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Department of Rehabilitation Medicine

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Walking activity of children with cerebral palsy and children developing typically: a comparison between the Netherlands and the United States


Van Weyl L. Dallmeijer A, .Balemans, ACJ, Zhou C, Becher, JG, Bjornson, KF



Publication Info:

Disability and Rehabilitation, 36(25):2136-2142


PURPOSE: To compare walking activity of children with and without cerebral palsy (CP) between the Netherlands and the United States.
METHODS: A cross-sectional analysis on walking activity data from an international retrospective comparison study including a convenience sample of 134 walking children aged 7–12 years with spastic CP, classified as Gross Motor Function Classification System (GMFCS) level I (N?=?64), II (N?=?49) or III (N?=?21), and 223 typically developing children (TDC) from the Netherlands and the United States. Walking activity was assessed during a one-week period using a StepWatch™ activity monitor. Outcomes were the daily number of strides, daily time being inactive and spent at low (0–15 strides/min), moderate (16–30 strides/min) and high stride rate (31–60 strides/min). Walking activity was compared between countries using multiple linear regression analyses.
RESULTS: Walking activity of TDC was not significantly different between countries. Compared to their American counterparts, Dutch children in GMFCS level I and II showed less walking activity (p? CONCLUSION: The absence of differences in walking activity between Dutch and American TDC, and the presence of differences in walking activity between Dutch and American children with CP suggest that between-country differences affect walking activity differently in children with CP.
IMPLICATIONS FOR REHABILITATION: -Physical activity of children with CP should be promoted in both the United States and the Netherlands. -The between-country differences in walking activity illustrate that apart from the severity of the CP walking activity seems to be influenced by environmental aspects. -In the promotion of physical activity, practitioners should pay attention to environmental barriers that families may experience for increasing physical activity.

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