24-Hour Movement Behaviors in Children with Chronic Disease and Their Healthy Peers: A Case-Control Study.

Rabha A Elmesmari,John J Reilly,James Y Paton

doi:10.3390/ijerph19052912

Abstract

Background: Time spent in 24-h movement behaviors is important to health and wellbeing in childhood, but levels of these behaviors in children with chronic disease are unknown. Methods: A case-control-study included 80 children with chronic disease; 20 with type 1 diabetes mellitus (T1DM), 20 with juvenile idiopathic arthritis (JIA), 20 with congenital heart disease (CHD), 20 with cystic fibrosis (CF); pair-matched individually for age, sex, and timing of measures with 80 healthy children. Habitual time spent in movement behaviors and step counts were all measured with an activPAL accelerometer over 7 days. Comparisons against recommendations and differences between the groups were made. Results: Time spent in physical activity and step counts/day were significantly lower in T1DM and CHD groups compared to controls. Only 20/80 children with chronic disease and 29/80 controls met step count recommendations. Sedentary time was significantly higher in children with CF compared to controls. Time spent asleep was slightly greater in children with chronic disease, significant only for the JIA group. Sleep disruption was consistently greater in those with chronic disease, reaching significance for T1DM, CHD, and CF groups. Conclusions: For some groups of children with chronic disease, 24-h movement behaviors may differ substantially from recommendations, and slightly but systematically from their healthy peers. Optimizing levels of 24-h movement behaviors should confer a number of benefits for child health, development, and wellbeing.

Highlights

There is growing concern about low levels of physical activity (PA) in children and adolescents
Of 136 potentially eligible children identified from outpatient clinics with chronic disease, a total of 99 (73%) agreed to take part
Of 111 healthy children identified as potentially healthy control children based on their age and sex, 89 (80%) agreed to take part

Summary

Introduction

There is growing concern about low levels of physical activity (PA) in children and adolescents. Our recent systematic review of objectively measured moderate-to-vigorous intensity PA (MVPA) in children with the chronic disease found only a relatively small amount of evidence (25 eligible studies across all groups with chronic disease and across all of childhood and adolescence), which suggested that habitual MVPA was consistently well below the recommended 60 min per day, though not very much lower than in healthy comparison groups. One exception was children being treated for malignancies where levels of MVPA were much lower [3]. A second systematic review of objectively measured MVPA in children or adolescents with obesity [4] found clear evidence that obesity is associated with much lower than recommended MVPA, though only again slightly lower than in children from healthy comparison groups

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Conclusion