Reduced Moderate-to-Vigorous Physical Activity and Increased Sedentary Behavior Are Associated With Elevated Blood Pressure Values in Children With Cerebral Palsy

Background Children with cerebral palsy (CP) participate in reduced levels of physical activity and spend increased time in sedentary behavior. The effect of reduced activity and increased sedentary behavior on their cardiometabolic health has not been investigated. Objectives The purposes of this study were: (1) to investigate the prevalence of overweight/obesity and elevated blood pressure (BP) among a cohort of ambulatory children with CP and (2) to investigate the associations among physical activity, sedentary behavior, overweight/obesity, and BP in children with CP. Study Design This was a cross-sectional study of 90 ambulatory children, aged 6 to 17 years, with CP. Methods Body mass index (BMI), waist circumference, waist-height ratio, and BP were measured on 1 occasion. Habitual physical activity was measured by accelerometry over 7 days. Results The prevalence of overweight/obesity in the cohort was 18.9%. Twenty-two percent of the children had BP values within the hypertensive or prehypertensive range. Systolic BP was positively associated with waist circumference (β=.324, P<.05) and BMI (β=.249, P<.05). Elevated BP values were associated with reduced time in moderate-to-vigorous activity, vigorous activity, and total activity, as well as increased time in sedentary behavior. The strongest association was observed between elevated BP and vigorous activity alone (odds ratio=0.61, 95% confidence interval=0.37–0.99, P<.05). Limitations A convenience sample was recruited for this study, and it is possible that this limitation resulted in selection bias. Conclusions Despite the relatively low prevalence of overweight/obesity, a relatively high proportion of children with CP had elevated BP values. Reducing sedentary behavior and increasing habitual physical activity, particularly vigorous activity, should be primary aims of rehabilitation in order to reduce cardiometabolic disease risk in this population.

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Comparison of Patterns of Physical Activity and Sedentary Behavior Between Children With Cerebral Palsy and Children With Typical Development

Physical Therapy ◽

10.2522/ptj.20140337 ◽

2015 ◽

Vol 95 (12) ◽

pp. 1609-1616 ◽

Cited By ~ 31

Author(s):

Jennifer M. Ryan ◽

Cuisle Forde ◽

Juliette M. Hussey ◽

John Gormley

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Sedentary Behavior ◽

Vigorous Physical Activity ◽

Similar Amount ◽

Moderate Activity ◽

Vigorous Activity ◽

Typical Development ◽

Preadolescent Children ◽

Children With Cerebral Palsy

Background Reduced participation in physical activity and increased time spent in sedentary behavior are associated with overweight, chronic disease, and disability. In order to optimize recommendations and interventions to increase physical activity and reduce sedentary behavior in children with cerebral palsy (CP), knowledge of their physical activity and sedentary behavior is needed. Objectives The aim of this study was to describe light, moderate, and vigorous physical activity and sedentary behavior in preadolescent children with and without CP and compare physical activity and sedentary behavior between the 2 groups. Design This was a cross-sectional study of 33 children, aged 6 to 10 years, with CP (Gross Motor Function Classification System [GMFCS] levels I–III) and 33 age- and sex-matched children with typical development. Methods Physical activity was measured using the RT3 accelerometer over 7 days. Results Children with CP spent more time in sedentary behavior and accumulated less total activity, moderate activity, vigorous activity, and sustained bouts of moderate-to-vigorous activity (MVPA). They also accumulated a fewer number of bouts of MVPA and vigorous activity, despite spending a similar amount of time in each bout. Limitations The small number of children in GMFCS levels II and III did not allow for adjustment for GMFCS level when comparing physical activity between children with and without CP. Conclusions Preadolescent children with CP spent less time in moderate and vigorous activity and more time in sedentary behavior than children with typical development. Children with CP also accumulated less continuous MVPA and vigorous activity as a result of achieving fewer sustained bouts of MVPA and vigorous activity throughout the day.

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Effects of Exercise Interventions on Habitual Physical Activity and Sedentary Behavior in Adolescents With Cerebral Palsy

Pediatric Exercise Science ◽

10.1123/pes.2018-0254 ◽

2019 ◽

Vol 31 (4) ◽

pp. 416-424 ◽

Cited By ~ 1

Author(s):

Simona Bar-Haim ◽

Ronit Aviram ◽

Anat Shkedy Rabani ◽

Akram Amro ◽

Ibtisam Nammourah ◽

...

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Resistance Training ◽

Sedentary Behavior ◽

Motor Function ◽

Classification System ◽

Habitual Physical Activity ◽

Progressive Resistance Training ◽

Exercise Interventions ◽

Progressive Resistance

Purpose:Exercise interventions have been shown to increase motor capacities in adolescents with cerebral palsy; however, how they affect habitual physical activity (HPA) and sedentary behavior is unclear. The main objective was to correlate changes in HPA with changes in mobility capacity following exercise interventions.Methods:A total of 54 participants (aged 12–20 y) with bilateral spastic cerebral palsy at Gross Motor Function Classification System (GMFCS) levels II and III received 4 months of group progressive resistance training or treadmill training. Mobility measurements and HPA (averaged over 96 h) were made before and after interventions.Results:Averaged baseline mobility and HPA measures and improvements in each after both interventions were positively correlated in all participants. Percentage of sedentary/awake time decreased 2%, with significant increases in HPA measures of step count (16%), walk time (14%), and upright time (9%). Mobility measures and HPA changes were quite similar between Gross Motor Function Classification System levels, but improvement in HPA after group progressive resistance training was greater than after treadmill training (12% vs 4%) and correlated with mobility improvement.Conclusions:Mobility capacity improved after these interventions and was clearly associated with improved HPA. The group progressive resistance training intervention seems preferable to improve HPA, perhaps related to greater social interaction and motivation provided by group training.

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Habitual Physical Activity in Children With Cerebral Palsy Aged 4 to 5 Years Across All Functional Abilities

Pediatric Physical Therapy ◽

10.1097/pep.0000000000000327 ◽

2017 ◽

Vol 29 (1) ◽

pp. 8-14 ◽

Cited By ~ 9

Author(s):

Piyapa Keawutan ◽

Kristie L. Bell ◽

Stina Oftedal ◽

Peter S. W. Davies ◽

Robert S. Ware ◽

...

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Habitual Physical Activity ◽

Functional Abilities ◽

Children With Cerebral Palsy

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Seventeen-Year Changes in Body Mass Index, Waist Circumference, Elevated Blood Pressure, and Diabetes Phenotypes in a Cohort of Filipino Women

Asia Pacific Journal of Public Health ◽

10.1177/1010539518800366 ◽

2018 ◽

Vol 30 (6) ◽

pp. 561-571 ◽

Cited By ~ 6

Author(s):

Linda S. Adair ◽

Christopher Kuzawa ◽

Thomas McDade ◽

Delia B. Carba ◽

Judith B. Borja

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Socioeconomic Status ◽

Waist Circumference ◽

Body Mass ◽

The Philippines ◽

Secular Trends ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Nutrition Survey

Obesity, hypertension, and diabetes have risen dramatically in Asia, but few cohort studies track age and secular trends in these conditions. We use Cebu (The Philippines) Longitudinal Health and Nutrition survey data to document 1998 to 2015 prevalence and co-occurrence of body mass index (BMI; >25 kg/m2), high waist circumference (WC; >80 cm), elevated blood pressure (EBP; systolic ⩾130 or diastolic ⩾85 mm Hg), and type 2 diabetes among ~2000 women aged 29 to 62 years in 1998; and identify their relationship to community, household, and individual factors using longitudinal logistic regression. Prevalence (1998-2015) rates were 35% to 49%, BMI >25 kg/m2; 32% to 58% high WC; 21% to 59% EBP; and 2% to 14% diabetes. Only 20% of women had none of these conditions in 2015. Diabetes was strongly driven by age and secular trends in high WC related to higher socioeconomic status and urbanization. Hypertension increased with age in lower socioeconomic status rural and more affluent urban women. Results underscore the continuing need for public health measures to prevent obesity and to identify and treat hypertension and diabetes.

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Cross-talk between ANGPTL4 gene SNP rs1044250 and weight management is a risk factor of Mets

10.21203/rs.3.rs-54841/v1 ◽

2020 ◽

Author(s):

Zhoujie Tong ◽

Jie Peng ◽

Hongtao Lan ◽

Wenwen Sai ◽

Yulin Li ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Waist Circumference ◽

Weight Management ◽

Independent Risk Factor ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

Base Line ◽

Elevated Blood

Abstract Background The prevalence of metabolic syndrome (Mets) is closely related to the increased incidence of cardiovascular events. Angiopoietin-like protein 4 (ANGPTL4) is contributory to the regulation of lipid metabolism, herein, may provide a target for gene-aimed therapy of Mets. This case-control study was designed to elucidate the relationship between Angiopoietin-like protein 4 (ANGPTL4) gene single nucleotide polymorphism (SNP) rs1044250 and the onset of Mets, and to explore the effect of interaction between SNP rs1044250 and weight management on Mets. Methods We have recruited 1018 Mets cases and 1029 controls in this study. The SNP rs1044250 was detected, base-line information and Mets-related indicators were collected. A 5-year follow-up survey was carried out to track the lifestyle changes, drug treatments and changes in Mets-related indicators. Results ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference (OR 1.618, 95% CI [1.119–2.340]; p = 0.011) and elevated blood pressure (OR 1.323, 95% CI [1.002–1.747]; p = 0.048), the prevalence of Mets (OR 1.875, 95% CI [1.363–2.580]; p < 0.001) is increased. The follow-up survey shows that rs1044250 CC genotype patients with weight gain have an increased number of Mets components (M [Q1, Q3]: CC 1 (0, 1), CT + TT 0 [-1, 1]; p = 0.021); The interaction between SNP rs1044250 and weight management is a risk factor for increased SBP (β = 0.075, p < 0.001) and increased DBP (β = 0.097, p < 0.001), the synergistic effect is negative (S < 1). Conclusion ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference and elevated blood pressure, therefore, for Mets. Weight management that interacts negatively with ANGPTL4 polymorphism is an essential lifestyle intervention approach for elevated blood pressure.

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The metabolic syndrome – What is it and how should it be managed?

European Journal of Preventive Cardiology ◽

10.1177/2047487319886404 ◽

2019 ◽

Vol 26 (2_suppl) ◽

pp. 33-46 ◽

Cited By ~ 7

Author(s):

Peter M Nilsson ◽

Jaakko Tuomilehto ◽

Lars Rydén

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Waist Circumference ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Successful Management ◽

Unhealthy Lifestyle ◽

The Metabolic Syndrome ◽

Frail Elderly People

A cluster of metabolic factors have been merged into an entity named the metabolic syndrome. Although the characteristics of this syndrome have varied over time the presently used definition was established in 2009. The presence of three abnormal findings out of five components qualifies a person for the metabolic syndrome: elevated waist circumference, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure and elevated fasting plasma glucose. Cut points have been defined for all components apart from waist circumference, for which national or regional values are used. The metabolic syndrome predicts cardiovascular disease and type 2 diabetes. This associated risk does not exceed its components whereof elevated blood pressure is the most frequent. A successful management should, however, address all factors involved. The management is always based on healthy lifestyle choices but has not infrequently to be supported by pharmacological treatment, especially blood pressure lowering drugs. The metabolic syndrome is a useful example of the importance of multiple targets for preventive interventions. To be successful management has to be individualized not the least when it comes to pharmacological therapy. Frail elderly people should not be over-treated. Knowledge transfer of how risk factors act should be accompanied by continuous trust building and motivation. In complex situations with a mix of biological risk factors, adverse social conditions and unhealthy lifestyle, everything cannot be changed at once. It is better to aim for small steps that are lasting than large, unsustainable steps with relapses to unhealthy behaviours. A person with the metabolic syndrome will always be afflicted by its components, which is the reason that management has to be sustained over a very long time. This review summarizes the knowledge on the metabolic syndrome and its management according to present state of the art.

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