Duration and patterns of habitual physical activity in adolescents and young adults with cerebral palsy

Abstract

AIM Adolescents and young adults with cerebral palsy (CP) show reduced motor function and gait efficiency, and lower levels of habitual physical activity (HPA), than adolescents with typical development and children with CP. This study examined activity duration and patterns in this population in the Middle East through long-term monitoring of a large sample using accelerometers. METHOD Adolescents and young adults with bilateral CP at Gross Motor FunctionClassification System (GMFCS) levels II, III, and IV, were monitored in their habitual environment for four consecutive days with ActivPAL3 monitors. Time spent in sedentary, standing, and walking activities, and frequency of walking steps and transitions, were analysed for each GMFCS level.RESULTS Measurements were made on 222 participants (132 males, 90 females; mean age 16y 9mo SD 2y, range 13y 4mo-22y). The Mann-Whitney U test demonstrated significant differences (p<0.05) between GMFCS levels, showing reduced walking and standing activity and increased sedentary duration at higher GMFCS levels (p<0.001), except for increased standing time between GMFCS levels II and III (p=0.07). Participants in educational facilities exhibited less sedentary behaviour than those who were homebound (p<0.05).INTERPRETATION These descriptions of duration and frequency of active and sedentary behaviours may serve as a basis for recommendations to minimize inactivity in this population. Adolescents and young adults with CP in the Middle East demonstrate similar patterns of HPA to their peers in other regions.Habitual physical activity (HPA) may be defined as the magnitude and pattern of body movements during the usual activities of daily living, including sleep and rest, work, and leisure. Sedentary behaviour refers to activities that increase energy expenditure above the resting level by less than 50% and includes activities such as sleeping, sitting, lying down, and watching screen-based entertainment.1,2 Regular and intensive physical activity, even in individuals with disabilities, is directly associated with physical fitness, improved quality of life, and psychological functions; 3 low levels of activity contribute to the risk of chronic cardiovascular disease 4 and other health issues. 5Adolescents and young adults with cerebral palsy (CP) face many difficulties with functional mobility in their transitional growth stages because, during adolescence, gross motor function capacity and gait efficiency decline. 6 Additionally, adolescents with CP face a discontinuity of care; as paediatric rehabilitation ends and they do not qualify for paediatric services there are few adult rehabilitation services available to meet their health needs.7 Compared with younger children with CP, adolescents and young adults with CP exhibit lower levels of physical activity, less walking activity, and more sedentary behaviour, 8 and their activity decreases as gross motor function deteriorates. 8,9 Adolescents and young adults are less physically active than their peers with typical development...

Sedentary behaviour in adolescents and young adults with cerebral palsy

“…The study of Shkedy Rabani et al . confirms previous reports that physical activity levels of young people with CP are low compared with their typically developing peers .…”

Physical activity participation in Pacific adolescent girls with a physical disability

“…However, at the time of the interviews two of the girls were meeting the recommended physical activity guidelines (SPARC, 2007;WHO, 2010) and five of the girls' sedentary behaviours were too high, (or over two hours per day), placing them at risk for poorer health. This is comparable with other studies which also suggest adolescents with a physical disability are spending extended hours in sedentary behaviours (Shkedy Rabani et al, 2014;Nooijen et al, 2014). Theoretically, these high sedentary behaviours may have an adverse effect on their health, including their metabolic and cardiovascular systems (Taylor, 2014).…”

“…Participation in physical activity on a regular basis is important for the physical and psychological wellbeing of all adolescents (Morris, 2008;Shkedy Rabani et al, 2014). In New Zealand, Pacific adolescents are found to be less active in comparison with other ethnic groups (Ministry of Health (MoH), 2008b;Sport New Zealand, 2012).…”

Measurement of habitual physical activity and sedentary behaviour of youth with cerebral palsy: work in progress

“…SIR-We read with great interest the recent publication by Shkedy Rabani et al 1 which described the duration and patterns of habitual physical activity in adolescents and young adults with cerebral palsy (CP). The authors should be commended because this study could be the largest study of its kind in terms of sample size, while reporting the objective measurement of habitual physical activity (HPA) and sedentary time.…”