Patterns of habitual physical activity in children and adolescents with cerebral palsy (GMFCS I-II).

BACKGROUND: To provide tailored recommendations and interventions for physical activity in children with cerebral palsy, it is important to gain insight not only into the amount and intensity, but also into the temporal pattern of activity. This descriptive study describes postures, bouts, transitions, timepoints, frequency, and type of activity in ambulatory children with Cerebral Palsy (CP) and compare these patterns with typically developing (TD) peers. METHODS: Twenty-three children with CP [GMFCS I-II, 11 males, mean age [range] 9 years [7-16]] and 23 TD peers [9 male, mean age[range] 10 years [7-15]] wore two accelerometers for seven consecutive days. A validated human activity recognition model classified following activities; lying, sitting, standing, walking, running, cycling and jumping based on raw acceleration data. RESULTS: Both groups accumulated about five hours of daily physical activity through active postures and locomotion, predominantly through standing (∼200 min) and walking (∼100 min), and short periods of running (∼10 min), cycling (<1 min) and jumping (1-2 min). The accumulated activity was ∼8% for CP and 10,5% higher for TD on weekdays than weekends. Children with CP were on average ∼10 to 17 min less active and had ∼15% less active-sedentary-transitions compared to TD, but without statistical significance. During weekdays, all children engaged in standing bouts of up to 10 min, walking bouts of up to two minutes and running bouts of up to 24 s. During weekends, the proportion of children performing different bout lengths decreased as bout length increased. CONCLUSION: Ambulatory children with CP, predominantly classified as GMFCS I, demonstrated habitual physical activity patterns, with no statistically significant difference from TD peers. Additionally, there was no statistically significant difference between weekdays and weekends for either group. Substantial within-group variation highlights the heterogeneity of habitual physical activity patterns in children. Furthermore, given small sample size and low statistical power, these findings should be regarded as descriptive and hypothesis-generating.