Research Report
Population: Pediatric
Cheryl I. Kerfeld, PT, PhD, Acting Assistant Professor, University of Washington ckerfe@uw.edu
Philip Hurvitz, PhD, Research Assistant Professor, University of Washington phurvitz@uw.edu
Kristie Bjornson, PT, PhD, Associate Professor, Seattle Children’s Research Institute, University of Washington kristie.bjornson@seattlechildrens.org
Keywords: Participation, Physical Activity, Environment, measurement
Purpose/Hypothesis
Children who are wheelchair (WC) users demonstrate significant limitations in habitual physical activity (PA) and community participation. PA and participation has been sampled primarily through questionnaires. The purpose of this case series research is to describe a novel combination of accelerometry, GPS, and travel diary to objectively quantify and compare amount and location of PA and participation of children who are WC users.
Subjects
Four children (6 – 12 years-old, 2 girls), who are WC users, participated: 1) Ambulatory, Gross Motor Classification System (GMFCS) III, manual WC user for sport activities (SWC), 2) Non-ambulatory, GMFCS IV, manual WC user (MWC), 3) Non-ambulatory, GMFCS IV, power WC user (PWC), and 4) Non-ambulatory, GMFCS V, dependent in WC (DWC), pushed by caregiver.
Material/Methods
Participants wore an Actigraph on their dominant wrist and GPS on their ankle all waking hours for 7 days. Actigraph recorded total duration of PA, sedentary (SPA), light (LPA), and moderate to vigorous (MVPA), (< 100, 100-2000, >2000 counts/min, respectively). Synchronized Actigraph and GPS data quantified duration and intensity of PA by location. Parent-reported travel diary described types and locations of activity participation. Daily maps of travel with GPS points, by PA intensity, highlight locations of PA relative to home.
Results
For SWC, MWC, PWC, and DWC, respectively, daily minutes of SPA at home averaged 4.0, 156.7, 72.6, 110.8 and in the community 30.5, 70.7, 68.4, 77.9. Daily minutes of LPA at home averaged 38.8, 170.5, 268.3, 244.8 and in the community 387.8, 211.9, 273.3, 147.9. Daily minutes of MVPA at home averaged 39.5, 35.1, 17.9, 22.9 and in the community 247.5, 84.8, 5.0, 6.7. Daily maps of travel with GPS points and PA levels in combination with parent-reported travel diaries show that children who are SWC and MWC have greater number of MVPA episodes in a more variety of settings (home, school, and community) whereas PWC and DWC have less MVPA episodes that take place primarily at or close to home. For example, during one day, SWC had 4 episodes of MVPA at home, school, physical therapy clinic, and the city fairgrounds, MWC 3 episodes of MVPA at home, school, and the sports center, PWC 2 episodes of MVPA at home and hippotherapy clinic, and DWC 1 episode of MVPA at home.
Conclusion
Synchronized Actigraph and GPS data has potential to provide rich objective data to quantify habitual physical activity and participation within daily life. This methodology appears sensitive to differentiating PA levels and location of PA for different WC users. Further work is warranted to validate this novel measurement methodology.
Clinical Relevance
Mapping of combined Actigraph, GPS, and travel diary data allows for analysis of environmental factors that may influence PA and participation. Specific knowledge of this information should be helpful in developing successful interventions to enhance PA and participation in children who use WC.
Citation:
Kerfeld, Cheryl I., PT, PhD; Hurvitz, Philip M., PhD; Bjornson, Kristie , PT, PhD. Measurement of Physical Activity and Participation of Children who are Wheelchair Users: Actigraph and Global Positioning System (GPS).. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/023_kerfeld-et-al/