Are clinic-based walking measures associated with community walking activity in children with cerebral palsy?

Abstract

To examine the relationship between clinic-based walking capacity measures and community-based walking activity in ambulatory children with cerebral palsy (CP). A secondary analysis of a cross-sectional cohort was employed at tertiary care children's hospital; n= 128, ages 2-9 years, Gross Motor Function Classification System (GMFCS) I-III. Walking capacity was captured with 1- and 6-minute walk tests (1MWT, 6MWT), Gross Motor Function Measure-walk/run/jump score (GMFM-E), and Activity Scale for Kids performance version (ASKp-30). Walking activity performance in the community was quantified by StepWatch (SW). Moderate correlations were documented for 6MWT to SW outputs of walking level, moderate high intensity, 60-minute peak and peak activity index (r= 0.55-0.58, p< 0.01). GMFM-E correlated with all SW outputs (r= 0.55-0.69, p< 0.01) except 1-minute peak walking rate. Per regression modeling, GMFM-E was associated with walking level and intensity (p< 0.02) and 6MWT related to high intensity walking (p< 0.4, R=2 0.28-0.48). 6MWT and GMFM-E have the strongest associations with level, amount and intensity of walking in daily life. Results suggest that the 6MWT and GMFM-E can be employed to estimate community walking activity in ambulatory children with CP. Future studies should focus on environmental and personal factors that influence community walking performance.