Abstract
Background Children with cerebral palsy (CP) participate in reduced levels of physical activity and spend increased time in sedentary behavior. The effect of reduced activity and increased sedentary behavior on their cardiometabolic health has not been investigated.
Objectives The purposes of this study were: (1) to investigate the prevalence of overweight/obesity and elevated blood pressure (BP) among a cohort of ambulatory children with CP and (2) to investigate the associations among physical activity, sedentary behavior, overweight/obesity, and BP in children with CP.
Study Design This was a cross-sectional study of 90 ambulatory children, aged 6 to 17 years, with CP.
Methods Body mass index (BMI), waist circumference, waist-height ratio, and BP were measured on 1 occasion. Habitual physical activity was measured by accelerometry over 7 days.
Results The prevalence of overweight/obesity in the cohort was 18.9%. Twenty-two percent of the children had BP values within the hypertensive or prehypertensive range. Systolic BP was positively associated with waist circumference (β=.324, P<.05) and BMI (β=.249, P<.05). Elevated BP values were associated with reduced time in moderate-to-vigorous activity, vigorous activity, and total activity, as well as increased time in sedentary behavior. The strongest association was observed between elevated BP and vigorous activity alone (odds ratio=0.61, 95% confidence interval=0.37–0.99, P<.05).
Limitations A convenience sample was recruited for this study, and it is possible that this limitation resulted in selection bias.
Conclusions Despite the relatively low prevalence of overweight/obesity, a relatively high proportion of children with CP had elevated BP values. Reducing sedentary behavior and increasing habitual physical activity, particularly vigorous activity, should be primary aims of rehabilitation in order to reduce cardiometabolic disease risk in this population.
Footnotes
Dr Ryan conceptualized and designed the study, carried out data collection, carried out data analysis, drafted the initial manuscript, and approved the final manuscript. Dr Hensey, Ms McLoughlin, and Mr Lyons contributed to the design of the study, provided study participants, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr Gormley conceptualized and designed the study, provided fund procurement, reviewed and revised the manuscript, and approved the final manuscript as submitted. The authors acknowledge all of the participating children and their parents for their cooperation in this study. They also thank the physical therapists in the Central Remedial Clinic and Enable Ireland for their support with the study.
Ethical approval for this study was granted by the University of Dublin's Faculty of Health Sciences' Ethics Committee, the Central Remedial Clinic's Ethics Committee, and the Enable Ireland Research Ethics and Quality Committee.
- Received November 6, 2013.
- Accepted March 27, 2014.
- © 2014 American Physical Therapy Association
Issue highlights
