Purpose: To compare ambulatory status in children with cerebral palsy aged 4 to 5 years with their habitual physical activity and time spent sedentary, and to compare their activity with physical activity guidelines. Methods: Sixty-seven participants—independently ambulant, marginally ambulant, and nonambulant—wore accelerometers for 3 days. Time spent sedentary as a percentage of wear time and activity counts were compared between groups. Results: There were significant differences in time spent sedentary and activity counts between groups. Children who were independently ambulant were more likely to meet physical activity guidelines. Conclusion: Children with cerebral palsy spent more than half of their waking hours in sedentary time. Interventions to reduce sedentary behavior and increase habitual physical activity are needed in children with cerebral palsy at age 4 to 5 years.
1 March 2018 in Research in Developmental Disabilities
Children with cerebral palsy (CP) have lower habitual physical activity (HPA) than their typically developing peers. There are limited studies of HPA in young children with CP under the age of 5 years. To investigate the relationships between HPA, sedentary time, motor capacity and capability in children with CP aged 4-5 years. Sixty-seven participants were classified using Gross Motor Function Classification System (GMFCS), assessed for motor capacity using Gross Motor Function Measure (GMFM) and wore accelerometers for three days to measure HPA and sedentary time. Motor capability was assessed using parent-reported Pediatric Evaluation of Disability Inventory (PEDI) functional skills of mobility domain. Mixed-effects regression models were used for analyses. GMFM was positively associated with HPA (mean difference (MD) = 19.6 counts/min; 95%CI = 16.6 to 22.7, p < 0.001) and negatively associated with sedentary time (MD = -0.6%; 95%CI = -0.7 to -0.5, p < 0.001). The PEDI was also positively associated with HPA (MD = 16.0 counts/min; 95%CI = 13.1 to 18.8, p < 0.001) and negatively associated with sedentary time (MD = -0.5%; 95%CI = -0.6 to -0.4, p < 0.001). After stratification for ambulatory status, GMFM and PEDI were associated with HPA and sedentary time in ambulant participants but not in non-ambulant participants. Gross motor capacity and motor capability are related to HPA and sedentary time in ambulant children with CP aged 4-5 years.
Mild cognitive impairment (MCI) is a slight cognitive decline with the ability to perform normal activities in daily life and an increased risk of dementia. Land-based exercise enhances cognitive abilities, but combining cognitive and physical interventions offers greater benefits in MCI. Water-based exercise is a low-impact activity that minimizes joint strain and reduces injury risk. This study investigated the effects of water-based exercise with or without cognitive training on cognition in older adults with MCI. Thirty-seven participants aged 65 years or older with MCI were randomly assigned to two groups: water-based exercise (W; n = 18) and water-based exercise combined with cognitive training (W-COG; n = 19). Both groups performed 60 min water-based aerobic sessions 3 days per week for 12 weeks. Cognitive assessments were conducted at baseline and after 12 weeks. Post-intervention, 77.77% of the W group and 89% of the W-COG group had improved their cognitive ability. Both groups showed significant improvements in their global cognition (p < 0.001, p < 0.001) and visuospatial ability (p < 0.01 for W, p < 0.05 for W-COG), respectively. In addition, cognitive flexibility and shifting abilities improved only in the W-COG group (p < 0.05). These findings suggest that water-based exercise combined with cognitive training enhances cognitive functions more effectively than exercise alone in older adults with MCI.