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Longitudinal physical activity and sedentary behaviour in preschool-aged children with cerebral palsy across all functional levels.

Longitudinal physical activity and sedentary behaviour in preschool-aged children with cerebral palsy across all functional levels.
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Keawutan P, Bell KL, Oftedal S, Ware RS, Stevenson RD, Davies PSW, Boyd RN,


Keawutan P, Bell KL, Oftedal S, Ware RS, Stevenson RD, Davies PSW, Boyd RN, (click to view)

Keawutan P, Bell KL, Oftedal S, Ware RS, Stevenson RD, Davies PSW, Boyd RN,

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Developmental medicine and child neurology 2017 04 22() doi 10.1111/dmcn.13439
Abstract
AIM
To investigate longitudinal changes of habitual physical activity (HPA) and sedentary time in children with cerebral palsy (CP) aged 1 year 6 months to 5 years across all functional abilities.

METHOD
At study entry, 95 children (62 males, 33 females) were classified using the Gross Motor Function Classification System (GMFCS) at levels I (50), II (9), III (16), IV (6), and V (14). Physical activity was recorded on a total of 159 occasions at four possible time points: 1 year 6 months to 2 years; 2 years 6 months to 3 years; 4 years; and 5 years using ActiGraph for 3 days. Mixed-effects regression models were used for analyses.

RESULTS
Participants classified at GMFCS levels I and II had stable HPA as they aged. HPA significantly decreased at 5 years in children classified at GMFCS levels III to V. Sedentary time significantly increased at 4 years and 5 years in all participants. Annual HPA significantly reduced in children classified at GMFCS levels III to V (-123 counts/min, 95% confidence interval [CI] -206 to -40) while annual sedentary time significantly increased in all participants (GMFCS levels I-II: 2.4%, 95% CI 0.7-4.1; GMFCS levels III-V: 6.9%, 95% CI 4.6-9.2).

INTERPRETATION
Children with CP at all GMFCS levels should be encouraged to be physically active from early childhood as HPA levels start to decline from 4 years. Breaks in sedentary time are required for all children with CP from the age of 3 years.

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