The perspectives of parents of youth with disabilities toward physical activity: A systematic review

"We're a lot closer, we talk more": family experiences and relationships following child's participation in an adapted physical activity camp

PURPOSE

Children and adolescents with developmental challenges may rely on their parents for assistance with everyday tasks to a greater extent than typically developing children. The objective of this study was to examine family members' perspectives regarding family relationships related to participation in an adapted summer camp for children and adolescents living with a disability.

MATERIALS AND METHODS

A collective case study was conducted with eleven families who had a child living with a disability who participated in an adapted physical activity (PA) summer camp. A focus group was conducted with each family and thematically analyzed.

RESULTS

Families experienced changes in perspectives and pride surrounding adapted PA, more family conversations about disability, less parental worry, more independence of the child living with a disability, and enhanced family bonds through PA. The children who participated in the camp saw impacts on their self-confidence and independence. COVID-19-related program suspension was associated with frustration, worry, and strained family relationships.

CONCLUSIONS

These findings elucidate how participation in adapted PA for children and youth with disabilities can impact family relationships. Future interventions allow for space for family interactions and create opportunity for children and adolescents with disabilities to be independent.

Physical activity of children with visual impairments: intentions and behaviors of parents post intervention

PURPOSE

Physical activity (PA) can provide multiple benefits for children with visual impairments (VI). To date, little research has explored the retention effects of PA interventions for children with VI. Thus, the purpose of this study was to explore the PA experiences of parents of children with VI three months after completing a PA intervention.

METHOD

This descriptive-qualitative study was situated in the Theory of Planned Behavior. Five parents completed semi-structured interviews that were transcribed and analyzed using a thematic line-by-line analysis.

RESULTS

Four themes characterizing how parents created PA opportunities for their children with VI were constructed: (a) Teaching from Awareness (b) Advocating for Needs, (c) Engaging Family through Community, and (d) Seeking More PA Opportunities.

CONCLUSION

Parent's awareness of their child's abilities, parents' advocacy, and parents' teaching skills all helped to expose their children to new types of PA in the community. Parents reflected about a lack of consistently offered community-based PA for their children. Researchers must consider the importance of educating parents on how to teach skills, increase awareness, and advocate for more community-based PA programs.

Parental physical activity support for parents of children with disabilities in Saudi Arabia

Physical activity (PA) is crucial for promoting physical, cognitive, and psychosocial health. Unfortunately, children with disabilities spend less time engaging in PA compared to their typically developing peers. Parents play a crucial role in supporting children with disabilities to increase their level of PA. However, there is scant research on the factors linked to parental support for PA among non-Western parents of children with disabilities, particularly in the context of Saudi Arabia. Therefore, to address this gap in the literature, the current study aimed to (i) measure parental support for encouraging PA in children with disabilities in Saudi Arabia, and (ii) examine the demographic factors associated with such support (e.g., family income, age of the child, type of disability, and parents' educational background). The sample included Saudi Arabian parents of children with disabilities (N = 239; fathers: n = 123; mothers: n = 116) who completed the Arabic version of the Parental Physical Activity Support Questionnaire for Parents of Children with Disabilities (PPSQ for PCD). The findings revealed that parental support for children with disabilities to engage in PA typically occurs less than once a week, indicating an inadequate level of support. A generalized linear model analysis demonstrated that several independent demographic variables are associated with overall parental support for PA among children with disabilities: participant age, educational background, parental engagement in PA, age of the child with a disability, disability status, club participation, knowledge of legislation or policies related to the rights of children with disabilities, and number of children in the family. The findings emphasize the significance of raising awareness among parents of children with disabilities to support their children in participating in PA, as well as addressing the barriers that hinder such support.

Run, walk, cheer or volunteer: a patient and public involvement survey

Background

Children with chronic diseases have been reported to participate in less regular physical activity (PA) than peers without chronic diseases; and less than recommended in guidelines. Sheffield Children's Foundation Trust (SCFT) is an Active Hospitals pilot site, exploring options to facilitate PA for all children. One option is collaboration with Junior Parkrun: a free, weekly 2 km running event for children. The team investigated whether Junior Parkrun was of interest to guardians of children attending SCFT to increase PA.

Aims

This patient and public involvement survey assessed perceptions of PA for children attending SCFT according to their accompanying guardians. This will inform a possible collaboration between SCFT and Junior Parkrun.

Methods

A three-part, 14-question survey was developed, including demographics (age, ethnicity, postcode); perceptions of PA (barriers and facilitators); PA behaviours self-reported on Likert scales; and perceptions of Junior Parkrun. Guardians were asked whether they and their child would be interested in attending Junior Parkrun with SCFT staff support. This was distributed to guardians of children attending outpatient appointments.

Results

126 guardians responded. The average age of child was 10 years 10 months. 29.1% of guardians supported daily PA for their child. Almost half of respondents reported their child would be interested in attending Junior Parkrun. Of those not interested, the most common reason was travel.

Conclusion

The findings highlighted PA barriers perceived by guardians, and identified that almost half of respondents would be interested in attending Junior Parkrun. A collaboration between Junior Parkrun and SCFT could be explored.

Facilitators and barriers to participation in physical activities in children and adolescents living with cerebral palsy: a scoping review

PURPOSE

This scoping review aimed to synthetize personal and environmental facilitators and barriers to participation in physical activities among youths living with cerebral palsy.

METHODS

A systematic literature search was performed in five databases: CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane, WEB OF SCIENCE. The studies were selected by two independent researchers based on inclusion and exclusion criteria. A semi-quantitative evaluation assessed the consistency of results for a given variable. Variables displaying consistent associations were classified based on the Physical Activity for people with Disability Model.

RESULTS

The electronic search yielded 10 795 articles, of which 57 were included. The main barriers to physical activity identified were motor impairments (30 studies), older age (15 studies), pain (6 studies), attendance in regular school (6 studies), and communication problems (4 studies). Barriers such as upper limb impairment and visual deficit were less frequently studied, while cognitive attributes, adapted physical environments and positive attitude, and family support were identified as facilitators.

CONCLUSION

Personal and environmental factors influencing physical activities behaviors among youths living with cerebral palsy are multiple and complex since they interact with each other. Rehabilitation interventions need to adopt a person-based approach to address barriers and reinforce facilitators.IMPLICATIONS FOR REHABILITATION:Physical activity participation among youths with cerebral palsy is a multidimensional phenomenon, dependent on different personal and environmental factors.Gross motor impairments, communication problems, and pain were the most common personal factors limiting physical activity participation.Environmental factors consistently associated with physical activity participation were school settings, physical environment such as transportation, and social and family support and attitude.Rehabilitation interventions to promote an active lifestyle should consider not only personal factors but their interaction with the child's environment.

Healthcare providers' promotion of physical activity among child and adolescent cancer survivors: strategies and challenges

PURPOSE

This study aims to investigate how healthcare providers (HCPs) promote physical activity (PA) to child and adolescent cancer survivors.

METHODS

Semi-structured interviews were conducted with HCPs (n = 16; women n = 12; men n = 4) who provide care for cancer survivor youth (age 3 to 18). Participants represented 7 professions, including child life specialists, oncologists, nurse practitioners, physical therapists, and social workers. A reflexive thematic analysis was conducted to explore the techniques that HCPs use to promote PA for this patient population and ways PA promotion can improve.

RESULTS

HCPs use five strategies to promote PA to cancer survivor youth: (1) broadening the definition of PA, (2) tailoring PA recommendations, (3) including families, (4) connecting patients to programming, and (5) promoting patient motivation.

CONCLUSIONS

This research highlights techniques that HCPs use to promote PA to young cancer survivors and reveals the need for additional ways to support HCPs to improve PA promotion for child and adolescent cancer survivors. While HCPs emphasized the importance of PA for this patient population, they navigate barriers that limit the quality of PA discussions.

IMPLICATIONS FOR CANCER SURVIVORS

Further research should explore interventions to improve PA promotion and PA participation among child and adolescent cancer survivors. By understanding the perspectives of HCPs, patients, and their families, PA promotion strategies can be improved, and more programs that support both patients and practitioners may be developed.

Stumbling Block in Providing Physical Activity Support Among Parents of Children with Autism Spectrum Disorder: A Moderated Mediation Analysis

Physical activity (PA) benefits children with autism spectrum disorder (ASD). Evidence suggests that some barriers impede parents from providing PA support for their children with ASD. Parental perceived stigma is one of these barriers. However, few studies have explored how parental perceived stigma influences parental PA support. This study aimed to investigate the relationship between parental perceived stigma and parental PA support, the mediating role of parental self-efficacy, and the moderating effect of having other typically developing children or not. A total of 274 participants were recruited to participate in the study. The results showed that parental self-efficacy mediated the association between parental perceived stigma and parental PA support and the moderating effect of having other typically developing children or not.

Exploring needs, barriers, and facilitators for promoting physical activity for children with intellectual developmental disorders: A qualitative focus group study

BACKGROUND

Many children with intellectual developmental disorders are insufficiently physically active and do not reach recommendations for physical activity. Pediatric healthcare providers play a key role in addressing these children's needs, including promoting interventions for physical activity.

AIM

To explore pediatric healthcare providers' perceived needs, barriers, and facilitators for promoting physical activity for children with intellectual developmental disorders.

METHODS

Semi-structured focus groups, analyzed using qualitative content analysis. Sixteen healthcare providers participated.

RESULTS

Main findings are the importance of parental support and engagement, need for structure, and stakeholder collaboration to bridge the gap between pediatric organizations and external stakeholders.

CONCLUSION

The study highlights the need for developing and implementing strategies to promote physical activity for children with intellectual developmental disorders in pediatric health care, and for producing guidelines regarding physical activity interventions for this vulnerable group.

Determinants of Physical Activity among Children with Disabilities

Maintaining children's physical activity levels is crucial to preventing obesity and improving their health and well-being. However, achieving the recommended daily level of 60 min of moderate-to-vigorous intensity physical activity can be difficult for children with disabilities. Moreover, children with disabilities spend less time engaging in physical activity than their typically developing peers. This study aimed to assess the personal, environmental, and social determinants of physical activity among children with disabilities. This quantitative, cross-sectional study was conducted through an online survey of a convenient sample, including 125 parents of children with disabilities aged between 5 and 18 years from different regions in the Kingdom of Saudi Arabia. Approximately 40.8% of the participants were aged between 41 and 50 years, and 57.6% (the participants and friends of their children) did not engage in regular exercise. Statistically significant differences were observed between the perception of children's health and physical activity summary scores and the engagement of children's friends in physical activity and physical activity summary scores. Efforts should be made to reinforce parents' perceptions of their children's health regarding physical activity and to support the social determinants of physical activity that ensure their children's friends' engagement. Specialized interventional studies are needed to support parents with children.

Effects of Exercise Programs on Functional Capacity and Quality of Life in People With Acquired Brain Injury: A Systematic Review and Meta-Analysis

OBJECTIVE

The aims of this systematic review and meta-analyses were to evaluate the effects of exercise on the functional capacity and quality of life (QoL) of people with acquired brain injury (ABI) and to analyze the influence of training variables.

METHODS

Five electronic databases (MEDLINE, Cochrane Library, CINAHL, SportDiscus, and Web of Science) were searched until October 2021 for clinical trials or experimental studies examining the effects of exercise on the functional capacity and QoL in adults with ABI and comparing exercise interventions with non-exercise (usual care).

RESULTS

Thirty-eight studies were evaluated. A total sample of 2219 people with ABI (exercise, n = 1572; control, n = 647) were included in the quantitative analysis. A greater improvement was observed in walking endurance (z score = 2.84), gait speed (z score = 2.01), QoL physical subscale (z score = 3.42), and QoL mental subscale (z score = 3.00) was observed in the experimental group than in the control group. In addition, an improvement was also observed in the experimental group in the "Timed Up and Go" Test scores and balance without differences from the control group. Significant interactions were also observed between the rehabilitation phases, type, frequency and volume of training, and overall effects.

CONCLUSION

The results suggest that exercise improves functional capacity and QoL regardless of model training, highlighting the effectiveness of long-term exercise that includes short sessions with components such as strength, balance, and aerobic exercise.

IMPACT

The results shown in this systematic review with meta-analysis will allow physical therapists to better understand the effects of training on people with ABI.

Clinical decision support methods for children and youths with mental health disorders in primary care

BACKGROUND

Mental health disorders among children and youths are common and often have negative consequences for children, youths, and families if unrecognized and untreated. With the goal of early recognition, primary care physicians (PCPs) play a significant role in the detection and referral of mental disorders. However, PCPs report several barriers related to confidence, knowledge, and interdisciplinary collaboration. Therefore, initiatives have been taken to assist PCPs in their clinical decision-making through clinical decision support methods (CDSMs).

OBJECTIVES

This review aimed to identify CDSMs in the literature and describe their functionalities and quality.

METHODS

In this review, a search strategy was performed to access all available studies in PubMed, PsychINFO, Embase, Web of Science, and COCHRANE using keywords. Studies that involved CDSMs for PCP clinical decision-making regarding psychosocial or psychiatric problems among children and youths (0-24 years old) were included. The search was conducted according to PRISMA-Protocols.

RESULTS

Of 1,294 studies identified, 25 were eligible for inclusion and varied in quality. Eighteen CDSMs were described. Fourteen studies described computer-based methods with decision support, focusing on self-help, probable diagnosis, and treatment suggestions. Nine studies described telecommunication methods, which offered support through interdisciplinary (video) calls. Two studies described CDSMs with a combination of components related to the two CDSM categories.

CONCLUSION

Easy-to-use CDSMs of good quality are valuable for advising PCPs on the detection and referral of children and youths with mental health disorders. However, valid multicentre research on a combination of computer-based methods and telecommunication is still needed.

"Sports for All"-An Evaluation of a Community Based Physical Activity Program on the Access to Mainstream Sport for Children with Intellectual Disability

Access to club sports is still not a given for children with ID. Parents and children report numerous structural and social barriers to accessing mainstream sports. Sports clubs, on the other hand, want to include this group of people, but often do not know how to do it. Using a community-based approach, children with intellectual disabilities (8-15 years) and their parents were given the opportunity to participate in an 8-week sports program in four mainstream clubs organized by a self-help organization for people with intellectual disabilities. Focus groups were conducted with all participants (parents, children, and club representatives) before and after the program and evaluated by means of a thematic analysis. The children rated participation very positively and only very occasionally reported that they had been excluded. The parents confirmed this experience, but were nevertheless more critical in their assessment. Outside the research context of this study, the sports clubs hardly provided good support, which can also be deduced from previous negative experiences of the parents. The sports clubs themselves received valuable information about what their failings were: sufficiently available and qualified staff, better access to sports facilities, and a wider range of inclusive groups are needed. On the other hand, there was hardly any prejudice on the part of the non-disabled club members towards the new members with ID, which was evaluated extremely positively, albeit surprisingly, by the sports clubs.

Development of a survey measuring parental physical activity support in parents of children with disabilities

PURPOSE

The purposes of the current study were to develop a questionnaire to measure parental physical activity (PA) support in parents of children with disabilities and to examine factors associated with parental PA support.

MATERIALS AND METHODS

A questionnaire measuring parental PA support in parents of children with disabilities (PPSQ for PCD), consisting of three constructs (encouragement, co-PA, and logistic support) with 19 items, was initially developed and evaluated by the Confirmatory Factor Analysis. Three independent multiple regression analyses were conducted to examine associations between the three constructs and parental PA orientation variables.

RESULTS

With the item deletion approach, the final model with 12 items (four items in each construct) was developed, which revealed an excellent model fit (x2= 78.42 [df = 51, p = .008], CFI = 0.98, GFI = 0.94. RMSEA = 0.05). The multiple regression analyses revealed that parental orientation variables were differently associated with each construct of the PPSQ for PCD.

CONCLUSIONS

The PPSQ for PCD consists of three constructs, differently associated with parental orientation variables. This questionnaire can be used as an instrument to assess parental PA support. Implications for RehabilitationThe Parental Physical Activity Questionnaire (PPAQ) can be used to assess parental physical activity support in parents of children with disabilities.The PPAQ measures three constructs (i.e., types) of parental physical activity support including encouragement, co-physical activity, and logistic support.Parental physical activity orientations (e.g., importance, enjoyment, and behavior) are differently associated with each construct of parental physical activity support.

Physical activity intention and attendance behaviour in Finnish youth with cerebral palsy - results from a physical activity intervention: an application of the theory of planned behaviour

Physical activity is associated with better health in individuals with cerebral palsy (CP). Numerous physical activity interventions have been designed to promote physical activity among youth with CP. No previous studies have explored the factors contributing to the intention to participate and predicting attendance behaviour for these interventions. Using theory of planned behaviour (TPB), this study explored the prediction of physical activity intention and attendance behaviour in a physical activity intervention aiming to promote physical activity in a sample of young individuals with CP. Males with CP aged 9–21 years were asked to complete measures of attitude, subjective norms, perceived behavioural control and, intentions towards a physical activity intervention. Participants had no cognitive impairments to understand and follow instructions, were categorised into Gross Motor Function Classification System I–III, did not receive any specific lower limbs’ medical treatment, or did not participate in a strength training program for lower limbs within 6 months before the study. Subjective norms were found to be the only significant predictor of intention, accounting for 83% of variance in intention. Intention and perceived behaviour control were found to be a nonsignificant predictor of attendance behaviour in youth with CP. The results show that TPB is a relevant tool in the prediction of intention towards a physical activity intervention in Finnish youth with CP.

Understanding parental physical activity support in parents of children with developmental disabilities across two different countries

BACKGROUND

It remains unclear if there is a difference between parental physical activity (PA) support in parents of children with developmental disabilities (DDs) and parental PA support in parents of children without DDs across countries.

AIMS

The purposes of the current study were to examine parental PA support in parents of children with and without DDs from the United States and South Korea and to examine their parental PA support mechanism based on the theory of planned behavior (TPB).

METHODS AND PROCEDURES

An online survey was used to measure demographic information, parental PA support, and four constructs of TPB in parents with and without DDs in the two countries (n = 277). One-way analysis of variance was used to compare parental PA support and the TPB constructs among the participants. Two separate path analyses were performed to examine associations between the TPB constructs and parental PA support in American parents of children with and without disabilities and South Korean parents of children with and without disabilities.

OUTCOMES AND RESULTS

Parental PA support was significantly higher in American parents of children with DDs than in South Korean parents of children with DDs. Intention was significantly associated with parental PA support, and attitude was the strongest predictor for intention in both pathway models.

CONCLUSIONS AND IMPLICATIONS

The difference in parental PA support between American parents of children with DDs and South Korean parents of children with DDs may exist. TPB-based intervention may be necessary in order to increase low parental PA support in South Korean parents of children with DDs.

Exploring parents' experiences of promoting physical activity for their child with intellectual disabilities

INTRODUCTION

Children and adolescents with intellectual disabilities participate in low levels of physical activity and have a greater reliance on their parents to provide activity opportunities. This study explored parents' experiences of promoting physical activity for their child with intellectual disabilities.

METHODS

Semi-structured interviews were conducted with eight parents of children and adolescents with intellectual disabilities. Interviews were independently coded and analysed by two researchers using thematic analysis.

RESULTS

Four themes and nine subthemes were identified. Overall, parents had positive views of physical activity. However, parents face numerous barriers that limit their ability to promote physical activity for their child with intellectual disabilities.

CONCLUSIONS

Parents experience high levels of exclusion and stigma that negatively affect their promotion of physical activity for their child with intellectual disabilities. Overcoming the barriers faced by parents could therefore be an indirect method to increase physical activity in children and adolescents with intellectual disabilities.