V U U N I V E R S I T YA M S T E R D A M

Physical activity in children with Spina Bifidacomparison of a triaxial activity monitor, HR monitor and activity diary during every day

activities

INTRODUCTION

Spina Bifida (SB)

Restricted in their daily life 1,5 hrs. vs. 3 hrs. (Berg-Emons et al., 2001)

Secondary health conditions

Insight in physical activity (PA) Physical activity is defined as any bodily movement produced

by skeletal muscles that requires energy expenditure (WHO, 2014)

Observation Activity Monitor

Pedometer

Activity diary

Questionnaires

Doubly labeled water

Heart rate monitor

Subjective

Objective

Golden standard

PURPOSE

Validation of an activity monitor during every day activities in children with SB aged 6-19

years

HypothesesDuring daily life activities the AM correlates moderately with the Heart Rate Monitor (HRM; r>0.50 & r<0.69) and low to

moderate with the Activity Diary (AD; r>0.30 & r<0.69), in a positive direction

Construct validation The relation between the AM with other instruments,

measuring the same construct (Portney & Watkins, 2008). Also the degree to which the scores of the AM are consistent with

hypotheses (COSMIN, 2014)

METHOD

Participants 48 children with SB

Aged 6-19 years

Manual wheelchair during daily life activities, during sport and/or during long distances

Testing procedure 3 days (2 weekdays, 1 weekend day)

Measurement from waking up till bedtime

Normal daily activities in their own environment

METHOD Instruments:

1. Activity Monitor Type of activity

Lying, sitting, standing, walking, running, (bi-)cycling,

wheelchair propulsion and general movements Intensity

Body Motility expressed as gravitational force

2. Activity Diary Type of activity: Total minutes per type of

activity

3. Heart Rate Monitor Intensity: Beats per minute

METHOD Statistical analysis (SPSS 22.0)

Intensity: Activity Monitor ↔ Heart Rate Monitor 21 complete data sets Correlation coefficients (Spearman’s rank order)

Type of activity: Activity Monitor ↔ Activity Diary 27 complete data sets Paired t-test & degree of agreement

RESULTS Feasibil ity

RESULTS IntensityN = 21Mean r= 0.501 (p<.01)

RESULTS Intensity

5 sensorsr= 0.584 (p<.01)

3 sensors r= 0.468 (p<.01)

DISCUSSION Intensity Previous research R ranged from 0.52

– 0.71 (Sallis et al. ,1990; Welk and Corbin, 1995; Coleman et al., 1997)

Labsetting

Environmental factors

HR tends to lag behind changes in physical movement

Difference between 3 sensors and 5 sensors

3 sensors HR of 102.8 bpm and of 5 sensors HR of 105.3 bpm

HR more variable and less reliable in lower intensities

DISCUSSION Type of activity

Consistent with previous studies (Coleman et al., 1997; Wickel et al., 2006; Martínez-Gómez et al., 2009)

Low agreement due to: Over-reporting in children 15 minutes of reporting in AD AM more sensitive Different body shapes and postures in

children with SB

DISCUSSION

Almost 50% of the participants had incomplete data

Cannot be worn during water activities or intensive sports (eg. boxing)

Some incorrect placed monitors

Difference between sedentary sitting and active sitting?

CONCLUSION

AM related to HRM and ADNot interchangeable

Some considerations with regard to the practical use in children with SB

More research needed to validate AM during daily life activities in children with

SB

Stelling:

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