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Abstract
Aims
To describe the walking performance and physical activity of children with cerebral palsy (CP) by Gross Motor Function Classification System (GMFCS) level, age, sex, and geographical location; and, to examine the concurrent validity of the 4-item Early Activity Scale for Endurance (EASE) to walking performance and physical activity scores.
Methods
Seventy-nine children with CP participated. Parents completed the 4-item EASE. All children wore an Actigraph monitor (n = 79), and children in GMFCS levels I – III also wore a StepWatch monitor (n = 50), for seven days.
Results
Only GMFCS level yielded significant differences in average strides taken per day, in strides per day taken faster than 30 strides per minute, in average physical activity counts per minute, and in minutes per day spent in moderate to vigorous physical activity. The 4-item EASE findings were moderately correlated with average physical activity counts per minute (.61, p< .001) and minutes per day spent in moderate to vigorous physical activity (.62, p < .001).
Conclusions
GMFCS level is predictive of both walking performance and physical activity in children with CP. The 4-item EASE may provide a quick and valid way to monitor physical activity in children with CP.
Acknowledgements
We acknowledge additional On Track Study Team members including academic researchers: Doreen Bartlett, Sarah Westcott McCoy, Lisa Chiarello, Lynn Jeffries, Robert Palisano, Jan Willem Gorter, Steven Hanna, and Lisa Avery; Canadian project coordinator Barb Galuppi; US project coordinator Monica Smersh; and parent researchers: Lisa Diller, Paula Drew, Nancy Ford, Marquitha Gilbert, tina hjorngaard, Kimberly Rayfield, and Barbara Sieck Taylor. We thank the participating children and families, whose continued involvement made this study possible. We also acknowledge the important contributions of the regional coordinators as well as the 90 therapists across North America who assessed children during the course of the study
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Erin E. Wentz
Dr. Erin E. Wentz is an Assistant Professor in the Department of Physical Therapy Education at SUNY Upstate Medical University. She completed her bachelor of science degree in Exercise Science at the University of Southern California and her bachelor of science degree in Physical Therapy from Georgia State University. She earned her PhD in Kinesiology from the University of Michigan. She teaches courses in developmental disabilities, pediatric physical therapy and ethics. She has a special interest in local and global service learning. Her research focuses on effective early intervention practices that promote optimal motor development, body composition and physical activity levels. Dr. Wentz is board certified as a Pediatric Clinical Specialist.
Kristie F. Bjornson
Dr. Kristie F. Bjornson is an Associate professor at the University of Washington and Seattle Children's Hospital Research Institute. She has over 40 years of clinical experience in pediatric physical therapy in a variety of settings. Her research focus is on the assessment of physical activity, health and quality of life in ambulatory children with cerebral palsy. She has completed an NICHD NIH K23 career development award focusing on the measurement of ambulatory physical activity, participation in daily life of children with cerebral palsy and the influence of orthotics.
Cheryl I. Kerfeld
Dr. Cheryl I. Kerfeld has over 30 years of experience working as a pediatric physical therapist in a variety of settings. She currently works for Seattle Public Schools as a member of the Educator Leadership Cadre in the Department of Special Education and is a community based Research Scientist. She completed her bachelor degree in Physical Therapy at the Mayo Clinic School of Health Sciences, a masters of science in Rehabilitation Medicine as well as a PhD in Rehabilitation Science from the University of Washington. Her research focus is the promotion of physical activity and participation of children with developmental disabilities. Dr. Kerfeld also has a strong interest in global health.
Nancy Cicirello
Dr. Nancy Cicirello is professor emerita from Pacific University, retiring in 2015. She received her bachelor of science in Physical Therapy from The Ohio State University, her masters in public health in Maternal and Child Health from the University of North Carolina and her EdD from Portland State University. She currently serves on the Board of Directors of United Cerebral Palsy of Oregon and is providing supervisory services at Portland Shriners Hospital in an ongoing research study. Prior to retirement, Dr. Cicirello taught pediatric and neurological condition content at Pacific University, assisted in data collections, and served the Section of Pediatrics and the APTA in state, regional and national positions as well as in international pediatric volunteer work.
Alyssa LaForme Fiss
Dr. Alyssa LaForme Fiss is anAssociate Professor and the Director of Research in the Department of Physical Therapy at Mercer University. She teaches courses in research and pediatric physical therapy. She completed her bachelor and master degrees in Physical Therapy at The Ohio State University, and her PhD in Rehabilitation Science from the University of Kentucky. She has published and presented her research extensively nationally and internationally. Dr. Fiss is board certified as a Pediatric Clinical Specialist and currently serves at the President of the Board of Directors of FOCUS + Fragile Kids, a nonprofit supporting children with disabilities and their families.