Faculty of Health Sciences, School of Rehabilitation Science, McMaster University, Institute of Applied Health Sciences, Hamilton, Canada.
Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, South Brisbane, Australia.
Disabil Rehabil. 2022 Oct;44(20):6070-6081. doi: 10.1080/09638288.2021.1949050. Epub 2021 Jul 31.
To explore the operationalization and measurement of sedentary behavior (SB) in individuals with cerebral palsy (CP).
We searched five databases from 2011 to 2020 for primary studies of experimental, qualitative, longitudinal, or observational designs measuring SB or postures typically characterized as sedentary (sitting, reclining, lying).
We screened 1112 citations and selected 47 studies. SB was operationalized through muscle activation, energy expenditure or oxygen consumption in typically sedentary postures ( = 9), and through thresholds and postures used by accelerometers, activity monitors, and a questionnaire to measure time spent in SB ( = 25). Seven out of the eight studies that measured energy expenditure found ≤1.5 metabolic equivalents of task (METs) for sitting and lying. While different accelerometer thresholds were used to measure SB, the behavior (SB) was consistently operationalized as sitting and lying. Little consistency existed in the subpopulation, instruments and cut-points for studies on validity or reliability of tools for measuring SB ( = 19).
Sitting and lying are considered sedentary postures, which is defined as ≤1.5 METs in individuals with CP. There is variability in the tools used to measure SB in individuals with CP. Therefore, consensus on the definition and reporting of SB is needed.Implications for rehabilitationAlthough sedentary behavior (SB) is increased in individuals with cerebral palsy (CP) compared to the typically developing population, there is no standard definition for SB for these individuals; this makes it difficult to synthesize data across studies.Sitting and lying are ≤1.5 METs in individuals with CP, suggesting we only need to measure posture to show change in SB.The commonly used accelerometer cut-point in the typically developing population of ≤100 counts per minute generally has excellent reliability across multiple devices in ambulatory children with CP.
探索脑瘫患者（CP）中久坐行为（SB）的操作化和测量方法。
我们从 2011 年至 2020 年在五个数据库中搜索了实验、定性、纵向或观察设计的原始研究，这些研究测量了 SB 或通常被视为久坐（坐、斜倚、躺）的姿势。
我们筛选了 1112 条引用文献，选择了 47 项研究。SB 通过典型的久坐姿势下的肌肉激活、能量消耗或耗氧量来操作化（ = 9），通过加速度计、活动监测器和测量 SB 时间的问卷中使用的阈值和姿势来操作化（ = 25）。在测量能量消耗的八项研究中有七项发现坐和躺的代谢当量（METs）≤1.5。虽然使用了不同的加速度计阈值来测量 SB，但行为（SB）始终被定义为坐和躺。在研究 SB 工具的有效性或可靠性的子群体、仪器和切点方面，一致性很小（ = 19）。
坐和躺被认为是久坐姿势，在 CP 患者中定义为≤1.5 METs。在 CP 患者中，用于测量 SB 的工具存在差异。因此，需要对 SB 的定义和报告达成共识。
尽管与正常发育人群相比，脑瘫患者（CP）的久坐行为（SB）增加，但对于这些患者，没有 SB 的标准定义；这使得难以在研究之间综合数据。
CP 患者坐和躺的代谢当量（METs）≤1.5，这表明我们只需要测量姿势就可以显示 SB 的变化。在移动的 CP 儿童中，通常使用的典型发育人群中的加速度计切点≤100 计数/分钟，在多个设备上具有出色的可靠性。
