 y; Gross Motor Function Classification System (GMFCS) distribution: n = 9 Level I, n = 5 Level II, n = 5 Level III, n = 4 Level IV) was recruited. Physical activity (PA) was objectively assessed using the ActiGraph GT1M activity monitor. Discomfort or adverse effects of wearing the accelerometers were recorded by participants. Levels of physical activity were determined as total PA, light PA (LPA), moderate PA (MPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) using cut-points recently validated for CP. Results. Most participants showed little reluctance. Mean daily MVPA for all participants was 30.7 minutes (SD 30.3), which corresponded to 2.7 (SD 2.4) minutes of MVPA per hour or 4.5% (SD 3.9) of the total monitoring time. Total PA and MVPA were greatest in ambulatory youth (GMFCS levels I and II) compared with youth who use a walking aid or wheelchair (GMFCS levels III and IV) (P < 0.05). Conclusion(s). The results support the use of the accelerometer as a feasible and useful measure of activity in ambulatory and nonambulatory adolescents with CP.

Accelerometer-Assessed Physical Activity and Sedentary Time in Youth With Disabilities

“…The lower habitual PA (except MVPA for the ID group) and higher sedentary time than in the TD group in the current study are consistent with previous accelerometer studies comparing youth with different disabilities and youth with TD in Europe and North America (Einarsson et al, 2015;Houwen et al, 2009;Nooijen et al, 2014;Obeid et al, 2014;Tyler et al, 2014). Furthermore, the finding that a low proportion of youth with disabilities met the PA recommendations is in line with previous findings in youth with various disabilities across the Western world (Bandini et al, 2013;Einarsson et al, 2015;Esposito et al, 2012;Gorter et al, 2012;Izquierdo-Gomez et al, 2014;Kozub, 2003;Mitchell et al, 2015b;Shields et al, 2009), indicating that low PA and high sedentary time in youth with disabilities is a widespread phenomenon, at least in developed countries.…”

“…The Actigraph is the most widely used activity monitor and has the largest body of evidence supporting its feasibility, reliability, and validity in children with TD (de Vries, Bakker, Hopman-Rock, Hirasing, & van Mechelen, 2006;Riddoch et al, 2004;Trost, 2007). It has also been shown to be feasible, reliable, and valid for youth with cerebral palsy (Clanchy, Tweedy, Boyd, & Trost, 2011;Gorter et al, 2012), ASDs (Rosser Sandt & Frey, 2005), and ID and Down syndrome (Roberts, 2007).…”

“…Previous accelerometer studies in youth with disabilities, however, show varying results regarding meeting these recommendations, such as between 0% and 25% of youth with cerebral palsy (Gorter, Noorduyn, Obeid, & Timmons, 2012;Mitchell, Ziviani, & Boyd, 2015b), between 0% and 50% of youth with intellectual disability (ID; Einarsson et al, 2015;Kozub, 2003;Roberts, 2007), between 23% and 100% of youth with autism spectrum disorders (ASDs; Bandini et al, 2013;Pan & Frey, 2006;Rosser Sandt & Frey, 2005;Tyler, MacDonald, & Menear, 2014), and between 21% and 93% of youth with Down syndrome (Esposito, MacDonald, Hornyak, & Ulrich, 2012;Izquierdo-Gomez et al, 2014;Roberts, 2007;Shields, Dodd, & Abblitt, 2009;Whitt-Glover, O'Neill, & Stettler, 2006).…”

Domains of Daily Physical Activity in Children with Mitochondrial Disease: A 3D Accelerometry Approach

“…Interestingly, also the number of breaks in sedentary activity was reduced and longer periods of rest were observed. The resting percentage found in our study was comparable to the resting percentage in ambulatory normally weighted children with Down's-, William's-and Prader-Willi syndrome (Nordstrom et al 2013) and patients with CP, when both patient groups were stratified based on their walking abilities (Gorter et al 2012). Five young ambulatory boys (4-6 years) with Duchenne Muscular Dystrophy (DMD) (Jeannet et al 2011), who were significantly younger than our study subjects, spent much less time resting, but had comparable levels of dynamic activity when compared to our ambulatory patients.…”

Shkedy Rabani et al. reply

“…Finally, in regards to the originality or uniqueness of our study, our omission of the Gorter et al study 4 using the ActiGraph GT1M monitor was not intentional; we were not aware of it at the time our study was first submitted to DMCN. One important difference between that study and ours is that we included 222 participants, whereas the study by Gorter et al included only 14 participants in groups II to IV.…”