Content » Vol 46, Issue 1

Original report

Daily stride rate activity and heart rate response in children with cerebral palsy

Astrid C.J. Balemans, Leontien van Wely, Anouk Middelweerd, Josien J.C. van den Noort , Jules G. Becher, Annet J. Dallmeijer
Department of Rehabilitation Medicine, MOVE Research Institute Amsterdam, EMGO Institute for Health and Care Research, Amsterdam, VU University Medical Center, Amsterdam, 1007 MB Amsterdam, The Netherlands. E-mail:
DOI: 10.2340/16501977-1237


Objective: To compare daily stride rate activity, daily exercise intensity, and heart rate intensity of stride rate in children with cerebral palsy with that of typically developing children.
Methods: Forty-three children with cerebral palsy, walking without (Gross Motor Function Classification System (GMFCS) I and II) or with (GMFCS III) an aid and 27 typically developing children (age range 7–14 years) wore a StepWatchTM activity monitor and a heart rate monitor. Time spent and mean heart rate reserve at each stride rate activity level and time spent in each mean heart rate reserve zone was compared.
Results: Daily stride rate activity was lower in children with cerebral palsy (39%, 49% and 79% in GMFCS I, II and III, respectively) compared with typically developing children (p < 0.05), while there were no differences in time spent at different mean heart rate reserve zones. Mean heart rate reserve at all stride rate activity levels was not different between typically developing children, GMFCS I and II, while mean heart rate reserve was higher for GFMCS III at stride rates < 30 strides/min (p < 0.05).
Conclusion: Stride rate activity levels reflect the effort of walking, in children with cerebral palsy who are walking without aids, similar to that of typically developing, whereas children with cerebral palsy using walking aids show higher effort of walking. Despite a lower stride rate activity in cerebral palsy, daily exercise intensity seems comparable, indicating that the StepWatchTM monitor and the heart rate monitor measure different aspects of physical activity.

Lay Abstract


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