https://doi.org/10.1186/s40945-017-0041-9, DOI: https://doi.org/10.1186/s40945-017-0041-9.

EG Optimal patterns of activity and sedentary behavior in children and youth with CP require evaluation.

Time-use diaries were used as a complement to the accelerometers to collect information about all the activities the child participated in during a week day and a weekend day, at what level of physical intensity they classified the activities as, and where and with whom the child was when doing the activities [52].
Developmental Medicine and Child Neurology. . Static standing is not considered sedentary behavior because a large proportion of the body's muscles are active during standing.60–62. Those not meeting the recommendations, and their families, should be supported to optimize their 24‐hour activity levels and sleep pattern. Motivational interviewing (MI) [32, 33] was used as a counselling method throughout the study period which enabled the physiotherapist to identify each child’s desire and to guide each child and their parents towards an active lifestyle. This article presents an evidence‐informed clinical practice guide with practical pointers to help practitioners in detecting 24‐hour activity problems as a critical step towards adoption of healthy lifestyle behaviours for children with CP that provide long‐term health benefits.

Despite increasing volitional functional physical activity, their total physical activity decreased at 8 months. Lauruschkus K, Nordmark E, Hallström I. Journal of Child Neurology. Further research of PAP is needed, preferably in a long term randomised controlled trial and including health economic analysis to show costs and benefits.

, Dunstan DW, Salmon J, et al. 2015;37(4):283–9. Verschuren

This process greatly increased the likelihood of identifying problems related to 24‐hour activities among children with CP, with referrals to specialized sleep clinics. Individually designed logbooks enabled children to document their frequency of participation in their self-selected physical activities and to write comments. Approximately 2-2.5/1000 children have CP with affected muscle tone, movement and motor skills, often accompanied by intellectual, communication, and behavioural impairment, as well as epilepsy and pain [2, 3]. Verschuren O, Wiart L, Ketelaar M. Stages of change in physical activity behaviour in children and adolescents with cerebral palsy. Correspondence to Effectiveness of functional progressive resistance exercise strength training on muscle strength and mobility in children with cerebral palsy: a randomized controlled trial, A randomized clinical trial of strength training in young people with cerebral palsy, Identification of facilitators and barriers to physical activity in children and adolescents with cerebral palsy, Indicators of distress in families of children with cerebral palsy. In other words, every question that has been answered negatively could be interpreted as a ‘red flag’ requiring follow‐up. 1999;48(3):167–75. .

The International Physical Activity Questionnaire (IPAQ) is commonly used, although not validated, for self-report physical activity measures for children with CP. Children with ≥ five hours of monitoring time on ≥ two days were included for analyses [51].
In the past, clinical practice guidelines have been viewed as static documents. American Journal of Prevention Medicine. , Williams MT, Olds T, Lane AE. Sedentary behavior is any waking behavior characterized by an energy expenditure of ≤1.5 METs while in a sitting or reclining posture.59, A recently published standardized definition of sedentary behavior is any waking behavior characterized by an energy expenditure of ≤1.5 METs while in a sitting or reclining posture.59 This definition of sedentary behavior includes 2 components: posture (sitting or reclining) and energy expenditure (expressed in METs). Although inquiring about sleep is widely advised in paediatric health care,9 sleep problems are still under‐reported and under‐recognized in children with CP.10 A recent qualitative study among parents of children with CP found that health care professionals rarely ask them about sleep issues during clinical encounters, and parents expressed a strong wish for sleep to receive more attention in paediatric rehabilitation settings.11 In addition, it is known that the physical inactivity and sedentary behaviour levels of children with CP are high and that these may require further attention to preserve and enhance their health and well‐being/development.1.

Maher statement and 2014;165:1011–6. McMaster University. Appropriate timeframes, weekday and accessibility of the physical activities, competent leaders, the opportunity to become friends with other children, and the costs of the activity were all important requirements when the children selected their physical activities. Neuromuscular deficits noted in CP include atypical muscle tone, impaired coordination, challenges with muscle co-contraction, balance impairments, and coordination and sensory deficits.65,66 In addition, the sequencing of multiple muscle action is impaired, and there is a high level of coactivation of agonist and antagonist muscles at a joint,65,66 leading to impaired postural control in some individuals with CP.60,61 The degree of movement severity is extremely variable among people with CP, and it is likely that there is heterogeneity in their energy expenditure and muscular activity in different postures, dependent on their degree of motor impairment and type of muscle tonus. Föreningen Idrott För Handikappade (FIFH): Association for Disability Sports. Four families chose family activities such as going swimming on the weekends or improving everyday activities such as cycling to school. , Matthews CE, Dunstan DW, et al.

(1) The checklist, which was filled out by parents at home before their visit to the health care setting, was clear and easy to answer for parents.


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