O'Neil Margaret E, Fragala-Pinkham Maria, Lennon Nancy, George Ameeka, Forman Jeffrey, Trost Stewart G
M.E. O'Neil, PT, PhD, MPH, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, 1601 Cherry St, Mail Stop 7502, Philadelphia, PA 19102 (USA).
M. Fragala-Pinkham, PT, DPT, MS, Research Center, Franciscan Hospital for Children, Brighton, Massachusetts.
Phys Ther. 2016 Jan;96(1):37-45. doi: 10.2522/ptj.20140201. Epub 2015 Jun 18.
Physical therapy for youth with cerebral palsy (CP) who are ambulatory includes interventions to increase functional mobility and participation in physical activity (PA). Thus, reliable and valid measures are needed to document PA in youth with CP.
The purpose of this study was to evaluate the inter-instrument reliability and concurrent validity of 3 accelerometer-based motion sensors with indirect calorimetry as the criterion for measuring PA intensity in youth with CP.
Fifty-seven youth with CP (mean age=12.5 years, SD=3.3; 51% female; 49.1% with spastic hemiplegia) participated. Inclusion criteria were: aged 6 to 20 years, ambulatory, Gross Motor Function Classification System (GMFCS) levels I through III, able to follow directions, and able to complete the full PA protocol. Protocol activities included standardized activity trials with increasing PA intensity (resting, writing, household chores, active video games, and walking at 3 self-selected speeds), as measured by weight-relative oxygen uptake (in mL/kg/min). During each trial, participants wore bilateral accelerometers on the upper arms, waist/hip, and ankle and a portable indirect calorimeter. Intraclass coefficient correlations (ICCs) were calculated to evaluate inter-instrument reliability (left-to-right accelerometer placement). Spearman correlations were used to examine concurrent validity between accelerometer output (activity and step counts) and indirect calorimetry. Friedman analyses of variance with post hoc pair-wise analyses were conducted to examine the validity of accelerometers to discriminate PA intensity across activity trials.
All accelerometers exhibited excellent inter-instrument reliability (ICC=.94-.99) and good concurrent validity (rho=.70-.85). All accelerometers discriminated PA intensity across most activity trials.
This PA protocol consisted of controlled activity trials.
Accelerometers provide valid and reliable measures of PA intensity among youth with CP.
对于能够行走的脑瘫（CP）青少年，物理治疗包括增加功能性活动能力和参与体育活动（PA）的干预措施。因此，需要可靠且有效的测量方法来记录CP青少年的体育活动情况。
本研究的目的是评估3种基于加速度计的运动传感器与间接量热法作为测量CP青少年体育活动强度标准的仪器间可靠性和同时效度。
57名CP青少年（平均年龄=12.5岁，标准差=3.3；51%为女性；49.1%为痉挛性偏瘫）参与了研究。纳入标准为：年龄6至20岁，能够行走，粗大运动功能分类系统（GMFCS）为I至III级，能够听从指令，并能够完成完整的体育活动方案。方案活动包括随着体育活动强度增加的标准化活动试验（休息、书写、家务、电子游戏活动，以及以3种自行选择的速度行走），通过相对体重摄氧量（毫升/千克/分钟）来测量。在每次试验期间，参与者在上臂、腰部/臀部和脚踝佩戴双侧加速度计，并佩戴便携式间接量热计。计算组内相关系数（ICC）以评估仪器间可靠性（加速度计左右放置）。使用斯皮尔曼相关性来检验加速度计输出（活动和步数）与间接量热法之间的同时效度。进行弗里德曼方差分析及事后两两分析，以检验加速度计在不同活动试验中区分体育活动强度的效度。
所有加速度计均表现出优异的仪器间可靠性（ICC = 0.94 - 0.99）和良好的同时效度（rho = 0.70 - 0.85）。所有加速度计在大多数活动试验中都能区分体育活动强度。
本体育活动方案由受控活动试验组成。
加速度计可为CP青少年的体育活动强度提供有效且可靠的测量方法。
