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McConnell K, McFeeters C, Marley J, Crawford A, Pedlow K. A co-designed mixed methods study on community-based gym exercise for non-ambulant adults with childhood onset disability. Disabil Rehabil 2024:1-9. [PMID: 38702917 DOI: 10.1080/09638288.2024.2346628] [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: 08/01/2023] [Accepted: 04/19/2024] [Indexed: 05/06/2024]
Abstract
PURPOSE Explore community-based gym exercise for non-ambulant adults with childhood-onset disability. MATERIALS AND METHODS Non-ambulant adults with childhood-onset disability participated in four, weekly gym sessions co-facilitated by physiotherapists and exercise professionals. Practicalities of participating in the sessions were recorded via uptake and attrition, weekly surveys, and focus groups. Perspectives of those who designed/delivered the study were gathered via weekly debrief meetings. Quantitative data were analysed descriptively, qualitative data were analysed thematically. RESULTS Ten non-ambulant adults with childhood-onset disability participated; 70% completed all exercise sessions. Focus groups identified three themes. "I wouldn't be able to exercise…there's no option for a community-based setting" described the lack of opportunities for exercise in gyms. "You don't realise the benefit of coming here" highlighted benefits of exercise. "We can do better" had two sub-themes: problem solving and ingredients for community-based gym exercise. Weekly feedback and debrief meetings identified practicalities related to equipment, exercises, and collaborative working between facilitators. CONCLUSIONS Whilst there is an interest in community-based gym exercise for non-ambulant adults with childhood-onset disability, there remains a lack of inclusive gyms. Co-design of inclusive gym guidelines and condition-specific physical activity referral scheme may enhance opportunities for participation in gym exercise for adults with childhood-onset disability.
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Affiliation(s)
- Karen McConnell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | - Joanne Marley
- School of Health Sciences, Ulster University, Londonderry, UK
| | | | - Katy Pedlow
- School of Health Sciences, Ulster University, Londonderry, UK
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McKenzie G, Willis C, Yao A, Munzel F, Kennedy R, Shields N. Identifying and prioritising strategies to optimise community gym participation for young adults with cerebral palsy: an e-Delphi study. Disabil Rehabil 2024; 46:1309-1317. [PMID: 37021370 DOI: 10.1080/09638288.2023.2193431] [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: 10/19/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Identify and prioritise strategies to optimise physical activity participation in the community gym setting for young adults with cerebral palsy. METHODS An e-Delphi method was implemented over three rounds with four stakeholder groups (young adults with cerebral palsy, their families, gym staff or exercise professionals, and health professionals). Strategies for change were identified by the stakeholders in round 1. In rounds 2 and 3, strategies for change were rated on the importance for implementation using a 7-point Likert scale (1 being lowest importance, 7 being highest). The consensus was achieved if ≥70% of participants identified a strategy as high importance. RESULTS Seventy participants (20 young adults 10 family members, 21 health professionals, and 19 exercise professionals) identified 83 strategies for improving gym participation. Of these, 44 strategies met the consensus criteria. The highest priority strategies related to changing the physical environment, addressing cost barriers, gym staff training, and developing partnerships between sectors. CONCLUSIONS Addressing physical accessibility, cost of attendance and the skills of gym staff were agreed upon by the stakeholder groups as priority areas for future resource allocation and research translation. Clinicians and community leisure facilities must work with consumers to implement strategies in their local contexts.
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Affiliation(s)
- Georgia McKenzie
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Claire Willis
- School of Allied Health, Human Services and Sport, La Trobe University, VIC, Australia
| | - Alexa Yao
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Freya Munzel
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rachel Kennedy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Shields N, Bhowon Y, Prendergast L, Cleary S, Taylor NF. Fostering positive attitudes towards interacting with young people with disability among health students: a stepped-wedge trial. Disabil Rehabil 2024; 46:1212-1219. [PMID: 37101339 DOI: 10.1080/09638288.2023.2193429] [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: 08/11/2022] [Accepted: 03/16/2023] [Indexed: 04/28/2023]
Abstract
PURPOSE To investigate if a 12-week community-based exercise program (FitSkills) fostered positive attitudes towards disability among university student mentors. METHODS A stepped-wedge cluster randomised trial was completed with 4 clusters. Students were eligible to be a mentor if enrolled in an entry-level health degree (any discipline, any year) at one of three universities. Each mentor was matched with a young person with a disability and the pair exercised together at the gym twice a week for an hour (24 sessions total). At 7 times over 18 months, mentors completed the Disability Discomfort Scale to indicate their level of discomfort when interacting with people with disability. Data were analysed according to the intention to treat principles using linear mixed-effects models to estimate changes in scores over time. RESULTS A total of 207 mentors completed the Disability Discomfort Scale at least once, of whom 123 participated in FitSkills. Analysis found an estimated reduction of 32.8% (95% confidence interval (CI) -36.8 to -28.4) in discomfort scores immediately after exposure to FitSkills across all four clusters. These decreases were sustained throughout the remainder of the trial. CONCLUSIONS Mentors reported more positive attitudes towards interacting with people with disability after completing FitSkills with changes retained for up to 15 months.
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Affiliation(s)
- Nora Shields
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Yeshna Bhowon
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Luke Prendergast
- Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Stacey Cleary
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Victoria, Australia
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Melbourne, Victoria, Australia
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Kennedy RA, McKenzie G, Holmes C, Shields N. Social Support Initiatives That Facilitate Exercise Participation in Community Gyms for People with Disability: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:699. [PMID: 36613019 PMCID: PMC9819822 DOI: 10.3390/ijerph20010699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/22/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
People with disability report social support facilitates participation in physical activity. A scoping review explored social support strategies used to facilitate exercise participation for people with disability (aged ≥ 15 years) in community gym settings. Seven electronic databases were searched. Studies were screened for eligibility based on title and abstract followed by full-text review. Data were analysed using content analysis and narrative synthesis. Forty-two articles reporting data from 35 studies were included. Eight types of social support were identified: supervision (n = 30), peer support (n = 21), specialist support (n = 19), orientation (n = 15), education (n = 7), logistical support (n = 6), motivational support (n = 5) and organised social activities (n = 4). Direct supervision was typically provided 1:1 or in small groups by staff experienced working with people with disability. Peer support typically involved support from exercise group participants or a peer mentor. Specialist support was usually provided by a health or exercise professional either directly to people with disability or to the people providing support to them (e.g., trainer). Orientation to the gym environment, equipment and exercise program was usually provided over 1 or 2 sessions. Gym staff may use these strategies to guide the implementation of social supports within their facilities to promote social connectedness and participation for people with disability.
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Affiliation(s)
- Rachel A. Kennedy
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
| | - Georgia McKenzie
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
| | - Carlee Holmes
- CP Achieve Centre of Research Excellence, Neurodisability and Rehabilitation, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Nora Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, La Trobe University, Bundoora 3086, Australia
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Shields N, Mizzi N, Buhlert‐Smith K, Strydom A, Prendergast L, Hocking DR. A 12-week exercise programme has a positive effect on everyday executive function in young people with Down syndrome: a pilot non-randomised controlled trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:924-938. [PMID: 36101998 PMCID: PMC9825892 DOI: 10.1111/jir.12979] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 07/24/2022] [Accepted: 08/17/2022] [Indexed: 05/15/2023]
Abstract
BACKGROUND Exercise has the potential to reduce cognitive decline in people with Down syndrome by maximising their cognitive function. The aim of the study was to determine the effect of regular exercise on cognitive functioning in young people with Down syndrome. METHOD People with Down syndrome were eligible if aged between 13 and 35 years and enrolled to participate in an exercise programme (called FitSkills). The intervention was a 12-week community-based exercise programme completed with a student mentor. Outcomes were assessed before (week 0) and immediately after (week 13) the intervention. Executive functioning (planning, response inhibition, attention shifting) was assessed using Tower of London, Sustained Attention to Response Task, CANTAB Intra-extra Dimensional Set Shift Test, Cognitive Scale for Down Syndrome, and Behaviour Rating Inventory of Executive Function (BRIEF). Working memory was assessed using the CANTAB Paired Associates Learning task, and information processing speed was assessed using the Motor Screening Task. Outcomes were analysed using ANCOVA with the baseline measure as the covariate. RESULTS Twenty participants (9 women; mean age 23.6 ± 6.6 years) enrolled. Between-group differences, in favour of the experimental group, were found for the global executive composite score of the BRIEF (mean difference -4.77 units, 95% CI -9.30 to -0.25). There were no between group differences for any other outcome measured. CONCLUSION Participation in a 12-week exercise programme was effective in improving everyday executive functions in young people with Down syndrome. These preliminary findings need to be confirmed in future randomised controlled trials of community-based exercise with larger sample sizes.
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Affiliation(s)
- N. Shields
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneAustralia
| | - N. Mizzi
- Developmental Neuromotor & Cognition Lab, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
| | - K. Buhlert‐Smith
- Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneAustralia
| | - A. Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & NeuroscienceKings College LondonLondonUK
| | - L. Prendergast
- Department of Mathematics and StatisticsLa Trobe UniversityMelbourneAustralia
| | - D. R. Hocking
- Developmental Neuromotor & Cognition Lab, School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
- Centre for Mental HealthSwinburne University of TechnologyMelbourneAustralia
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Ketelaar M, Willis C, Rosenbaum P. Partnering to solve the participation puzzle. Disabil Rehabil 2022; 44:1619. [PMID: 34985392 DOI: 10.1080/09638288.2021.1994028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Claire Willis
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Peter Rosenbaum
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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