Adolescents with cerebral palsy do not meet the recommendations for healthy weight and physical activity, a study shows. They may also have a high percentage of body fat as well as sedentary behaviors.
The study, “Do adolescents with cerebral palsy meet recommendations for healthy weight and physical activity behaviours?,” was published in the journal Disability and Rehabilitation.
In general, sedentary habits and low physical activity are known risk factors for several diseases, including diabetes and cardiovascular disorders. This is also true among children with cerebral palsy.
This young population commonly spends more time in sedentary behaviors and has an increased risk of becoming obese. This pattern of reduced physical activity in childhood may continue into adolescence.
Australian researchers evaluated the time spent in sedentary, light, and moderate-vigorous physical activity, body fat percentage, body mass index (BMI), and nutritional intake in adolescents with cerebral palsy. The team compared these values with national guidelines and available cerebral palsy-specific recommendations. They also determined the validity of skinfold assessments (namely in triceps and subscapular muscles) for estimating body fat percentage in this specific population.
Skinfold measurements provide an estimate of body fat, describing the amount of subcutaneous fat when the fold is lifted and its thickness measured by specialized calipers.
The study enrolled 12 adolescents (ages 12-19) with cerebral palsy who had different levels of motor limitations, as determined by the Gross Motor Function Classification System (GMFCS). The majority of participants had reduced or no limitations in eating or drinking, as determined by the Eating and Drinking Ability Classification System (EDACS), with only one participant receiving nutrition through a G-tube (a tube inserted into the abdomen that delivers nutrition directly to the stomach) who did not respond to the nutrition questionnaire.
More than half of the participants achieved the target health scores for health behaviors (91%), sweetened beverages (63%), and environment (54%). Still, less than half reached target scores for water (45%), fruit (36%), vegetables (27%), and non-core foods (36%) intake.
Evaluation of the group physical activity revealed that patients spent 413.3 minutes per half-day engaged in sedentary behaviors; 206.2 minutes were spend in light activities, and 65.5 minutes in moderate-vigorous physical activities.
Overall, 64% of the participants met the recommendations of engaging in 60 minutes of moderate-vigorous physical activity on at least three days. In contrast, only one adolescent met the target of 2 hours or less of sedentary behavior per day.
Analysis of physical activity energy expenditure data, collected by the Actihear system (marketed by CamNtech) and participants’ reports, revealed that adolescents engaged in a wide variety of activities, ranging from apparently sedentary behavior, such as sitting and lying, to very active behaviors, including wheelchair racing and running.
Additional assessments revealed that the participants had a median 43.5% fat mass and 55% lean mass. Approximately 73% of the participants were classified as having a potentially unhealthy body composition according to body fat, with seven adolescents (two boys and five girls) being identified as obese and one girl as overweight. However, the body mass indexes (BMI) of these participants were not high, with only one of the two obese boys and none of the five girls classified as obese by BMI.
According to skinfold assessments, participants had a mean of 40.5% body fat. Skinfold assessments were in agreement with BMI observations, “showing that skinfold assessment is a valid tool for predicting percentage body fat in adolescents with [cerebral palsy],” researchers said.
No associations were found between the patterns of physical activity and the percentage of body fat.
These findings suggested that “some young people with CP are using more energy at rest and with movement than might appear from observing their activities,” researchers stated. However, “participants displayed high percentages of body fat, possibly owing to relatively high amounts of time spent in sedentary behavior, and potentially due to dietary choices associated with high energy balances.”
“Cerebral palsy-specific strategies to decrease time in sedentary activity need to be determined,” they concluded.