Differences in habitual physical activity levels of young people with cerebral palsy and their typically developing peers: a systematic review

Purpose: To systematically review and compare the daily habitual physical activity levels and sedentary times of young people with cerebral palsy to their typically developing peers and to physical activity guidelines. Method: After searching electronic databases, two reviewers independently applied criteria. Studies were required to include young people with cerebral palsy (up to 18 years) and to quantitatively measure habitual physical activity, defined as activity across at least one day. Data extraction was independently verified, and quality analysis completed by two reviewers. Results: Of 895 identified studies, six moderate to high quality studies were included. There were four measures of habitual physical activity. Participants were aged 5 to 18 years and typically had moderate to high gross motor function. Across all ages and levels of motor function, young people with cerebral palsy participated in 13% to 53% less habitual physical activity than their peers. Levels of activity were approximately 30% lower than guidelines. Sedentary times were twice the maximum recommended amount. Conclusions: Young people with cerebral palsy participate in significantly lower levels of habitual physical activity than their peers, and less than recommended guidelines. Long-term negative health consequences of inactivity such as metabolic dysfunction, cardiovascular disease and poor bone density are therefore more likely. Implications for Rehabilitation Young people with cerebral palsy have reduced levels of habitual physical activity compared with their typically developing peers. Levels of habitual physical activity in young people with cerebral palsy do not meet the recommended levels to maintain good health. Clinicians should encourage and facilitate opportunities to increase habitual physical activity and reduce the amount of time spent sedentary to optimize long-term health outcomes.