I Would Like to Do It Very Much! Leisure Participation Patterns and Determinants of Brazilian Children and Adolescents With Physical Disabilities

What are the barriers and facilitators to participation of people with Down syndrome? A scoping review

AIM

To determine the barriers and facilitators of active community participation of children, adolescents, and adults with Down syndrome.

METHOD

Searches were completed in five electronic databases to identify original studies about participation of children, adolescents (ages < 18 years), and adults (ages 18-59 years) with Down syndrome. Barriers and facilitators to participation were categorized into four factors: personal, social, environmental, and policy and programme. Findings were analysed and validated by a young adult with Down syndrome and a family member, using the public and patient involvement strategy.

RESULTS

Fourteen studies were included: eight with children and adolescents and six with adults. Of the 14 studies, 10 were qualitative and four quantitative. Most studies (n = 9) investigated participation in physical activities, while only a few examined participation in community/social activities (n = 3), daily activities (n = 2), and leisure activities (n = 1). The most commonly cited barriers and facilitators were the availability of programmes and specialized professionals, transportation, as well as attitudes and behaviours. Physical and psychological characteristics of people with Down syndrome and facilities were also frequently mentioned as barriers. On the other hand, the desire to stay active and personal interest in the activity were among the most frequently reported facilitators.

INTERPRETATION

The participation of people with Down syndrome is mainly influenced by physical or psychological factors, the support and attitudes of parents/caregivers, and the availability of specialized programmes. Given the scarcity of research investigating the participation of people with Down syndrome in community activities, daily activities, and leisure, especially in adults, more studies are still needed.

Quais são as barreiras e facilitadores para a participação de pessoas com Síndrome de Down? Uma Revisão de Escopo

Objetivo

Determinar as barreiras e facilitadores da participação ativa na comunidade de crianças, adolescentes e adultos com Síndrome de Down (SD). Métodos: Foram realizadas buscas em cinco bases de dados eletrônicas para identificar estudos originais sobre a participação de crianças, adolescentes (idades <18 anos) e adultos (idades de 18 a 59 anos) com SD. Barreiras e facilitadores para a participação foram categorizados em fatores: pessoais, sociais, ambientais e de políticas e programas. Os achados foram analisados e validados por um jovem adulto com SD e um membro da família, utilizando a estratégia de Envolvimento do Público e Paciente. Resultados: Quatorze estudos foram incluídos, oito com crianças e adolescentes e seis com adultos. Dos 14 estudos, dez eram qualitativos e quatro quantitativos. A maioria dos estudos (n = 9) investigou a participação em atividades físicas, enquanto apenas alguns estudos examinaram a participação em atividades comunitárias/sociais (n = 3), atividades diárias (n = 2) e atividades de lazer (n = 1). As barreiras e facilitadores mais frequentemente citados foram a disponibilidade de programas e profissionais especializados, transporte, bem como atitudes e comportamentos. As características físicas e psicológicas das pessoas com SD e as instalações também foram frequentemente mencionadas como barreiras. Por outro lado, o desejo de se manter ativo e o interesse pessoal na atividade estavam entre os facilitadores mais frequentemente relatados.

Interpretação

A participação de pessoas com SD é principalmente influenciada por fatores físicos ou psicológicos, o apoio e as atitudes dos pais/cuidadores e a disponibilidade de programas especializados. Dada a escassez de pesquisas investigando a participação de pessoas com SD em atividades comunitárias, atividades diárias e lazer, especialmente em adultos, mais estudos ainda são necessários.

Intervenções de esportes modificados para crianças e adolescentes com deficiência: Uma revisão de escopo

Resumo gráfico: Intervenções de esportes modificados para crianças e adolescentes com deficiência: Uma revisão de escopo.

Modified sports interventions for children and adolescents with disabilities: A scoping review

AIM

To establish the scope of the literature on modified sports interventions for children and adolescents with disabilities.

METHOD

For this scoping review, articles were screened and the characteristics of studies were extracted. The modified sports interventions were described in terms of their structure, using the items of the Template for Intervention Description and Replication. Components of intervention treatment were described by using the language of the Rehabilitation Treatment Specification System. Results were analysed and validated by a group of professionals, using the Public and Patient Involvement strategy.

RESULTS

Twelve studies were eligible for inclusion, investigating interventions for children with autism spectrum disorder, cerebral palsy, and other conditions. Most studies presented a moderate level of evidence. Active ingredients were repeated sports-related motor training and introduction to the sport through a 'learning by action' mechanism. The intervention target was gross motor skills performance, and intervention aims (indirect outcomes) were physical activity participation and different body functions.

INTERPRETATION

The inclusion of stakeholders in this review helped to validate our findings about the characteristics and structure of modified sports interventions, to identify research gaps, and to provide a step process for clinical implementation. Future investigations are warranted of the effectiveness of modified sports investigations with better quality studies, including participation outcomes and studies with non-ambulant children.

Recreational screen time behaviour among ambulatory children and adolescents diagnosed with cerebral palsy: A cross-sectional analysis

AIM

To describe the recreational screen time behaviour of 8-16-year-olds diagnosed with cerebral palsy (CP) and explore associations between health-related quality of life, sleep duration and physical activity behaviour versus screen time.

METHODS

This cross-sectional study used proxy-reported questionnaire data of 381 ambulatory (with or without assistance) 8-16-year-olds diagnosed with CP corresponding to Gross Motor Function Classification System (GMFCS) levels I-III. Descriptive statistics were used to report age, sex and the GMFCS level. The potential associations of health-related quality of life, physical activity behaviour and sleep duration (dependent variables) versus screen time (independent variable) were determined using multiple linear regression. Health-related quality of life was evaluated using the Pediatric Quality of Life Inventory, including seven dimensions: Daily Activities; School Activities; Movement and Balance; Pain and Hurt; Fatigue; Eating Activities; and Speech and Communication.

RESULTS

The participants spent a median screen time of 3.9 h daily. The boys spent a longer screen time during weekends than the girls (p = 0.003). Boys spent more time on games (p < 0.001), whereas girls spent more time on social media and video calls (p < 0.001). Increasing age (p < 0.001) was associated with increased screen time but did not differ between the GMFCS levels. Sleep duration, perceived fatigue and perceived movement and balance correlated negatively with screen time.

CONCLUSION

This study sheds light on the recreational screen time habits of ambulatory children and adolescents diagnosed with CP. Further investigation into the observed associations is warranted to investigate potential causation and relationships between sleep behaviour, quality of life and screen time behaviour.