Ann Rehabil Med.  2020 Aug;44(4):301-310. 10.5535/arm.19156.

The Formula for Health and Well-Being in Individuals With Cerebral Palsy: Cross-Sectional Data on Physical Activity, Sleep, and Nutrition

• McPhee PG
• Verschuren O
• Peterson MD
• Tang A
• Gorter JW

• KMID: 2505390
• DOI: http://doi.org/10.5535/arm.19156

Abstract

Objective
To determine physical activity, sleep, and nutrition patterns in individuals with cerebral palsy (CP) and investigate the association of Gross Motor Function Classification System (GMFCS) and age with these health behaviors.
Methods
A cross-sectional study was conducted in an outpatient setting. Participants included adolescents and adults with CP (n=28; GMFCS level I–V; mean age 35.1±14.4 years). An Exercise Questionnaire or Leisure Time Physical Activity Questionnaire was used to measure physical activity in adolescents and adults, respectively. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). An adapted version of the PrimeScreen questionnaire was used to assess nutrition. Linear regression analyses were performed to investigate the association between GMFCS and age with physical activity, sleep, and nutrition.
Results
The average total physical activity was 29.2±30.0 min/day. Seventy-five percent of the participants had poor sleep quality (PSQI score >5). Seventy-one percent reported “fair” eating behaviors; none reported “excellent” eating behaviors. Neither GMFCS nor age were significantly associated with PSQI score, PrimeScreen score, or total physical activity. A negative correlation existed between sleep quantity (hr/night) and PSQI score (r=-0.66, p=0.01).
Conclusion
The triad of health components, consisting of physical activity, sleep, and nutrition, was not associated with GMFCS or age in our sample of 28 individuals with CP, suggesting that these three health behaviors should be assessed during clinical encounters of CP in adolescents and adults at all levels of the GMFCS.

Keyword

Cerebral palsy; Exercise; Sleep; Nutrition assessment

Figure

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  Fig. 1. Average total physical activity (PA) for each Gross Motor Function Classification System (GMFCS) level. Error bars indicate standard deviation.

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  Fig. 2. (A) Average Pittsburgh Sleep Quality Index (PSQI) score for each Gross Motor Function Classification System (GMFCS) level. (B) Average sleep hours per night for each GMFCS level. Error bars indicate standard deviation.

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  Fig. 3. Average PrimeScreen score for each Gross Motor Function Classification System (GMFCS) level. Error bars indicate standard deviation.

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  Fig. 4. (A) Pearson correlation between BMI and PrimeScreen score. (B) Pearson correlation between waist circumference and PrimeScreen score. (C) Pearson correlation between sleep quantity and PSQI score. BMI, body mass index; PSQI, Pittsburgh Sleep Quality Index.

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