Predictors of physical activity levels in children and adolescents with cerebral palsy: clinical cohort study protocol

Abstract

Introduction: Children and adolescents with cerebral palsy may be trapped in a vicious circle of low physical fitness, resulting in deconditioning that causes a further decrease in physical activity (PA), a lower quality of life and an increased risk of developing non-communicable diseases. Therefore, establishing a healthy and active lifestyle during childhood is even more important for individuals with a disability. However, the factors that influence habitual PA in children and adolescents with cerebral palsy remain unknown.The present protocol outlines a prospective cohort study with the aim of investigating potential predictors of habitual PA in children and adolescents with cerebral palsy in order to provide evidence for optimising PA levels and associated overall health.

Methods and analysis: This prospective cohort study will enrol participants with cerebral palsy between the ages of 8 and 15 years at Gross Motor Function Classification System levels I-III. Using a modified version of the International Classification of Functioning, Disability and Health model as a conceptual analytical framework, the analysis will be divided into six components and will provide predictors for habitual PA measured by accelerometry. The potential predictive variables are registry data on physical function (Danish Cerebral Palsy Follow-Up Programme); validated proxy-reported questionnaires on quality of life (Paediatric Quality of Life Inventory), overall health, pain and participation in daily activities (Paediatric Outcomes Data Collection Instrument) and supplementary questions regarding sleep, screen time and socioeconomic status.

Ethics and dissemination: The project is approved by the Danish Data Protection Agency (19/16396) and has been declared not notifiable by the Regional Committee on Health Research Ethics, cf. Committee Act Art. 14, paragraph 1 (S-20192000-23). The study results will be published in international peer-reviewed journals, presented at international conferences, and published in a PhD dissertation.

Trial registration number: NCT04614207.

Keywords: developmental neurology & neurodisability; epidemiology; musculoskeletal disorders.

Figure 1

Flow diagram. GMFCS, Gross Motor Function Classification System.

Figure 2

Included predictive variables sorted into components according to the modified ICF model, including data collection timeline in months. Variables derived from the following: ^aCPUP registry, ^bParent-Reported Questionnaire, ^cPODCI questionnaire, ^dPedsQLquestionnaire. BMI, body mass index; CP, cerebral palsy; CPUP, Cerebral Palsy Follow-Up Programme; GMFCS, Gross Motor Function Classification System; ICF, International Classification of Functioning, Disability and Health; PedsQL, Paediatric Quality of Life Inventory; PODCI, Paediatric Outcomes Data Collection Instrument; PedsQL, Paediatric Quality of Life Inventory.