Development of an Electronic Version of The Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (CSAPPA) Scale.

PURPOSE: To develop an electronic version of the Children's Self-Perceptions of Adequacy in and Predilection for Physical Activity (eCSAPPA), which would allow individual administration to children younger than nine years of age. METHODS: Fifty-four, four-nine-year-old children completed the eCSAPPA and the Test of Gross Motor Development-2 (TGMD-2). Parental measures of physical activity, and body mass index were obtained. Twenty-one participants additionally completed the paper version of the CSAPPA. RESULTS: All children successfully completed the eCSAPPA with interclass correlation coefficients of .76 for Adequacy and .86 for Total Score. Correlations and linear predictive equations for eCSAPPA revealed the TGMD-2's Locomotor subtest, age, and parent's activity rating explained 28-30% of the variability in Total and Adequacy eCSAPPA scores. Predilection and Enjoyment of Physical Education (PE) scores were less stable, with the TGMD-2's Locomotor subtest and age predicting 17% of the Predilection score and the TGMD-2's Object Control subtest demonstrating 17% of Enjoyment of PE. CONCLUSION: Children ages four-nine years can feasibly complete the electronic version of the CSAPPA and results hint that self-efficacy may be more plastic in younger children. The eCSAPPA is a promising instrument allowing the exploration of young children's development of adequacy and predilection toward physical activity as well as enjoyment of PE.

Lying obliquely--a clinical sign of cognitive impairment: cross sectional observational study.

OBJECTIVE: To determine if failure to spontaneously orient the body along the longitudinal axis of a hospital bed when asked to lie down is associated with cognitive impairment in older patients. DESIGN: Cross sectional observational study. SETTING: Neurology department of a university hospital in Germany. PARTICIPANTS: Convenience sample of 110 older (>or=60 years) inpatients with neurological conditions and 23 staff neurologists. MAIN OUTCOME MEASURES: The main outcome measure was the association between the angle of the body axis and the results of three cognitive screening tests (mini-mental state examination, DemTect, and clock drawing test). Staff doctors were shown photographs of a model taken at a natural viewing able to determine their subjective perspective of what constitutes oblique. RESULTS: 110 neurological inpatients (mean age 70.9 (SD 6.8) years) were included after exclusions. Evidence of cognitive impairment was found in 34, with scores indicating dementia in eight, according to the mini-mental state examination, and in 11 according to the DemTect. Across all patients, the mean angular deviation of the body axis from the longitudinal axis of the bed (range 0-23 degrees ) correlated linearly with the mini-mental state examination (r=-0.480), DemTect (r=-0.527), and the clock drawing test (r=-0.552) scores (P<0.001 for all), even after removing age as a covariate. Overall, 90% of staff neurologists considered a minimal body angle of 7 degrees to be oblique. Angular deviation of at least 7 degrees predicted cognitive impairment according to the three different tests, with specificities between 89% and 96% and sensitivities between 27% and 50%. CONCLUSION: Clinicians might suspect cognitive impairment in mobile older inpatients with neurological disorders who spontaneously position themselves obliquely when asked to lie on a bed.