The relationship between fundamental movement skills and physical activity in children with and without cerebral palsy

Abstract

Previous research has shown that fundamental movement skills (FMS) proficiency influences physical activity (PA) in children, such that those who are more proficient tend to be more active. Sufficient PA engagement in childhood has been associated with positive health outcomes, but little is known about PA levels in children with disabilities. Children with cerebral palsy (CP) represent the largest diagnostic group in pediatric rehabilitation. In one systematic review and six studies, FMS proficiency and PA levels among children with CP were measured, analyzed, and compared with typically developing children. The lack of a valid objective PA measurement method for children with CP was determined in the systematic review, and the first study (Chapter 2) validated the Actigraph accelerometer as a valid objective PA measurement instrument in this population group. FMS measurement in children with CP was addressed in the second study (Chapter 3), which showed that process-and product-oriented measurement are both important in characterizing FMS proficiency in a holistic manner. With the said measurement techniques validated, the third study (Chapter 4) utilized a cross- sectional study design to examine FMS proficiency and PA in children with and without CP. It was found that children were less active and more sedentary during weekends than weekdays. FMS proficiency was negatively associated with sedentary time and positively associated with time spent in moderate to vigorous PA in both groups of children. Process-oriented FMS measures were found to have a stronger influence on PA in children with CP than in typically developing children. With the intention to examine these relationships in a cause-effect study design, a theoretical model for FMS training programs was tested in children with and without disabilities in the fourth and fifth studies (Chapter 5). A movement training approach that minimized the amount of practice errors was found to facilitate improvements in FMS proficiency. This approach was then utilized in the sixth study (Chapter 6), wherein the relationship of FMS proficiency and PA were examined in a quasi-experimental design. It was found that by training FMS, weekend PA was heightened and weekend sedentary time was decreased among children with CP. In comparison, typically developing children manifested decreased weekend sedentary time after FMS training. The findings from these studies contribute to understanding the measurement of FMS and PA in children with CP, the implementation of FMS training in children in general, and the relationship between FMS and PA in children with and without disabilities.