Aspects of Physical Activity and Quality of Life in Adults with Cerebral Palsy.

Background: Physical activity and sedentary behavior may differentially impact health-related quality of life in adults with cerebral palsy. Objective: The present investigation assessed the independent relationships between aspects of physical activity and sedentary behavior related to health related quality of life in adults with cerebral palsy. Methods: Through a cross-sectional online survey of 118 adults with cerebral palsy, participants self-reported the extent of their functional impairments using the Gross Motor Function Classification System, Manual Ability Classification System, and Communication Function Classification System; while mental and physical health-related quality of life were assessed using the RAND-36. Physical activity and sedentary behavior were quantified using the Physical Activity and Disability Survey-Revised and Sedentary Behavior Questionnaire, respectively. Results: Accounting for potential confounding influences of impairments, neither exercise-related physical activity, leisure time- related physical activity, occupational physical activity, nor sedentary behavior was associated with any characterization of health-related quality of life. However, greater engagement in general lifestyle physical activity was related to superior mental health-related quality of life. Conclusion: These findings provide initial evidence to suggest that focusing public health and therapeutic recommendations for individuals with cerebral palsy on general physical activity engagement throughout the day might incur potential benefits for enhancing mental health- related quality of life in this population.

A-ONE - An Accessible Online Nutrition & Exercise Program For Youth with Physical Disabilities.

BACKGROUND: Pediatric disability prevalence has increased to 17.8% in recent years. This youth population faces a range of individual, social, and environmental level barriers to a healthy lifestyle. This is particularly concerning because this population is at a higher risk of obesity and lifestyle-related morbidity and mortality. Therefore, A-ONE: An Accessible and Online Nutrition & Exercise Program was designed to provide a comprehensive and holistic online program for youth with physical disabilities. METHODS: A-ONE will offer two individualized fitness workouts and one accessible cooking session per week for 16-weeks. In addition, A-ONE will offer one social-mentoring session per week. All programming (4 sessions per week) will occur during after-school hours. The program will be offered 6 times during the 2-year grant period, enrolling 10 youth per cohort, for a total of 60 youth with physical disabilities. Outcomes to be examined include physical activity, fruit and vegetable consumption, independent meal preparation, quality of life, and self-efficacy. They will be assessed pre, post, and 4-weeks following the end of the program. Program fidelity and feasibility will also be assessed. CONCLUSION: While children with physical disabilities benefit from opportunities to engage in physical activity and nutrition, accessible programming is unavailable. Despite decades of disability rights legislation mandating access to equal education, there is still a lack of system level solutions to improve the health inequity for youth experiencing disabilities. This program represents a sustainable and scalable way to remove barriers and improve the trajectories of health among youth with a physical disability.

Promoting Adapted Physical Activity Regardless of Language Ability in Young Children With Autism Spectrum Disorder.

Purpose: There is a relationship between motor and language skills in children with Autism Spectrum Disorder (ASD), but little work addresses the ramifications of this relationship for professionals who teach motor skills to this population. Within a motor skills intervention, this study probed the importance of language skills for motor intervention. We examined the relationship between motor and language skills at baseline, and then the relationship between baseline language skills and motor improvements resulting from the intervention. Method: Twenty children aged 4-6 years with ASD participated. Eleven children received 20 hr per week of motor intervention for 8 weeks. Nine children did not receive motor intervention. Language skills (Mullen Scales of Early Learning) and motor skills (Test of Gross Motor Development - 2) were assessed at baseline and post-intervention. Spearman correlations tested the associations between baseline language and baseline motor skills. This analysis was repeated in the intervention sample to test the association between baseline language level and response to intervention (motor skill changes from baseline to post-intervention). Results: Prior to intervention, locomotor skills are positively correlated (p < .001) with both receptive (rs = 0.827) and expressive (rs = 0.722) language skills. Similarly, object-control skills are positively correlated (rs < .001) with receptive (rs = 0.779) and expressive (rs = 0.729) language skills. However, those baseline language skills do not relate to motor change in the experimental group. Conclusion: These results suggest that motor programs may improve motor skills in children with ASD when language is supported, regardless of pre-program language ability.

Wakeful Prone "Tummy Time" During Infancy: How Can We Help Parents?

AIMS: This study's purpose is to present facilitators and barriers for wakeful prone positioning or "tummy time" during infancy by exploring the personal perspectives of infant caregivers attempting to provide daily tummy time. METHODS: The study was qualitative in design, using thematic analysis to identify major and minor themes from semi-structured interviews. The Capability, Opportunity, Motivation - Behavior Model provided a conceptual framework for the interview guide and categorization of major themes. RESULTS: Within capability, opportunity, and motivation, the major themes of self-efficacy, scheduling, variations, siblings, committed adult help, social responses of acquaintances, and caregiver enjoyment could be barriers or facilitators, depending on the context. Optimized physical circumstances, caregiver interest, perceived benefits to the infant, pride and accomplishment, and obligation were identified as facilitators only. Barriers included negative infant affect. CONCLUSIONS: These results offer preliminary guidance in a knowledge gap: tummy time support that addresses the self-identified concerns of infant caregivers.

Early Movement Matters: Interplay of Physical Activity and Motor Skill Development in Infants With Down Syndrome.

This longitudinal study investigated monthly motor development and physical activity (PA) of infants with and without Down syndrome. Gross and fine motor skills (Bayley Scales of Infant Development-III) and PA (accelerometer) were assessed in 35 infants at eight time points during infancy. A multivariate mixed model identified time points when motor scores diverged between the groups. In infants with Down syndrome, bivariate correlations between monthly PA and motor changes were calculated, and multivariate analysis of variance probed the influence of early PA on motor-skill timing. Results indicate that differences in gross and fine motor skills first emerge at 2 and 4 months, respectively. In infants with Down syndrome, gross motor and PA changes between 4 and 6 months were positively correlated. Infants more active than the mean at 2 or 3 months achieved several prone and sitting skills earlier. These results highlight the adaptability of early infancy and the importance of early intervention.

Sleep duration associates with moderate-to-vigorous intensity physical activity and body fat in 1- to 3-year-old children.

Sleep during early childhood is important for many developmental outcomes and shows promise as an important correlate of both obesity risk and physical activity behaviors. This was a cross-sectional study concerning the relationships between sleep and moderate- to - vigorous intensity physical activity and body fat percentage in a sample of 1- to 3-year-old children (N = 50; ages 27.512 ± 10.363 months). Sleep was measured with a caregiver questionnaire. Sedentary time, light, moderate, vigorous, and moderate- to - vigorous intensity physical activity were measured with Actigraph wT3x-BT accelerometers. Body fat was measured using Air Displacement Plethysmography with the BodPod Pediatric Option. Moderate- to - vigorous intensity physical activity and body fat percentage both associated with sleep duration, controlling for age and accelerometer wear time. These factors combined explained 54.3 % of the variance in sleep duration present in the sample. These results suggest the presence of relationships between sleep and physical activity and body composition constructs in this sample. Sleep may be an important variable in efforts to both promote early childhood physical activity and healthy body composition.

Time Spent in Sedentary Activity Is Related to Gross Motor Ability During the Second Year of Life.

Sedentary activity occupies a substantial amount of time during early childhood, with these habits influenced by changing trends in screen time for very young children. Among school-aged children, motor ability is inversely related to sedentary activity. However, the concept of sedentary activity is rarely investigated in toddlers, and thus little is known concerning its relationship with motor development during this rapidly changing and early period of life. Among two groups of toddlers, aged 18 months (N = 26) and aged 24 months (N = 16), this study investigated cross-sectional correlations of motor development (Bayley Scales of Infant Development-III) with daily sedentary activity (accelerometers). In both groups, gross motor ability, but not fine motor ability, was inversely correlated with time spent in sedentary activity. At 18 months, gross motor raw scores inversely correlated significantly with time in sedentary activity (r = -.533, p < .001) but fine motor raw scores did not (r = .182, p = .441). Also, at 24 months, gross motor raw scores inversely correlated with time in sedentary activity (r = -.563, p = .029), while fine motor raw scores did not (r = -.112, p = .425). These findings add important missing knowledge to the empirical literature regarding sedentary activity in toddlers and its relationship to emerging motor development. Future work might investigate best practices for measuring sedentary activity in this age-group and mechanisms behind its relationship with gross motor skills.

A comparison of low-intensity physical activity, growth, and sleep behavior in 6-month old infants.

This study examined low-intensity physical activity (PA), sleep behavior (24-hour accelerometry), and growth in 22 6-month old infants. Relationships were assessed using bivariate correlations. Infants accumulating less 'total' sleep spent more time in low-intensity PA (r = -.524, p = .012). Those with less 'nighttime' sleep had greater nap frequency (r = -.460, p = .031), nap duration (r = -.529, p = .011) and weight-for-length z-scores (r = -.481, p = .024), but still accumulated less total sleep (r = .608, p = .003). These preliminary data highlight the importance of promoting healthy nighttime sleep behavior during infancy.

Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework.

Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.

Methodology to Promote Physical Activity Monitoring Adherence in Youth with Autism Spectrum Disorder.

BACKGROUND: Objective physical activity (PA) monitoring via accelerometry is both costly and time consuming. Furthermore, overall adherence to a monitoring protocol is often complicated by disability. Therefore, it is essential that strategies for supporting accelerometer wear for youth with disabilities are maximized. The purpose of this perspective was to provide researchers a set of efficacious PA monitoring strategies based on the retrospective examination of support methodology on adherence rates for youth with autism spectrum disorder (ASD). METHOD: Accelerometer data were collected from 163 participants with ASD in three independent cohorts. Each cohort was provided a varying set of support strategies to help maximize adherence. Chi-square analysis was used to determine differences in adherence between each cohort. RESULTS: Adherence rates significantly increased from 51.9% in cohort 1 to 88.7% in cohort 2 [χ2(1) = 18.333, p < 0.001] and again from 88.7% in cohort 2 to 97.4% in cohort 3 [χ2(1) = 2.663, p = 0.103]. The greatest increase in adherence was observed from 51.9% in cohort 1 to 97.4% in cohort 3 [χ2(1) = 19.837, p < 0.001]. Support strategies associated with these increases included (1) social story, (2) incentive, (3) concealing techniques, and (4) 24 h/day wear instructions. CONCLUSION: Adherence to PA measurement increased when additional support strategies were utilized in combination with a traditional protocol. We recommend these support methodology to be considered as preliminary best practices when measuring objective PA in youth with ASD with likely success in other disability populations.

Acute Effects of a Therapeutic Mobility Device on Physical Activity and Heart Rate in Children With Down Syndrome.

PURPOSE: The purpose of this feasibility study was to provide an opportunity to increase physical activity (PA) and heart rate (HR) for children with Down syndrome (DS) during unstructured group exercise utilizing a riding device called the Power Pumper®. METHOD: Twenty-four children aged 5 to 7 years old participated in this case-control study, including 12 children with DS and 12 children without DS. Those without DS participated as age-matched controls. A 30-min unstructured PA session utilizing the Power Pumper was provided to both groups on 2 occasions. HR and PA were measured at baseline and during both sessions. RESULTS: For children with DS, findings revealed a statistically significant increase in time spent in moderate-to-vigorous PA (MVPA), F(1, 15) = 16.503, p < .010, ES = 0.76, and a nonsignificant increase in HR (ES = 0.41) when comparing exercise session performance to baseline. For children without DS, findings revealed statistically significant increases in time spent in MVPA, F(1, 15) = 73.604, p < .010, ES = 0.94, and HR, F(1, 22) = 34.634, p < .010, ES = 0.69, between exercise and baseline. Total MVPA approached the recommended 60 min following device use. PA and HR differences between baseline and exercise were greater in magnitude for children without DS. CONCLUSION: By participating in unstructured exercise in a social environment using the Power Pumper, children with DS engaged in higher-intensity PA accompanied by a nonsignificant physiological response in HR. These outcomes support PA guidelines recommended by the National Association for Sport and Physical Education. This device supports 1 option for achieving 60 min of MVPA daily.