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Kilgour G, Stott NS, Steele M, Adair B, Hogan A, Imms C. More than just having fun! Understanding the experience of involvement in physical activity of adolescents living with cerebral palsy. Disabil Rehabil 2024; 46:3396-3407. [PMID: 37675880 DOI: 10.1080/09638288.2023.2251395] [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: 01/16/2023] [Revised: 08/11/2023] [Accepted: 08/18/2023] [Indexed: 09/08/2023]
Abstract
Purpose: To explore the experiences of involvement of adolescents living with cerebral palsy, and their parents, while participating in physical activity. Understanding involvement in physical activity may be used to guide future participation.Methods: Eight adolescents (mean age 13 years 11 months, SD 1 year 6 months) with cerebral palsy participated in a New Zealand-based high-level mobility programme (HLMP) focused on running skills, twice per week for 12 weeks. The adolescents and 12 parents were interviewed before, after the 12 weeks and 9-months following the HLMP. Guided by interpretative description, 38 interviews were coded, analysed, and interpreted.Results: Four themes were: "Turning up is not enough" ("There's no point being there if you're not involved"); "In it all the way", "Changes on a dime", and "What works for me." Perceptions of involvement varied between adolescents and parents. Being "very involved" related to high levels of focus, concentration, effort; but not always enjoyment.Conclusions: Focusing on enjoyment as the key experience of involvement understates the complexity and dynamic nature of involvement. "Being involved" is not always easy and may not mean the absence of discomfort or effort. Optimising the individuals' involvement continuum during physical activity may be essential to promote lifelong participation.IMPLICATIONS FOR REHABILITATIONAdolescents living with cerebral palsy and their parents have differing perspective of involvement and utilise different strategies to encourage being and staying active.Teaching adolescents living with cerebral palsy about their involvement continuum and optimal level of involvement for each activity, context and environment could promote sustained participation.To ensure adolescents are "being involved" in physical activity, opportunities for engagement, motivation and persistence are important; enjoyment is a possible, but not essential attribute of involvement.Encouraging involvement in physical activity can be a source of family conflict from a young age therefore clinicians have a role as an essential supporter, motivator and educator.
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Affiliation(s)
- Gaela Kilgour
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Ngaire Susan Stott
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Michael Steele
- Department of Biostatistics, Australian Catholic University, Brisbane, Australia
| | | | | | - Christine Imms
- Department of Paediatrics, The University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
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Duarte Machado E, Cole MH, Miller L, McGuckian TB, Wilson PH. The efficacy of dance interventions for the activity and participation of individuals with cerebral palsy - a systematic review and meta-analysis. Disabil Rehabil 2024; 46:1485-1501. [PMID: 37122166 DOI: 10.1080/09638288.2023.2200259] [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: 07/08/2022] [Accepted: 04/04/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE The aim of this review was to examine the efficacy of dance interventions for individuals with cerebral palsy (CP), measured at any level of the International Classification of Functioning, Disability and Health (ICF). METHODS A systematic review and meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive search of peer-reviewed articles was performed using six electronic databases. RESULTS Fourteen studies were included in this review, nine of which were also included in the meta-analysis. The meta-analyses yielded a large overall effect for cognitive, motor, and social-emotional function outcomes, with a high degree of heterogeneity between outcome effects, attributable to differences in study design. CONCLUSION Although recent studies provide support for the acceptance and efficacy of dance interventions for people with CP, the systematic review revealed significant limitations in study design (only 2 randomised control trials). High-quality research that measures outcomes across all dimensions of the ICF, and particularly at the level of participation, are needed to improve the level of empirical support for dance-based interventions.
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Affiliation(s)
- Eduardo Duarte Machado
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Michael H Cole
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Australia
| | - Thomas B McGuckian
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
| | - Peter H Wilson
- Development and Disability Over the Lifespan, Healthy Brain and Mind Research Centre, Australian Catholic University, Australia
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
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Bernard M, Hoffmann L, Richter M, Völlm C, Fink A, Dawal B. Participation of adolescents with and without physical disabilities and chronic diseases: A comprehensive conceptualization. Child Care Health Dev 2024; 50:e13240. [PMID: 38426628 DOI: 10.1111/cch.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND In 2001, the International Classification of Functioning and Disability (ICF) introduced participation as a main goal of rehabilitation processes. However, to date, a comprehensive concept of participation in the rehabilitative context is missing, particularly in German-speaking countries. We thus aimed to refine and extend the existing concepts of participation in this brief communication. METHODS In preceding studies, we conducted semi-structured interviews with adolescents who either had chronic diseases and/or physical disabilities or had no impairments and focus groups with parents and experts. Based on these diverse perspectives and findings, we refine the term participation. RESULTS Participation is a construct that is embedded in a social context and consists of objective (i.e., attendance) and subjective (i.e., satisfaction and involvement) dimensions. These dimensions are reflected in different domains and areas that are relevant to adolescents' lives. In addition, the subjective relevance of respective areas in life needs to be regarded as a weighing component when evaluating participation. CONCLUSION Our results reflect international models on participation, refine the existing concept, and underline the multidimensional character of participation. These findings are urgently needed to develop appropriate instruments, for example, for assessing whether rehabilitative processes are effective regarding the goal of participation.
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Affiliation(s)
- Marie Bernard
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
| | - Laura Hoffmann
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
- TUM School of Medicine and Health, Department Health and Sport Sciences, Chair of Social Determinants of Health, Technical University of Munich, Germany
| | - Matthias Richter
- Institute of Medical Sociology (IMS), Interdisciplinary Center for Health Sciences, Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany
- TUM School of Medicine and Health, Department Health and Sport Sciences, Chair of Social Determinants of Health, Technical University of Munich, Germany
| | - Carina Völlm
- Health Department, City of Stuttgart, Stuttgart, Germany
| | - Astrid Fink
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Groß-Gerau, Germany
| | - Britta Dawal
- Department of Educational-and Social Sciences, University of Applied Sciences Südwestfalen, Germany
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Thorslund E, Rosberg S. The meaning of adapted ice-skating for children and youths with disabilities. Disabil Rehabil 2024:1-13. [PMID: 38385956 DOI: 10.1080/09638288.2024.2317998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE Children and youths with disabilities have low levels of physical activity and limited opportunities to participate in physical activity. This study aimed to explore the lived experiences and meaning of an adapted ice-skating approach with access to a tailored harness system as a physical activity for children and youths with disabilities in Sweden. MATERIALS AND METHODS Semi-structured interviews were conducted with 12 guardians, 5 ice-skating trainers and 15 ice-skating children and youths with disabilities. The interviews were supplemented with participant observations of 23 children and youths with disabilities while ice-skating. RESULTS Four categories emerged: "To grow as a person," "To arouse zest for life," "To train for life" and "To become part of society." Ice-skating was found to be a source of joy of movement, zest for life and longing, enabling children and youths with disabilities to explore and develop their abilities, social interactions, confidence, identity, and independence in a safe and joy-bringing context. CONCLUSION The study highlights social and existential dimensions of an adapted ice-skating approach with access to a harness system tailored for children and youths with disabilities, that enables them to be included in ice-skating, regardless of disabilities, creating increased opportunities for physical activity and movement.
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Affiliation(s)
- Elina Thorslund
- Department of Physiotherapy, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Susanne Rosberg
- Department of Physiotherapy, The Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Ullenhag A, Jahnsen R, Klove N, Smedvig S, Hoberg A. How did youth with cerebral palsy perceive participation in everyday life after participating in a periodical intensive rehabilitation program based on adapted physical activity in groups? A qualitative interview study. Disabil Rehabil 2024; 46:58-66. [PMID: 36803505 DOI: 10.1080/09638288.2023.2180096] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Explore how youths with CP experience participation in everyday life, their experience of having participated in a periodical intensive rehabilitation programme and their expectations for the future. MATERIALS & METHODS A qualitative design that included semi-structured interviews with 14 youths with CP (mean age 17 years). RESULTS The qualitative content analysis exposed six themes, (1) Everyday life - to get the pieces of your life to fit together, (2) Participation means inclusion and belonging - the meaning of life, (3) Individual and environmental factors influencing participation, (4) Experience of physical and social activities away from home together with like-minded people, (5) To be continued locally, and (6) You do not know the future, anything can happen - visions for the future. CONCLUSIONS Participation in everyday life increases the meaning of life but takes energy. Periodical intensive rehabilitation programme enabled youths to try new activities, make friends and increase self-insight in their own strengths and limitations.IMPLICATIONS FOR REHABILITATIONYoung people with cerebral palsy (CP) describe participation as the meaning of life and state that it is essential for inclusion and being able to contribute to societyAdaptation of environmental factors including collaboration across service sectors and capacity building in young people within their preferred life situations appear to be essentialA periodical intensive rehabilitation, including adapted physical activities in groups, is recommended to provide peer learning and mastery experiences in young people with CP.Young people with CP seem to have the same hopes for the future as their typically developing peers.
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Affiliation(s)
- Anna Ullenhag
- Department of Research, Beitostolens Healthsports Center, Beitostølen, Norway
- School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden
| | - Reidun Jahnsen
- Department of Research, Beitostolens Healthsports Center, Beitostølen, Norway
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, CHARM, University of Oslo, Oslo, Norway
| | - Nina Klove
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Solveig Smedvig
- Department of Research, Beitostolens Healthsports Center, Beitostølen, Norway
| | - Anita Hoberg
- Department of Research, Beitostolens Healthsports Center, Beitostølen, Norway
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Kilgour G, Stott NS, Steele M, Adair B, Hogan A, Imms C. The Journey to Sustainable Participation in Physical Activity for Adolescents Living with Cerebral Palsy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1533. [PMID: 37761494 PMCID: PMC10528208 DOI: 10.3390/children10091533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023]
Abstract
PURPOSE To understand adolescents' and their parents' perspectives on 'being active', this study explored the experience of participation in physical activity (PA), the role of long-term participation in PA, and the importance of remaining active for life. METHODS Eight ambulant adolescents with CP (aged 11-16 years, seven male) participated in a high-level mobility programme twice per week for 12 weeks. Guided using interpretive description, adolescents and 12 of their parents were interviewed before, after and nine months following the programme. Thirty-eight interviews were coded, analysed, and interpreted, informed by audit information, reflective journaling, and team discussions. RESULTS Adolescents and their parents highly value being active now and into adulthood. Sustainable participation in PA requires adolescents and families to navigate complex environments (interpersonal, organisational, community, and policy). Core themes were: 'Just Doing it', 'Getting the Mix Right' (right people, right place, right time), 'Balancing the Continua' and 'Navigating the Systems'. The continua involved balancing intra-personal attributes: 'I will try anything' through to 'I will do it if I want to' and 'It's OK to be different' through to 'It sucks being disabled'. CONCLUSIONS The journey to sustainable participation was complex and dynamic. Experiences of successful journeys are needed to help adolescents with CP "stay on track" to sustainable participation.
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Affiliation(s)
- Gaela Kilgour
- Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, VIC 3052, Australia;
| | - Ngaire Susan Stott
- Department of Surgery, The University of Auckland, Grafton Road, Auckland 1023, New Zealand;
| | - Michael Steele
- School of Allied Health, Australian Catholic University, 1100 Nudgee Road, Banyo, QLD 4014, Australia;
| | - Brooke Adair
- Grow Strong Children’s Physiotherapy, Melbourne, VIC 3185, Australia;
| | - Amy Hogan
- Cerebral Palsy Society of New Zealand, Auckland 1023, New Zealand;
| | - Christine Imms
- Cerebral Palsy Society of New Zealand, Auckland 1023, New Zealand;
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Hoffmann L, Völlm C, Bernard M, Fink A, Richter M, Dawal B. What does social participation mean? A qualitative study exploring the concept of participation from the perspectives of experts and parents. BMJ Open 2023; 13:e072684. [PMID: 37451711 PMCID: PMC10351295 DOI: 10.1136/bmjopen-2023-072684] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES This study aimed to assess the theoretical framework regarding social participation from the perspectives of experts and parents of youth aged between 10 and 17 years, and therefore, provides new insights into the concept of social participation. DESIGN A qualitative study was conducted to understand the construct of social participation in more detail. Eight focus groups were held with experts (n=21) and parents (n=24) and analysed based on content analysis. PARTICIPANTS We used purposive and snowball sampling to obtain a comprehensive sample of (A) parents of adolescents with and without chronic and/or physical-motor impairments and (B) experts involved in participatory research and/or treatment of adolescents with chronic and/or physical-motor impairments. The final sample consisted of 3 focus groups with a total of 21 experts and 5 focus groups with 24 parents. This included 10 parents who had disabled children. RESULTS The concept of social participation consists of subjective and objective components. The focus from the experts' perspective is clearly on the subjective level; that is, revolving around the question 'Does the adolescent feel involved?' In contrast, the parents' focus is more on normative expectations. The possibility of participation in all areas of life through the adjustment of environmental factors was identified as a central factor. CONCLUSIONS The results underline the importance of the subjective feelings of adolescents, as well as the significance of normative requirements. To capture the subjective component of participation, suitable measurements are needed. TRIAL REGISTRATION NUMBER DRKS00014739.
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Affiliation(s)
- Laura Hoffmann
- Chair of Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | | | - Marie Bernard
- Institute of Medical Sociology, Martin Luther University, Halle, Germany
| | - Astrid Fink
- Institute of Medical Sociology, Martin Luther University, Halle, Germany
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Germany
| | - Matthias Richter
- Chair of Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Britta Dawal
- Department of Education and Social Sciences, South Westphalia University of Applied Sciences, Soest, Germany
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Bärwalde T, Hoffmann L, Fink A, Völlm C, Martin O, Bernard M, Gebhard B, Richter M. The Adolescent Concept of Social Participation-A Qualitative Study on the Concept of Social Participation from Adolescents with and without Physical Disabilities. QUALITATIVE HEALTH RESEARCH 2023; 33:143-153. [PMID: 36527275 DOI: 10.1177/10497323221146414] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE The construct of social participation is still not clearly defined. To reach a better understanding of social participation, the perspectives of adolescents must be taken into account. This study explores the adolescent concept of social participation and expands knowledge of the meaning of subjective components of the term. METHODS Thirty-four semi-structured interviews were conducted with adolescents with and without physical disabilities or chronic diseases between the ages of 12 and 17 and analyzed according to grounded theory. RESULTS Adolescents describe social participation as involving reflexive interaction with their social environment. Furthermore, forming a social environment plays an important role. All components of the concept are embedded in a context that influences the ways adolescents participate. Adolescents differentiate between active and passive forms of social participation. The concept of reflexive interaction is situated within an interdependent structure of components such as the "feeling of belonging" and the feeling of "well-being" among adolescents. CONCLUSION The results expand the current state of knowledge regarding the theoretical differentiation of social participation by exploring subjective components of the term. This offers the possibility of supplementing the theoretical frameworks of social participation and supports the understanding of the critical importance of social participation for adolescents.
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Affiliation(s)
- Tim Bärwalde
- Department of Anesthesiology and Intensive Care Medicine, 14955Park-Klinik Weissensee, Berlin, Germany
| | - Laura Hoffmann
- Institute of Medical Sociology, 9176Martin Luther University Halle-Wittenberg, Germany
- TUM Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
| | - Astrid Fink
- Department of Health and Consumer Protection, Kreis Groß-Gerau, Groß-Gerau, Germany
| | - Carina Völlm
- Department of Educational- and Social Sciences, South Westphalia University of Applied Sciences, Germany
| | - Olaf Martin
- Institute of Nursing Science and Interprofessional Learning, 60634University Medicine Greifswald, Germany
| | - Marie Bernard
- Institute of Medical Sociology, 9176Martin Luther University Halle-Wittenberg, Germany
| | - Britta Gebhard
- Department of Educational- and Social Sciences, South Westphalia University of Applied Sciences, Germany
| | - Matthias Richter
- TUM Department of Sport and Health Sciences, 9184Technical University of Munich, Germany
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Carbone PS, Smith PJ, Lewis C, LeBlanc C. Promoting the Participation of Children and Adolescents With Disabilities in Sports, Recreation, and Physical Activity. Pediatrics 2021; 148:183444. [PMID: 34851421 DOI: 10.1542/peds.2021-054664] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The benefits of physical activity are likely universal for all children, including children and adolescents with disabilities (CWD). The participation of CWD in physical activity, including adaptive or therapeutic sports and recreation, promotes inclusion, minimizes deconditioning, optimizes physical functioning, improves mental health as well as academic achievement, and enhances overall well-being. Despite these benefits, CWD face barriers to participation and have lower levels of fitness, reduced rates of participation, and a higher prevalence of overweight and obesity compared with typically developing peers. Pediatricians and caregivers may overestimate the risks or overlook the benefits of physical activity in CWD, which further limits participation. Preparticipation evaluations often include assessment of health status, functional capacity, individual activity preferences, availability of appropriate programs, and safety precautions. Given the complexity, the preparticipation evaluation for CWD may not occur in the context of a single office visit but rather over a period of time with input from the child's multidisciplinary team (physicians, coaches, physical education teachers, school nurses, adaptive recreation specialists, physical and occupational therapists, and others). Some CWD may desire to participate in organized sports to experience the challenge of competition, and others may prefer recreational activities for enjoyment. To reach the goal of inclusion in appropriate physical activities for all children with disabilities, child, family, financial, and societal barriers to participation need to be identified and addressed. Health care providers can facilitate participation by encouraging physical activity among CWD and their families during visits. Health care providers can create "physical activity prescriptions" for CWD on the basis of the child's preferred activities, functional status, need for adaptation of the activity and the recreational opportunities available in the community. This clinical report discusses the importance of participation in sports, recreation, and physical activity for CWD and offers practical suggestions to health care providers.
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Affiliation(s)
- Paul S Carbone
- Department of Pediatrics, The University of Utah, Salt Lake City, Utah
| | - Peter J Smith
- Section on Developmental and Behavioral Pediatrics, The University of Chicago, Chicago, Illinois
| | - Charron Lewis
- Division of Developmental-Behavioral Pediatrics and Psychology, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Claire LeBlanc
- Department of Pediatrics, McGill University, Montreal, Quebec, Canada
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Para Sport Development Experiences: Perspectives of Para Swimmers and Parents. Adapt Phys Activ Q 2021; 38:643-660. [PMID: 34453016 DOI: 10.1123/apaq.2021-0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 11/18/2022] Open
Abstract
This study examined para swimmers' athlete development experiences from the perspectives and reflections of athletes, and parents of athletes, with a focus on the constraints and challenges experienced. Guided by interpretive phenomenological analysis, 12 participants engaged in the interview process (seven parents and five athletes). Five themes were identified: fundamental skill development, personal connection, coaching, classification, and connecting with others "like me." Through a discussion of the differences in development experiences between the participants in this study and the current literature on athlete development, the authors highlight areas of concern in applying a non-para-specific athlete development model to para swimmers. This study identifies several areas of consideration in the future design of a para athlete development framework or model.
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Arfa S, Solvang PK, Berg B, Jahnsen R. Participation in a rehabilitation program based on adapted physical activities in Norway: a qualitative study of experiences of immigrant parents and their children with disabilities. Disabil Rehabil 2021; 44:1642-1649. [PMID: 33826448 DOI: 10.1080/09638288.2021.1907454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE By exploring immigrant families' experiences of participating in a three-week rehabilitation program focused on adapted physical activity in Norway, this study investigated how beneficial, culturally adapted, and accessible the services were from the families' perspectives. METHODS A hermeneutic design with semi-structured interviews supplemented by participant observation was applied. Inductive thematic analysis was conducted. RESULTS Three themes were identified: "learning through participating," "sharing the same experience," and "gaps in service delivery." By participating in physical activities together with their children, parents became aware of their children's capabilities and interests, as well as the available resources. Parents also socialized and exchanged experiences and information with each other. Children learned new skills, became aware of their preferences and capabilities, built friendships, and improved their social skills. However, a lack of cultural adaptation, such as insufficient information, as well as the location of the rehabilitation center, language barriers, and exclusion of siblings affected accessibility of the services to immigrant families. CONCLUSIONS Although the beneficial aspects of the services were demonstrated, the cultural adaptation and accessibility of the services were limited. Providing flexible and culturally adapted services that meet immigrant families' needs may improve the accessibility of rehabilitation services to immigrant families.IMPLICATIONS FOR REHABILITATIONMaking information available to immigrant families, mapping their resources and needs well before the intervention may improve the accessibility of the services for these families.Rehabilitation professionals need to consider families' perceptions of their own role through the goal-setting process when engaging with families from cultural backgrounds different from their own.When planning the intervention, grounding physical activities in the diverse cultural background of participants may increase immigrant families' sense of belonging and inclusion, and thereby facilitate interaction between families regardless of cultural differences.
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Affiliation(s)
- Shahrzad Arfa
- Research Department, Beitostølen Healthsports Center, Beitostølen, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Per Koren Solvang
- Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Berit Berg
- Department of Social Work, Norwegian University of Science and Technology, Trondheim, Norway
| | - Reidun Jahnsen
- Research Department, Beitostølen Healthsports Center, Beitostølen, Norway.,Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Research Center for Habilitation and Rehabilitation Models and Services, CHARM, Institute of Health and Society, University of Oslo, Oslo, Norway
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Bentzen M, Malmquist LK. Differences in participation across physical activity contexts between adolescents with and without disability over three years: a self-determination theory perspective. Disabil Rehabil 2021; 44:1660-1668. [PMID: 33721549 DOI: 10.1080/09638288.2021.1894489] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Meaningful participation is related to satisfaction of the psychological needs of competence, autonomy, and relatedness within Self-determination theory. The purpose of this study is to explore whether need satisfaction in physical education (PE), organized sport, and self-organized physical activity (PA) among adolescents with disability differs in relation to their peers without disabilities over a three-year period. METHODS Participants were students of secondary or upper secondary school (T1: N = 2979), reporting either having a disability (n = 328) or not (n = 2651). The psychological needs were measured in the three PA contexts over three time-points. Differences between groups were assessed with t-tests and Cohen's d. RESULTS Adolescents with disability reported: in PE, lower need satisfaction across all three time-points; in organized sport, lower levels on all needs at T1, and lower levels of autonomy and relatedness at T2; in self-organized PA, no differences between the groups across all three time points, except for lower autonomy at T2. CONCLUSIONS The findings indicate that adolescents with disabilities are particularly vulnerable to reduced participation in PE and partly in organized sport. Rehabilitation institutions should collaborate closely with stakeholders in PA (e.g., PE teachers and coaches) in adolescents' municipalities to transfer knowledge about nurturing psychological needs in PA.Implications for rehabilitationMeaningful participation in physical activity (PA) for the individual can be related to their own perceptions of satisfaction of the three basic psychological needs of competence, autonomy, and relatedness.Findings from the current study indicate that adolescents with disabilities are particularly vulnerable to experiencing reduced participation in physical education (PE) and partly in organized sport.Health care practitioners working in rehabilitation should support adolescents' three psychological needs in PA while they are attending rehabilitation to give them valuable experiences with meaningful participation in PA, which could be transferred and useful for PA participation after rehabilitation.Health care practitioners at rehabilitation institutions should collaborate closely with stakeholders in the PA context of adolescents' local areas (e.g., PE teachers and coaches) to transfer knowledge about how to nurture psychological need fulfillment in PA.
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Affiliation(s)
- Marte Bentzen
- Department of Teacher Education and Outdoor Studies, Norwegian School of Sport Sciences, Oslo, Norway
| | - Linn Kristin Malmquist
- Department of Teacher Education and Outdoor Studies, Norwegian School of Sport Sciences, Oslo, Norway
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13
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Papadopoulos NV, Whelan M, Skouteris H, Williams K, McGinley J, Shih STF, Emonson C, Moss SA, Sivaratnam C, Whitehouse AJO, Rinehart NJ. An Examination of Parent-Reported Facilitators and Barriers to Organized Physical Activity Engagement for Youth With Neurodevelopmental Disorders, Physical, and Medical Conditions. Front Psychol 2020; 11:568723. [PMID: 33132976 PMCID: PMC7550411 DOI: 10.3389/fpsyg.2020.568723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/19/2020] [Indexed: 01/31/2023] Open
Abstract
Organized physical activity (OPA) is an important contributor to physical, social, and emotional health and well-being; however, young people with disabilities are participating at lower rates than their peers without disabilities. This study aimed to (1) compare facilitators and barriers to OPA for young people with disabilities who currently do and do not participate in OPA and (2) to assess whether groups differed in the type of internal and external assets they reported. Parents of 218 young people (41% with a primary diagnosis of autism spectrum disorder) with a diverse representation of disabilities completed an online survey. Young people were categorized as either participants in OPA (n = 131) or non-participants (n = 87) by parent report. Non-participation was significantly predicted by the barrier “there are no activities my child enjoys” and by a lack of children’s motivation and happiness during OPA. Significant internal assets differentiating participants from non-participants were the ability to understand simple instructions, love of sport, and meeting physical activity guidelines. Significant external assets were parent and sibling participation in OPA, school type, and household income. The findings from this study have important implications for the design of public health interventions that aim to promote OPA in young people with disabilities, highlighting the need to make activities enjoyable, promote participation of siblings and parents, and support low-income families to participate.
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Affiliation(s)
- Nicole V Papadopoulos
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Moira Whelan
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Clayton, VIC, Australia
| | - Katrina Williams
- Clinical Sciences, Murdoch Children's Research Institute, Parkville, VIC, Australia.,Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.,Department of Paediatrics, Monash University, Clayton, VIC, Australia
| | - Jennifer McGinley
- Department of Physiotherapy, University of Melbourne, Parkville, VIC, Australia
| | - Sophy T F Shih
- Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Surveillance, Evaluation and Research Program, The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Chloe Emonson
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Simon A Moss
- Research and Research Training, Charles Darwin University, Palmerston City, NT, Australia
| | - Carmel Sivaratnam
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | | | - Nicole J Rinehart
- Deakin Child Study Centre, School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
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Fancourt D, Wee J, Lorencatto F. Identifying mechanisms of change in a magic-themed hand-arm bimanual intensive therapy programme for children with unilateral spastic cerebral palsy: a qualitative study using behaviour change theory. BMC Pediatr 2020; 20:363. [PMID: 32736618 PMCID: PMC7394671 DOI: 10.1186/s12887-020-02246-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 07/13/2020] [Indexed: 01/17/2023] Open
Abstract
Background There has been much research into how to promote upper-limb skills to achieve functional independence in children with unilateral spastic cerebral palsy (USCP). One researched intervention is the Breathe Magic programme, which follows the protocol of hand-arm bimanual intensive therapy (HABIT) whilst, incorporating magic tricks to develop children’s motor skills and bimanual skills. However, whilst research has found the programme to be effective, there has been little consideration of how the intervention leads to a positive outcome: what the psychological, social and physical mechanisms of action are. Methods Qualitative semi-structured interviews with 21 children with USCP who participated in the Breathe Magic HABIT intervention, and focus groups with 17 parents and/or carers were undertaken. Analysis was conducted through the lens of the COM-B behaviour change model using a combined deductive framework and inductive thematic analysis. Reliability of coding was confirmed through random extraction and double coding of a portion of responses and the calculation of inter-rater reliability. Results Breathe Magic brings about change and positive outcomes by increasing children’s psychological and physical capabilities, providing social opportunities, and enhancing reflective and automatic motivation. Additionally, a number of enablers to engaging in the intervention were identified, particularly under psychological capabilities, social opportunities and both reflective and automatic motivation. Very few barriers were raised; those that were raised were of relatively low frequency of reporting. Conclusions By conducting a theory-based qualitative process evaluation, this study demonstrated the mechanisms of change behind the Breathe Magic HABIT intervention for children with USCP. Breathe Magic was found to be a well-structured combination of intended and unintended mechanisms of change. Overall, the success of Breathe Magic was observed through not only its intended mechanisms to enhance hand skills, but also through unintended psychological improvements in children’s hand function, as well as social and motivational benefits resulting from interaction between children and parents.
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Affiliation(s)
- Daisy Fancourt
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Jaeyoung Wee
- Centre for Behaviour Change, University College London, London, UK
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15
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A Strength-Based Intervention to Increase Participation in Leisure Activities in Children with Neuropsychiatric Disabilities: A Pilot Study. Occup Ther Int 2020; 2020:1358707. [PMID: 32454804 PMCID: PMC7154983 DOI: 10.1155/2020/1358707] [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: 07/12/2019] [Accepted: 03/10/2020] [Indexed: 11/18/2022] Open
Abstract
The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child's participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified. The intervention was carried out over 8 weeks and took place in the adolescent's everyday environment and at the pediatric rehabilitation center. The goal attainment of participation goals (GAS), the perceived performance ability according to the Canadian Occupational Performance Measure (COPM), the self-efficacy, and the participants' satisfaction were used to study the effect. The participants succeeded in attaining their leisure goals as specified by the GAS by achieving +2 on one goal and +1 on the other two goals. They estimated higher performance ability and self-efficacy in their goal performance. Participants, parents, and therapists were overall satisfied and found the intervention to be applicable and helpful in optimizing leisure participation. The intervention model with a client-centered goal-directed approach in which participants define their own leisure activity goals appears to be effective in increasing participation in leisure activities.
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