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

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

Physical Therapy ◽

10.2522/ptj.20130499 ◽

2014 ◽

Vol 94 (8) ◽

pp. 1144-1153 ◽

Cited By ~ 25

Author(s):

Jennifer M. Ryan ◽

Owen Hensey ◽

Brenda McLoughlin ◽

Alan Lyons ◽

John Gormley

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Cerebral Palsy ◽

Waist Circumference ◽

Sedentary Behavior ◽

Habitual Physical Activity ◽

Elevated Blood Pressure ◽

Vigorous Activity ◽

Elevated Blood ◽

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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Objectively Quantified Physical Activity and Sedentary Behavior in Predicting Visceral Adiposity and Liver Fat

Journal of Obesity ◽

10.1155/2016/2719014 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 7

Author(s):

Shelley E. Keating ◽

Helen M. Parker ◽

Toby G. Pavey ◽

Michael K. Baker ◽

Ian D. Caterson ◽

...

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Vigorous Physical Activity ◽

Liver Lipid ◽

Habitual Physical Activity ◽

Liver Fat ◽

Moderate Activity ◽

Activity Levels ◽

Nonalcoholic Fatty Liver ◽

Physical Activity Levels

Objective. Epidemiologic studies suggest an inverse relationship between nonalcoholic fatty liver disease (NAFLD), visceral adipose tissue (VAT), and self-reported physical activity levels. However, subjective measurements can be inaccurate and prone to reporter bias. We investigated whether objectively quantified physical activity levels predicted liver fat and VAT in overweight/obese adults.Methods. Habitual physical activity was measured by triaxial accelerometry for four days (n=82). Time spent in sedentary behavior (MET < 1.6) and light (MET 1.6 < 3), moderate (MET 3 < 6), and vigorous (MET 6 < 9) physical activity was quantified. Magnetic resonance imaging and spectroscopy were used to quantify visceral and liver fat. Bivariate correlations and hierarchical multiple regression analyses were performed.Results. There were no associations between physical activity or sedentary behavior and liver lipid. Sedentary behavior and moderate and vigorous physical activity accounted for just 3% of variance for VAT (p=0.14) and 0.003% for liver fat (p=0.96). Higher levels of VAT were associated with time spent in moderate activity (r=0.294,p=0.007), but there was no association with sedentary behavior. Known risk factors for obesity-related NAFLD accounted for 62% and 40% of variance in VAT and liver fat, respectively (p<0.01).Conclusion. Objectively measured levels of habitual physical activity and sedentary behavior did not influence VAT or liver fat.

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Ability of RT3 Accelerometer Cut Points to Detect Physical Activity Intensity in Ambulatory Children With Cerebral Palsy

Adapted Physical Activity Quarterly ◽

10.1123/apaq.2013-0088 ◽

2014 ◽

Vol 31 (4) ◽

pp. 310-324 ◽

Cited By ~ 7

Author(s):

Jennifer Ryan ◽

Michael Walsh ◽

John Gormley

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Vigorous Physical Activity ◽

Accelerometer Data ◽

Physical Activity Intensity ◽

Cut Points ◽

Cut Point ◽

Activity Intensity ◽

Metabolic Equivalents ◽

Children With Cerebral Palsy

This study investigated the ability of published cut points for the RT3 accelerometer to differentiate between levels of physical activity intensity in children with cerebral palsy (CP). Oxygen consumption (metabolic equivalents; METs) and RT3 data (counts/min) were measured during rest and 5 walking trials. METs and corresponding counts/min were classified as sedentary, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) according to MET thresholds. Counts were also classified according to published cut points. A published cut point exhibited an excellent ability to classify sedentary activity (sensitivity = 89.5%, specificity = 100.0%). Classification accuracy decreased when published cut points were used to classify LPA (sensitivity = 88.9%, specificity = 79.6%) and MVPA (sensitivity = 70%, specificity = 95–97%). Derivation of a new cut point improved classification of both LPA and MVPA. Applying published cut points to RT3 accelerometer data collected in children with CP may result in misclassification of LPA and MVPA.

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Physical activity phenotyping with activity bigrams, and their association with BMI

10.1101/121145 ◽

2017 ◽

Author(s):

Louise AC Millard ◽

Kate Tilling ◽

Debbie A Lawlor ◽

Peter A Flach ◽

Tom R Gaunt

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Activity Patterns ◽

Moderate Activity ◽

List Type ◽

Activity Levels ◽

Vigorous Activity ◽

Parents And Children ◽

Health Advice ◽

Avon Longitudinal Study

ABSTRACTBackgroundAnalysis of physical activity usually focuses on a small number of summary statistics derived from accelerometer recordings: average counts per minute, and the proportion of time spent in moderate-vigorous physical activity or in sedentary behaviour. We show how bigrams, a concept from the field of text mining, can be used to describe how a person’s activity levels change across (brief) time points. These variables can, for instance, differentiate between two people with the same time in moderate activity, where one person often stays in moderate activity from one moment to the next and the other does not.MethodsWe use data on 4810 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). We generate a profile of bigram frequencies for each participant and test the association of each frequency with body mass index (BMI), as an exemplar.ResultsWe found several associations between changes in bigram frequencies and BMI. For instance, a 1 standard deviation decrease in the number of adjacent minutes in sedentary then moderate activity (or vice versa), with a corresponding increase in the number of adjacent minutes in moderate then vigorous activity (or vice versa), was associated with a 2.36 kg/m2 lower BMI [95% CI: -3.47, -1.26], after accounting for the time spent at sedentary, low, moderate and vigorous activity.ConclusionsActivity bigrams are novel variables that capture how a person’s activity changes from one moment to the next. These variables can be used to investigate how sequential activity patterns associate with other traits.Key MessagesEpidemiologists typically use only a small number of variables to analyse the association of physical activity with other traits, such as the average counts per minute and the proportion of time spent in moderate-vigorous physical activity or being sedentary.We demonstrate how activity bigrams can be used as a set of interpretable variables describing how a person’s activity levels change from one moment to the next.Testing the association of activity bigrams with exposures or outcomes can help us gain further understanding of how physical activity is associated with other traits; with further research they might provide evidence for more refined public health advice.

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Sedentary Time in US Older Adults Associated With Disability in Activities of Daily Living Independent of Physical Activity

Journal of Physical Activity and Health ◽

10.1123/jpah.2013-0311 ◽

2015 ◽

Vol 12 (1) ◽

pp. 93-101 ◽

Cited By ~ 95

Author(s):

Dorothy D. Dunlop ◽

Jing Song ◽

Emily K. Arntson ◽

Pamela A. Semanik ◽

Jungwha Lee ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Activities Of Daily Living ◽

Sedentary Behavior ◽

Daily Living ◽

Sedentary Time ◽

Vigorous Physical Activity ◽

Strong Relationship ◽

Vigorous Activity ◽

Adl Disability

Background:The harmful relationship of sedentary behavior to health may reflect an exchange of sedentary activity for moderateto- vigorous physical activity (MVPA), or sedentary behavior may be a separate risk factor. We examined whether time spent in sedentary behavior is related to disability in activities of daily living (ADL), independent of time spent in MVPA in older adults.Methods:The nationally representative 2003−2006 National Health and Nutrition Examinations Surveys (NHANES) included 2286 adults aged 60 years and older in whom physical activity was assessed by accelerometer. The association between ADL task disability and the daily percentage of sedentary time was evaluated by multiple logistic regression.Results:These adults on average spent 9h/d being sedentary during waking hours and 4.5% reported ADL disability. The odds of ADL disability were 46% greater (odds ratio, 1.46; 95% confidence interval, 1.07−1.98) for each daily hour spent in sedentary behavior, adjusted for MVPA and socioeconomic and health factors.Conclusion:These US national data show a strong relationship between greater time spent in sedentary behavior and the presence of ADL disability, independent of time spent in moderate or vigorous activity. These findings support programs encouraging older adults to decrease sedentary behavior regardless of their engagement in moderate or vigorous activity.

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Self-Reported and Objectively Measured Physical Activity Among a Cohort of Postpartum Women: The PIN Postpartum Study

Journal of Physical Activity and Health ◽

10.1123/jpah.9.1.5 ◽

2012 ◽

Vol 9 (1) ◽

pp. 5-20 ◽

Cited By ~ 14

Author(s):

Kelly R. Evenson ◽

Amy H. Herring ◽

Fang Wen

Keyword(s):

Physical Activity ◽

Sedentary Behavior ◽

Post Partum ◽

Vigorous Physical Activity ◽

Moderate Activity ◽

Multiple Time ◽

Time Points ◽

Multiple Time Points ◽

Objectively Measured ◽

Objectively Measured Physical Activity

Background:Few studies measure physical activity objectively or at multiple time points during postpartum. We describe physical activity at 3- and 12-months postpartum among a cohort of women using both self-reported and objective measures.Methods:In total, 181 women completed the 3-month postpartum measures, and 204 women completed the 12-month postpartum measures. Participants wore an ActiGraph accelerometer for 1 week and completed in-home interviews that included questions on physical activity. A cohort of 80 women participated at both time points. Poisson regression models were used to determine whether physical activity differed over time for the cohort.Results:For the cohort, average counts/minute were 364 at 3-months post-partum and 394 at 12-months postpartum. At both time periods for the cohort, vigorous activity averaged 1 to 3 minutes/day, and moderate activity averaged 16 minutes/day. Sedentary time averaged 9.3 hours at 3-months postpartum and 8.8 hours at 12-months postpartum, out of a 19-hour day. Average counts/minute increased and sedentary behavior declined from 3- to 12-months postpartum.Conclusion:Interventions are needed to help women integrate more moderate to vigorous physical activity and to capitalize on the improvements in sedentary behavior that occur during postpartum.

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Food pattern and nutritional status of children with cerebral palsy

Revista Paulista de Pediatria ◽

10.1590/s0103-05822013000300011 ◽

2013 ◽

Vol 31 (3) ◽

pp. 344-349 ◽

Cited By ~ 16

Author(s):

Patrícia Ayrosa C. Lopes ◽

Olga Maria S. Amancio ◽

Roberta Faria C. Araújo ◽

Maria Sylvia de S. Vitalle ◽

Josefina Aparecida P. Braga

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Food Intake ◽

Nutritional Status ◽

Old Age ◽

Energy Intake ◽

Moderate Activity ◽

Age Group ◽

Children With Cerebral Palsy ◽

Nutritional Status Of Children

OBJECTIVES To assess the food intake pattern and the nutritional status of children with cerebral palsy. METHODS Cross-sectional study with 90 children from two to 12.8 years with cerebral palsy in the following forms: hemiplegia, diplegia, and tetraplegia. Nutritional status was assessed by weight, height, and age data. Food intake was verified by the 24-hour recall and food frequency questionnaire. The ability to chew and/or swallowing, intestinal habits, and physical activity were also evaluated. RESULTS For 2-3 year-old age group, the mean energy intake followed the recommended range; in 4-6 year-old age group with hemiplegia and tetraplegia, energy intake was below the recommended limits. All children presented low intake of carbohydrates, adequate intake of proteins and high intake of lipids. The tetraplegia group had a higher prevalence of chewing (41%) and swallowing (12.8%) difficulties compared to 14.5 and 6.6% of children with hemiplegia, respectively. Most children of all groups had a daily intestinal habit. All children presented mild physical activity, while moderate activity was not practiced by any child of the tetraplegia group, which had a significantly lower height/age Z score than those with hemiplegia (-2.14 versus -1.05; p=0.003). CONCLUSIONS The children with cerebral palsy presented inadequate dietary pattern and impaired nutritional status, with special compromise of height. Tetraplegia imposes difficulties regarding chewing/swallowing and moderate physical activity practice.

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Pattern of vigorous physical activity among Egyptian freshmen university students

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2011/v23i4a323 ◽

2011 ◽

Vol 23 (4) ◽

Cited By ~ 1

Author(s):

Nadia Abd El-Hamed Montasser ◽

Abdel-Hady El-Gilany Abd El- Fattah ◽

Randah Mohamad Helal

Keyword(s):

Physical Activity ◽

University Students ◽

Short Form ◽

Vigorous Physical Activity ◽

Sociodemographic Factors ◽

Cross Sectional Study ◽

Moderate Activity ◽

Vigorous Activity ◽

Personal Factors ◽

Cross Sectional

Objectives. To highlight the pattern of vigorous physical activity among freshmen university students and to evaluate the association between sociodemographic factors, perceived barriers, support factors, sedentary behaviours and body mass index. Methods. A cross-sectional study was conducted on Mansoura University students at the beginning of the academic year 2008 - 2009. A total of 500 freshmen students were selected by systematic random sample. Participants responded to the short form of International Physical Activity Questionnaire and other questions. Results. The study revealed that the prevalence of vigorous activity among the students was 9.8% (N=49) versus 90.2% (N=451) for mild and moderate activity. Body-related barriers were significantly higher among those reporting mild and moderate activities as shyness from others when doing exercise (6.9% versus 0.0%) and shyness from body looks in front of people (14.6% versus 4.1%). Lack of equipment was also perceived to be a barrier (31.0% versus 16.3%), for those doing mild to moderate versus vigorous, respectively. A significantly higher proportion of persons doing vigorous activity reported the influence of support factors such as perceived benefit for health (53.1% versus 33.7%), encouragement from others (53.1% versus 30.4%) and participation from others (51.0% versus 23.9%), compared with the more sedentary students. The majority of both groups spent <4 hours daily in front of a computer, but the overall proportion was significantly higher among those only reporting mild and moderate activity (88.0% versus 63.3%). Conclusion. The prevalence of most of the barriers studied was higher among those reporting mild and moderate activities and support factors were higher among those reporting vigorous activity. These results highlight the importance of environmental factors, social norms and intra-personal factors in determining the pattern of activity among Egyptian freshmen university students.SAJSM, vol 23 No. 4 2011

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Increased prolonged sitting in rheumatoid arthritis patients during the COVID-19 pandemic: a within-subjects, accelerometer-based study

10.1101/2020.09.09.20191395 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ana Jessica Pinto ◽

Diego Rezende ◽

Sofia Mendes Sieczkowska ◽

Kamila Meireles ◽

Karina Bonfiglioli ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

High Risk ◽

Sedentary Behavior ◽

Vigorous Physical Activity ◽

High Risk Patient ◽

Moderate Activity ◽

Social Distancing ◽

Prolonged Sitting ◽

Within Subjects

Background: Social distancing measures designed to contain the COVID-19 pandemic can explicitly and implicitly restrict physical activity, a particular concern for high-risk patient groups. Using a within-subjects design with objective measurement (via validated accelerometers), we assessed rheumatoid arthritis patients' physical activity and sedentary behavior levels prior to and during the social distancing measures implemented in Sao Paulo, Brazil. Methods: Post-menopausal women diagnosed with rheumatoid arthritis were assessed before (from March 2018 to March 2020) and during (from 24th May to 7th July 2020) social distancing measures to contain COVID-19 pandemic, using a within-subjects, repeated-measure design. Physical activity and sedentary behavior were assessed using postural-based accelerometry (ActivPAL micro). Findings: Mean age was 60.9 years (95%CI: 58.0, 63.7) and BMI was 29.5 Kg/m2 (95%CI: 27.2, 31.9). Disease activity ranged from remission to moderate activity. Most of the patients were using disease-modifying anti-rheumatic drugs and prednisone. Hypertension and dyslipidemia were the most frequent comorbidities During social distancing, there were reductions in total stepping time (15.7% [-0.3 h/day, 95%CI: -0.4, -0.1; p=0.004]), in light-intensity activity (13.0% [-0.2 h/day, 95%CI: -0.4, -0.04; p=0.016]) and in moderate-to-vigorous physical activity (38.8% [-4.5 min/day, 95%CI: -8.1, -0.9; p=0.015]), but no changes in total standing time or total sedentary time. However, time spent in prolonged bouts of sitting <30 min increased by 34% (1.0 h/day, 95%CI: 0.3, 1.7; p=0.006) and sitting bouts <60 min increased by 85% (1.0 h/day, 95%CI: 0.5, 1.6) Sit-stand transitions were reduced by 10% (-5.1/day, 95%CI: -10.3, 0.0; p=0.051). Conclusion: Imposed social distancing measures to contain the COVID-19 outbreak were associated with decreased physical activity and increased prolonged sitting among rheumatoid arthritis patients. Since this has the potential to increase the burden of cardiovascular disease in such high-risk patients, attention to maintaining physical activity is an urgent consideration during the pandemic.

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Health-Enhancing Physical Activity in Children With Cerebral Palsy: More of the Same Is Not Enough

Physical Therapy ◽

10.2522/ptj.20130214 ◽

2014 ◽

Vol 94 (2) ◽

pp. 297-305 ◽

Cited By ~ 48

Author(s):

Olaf Verschuren ◽

Johanna Darrah ◽

Iona Novak ◽

Marjolijn Ketelaar ◽

Lesley Wiart

Keyword(s):

Physical Activity ◽

Cerebral Palsy ◽

Children And Adolescents ◽

Sedentary Behavior ◽

Vigorous Physical Activity ◽

Vigorous Exercise ◽

Physiological Mechanisms ◽

Research Directions ◽

What Works ◽

Health Enhancing Physical Activity

Physical activity is important for young people's health. The emphasis over the last 2 decades has been on moderate to vigorous exercise when designing activity and exercise programs for children and adolescents with cerebral palsy (CP). Emerging evidence suggests that sedentary behavior is distinctly different from a lack of moderate to vigorous physical activity and has independent and different physiological mechanisms. The concept of concurrently increasing moderate to vigorous physical activity and replacing sedentary behavior with light physical activity may be beneficial for children and adolescents with CP. This article is a summary of the evidence for what works and what does not work for improving the physical activity of children and adolescents with CP. It also discusses what is known about sedentary behavior of children and adolescents with CP and what research directions are needed to build foundational knowledge in this area with this population.

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