title: Sedentary and Active Time in Toddlers with and without Cerebral Palsy.
abstract: OBJECTIVE
  To evaluate differences in sedentary time and compare levels of physical activity and sedentary behavior to the Australian physical activity recommendations between toddlers with cerebral palsy (CP) according to functional capacity (Gross Motor Function Classification System [GMFCS]) and age-matched children with typical development (CTD).
  
  
  METHODS
  Children (2.4 ± 0.5 yr old) were split into CTD (n = 20), GMFCS I-II (n = 32), GMFCS III (n = 14), and GMFCS IV-V (n = 12) groups and wore a triaxial ActiGraph® for 3 d. Validated cut points were applied to identify sedentary and active time and the number and duration of sedentary bouts and breaks for each group. Analysis of variance (ANOVA) with post hoc testing, chi-square analysis, and the Fisher exact test were used to compare groups.
  
  
  RESULTS
  No difference between the CTD group (49%) and GMFCS I-II group (52%) was found for sedentary time as a percentage of wear time. The GMFCS III group was more sedentary than both these groups (62%, P < 0.05). The GMFCS IV-V group was more sedentary than all the other groups (74%, P < 0.05). The CTD group and GMFCS I-II group was more likely to spend 180 min or longer in active play on all 3 d than the GMFCS IV-V group (P < 0.05). The GMFCS IV-V group was more likely to have sedentary bouts ≥60 min or longer than all other groups (P < 0.05).
  
  
  CONCLUSIONS
  Differences in sedentary behavior between the CTD and mildly impaired children with CP (GMFCS I-II) are not evident in the toddler years. Children with moderate-to-severe functional impairment are progressively more sedentary and less likely to meet physical activity guidelines. Further research into the health implications of high levels of sedentary behavior in toddlers is required.
authors.affiliation: 1Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine,The University of Queensland, Brisbane, AUSTRALIA; 2Children's Nutrition Research Centre, Queensland Children's Medical Research Institute,The University of Queensland, Brisbane, AUSTRALIA; 3Queensland Children's Medical Research Institute,The University of Queensland, Brisbane, AUSTRALIA; and 4School of Population Health, The University of Queensland, Brisbane, AUSTRALIA.
authors.forename: Stina
authors.initials: S
authors.lastname: Oftedal
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Bell
authors.forename: Peter S W
authors.initials: PS
authors.lastname: Davies
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
mesh_terms: D061725:Accelerometry; D001315:Australia; D002547:Cerebral Palsy / Q000503:physiopathology*; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D057185:Sedentary Behavior; D013997:Time Factors