Short summary

Children and adolescents with cerebral palsy may be trapped in a vicious circle of low physical fitness, resulting in deconditioning that causes a further decrease in physical activity (PA), a lower quality of life, and an increased risk of developing non-communicable diseases (NCDs). Therefore, establishing a healthy and active lifestyle during childhood is even more important for individuals with a disability. However, the factors that influence habitual PA in children and adolescents with cer

Rationale

Cerebral palsy (CP) is a condition that describes a group of disorders (altered muscle tone, movement disorders, muscle weakness, ataxia, and rigidity) related to the development of movement and posture causing activity limitations and reduced quality of life. Although CP is a non-progressive diagnosis, it is a lifelong condition that requires attention through most of the person's life, as impairments are constantly evolving and inhibit performance of activities and participation in daily living. Low levels of PA are a worldwide threat to the health of children, including those with disabilities. Although there are no specific evidence-based PA guidelines for children with cerebral palsy, it is clear that they have lower levels of PA and higher levels of time spent sedentary than their peers and that their level of mobility limitation is negatively associated with their level of PA. To optimize activities of daily living and long-term health outcomes for the present population, a key objective is to encourage and facilitate an increase in habitual PA and reduce the amount of time spent sedentary. However, the current literature does not provide evidence for barriers to or motivators for PA in children and adolescents with cerebral palsy. Furthermore, no studies have examined the underlying reasons for altering habitual PA.

The aim of the present cohort-study is to identify and investigate potential predictors of habitual PA in children and adolescents with cerebral palsy, with the perspective of providing evidence to optimize PA levels and associated overall health.

Description of the cohort

Participants with cerebral palsy born between 2003 and 2013, at Gross Motor Function Classification System (GMFCS) levels I-III, will be included in the study.

Data and biological material

Using a modified version of the International Classification of Functioning, Disability and Health (ICF) model as a conceptual analytical framework, the analysis will be divided into six components and will provide predictors for habitual PA measured by accelerometry. The potential predictive variables are registry data on physical function (Danish Cerebral Palsy Follow Up Program [CPUP]); validated proxy-reported questionnaires on quality of life (Pediatric Quality of Life Inventory (PedsQL)), overall health, pain, and participation in daily activities (Pediatric Outcomes Data Collection Instrument (PODCI)); and supplementary questions regarding sleep, screen time, and socio-economic status.

Collaborating researchers and departments

Department of Clinical Research, University of Southern Denmark

Department of Orthopaedics and Traumatology, Odense University Hospital

• Associate Professor, Anders Holsgaard-Larsen, MSc, PhD.

Department of Sports Science and Clinical Biomechanics, University of Southern Denmark

• Professor, Jens Troelsen MSc, PhD

Department of Paediatrics, Lillebaelt Hospital, Kolding

• MD, Ulrike Dunkhase-Heinl

Publications associated with the project

Fonvig CE, Troelsen J, Dunkhase-Heinl U, et al. Predictors of physical activity levels in children and adolescents with cerebral palsy: clinical cohort study protocol. BMJ Open 2021;11:e047522. doi:10.1136/ bmjopen-2020-047522