Patterns of habitual physical activity performance in independently ambulant children and adolescents with congenital hemiplegia

Abstract

Background/Objectives: To quantify habitual physical activity (HPA) performed by independently ambulant youth with congenital hemiplegia. Design: Cross-sectional study. Participants and Setting: Children and adolescents with congenital hemiplegia (n=95; 48 males; 49 right hemiplegia; mean 11yr 3m[2yr 4m], range 8 to 17yr) classified at Gross Motor Functional Classification System (GMFCS) levels I=41 and II=54 participated in the community. Methods: HPA was recorded over 4 days using Acti- Graph®GT3X+ tri-axial accelerometers. ActiGraph® activity counts were converted into activity intensity using uni-axial (vertical counts/min: sedentary <100, light >100, moderate-tovigorous physical activity [MVPA]≥2296) and tri-axial vector magnitude (VM; counts/min: sedentary <180, light≥180, MVPA >3360) cut-points using ActiLife™ software. Bouts of 5 and 10 minute continuous MVPA were analyzed. Descriptive statistics and t-tests were calculated. Significance was p≤0.05; data are mean×1SD. Results: Of a potential 380 days, 357 days (94%) were collected. On 69% of days, participants did not complete 60 minutes of MVPA. On average, participants recorded 438(234) counts/ min, took 7541(3894) steps, and wore the monitor for 11:44 (1:56) hours daily. Using validated cut-points, participants were sedentary for 8:26(1:55) hours (72% recorded time), and participated in 2:34(0:54) hours light activity (22%) and 0:43 (0:25) hours MVPA (6%). Using VM cut-points, participants were sedentary for 7:18(3:48) hours (61%), and participated in 3:30(1:05) hours light activity (29%) and 1:20(0:30) hours MVPA (10%), which is significantly different to uni-axial derived results (p<0.001). Participants completed 2.5(1.9) bouts of >5 minutes continuous MVPA and 0.3(0.5) bouts of >10 minutes daily, which were of short duration (06:50(01:33) and 13:37(05:24)min respectively). On weekdays, participants were most active at 8am, 1pm, and 3 to 5pm and most sedentary at 9am and 7 to 9pm, whereas weekend MVPA was less structured and peaked between 10am to 2pm (Figure 1). When wear time was standardised, there were no differences in sedentary (p=0.94), light (p=0.70), or MVPA (p=0.39) between GMFCS I and II. Children (<13yrs) participated in more light activity (mean difference[MD]=0:46, p<0.001), MVPA (MD=0:09h, p<0.01), were less sedentary (MD=0:54h, p<0.001), recorded more step counts (MD=1096 steps, p=0.01) and counts min -1 (MD=116, p<0.001) than adolescents. Step counts were greater on weekdays (MD=998, p=0.02) however were no significant differences between weekend and weekday activity levels (all p>0.05). Conclusions: Consistent with typically developing children, independently ambulant children and adolescents with congenital hemiplegia do not perform sufficient physical activity to meet international public health recommendations. Interventions to target an increase in HPA and reduce sedentary time are needed, particularly for adolescents. Additionally, further work is needed to validate tri-axial cut points in this population. (Figure Presented).L717462712015-02-03 <br />