Accelerometer-measured physical activity, sedentary behavior, and sleep in children with cerebral palsy and their adherence to the 24-hour activity guidelines.
Raquel Y Hulst, Jan Willem Gorter, Joyce Obeid and 6 others
PMID 35833425WHAT IT FOUND
Only 5.9% of ambulatory children with cerebral palsy met both physical activity and sleep guideline targets.
Most had too little vigorous activity and too little sleep, especially children in GMFCS level III and preschoolers.
Key findings
01Only 13% of children met the physical activity recommendation of at least 60 minutes of moderate-to-vigorous activity per day, and 35.3% met age-appropriate sleep duration recommendations.
02Only 5.9% met both the physical activity and sleep recommendations, while 56.9% met neither.
03Children averaged 38.5 minutes per day of moderate-to-vigorous activity and 61.1% of wear time in sedentary behavior, with an average total sleep time of 9.0 hours.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study measured children at one time point, so it cannot show that increasing activity or sleep would improve health outcomes. It included only children in GMFCS levels I to III, so it does not describe children with more severe mobility limitations. Activity intensity cut-points were developed for ambulatory school-age children, and the sleep algorithm has not been validated in children with CP. Children removed the accelerometer for swimming, so 19 days of swimming across 15 children were not counted, which may have undercounted activity. Naps were recorded but not included in total sleep time, which could make sleep duration look shorter; naps were reported by 9% of children. Recreational screen time was not measured, so adherence to the sedentary behavior guideline could not be judged. Subgroup analyses had small groups, especially GMFCS level III with 9 children. Comorbidities such as epilepsy or intellectual disability were not recorded, so they could have affected activity or sleep. Data were collected during 2020, including a pause for school lockdown, so the measured week may not reflect usual patterns in other years.
Declared interests
The study was funded by JKF Kinderfonds and Kinderrevalidatiefonds Adriaanstichting, the Netherlands.
The easy way to misread this
Do not conclude that this study shows what will happen if a child changes activity or sleep. It measured physical activity, sedentary behavior, and sleep at one time point and did not test an intervention or link guideline adherence to health outcomes.