Accelerometer Measured Levels of Moderate-to-Vigorous Intensity Physical Activity and Sedentary Time in Children and Adolescents with Chronic Disease: a Systematic Review and Meta-Analysis

Rabha Elmesmari, John J Reilly, Anne Martin, James Y Paton

Research output: Contribution to journalArticlepeer-review

Abstract

Context: Moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) are important for child and adolescent health.
Objective: To examine habitual levels of accelerometer measured MVPA and ST in children and adolescents with chronic disease, and how these levels compare to those of healthy peers.
Methods:
Data sources: An extensive search was carried out in Medline, Cochrane library, EMBASE, SPORTDiscus and CINAHL from 2000-2017.
Study selection: Studies with accelerometer-measured MVPA and/or ST (at least 3 days and 6 hours/day to provide estimates of habitual levels) in children 0-19 years of age with chronic diseases but without comorbidities that would present major physical impediments to physical activity. In all cases patients were studied while well and clinically stable.
Results: Out of 1592 records, 25 studies were eligible, in four chronic disease categories: cardiovascular disease (7 studies), respiratory disease (7 studies), diabetes (7 studies), and malignancy (3 studies). Patient MVPA was generally below the recommended 60 min/day and ST generally high regardless of the disease condition. Comparison with healthy controls suggested no marked differences in MVPA between controls and patients with cardiovascular disease (1 study, n=42) and type 1 diabetes (5 studies, n= 400; SMD -0.70, 95% CI -1.89 to 0.48, p=0.25). In patients with respiratory disease, MVPA was lower in patients than controls (4 studies, n=470; SMD -0.39, 95% CI -0.80, 0.02, p=0.06). Meta-analysis indicated significantly lower MVPA in patients with malignancies than in the controls (2 studies, n=90; SMD -2.2, 95% CI -4.08 to -0.26, p=0.03). Time spent sedentary was significantly higher in patients in 4/10 studies compared with healthy control groups, significantly lower in 1 study, while 5 studies showed no significant group difference.
Conclusions: MVPA in children/adolescents with chronic disease appear to be well below recommendations, although comparable with activity levels of their healthy peers except for children with malignancies. Tailored and disease appropriate intervention strategies may be needed to increase MVPA and reduce ST in children and adolescents with chronic diseases.
Original languageEnglish
JournalPLoS ONE
DOIs
Publication statusPublished - 22 Jun 2017

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