Abstract
BackgroundChildren with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. Poor cardiorespiratory fitness may contribute to increased cardiometabolic risk.PurposeThe aim of this study was to determine the association between sedentary behaviour, physical activity and cardiorespiratory fitness in children with CP. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP.MethodsThis study included 55 ambulatory children with CP [mean (SD) age 11.3 (0.2) yr, range 6-17 yr; Gross Motor Function Classification System (GMFCS) levels I and II]. Anthropometric measures (BMI, waist circumference and waist-height ratio) and blood pressure were taken. Cardiorespiratory fitness was measured using a 10 m shuttle run test. Children were classified as low, middle and high fitness according to level achieved on the test using reference curves. Physical activity was measured by accelerometry over 7 days. In addition to total activity, time in sedentary behaviour and light, moderate, vigorous, and sustained moderate-to-vigorous activity (≥10 min bouts) were calculated.ResultsMultiple regression analyses revealed that vigorous activity (β = 0.339, p<0.01), sustained moderate-to-vigorous activity (β = 0.250, p<0.05) and total activity (β = 0.238, p<0.05) were associated with level achieved on the shuttle run test after adjustment for age, sex and GMFCS level. Children with high fitness spent more time in vigorous activity than children with middle fitness (p<0.05). Shuttle run test level was negatively associated with BMI (r2 = -0.451, p<0.01), waist circumference (r2 = -0.560, p<0.001), waist-height ratio (r2 = -0.560, p<0.001) and systolic blood pressure (r2 = -0.306, p<0.05) after adjustment for age, sex and GMFCS level.ConclusionsParticipation in physical activity, particularly at a vigorous intensity, is associated with high cardiorespiratory fitness in children with CP. Low cardiorespiratory fitness is associated with increased cardiometabolic risk.
Highlights
Cerebral palsy (CP) is a neurodevelopmental condition that begins in childhood but has a lifelong impact on the individual
Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity
Shuttle run test level was negatively associated with body mass index (BMI) (r2 = -0.451, p
Summary
Cerebral palsy (CP) is a neurodevelopmental condition that begins in childhood but has a lifelong impact on the individual. Children with CP have reduced levels of everyday physical activity and poor cardiorespiratory fitness in comparison to their peers with typical development [1–4]. In combination with the increased cost of locomotion due to motor impairments and orthopedic conditions, reduced cardiorespiratory fitness increases the physical strain associated with walking in children with CP [6]. Low cardiorespiratory fitness is associated with obesity, hypertension, dyslipidemia, insulin resistance and the metabolic syndrome in children with typical development [8–10]. It is unknown, if a similar relationship exists in children with CP. Children with cerebral palsy (CP) have poor cardiorespiratory fitness in comparison to their peers with typical development, which may be due to low levels of physical activity. An objective was to determine the association between cardiorespiratory fitness, anthropometric measures and blood pressure in children with CP
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