Sport Injury Prevention Research Center, Faculty of Kinesiology, University of Calgary, Calgary, AB,Canada.
Vi Riddell Pediatric Rehabilitation Research Program, Alberta Children's Hospital Research Institute, Calgary, AB,Canada.
Pediatr Exerc Sci. 2023 Mar 21;35(4):225-231. doi: 10.1123/pes.2022-0064. Print 2023 Nov 1.
This study assessed physical activity (PA) and body composition of ambulatory children and adolescents with cerebral palsy (CP) and their typically developing peers.
Participants included youth with CP (ages 8-18 y and Gross Motor Function Classification System [GMFCS] levels I-III) and their typically developing peers. Outcomes included PA (actigraphy) and fat/lean mass index (FMI/LMI; dual-energy X-ray absorptiometry). Statistical analyses included linear mixed effects models with Bonferroni adjustment. Fixed effects were study group (CP and typically developing); random effects were participant clusters (sex and age). Exploratory analyses included association of body composition and PA, GMFCS level, and CP involvement (unilateral and bilateral).
Seventy-eight participants (CP: n = 40, girls: n = 29; GMFCS I: n = 20; GMFCS II: n = 14; GMFCS III: n = 6) met inclusion criteria. Individuals with CP had lower moderate to vigorous PA (MVPA; β = -12.5; 98.3% confidence interval, -22.6 to -2.5 min; P = .004) and lower LMI (β = -1.1; 97.5% confidence interval, -2.1 to -0.0 kg/m2; P = .020). Exploratory analyses indicated increased LMI with greater MVPA (P = .001), reduced MVPA for GMFCS II (P = .005) and III (P = .001), increased sedentary time for GMFCS III (P = .006), and greater fat mass index with unilateral motor impairment (P = .026).
The findings contribute to the knowledge base of increasing MVPA and LMI deficits with the greater functional impact of CP. Associations of increasing LMI with greater MVPA support efforts targeting enhanced PA participation to promote independent mobility.
本研究评估了脑瘫（CP）患儿和其正常发育同龄人（年龄 8-18 岁，运动功能分级系统 [GMFCS] I-III 级）的身体活动（PA）和身体成分。
参与者包括 CP 患儿（年龄 8-18 岁，运动功能分级系统 [GMFCS] I-III 级）及其正常发育的同龄人。结果包括 PA（活动记录仪）和脂肪/瘦体重指数（FMI/LMI；双能 X 射线吸收法）。统计分析采用 Bonferroni 校正的线性混合效应模型。固定效应为研究组（CP 和正常发育）；随机效应为参与者聚类（性别和年龄）。探索性分析包括身体成分与 PA、GMFCS 分级和 CP 受累（单侧和双侧）的关联。
78 名参与者（CP：n=40，女性：n=29；GMFCS I：n=20；GMFCS II：n=14；GMFCS III：n=6）符合纳入标准。CP 患者的中度到剧烈 PA（MVPA；β=-12.5；98.3%置信区间，-22.6 至-2.5 分钟；P=0.004）和 LMI 较低（β=-1.1；97.5%置信区间，-2.1 至-0.0 kg/m2；P=0.020）。探索性分析表明，MVPA 增加时 LMI 增加（P=0.001），GMFCS II（P=0.005）和 III（P=0.001）时 MVPA 减少，GMFCS III 时久坐时间增加（P=0.006），单侧运动障碍时脂肪质量指数增加（P=0.026）。
这些发现增加了对 CP 功能影响较大时 MVPA 和 LMI 缺陷增加的认识。LMI 增加与 MVPA 增加的相关性支持了通过增强 PA 参与促进独立移动的努力。
