Association Between Daily Physical Activity and Clinical Anthropomorphic Measures in Adults With Cerebral Palsy

Abstract

ObjectiveTo describe the relationship between activity level and cardiovascular risk measures as well as describe general activity patterns of adults with cerebral palsy. DesignCross‐sectional. SettingAcademic outpatient rehabilitation clinic. ParticipantsAdults with cerebral palsy (N=47). InterventionsNot applicable. Main Outcome MeasuresGross Motor Functional Classification System (GMFCS) level was determined by validated self‐report questionnaire. Activity (daily step count, walk time, sitting time, standing time, and transitional movements) over 6 days recorded using an activPAL. Weight, body mass index (BMI), and waist-to-hip ratio were measured. Bivariate relationships between anthropomorphic and activity measures were assessed. ResultsThirty-eight participants completed all measurements. Nine were excluded because of incomplete activPAL data. The median age was 28.50 years (interquartile range [IQR]=24.25-47.00), range 18-77 years. Participants’ GMFCS levels were I: 13%; II: 16%; III: 21%; IV: 34%; and V: 16%. Median steps/day for GMFCS I/II participants were 5258.3 (IQR=3606.8-6634.7), and median steps/day were 1681.3 (IQR=657.2-2751.8) and 30.0 (IQR=6.8-54.2) for GMFCS level III and IV/V participants, respectively. Significantly greater steps/day were found for GMFCS I/II or III participants compared to those GMFCS IV/V (P<.001 and P=.0074, respectively). In addition, 60.5% of the subjects had a BMI in the normal range, 10.5% were obese, 23.6% were overweight, and 5.3% were underweight. For subjects with GMFCS I/II, the Spearman's rank correlation coefficient for time standing and waist circumference was −0.73 (0.01). GMFCS III and GMFCS IV/V participants had respective correlations of −0.16 (0.71) and −0.01 (0.98). For subjects with GMFCS I/II, the Spearman's rank correlation coefficient for standing time and BMI was −0.55 (P=.08). For the GMFCS III and GMFCS IV/V groups the respective correlations were −0.19 (0.67) and 0.00 (1.00). ConclusionsSubjects with GMFCS level I or II who engaged in more activity tended to have more favorable anthropometric profiles. Subjects with GMFCS level III, IV, or V did not have a similar trend. Our findings suggest factors beyond activity patterns affect anthropometrics to a greater degree in those with higher GMFCS levels.