Measurement of habitual physical activity performance in adolescents with cerebral palsy: a systematic review

AIM This systematic review compares the validity, reliability, and clinical use of habitual physical activity (HPA) performance measures in adolescents with cerebral palsy (CP). METHOD Measures of HPA across GrossMotor Function Classification System(GMFCS) levels I-V for adolescents (10-18y) with CP were included if at least 60% of items reported HPA performance in the domains of intensity, frequency, duration, and mode. RESULTS Seven measures of HPA performance met the criteria: StepWatch, pedometers, Uptimer, heart rate flex method, accelerometers, and self-report measures including the Children's Activity Participation and Enjoyment (CAPE) scale and the Physical Activity Questionnaire for Adolescents. The CAPE scale had the strongest validity and reliability but was limited by its inability to measure activity intensity. No study was identified that evaluated the psychometric properties of physical activity measures in non-ambulant adolescents with CP (GMFCS levels IV and V). INTERPRETATION When deciding on an appropriate measure of HPA in adolescents with CP, clinicians need to consider their research question including the domains of HPA they are evaluating and the population they wish to assess. Accelerometers provide the most robust information about the patterns of HPA, with some evidence of validity but limited data on reliability. Further research is needed to compare the use of tri- and uniaxial accelerometers

Measurement of habitual physical activity performance in adolescents with cerebral palsy: a systematic review

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Evaluation of a Physical Activity Intervention for Adults With Brain Impairment: A Controlled Clinical Trial

Background. Individuals with brain impairment (BI) are less active than the general population and have increased risk of chronic disease. Objective. This controlled trial evaluated the efficacy of a physical activity (PA) intervention for community-dwelling adults with BI. Methods. A total of 43 adults with BI (27 male, 16 female; age 38.1 ± 11.9 years; stage of change 1-3) who walked as their primary means of locomotion were allocated to an intervention (n = 23) or control (n = 20) condition. The intervention comprised 10 face-to-face home visits over 12 weeks, including a tailored combination of stage-matched behavior change activities, exercise prescription, community access facilitation, and relapse prevention strategies. The control group received 10 face-to-face visits over 12 weeks to promote sun safety, healthy sleep, and oral health. Primary outcomes were daily activity counts and minutes of moderate-to-vigorous-intensity PA (MVPA) measured with the ActiGraph GT1M at baseline (0 weeks), postintervention (12 weeks) and follow-up (24 weeks). Between-group differences were evaluated for statistical significance using repeated-measures ANOVA. Results. MVPA for the intervention group increased significantly from baseline to 12 weeks (20.8 ± 3.1 to 31.2 ± 3.1 min/d; P = .01), but differences between baseline and 24 weeks were nonsignificant (20.8 ± 3.1 to 25.3 ± 3.2 min/d; P = .28). MVPA changes for the control group were negligible and nonsignificant. Between-group differences for change in MVPA were significant at 12 weeks (P = .03) but not at 24 weeks (P = .49). Conclusion. The 12-week intervention effectively increased adoption of PA in a sample of community-dwelling adults with BI immediately after the intervention but not at follow-up. Future studies should explore strategies to foster maintenance of PA participation

Evaluation of a physical activity intervention for adults with brain impairment: A controlled clinical trial

<b>Background</b>\ud \ud Individuals with brain impairment (BI) are less active than the general population and have increased risk of chronic disease.\ud \ud <b>Objective</b>\ud \ud This controlled trial evaluated the efficacy of a physical activity (PA) intervention for community-dwelling adults with BI.\ud \ud <b>Methods</b>\ud \ud A total of 43 adults with BI (27 male, 16 female; age 38.1 ± 11.9 years; stage of change 1-3) who walked as their primary means of locomotion were allocated to an intervention (n = 23) or control (n = 20) condition. The intervention comprised 10 face-to-face home visits over 12 weeks, including a tailored combination of stage-matched behavior change activities, exercise prescription, community access facilitation, and relapse prevention strategies. The control group received 10 face-to-face visits over 12 weeks to promote sun safety, healthy sleep, and oral health. Primary outcomes were daily activity counts and minutes of moderate-to-vigorous-intensity PA (MVPA) measured with the ActiGraph GT1M at baseline (0 weeks), postintervention (12 weeks) and follow-up (24 weeks). Between-group differences were evaluated for statistical significance using repeated-measures ANOVA.\ud \ud <b>Results</b>\ud \ud MVPA for the intervention group increased significantly from baseline to 12 weeks (20.8 ± 3.1 to 31.2 ± 3.1 min/d; P = .01), but differences between baseline and 24 weeks were nonsignificant (20.8 ± 3.1 to 25.3 ± 3.2 min/d; P = .28). MVPA changes for the control group were negligible and nonsignificant. Between-group differences for change in MVPA were significant at 12 weeks (P = .03) but not at 24 weeks (P = .49).\ud \ud <b>Conclusion</b>\ud \ud The 12-week intervention effectively increased adoption of PA in a sample of community-dwelling adults with BI immediately after the intervention but not at follow-up. Future studies should explore strategies to foster maintenance of PA participation

The adapted physical activity program: A theory-driven, evidence-based physical activity intervention for people with brain impairment

People with brain impairments are less active than the general population and consequently have an increased risk of chronic disease. To increase activity requires interventions that are theory driven and evidence based. Here, we describe the adapted physical activity program (APAP), a physical activity promotion program with demonstrated efficacy in community dwelling adults with brain impairments. Distinguishing features of the APAP include the following: delivery in the participants home/or community environment and the utilisation of the principals of community-based rehabilitation; the assessment of each of the domains of the International Classification of Functioning, Disability and Health (ICF) (i.e., health conditions, impairments, activity limitations, participation restrictions and personal and environmental characteristics) to determine how they will impact physical activity adoption and maintenance; the incorporation of theory-based physical activity adoption and maintenance strategies; the utilisation of lifestyle physical activity programs (including client-centred selection of activities) and/or structured exercise programs (requiring principles of exercise prescription). It is anticipated that this program description will permit researchers and/or practitioners to implement the program, replicate its evaluation and/or translate the program into multi-professional rehabilitation settings

Validity of accelerometry in ambulatory children and adolescents with cerebral palsy

To evaluate the validity of the ActiGraph accelerometer for the measurement of physical activity intensity in children and adolescents with cerebral palsy (CP) using oxygen uptake (VO(2)) as the criterion measure. Thirty children and adolescents with CP (mean age 12.6 ± 2.0 years) wore an ActiGraph 7164 and a Cosmed K4b(2) portable indirect calorimeter during four activities; quiet sitting, comfortable paced walking, brisk paced walking and fast paced walking. VO(2) was converted to METs and activity energy expenditure and classified as sedentary, light or moderate-to-vigorous intensity according to the conventions for children. Mean ActiGraph counts min(-1) were classified as sedentary, light or moderate-to-vigorous (MVPA) intensity using four different sets of cut-points. VO(2) and counts min(-1) increased significantly with increases in walking speed (P < 0.001). Receiver operating characteristic (ROC) curve analysis indicated that, of the four sets of cut-points evaluated, the Evenson et al. (J Sports Sci 26(14):1557-1565, 2008) cut-points had the highest classification accuracy for sedentary (92%) and MVPA (91%), as well as the second highest classification accuracy for light intensity physical activity (67%). A ROC curve analysis of data from our participants yielded a CP-specific cut-point for MVPA that was lower than the Evenson cut-point (2,012 vs. 2,296 counts min(-1)), however, the difference in classification accuracy was not statistically significant 94% (95% CI = 88.2-97.7%) vs. 91% (95% CI = 83.5-96.5%). In conclusion, among children and adolescents with CP, the ActiGraph is able to differentiate between different intensities of walking. The use of the Evenson cut-points will permit the estimation of time spent in MVPA and allows comparisons to be made between activity measured in typically developing adolescents and adolescents with CP

Validity of accelerometry in ambulatory children and adolescents with cerebral palsy

To evaluate the validity of the ActiGraph accelerometer for the measurement of physical activity intensity in children and adolescents with cerebral palsy (CP) using oxygen uptake (VO₂) as the criterion measure. Thirty children and adolescents with CP (mean age 12.6 ± 2.0 years) wore an ActiGraph 7164 and a Cosmed K4b² portable indirect calorimeter during four activities; quiet sitting, comfortable paced walking, brisk paced walking and fast paced walking. VO₂ was converted to METs and activity energy expenditure and classified as sedentary, light or moderate-to-vigorous intensity according to the conventions for children. Mean ActiGraph counts min⁻¹ were classified as sedentary, light or moderate-to-vigorous (MVPA) intensity using four different sets of cut-points. VO₂ and counts min⁻¹ increased significantly with increases in walking speed ('P

Validity of the Apple Watch® for monitoring push counts in people using manual wheelchairs

A recent Apple Watch activity-monitoring innovation permits manual wheelchair users to monitor daily push counts. This study evaluated the validity of the Apple Watch push count estimate.Criterion validity.Southern Finland and Southeast Queensland, Australia.Twenty-six manual wheelchair users from Finland and Australia were filmed completing a standardized battery of activities while wearing the Apple Watch (dominant wrist).Wheelchair pushes as determined by the Apple Watch were compared to directly observed pushes.Agreement between Apple Watch push counts and directly observed pushes was evaluated using Intraclass correlation coefficients (ICC), Pearson correlations and Bland-Altman analyses. Apple Watch pushes and directly observed push counts were strongly correlated (ICC = 0.77, P

User profile ontology to support personalization for e-Coaching systems

In recent years, e-coaching systems have played an increasingly significant role in promoting a healthy lifestyle and positive behavior change. Research efforts have grown to provide more useful and effective e-coaching systems for research or other purposes. The implementation of e-coaching systems resulting from these efforts utilizes several techniques including Artificial Intelligence (AI) methodologies. This study proposes a personalised approach to support an e-coaching system that is tailored to the user’s characteristics. A key component of this system comprises an ontological model of the user profile. The objective of this research was to propose an ontology that is able to collect and analyze the user related information as well as customize the profiles with the most appropriate coaching recommendation or materials. The ontology employed in this study was developed using the OWL (Ontology Web Language), a knowledge representation language for authoring ontologies. The effectiveness of this approach will be enhanced by filtering the information that was presented to the users

Validity of two wheelchair-mounted devices for estimating wheelchair speed and distance traveled

This study evaluated the validity of two wheelchair-mounted devices—the Cateye® and Wheeler—for monitoring wheelchair speed and distance traveled. Speed estimates were validated against a calibrated treadmill at speeds from 1.5 to 10 km/hr. Twenty-five wheelchair users completed a course of known distance comprising a sequence of everyday wheelchair activities. Speed estimate validity was very good (mean absolute percentage error ≤ 5%) for the Wheeleri at all speeds and for the Cateye at speeds >3 km/hr but not speeds 20%). Wheeleri distance estimates were good (mean absolute percentage error < 10%) for linear pushing activities and general maneuvering but poor for confined-space maneuvering. Cateye estimates were good for continuous linear propulsion but poor for discontinuous pushing and maneuvering (both general and confined space). Both devices provided valid estimates of speed and distance for typical wheelchair-based exercise activities. However, the Wheeleri provided more accurate estimates of speed and distance during typical everyday wheelchair activities