Children with cerebral palsy (CP) should be encouraged to engage in regular physical activities starting at an early age and continuing throughout their lifetimes. This is important to counteract sedentary behaviors that increase at about age 5, according to a study published in the journal Developmental Medicine & Child Neurology.
In general, sedentary habits and low physical activity are well-known risk factors for several diseases, such as diabetes and cardiovascular disorders. This is also true for children with CP.
Children with CP commonly have lower levels of daily physical activity than children with typical development, partly due to motor skill impairment.
Previous studies have shown that this more sedentary profile in the CP population is associated with higher blood pressure in CP children and increased risk for cardio-metabolic diseases in CP adults.
According to international recommendations, “people with CP should have moderate-to-vigorous physical activity for 60 minutes, 5 days a week or more, and sedentary time for less than 2 hours a day, or they should break up sitting for 2 minutes every 30 to 60 minutes,” the authors wrote.
For children with CP younger than 5, the guidelines are different, recommending that children be physically active for at least three hours every day. Additionally, they should not be sedentary, restrained, or kept inactive for more than one hour at a time.
In the study, “Longitudinal physical activity and sedentary behaviour in preschool-aged children with cerebral palsy across all functional levels,” researchers from the University of Queensland, Australia, investigated the changes in physical activity habits and sedentary time in children with CP.
Ninety-five children with CP across all functional levels, from Gross Motor Function Classification System I (less affected) to V (severely affected), and ages 1.5 to 5 years were included in the study.
The team observed that children with less motor function impairment (GMFCS levels I–II) maintained more stable physical activity during the study period but gradually increased their sedentary time. As functional severity increased, the children showed a tendency to reduce physical activity starting at age 4, while sedentary time increased at about the age of 2.5 to 3 years. Those classified at GMFCS levels III to V showed a significant decline in physical activity at the age of 5.
“These data suggest that children with CP should be encouraged to be physically active from the age of 4 years, especially those classified at GMFCS levels III to V,” the authors wrote. “More importantly, breaks in sedentary time should be introduced in all children with CP from the age of 3 years.”
These results partly can be explained by the children’s gross motor capacity. However, the authors highlighted that it is important to consider that factors such as a lack of self-motivation and family motivation, awareness of the benefits of physical activity, and access to sports facilities at home, in the surrounding community, and at preschool can be detrimental to a child’s active lifestyle.
“Our findings suggest that patterns of HPA [habitual physical activity] and sedentary behavior may be evident from 3 years of age,” the authors wrote. “Greater emphasis needs to be placed on monitoring HPA in addition to motor capacity in preschool-aged children with CP and, more importantly, the impact of sedentary behavior on health outcomes.”