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Abid M, Cherni Y, Batcho CS, Traverse E, Lavoie MD, Mercier C. Facilitators and barriers to participation in physical activities in children and adolescents living with cerebral palsy: a scoping review. Disabil Rehabil 2023; 45:4322-4337. [PMID: 36447398 DOI: 10.1080/09638288.2022.2150327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
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.
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Affiliation(s)
- Manel Abid
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Yosra Cherni
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Charles Sèbiyo Batcho
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Elodie Traverse
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
| | | | - Catherine Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), CIUSSS de la Capitale-Nationale, Quebec City, Canada
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, Canada
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Dere T, Serel Arslan S, Alemdaroğlu-Gürbüz İ. Validity and reliability of the turkish version of the early activity scale for endurance in preschool children with cerebral palsy. Dev Neurorehabil 2023; 26:101-108. [PMID: 36628489 DOI: 10.1080/17518423.2023.2166616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study presented the Turkish translation of the Early Activity Scale for Endurance (T-EASE) which was developed to evaluate the endurance for physical activity of preschool children with Cerebral Palsy (CP), and its validity and reliability. Fifty-five children with CP aged between 2 and 5 years were included in the study. The Gross Motor Function Classification Scale (GMFCS) and Pediatric Outcomes Data Collection Instrument (PODCI) were used to determine motor function levels and quality of life of the study population. The T-EASE had good test-retest reliability (ICC = 0.996), internal consistency (α = 0.903), higher construct validity approved by confirmatory factor analysis, and criterion validity supported by the weak-to-strong correlations between T-EASE and GMFCS, and PODCI. The T-EASE scores were significantly different between GMFCS levels (p < .05). The T-EASE was found to be valid and reliable to determine the endurance for physical activity of Turkish pre-school children with CP with the sensitivity to changes in motor function levels.
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Affiliation(s)
- Tuğba Dere
- Sarıkaya School of Physiotherapy and Rehabilitation, Yozgat Bozok University, Yozgat, Turkey
| | - Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Sharawat IK, Panda PK. Quality of Life and Its Association with Level of Functioning in Young Children with Cerebral Palsy. Neuropediatrics 2022; 53:227-234. [PMID: 35196712 DOI: 10.1055/s-0042-1743432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Quality of life (QOL) in older children, adolescents, and adults with cerebral palsy (CP) is significantly impaired. Level of functioning is one of the probable determinants of impairment in QOL. However, such studies in young children with CP are scarce in the literature. METHODS Parents of all consecutive children aged between 1 and 4 years with a confirmed diagnosis of CP completed the Infant Toddler Quality of Life (ITQOL) questionnaire. Total and individual subdomain scores of ITQOL were examined for association with the level of functioning measured by Gross Motor Function Classification System-Expanded & Revised (GMFCS E&R), Mini-Manual Ability Classification System (Mini-MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS), with/without adjustment to probable confounding variables. RESULTS One hundred three children with CP (74 boys, mean age: 2.6 ± 0.9 years, 49% lower and 39% middle socioeconomic status) were enrolled. All four scales (GMFCS, Mini-MACS, CFCS, and EDACS) describing levels of functioning had significant association with ITQOL total score (β= -0.19, -0.15, -0.11, -0.09, respectively), which persisted even after adjusting for confounding variables (p = 0.004, 0.01, 0.03, and 0.046, respectively). Among the confounding variables, uncontrolled seizures, significant vision impairment, lower socioeconomic status, type of CP, and institution of comprehensive rehabilitation measures for ≥6 months had a significant association with ITQOL score (p = 0.03, 0.04, 0.02, 0.02, and 0.01, respectively). CONCLUSION Level of functioning as measured by GMFCS, Mini-MACS, EDACS, and CFCS is independent predictors of impairment in QOL in young children with CP.
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Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Physical Activity Energy Expenditure Predicts Quality of Life in Ambulatory School-Age Children with Cerebral Palsy. J Clin Med 2022; 11:jcm11123362. [PMID: 35743433 PMCID: PMC9225112 DOI: 10.3390/jcm11123362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Participation in physical activities is positively associated with better quality of life in children with cerebral palsy (CP). The objective of this study was to elucidate the relationship between the intensity of habitual physical activity (HPA) measured with an accelerometer and health-related quality of life (HRQOL) in school-age children with CP. Method: A secondary analysis of the cross-sectional data of 46 ambulatory children with CP was conducted. The participants wore an accelerometer for seven days to measure HPA: activity counts (counts/min) and physical activity energy expenditure (PAEE, kcal/kg/day), as well as %moderate-to-vigorous intensity physical activity (%MVPA), %light intensity physical activity (%LPA), and %sedentary physical activity (%SPA) were measured. Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and Child Health Questionnaire Parent Form 50 Questions (CHQ-PF50) were used to measure HRQOL. A Pearson analysis and a hierarchical regression analysis were performed. Results: PAEE significantly predicted the results of the PedsQL(child) physical domain (β = 0.579, p = 0.030), PedsQL(child) emotional domain (β = 0.570, p = 0.037), PedsQL(child) social domain (β = 0.527, p = 0.043), and PedsQL(child) total (β = 0.626, p = 0.017). However, other HPA parameters could not predict any other HRQOL. Conclusions: PAEE could be used as a biomarker in studies on HRQOL and HPA in ambulatory school-age children with CP.
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Starowicz J, Pratt K, McMorris C, Brunton L. Mental Health Benefits of Physical Activity in Youth with Cerebral Palsy: A Scoping Review. Phys Occup Ther Pediatr 2022; 42:434-450. [PMID: 35484717 DOI: 10.1080/01942638.2022.2060058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIMS Children and adolescents with cerebral palsy (CP) are at heightened risk for mental health problems. Physical activity is an effective strategy to promote quality of life (QoL) and reduce mental health symptoms along with evidence-based therapies. This study described existing literature examining the mental health outcomes (e.g., QoL, well-being, anxiety, and depression) of physical activity interventions in children and adolescents with CP to help inform the implementation of physical activity interventions for this population. METHODS Ascoping review framework was used to map the existing quantitative literature. RESULTS The search returned 243 articles; after titles, abstracts, and full manuscripts were reviewed, 21 articles were included. The association between physical activity and QoL was examined in most studies (n = 17) with mixed findings. Eight studies documented at least one significant positive association between physical activity and QoL, and four found that physical activity interventions were highly enjoyable. Only one study assessed anxiety and/or depression following a PA intervention. CONCLUSIONS Physical activity may benefit aspects of QoL and mental health symptoms; however, this was not a consistent finding in the existing literature. Along with other therapies, physical activity interventions may be valuable in improving QoL, and in turn, the mental health symptoms of children with CP.
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Affiliation(s)
- Jessica Starowicz
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Karen Pratt
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Carly McMorris
- Werklund School of Education, University of Calgary, Calgary, Canada
| | - Laura Brunton
- School of Physical Therapy, Western University, London, Canada
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Yoon MJ, Choi H, Kim JS, Lim SH, Yoo YJ, Hong BY. Physical activity, quality of life and parenting stress in children with cerebral palsy. Pediatr Int 2022; 64:e15295. [PMID: 36112040 DOI: 10.1111/ped.15295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/13/2022] [Accepted: 07/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with cerebral palsy (CP) are less physically active than their typically developing peers. The effects of decreased physical activity on children's quality of life (QOL) or caregiver's lives are not well understood. This study aimed to investigate the association between physical activity, QOL, and parenting stress in children with CP. METHODS A prospective cross-sectional study was done in children with CP. Daily physical activity was measured over 7 days using an accelerometer (ActiGraph™). Caregivers completed the Child Health Questionnaire - Parent Form 50 and Parenting Stress Index - Short Form. Multiple regression analysis was used. RESULTS In total, data from 65 children with Gross Motor Function Classification System (GMFCS) levels I-V, aged 4-13 years, were analyzed. Non-ambulatory (GMFCS IV-V) children had significantly lower activity counts and moderate to vigorous physical activity (MVPA) in comparison with ambulatory (GMFCS I-II) and marginally ambulatory (GMFCS III) children. The ambulatory group had better physical QOL than the non-ambulatory group. Caregivers of the non-ambulatory or marginally ambulatory children with CP reported higher parenting stress levels than those of the ambulatory group. Time spent in MVPA and activity counts were positively associated with physical QOL in children with CP. Low activity counts and low amounts of MVPA of children with CP were significant predictors of high parenting stress. CONCLUSIONS Physical activity in children with CP is associated with children's QOL and parenting stress. These results suggest that clinicians should conduct physical activity assessment and counseling to promote physical activity.
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Affiliation(s)
- Mi-Jeong Yoon
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Hyehoon Choi
- Department of Rehabilitation Medicine, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - Joon-Sung Kim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Yeun-Jie Yoo
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Bo Young Hong
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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Minimally Invasive SPML Surgery for Children with Cerebral Palsy: Program Development. Minim Invasive Surg 2020; 2020:5124952. [PMID: 32922995 PMCID: PMC7453246 DOI: 10.1155/2020/5124952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/10/2020] [Indexed: 11/25/2022] Open
Abstract
Improvements in surgical and rehabilitation care are critical to lessen the burden of cerebral palsy (CP), the most common cause of severe physical disability in childhood. The selective percutaneous myofascial lengthening (SPML) surgical procedure is a minimally invasive method designed to improve ambulation by lengthening contracted musculoskeletal tissues. Information on surgical procedures, efficacy, and safety of SPML for children with CP is lacking. Phase 1 of our research is a “proof-of-principle” study for multisite SPML to improve functional mobility of children with CP, and Phase 2 assesses safety, reoperation rates, and efficacy over time in subsequent patient series. Phase 1 was a repeated measurement case series study of 17 children (mean age 7.6 years). One physical therapist, blinded to the surgeon's measurements, measured bilateral knee and ankle motion before and after SPML procedures, using video recordings of a standardized gait path. Functional Mobility Scale (FMS) 5, 50, and 500 outcomes were taken pre- and postoperatively and via telephone follow-up. In Phase 2, multisite SPLM surgeries were implemented in larger successive cohorts from 2006 to 2017. Complications, reoperation rates, and efficacy were retrospectively analyzed. Phase 1 results showed improvement in the children's knee and ankle motion while ambulating and improved FMS 5, 50, and 500 outcomes postoperatively (mean, 6.3 months). At second follow-up (mean 33.3 months), FMS 500 scores continued improvement, while FMS 5 and FMS 50 scores maintained. During Phase 2, the complication rate was 2.4%, and reoperation rates (including reoperations due to maturation) were between 8% and 13%. Improvements to correct ankle equinus were recorded in 498 cases. In conclusion, in a specialized center, single-event, multilevel SPML surgeries of children with CP safely improved ambulatory knee and ankle angle motion and daily mobility outcomes. Future educational studies of training needs for surgeons new to the approach are needed.
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Orlando JM, Pierce S, Mohan M, Skorup J, Paremski A, Bochnak M, Prosser LA. Physical activity in non-ambulatory toddlers with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 90:51-58. [PMID: 31063871 DOI: 10.1016/j.ridd.2019.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/21/2018] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Children with cerebral palsy are less likely to be physically active than their peers, however there is limited evidence regarding self-initiated physical activity in toddlers who are not able, or who may never be able, to walk. AIMS The aim of this study was to measure self-initiated physical activity and its relationship to gross motor function and participation in non-ambulatory toddlers with cerebral palsy. METHODS AND PROCEDURES Participants were between the ages of 1-3 years. Physical activity during independent floor-play at home was recorded using a wearable tri-axial accelerometer worn on the child's thigh. The Gross Motor Function Measure-66 and the Child Engagement in Daily Life, a parent-reported questionnaire of participation, were administered. OUTCOMES AND RESULTS Data were analyzed from the twenty participants who recorded at least 90 min of floor-play (mean: 229 min), resulting in 4598 total floor-play minutes. The relationship between physical activity and gross motor function was not statistically significant (r = 0.20; p = 0.39), nor were the relationships between physical activity and participation (r = 0.05-0.09; p = 0.71-0.84). CONCLUSIONS AND IMPLICATIONS The results suggest physical activity during floor-play is not related to gross motor function or participation in non-ambulatory toddlers with cerebral palsy. Clinicians and researchers should independently measure physical activity, gross motor function, and participation.
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Affiliation(s)
- Julie M Orlando
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Samuel Pierce
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States.
| | - Mayumi Mohan
- University of Pennsylvania, School of Engineering and Applied Science, 220 S 33rd St, Philadelphia, PA 19104, United States
| | - Julie Skorup
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Athylia Paremski
- The Children's Hospital of Philadelphia, Division of Rehabilitation Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Megan Bochnak
- The Children's Hospital of Philadelphia, Department of Physical Therapy, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States
| | - Laura A Prosser
- The Children's Hospital of Philadelphia, Division of Rehabilitation Medicine, 3401 Civic Center Boulevard, Philadelphia, PA 19104, United States; University of Pennsylvania, School of Medicine, Department of Pediatrics, 220 S 33rd St, Philadelphia, PA 19104, United States
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