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Developing a Clinical Protocol for Habitual Physical Activity Monitoring in Youth With Cerebral Palsy

Nicholson, Kristen PhD; Weaver, Aaron DO; George, Ameeka BS; Hulbert, Robert MS; Church, Chris MPT; Lennon, Nancy MS, PT

doi: 10.1097/PEP.0000000000000320
Research Reports

Purpose: The StepWatch (SW) has been used to monitor physical activity (PA) in youth with cerebral palsy; however, there is no standard collection protocol. The goal was to develop such a protocol.

Methods: Data were examined from patients who wore the SW for 8 to 14 days. The Spearman-Brown prediction formula determined the minimum number of days for reliable PA. Weekdays were compared to weekends and 10- and 60-second collection intervals were examined.

Results: The PA data were collected from 98 youth with cerebral palsy. Results showed 3 days would provide reliable representation of PA, participants took significantly more steps during school days compared with weekends, and there were no differences between collection intervals.

Conclusions: We recommend setting the SW for 7 days at 10-second collection rate. Data should be analyzed if at least 3 days of data are present. Weekdays and weekend days should be noted, and both included when possible.

The goal of this study was to develop a standard collection protocol for monitoring physical activity in youth with cerebral palsy.

Nemours/Alfred I duPont Hospital for Children, Wilmington, Delaware.

Correspondence: Kristen Nicholson, PhD, Nemours Alfred I duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE 19803 (

At the time this article was written Aaron Weaver was a student at the Philadelphia College of Osteopathic Medicine.

The authors declare no conflicts of interest. This study received no outside funding.

Copyright © 2017 Wolters Kluwer Health, Inc. and Section on Pediatrics of the American Physical Therapy Association. All rights reserved.