Walking. A relatively simple act. But do we walk enough? Mitchell, 2014, suggests we need to consider not only time spent engaging in physical activity which reduces sedentary behavior, but also intensity of physical activity in order to meet physical activity guidelines. In a recent study of ambulatory children with cerebral palsy, age 4-5, children were significantly more sedentary and spent nearly half of their waking time being sedentary, with more activity noted on school days. It is clear we need to encourage walking as a physical activity (Keawutan, 2017).
In a previous blog, I discussed Fitbits, Steps and Expectations. Since then, I have continued to advocate for walking programs. I find that in the context of PE, they can be fun, engaging and a great source of pride when goals are set. One of my PE teachers has the kids walking weekly, for laps, and provides incentives for "miles" walked...and the kids reach them!!!
In my search for ways to share information, I have been experimenting with infographics that can be used by therapists to educate school staff and families on how many steps we should take. I do think it is important that we educate each other first...this infographic summarizes some key information from one research article. In this article, Adams, et al looked at physical activity guidelines, hours of physical activity per day and related them to how many steps per day a child needs to take to meet the 2005–2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data, and additionally they wanted to evaluate the 12,000 steps/day recommendation recently adopted by the President’s Challenge Physical Activity and Fitness Awards Program. Participants in the study were from a normative population, 915 children age 6-11, and 1302 adolescents age 12-17.
The good news is that children and youth who exercise for 60 minutes per day take about 9000 steps. So if you are using a pedometer/accelerometer, the target should be 9000 steps to meet the physical activity recommendations. This infographic can be used to educate schools and families on physical activity recommendations for youth.
One of the weaknesses of pedometer use is it does not take into account the intensity of activity: there is a big difference between walking and running in terms of cardiopulmonary health. Hopefully cheap accelerometers will be available in the future so we can use them in schools.
One of the simplest things that we, as physical therapists can do to promote the health and well being of all youth is to promote meeting these physical activity guidelines, encourage walking programs for students and staff in our schools, and that students engage in vigorous physical activity during recess. These efforts can go a long way to support physical activity of our students.
Adams, M. A., Johnson, W. D., & Tudor-Locke, C. (2013). Steps/day translation of the moderate-to-vigorous physical activity guideline for children and adolescents. The International Journal of Behavioral Nutrition and Physical Activity, 10, 49. http://doi.org/10.1186/1479-5868-10-49
Keawutan, P., Bell, K.L., Oftedal, S, Davies, P., Ware, R. (2017). Habitual Physical Activity in Children with Cerebral Palsy Aged 4 to 5 years Across All Functional Abilities. Pediatric Physical Therapy, 29(1), pp 8-14.
Mitchell, L., Ziviani, J. and Boyd, R. (2014). Habitual Physical Activity of Independently Ambulant Children and Adolescents With Cerebral Palsy: Are They Doing Enough?. Physical Therapy, 95(2), pp.202-211.