Understanding the current levels of physical activity and fitness in the most severely impaired children with cerebral palsy (CP) is important for practitioners to design the optimal cardiovascular fitness intervention protocols necessary to address sedentary lifestyles. Accelerometers and wrist-worn heart rate monitors have been validated as reliable and valid measures of physical activity (PA) in ambulatory children with CP gross motor function classification system (GMFCS) levels I – II; however, no study to date has assessed PA in children within GMFCS levels IV – V. The purpose of this study is to explore PA levels in children with CP, classified levels of GMFCS IV – V, and to compare PA levels in the home and school environment.
PA is defined as any bodily movement produced by skeletal muscles that require energy expenditure and encompasses all activities, at any intensity, performed during the 24-hour day. PA data of children with CP, GMFCS IV-V, were analyzed along with measures of energy expenditure (HR fluctuation, caloric intake), anthropometric measures, and activity patterns (as measured by accelerometry). Over the one-week observational period, student participants were asked to wear Actigraph GT9X ® accelerometer (on the dominant wrist and waist) and smartwatch (Fitbit ® Charge 3) on the non-dominant wrist for 7 days 23 hours/day.
For the duration of the study, parents completed activity and feeding journals during school days in the evening and all day during the weekends. The parents were instructed to include the duration of feeding, types of food, and positioning. Parents were responsible to maintain placement of Actigraph waist/wrist sensors and smartwatch on non-dominant wrist for 23-24 hours/day. School staff assigned to each student (one-to-one paraprofessional) completed activities and journals during school hours.
The results of this study could help understand the links between physical activity, environmental factors, and functional capabilities. This exploratory study will provide data about periods of inactivity in comparison to levels of greatest energy expenditure in children with CP who are non-ambulatory.
Project Lead: Nia Toomer-Mensah
Project Member: Miriam King