Accelerometry: a feasible method to quantify physical activity in ambulatory and nonambulatory adolescents with cerebral palsy

Abstract

Objective. To determine the feasibility of physical activity monitoring in adolescents with cerebral palsy (CP). Methods. A convenience sample of ambulatory and non-ambulatory adolescents (N = 23; 17 males, 6 females; mean age 13.5 y, SD 2.6 y; Gross Motor Function Classification System (GMFCS) distribution: n = 9 Level I, n = 5 Level II, n = 5 Level III, n = 4 Level IV) was recruited. Physical activity (PA) was objectively assessed using the ActiGraph GT1M activity monitor. Discomfort or adverse effects of wearing the accelerometers were recorded by participants. Levels of physical activity were determined as total PA, light PA (LPA), moderate PA (MPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) using cut-points recently validated for CP. Results. Most participants showed little reluctance. Mean daily MVPA for all participants was 30.7 minutes (SD 30.3), which corresponded to 2.7 (SD 2.4) minutes of MVPA per hour or 4.5% (SD 3.9) of the total monitoring time. Total PA and MVPA were greatest in ambulatory youth (GMFCS levels I and II) compared with youth who use a walking aid or wheelchair (GMFCS levels III and IV) (P < 0.05). Conclusion(s). The results support the use of the accelerometer as a feasible and useful measure of activity in ambulatory and nonambulatory adolescents with CP.

Figure 1

An example of a typical monitoring day for one participant with CP (female, 11 years of age, GMFCS level I).The table is a sample from the participantʼs log book in which they were asked to record the times the device was put on and taken off for each of the monitoring days. The figure to the right represents the accelerometer output for the corresponding day. No activity was recorded by the device from 7:05 to approximately 7:56 pm, which corresponds to the time the participants indicated they removed the device.

Figure 2

Moderate-to-vigorous activity time in adolescents with CP by GMFCS level. MVPA: moderate-to-vigorous physical activity; CP: cerebral palsy; GMFCS: Gross Motor Function Classification System; min: minutes.