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Gour-Provençal G, Costa C. Metabolic Syndrome in Children With Myelomeningocele and the Role of Physical Activity: A Narrative Review of the Literature. Top Spinal Cord Inj Rehabil 2022; 28:15-40. [PMID: 36017122 DOI: 10.46292/sci21-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objectives The purpose of this review is to describe the current scientific literature on the prevalence of metabolic syndrome in children with myelomeningocele and to gain insight into the baseline levels of aerobic fitness, endurance, and strength in this population in order to identify gaps in knowledge, suggest potential primary prevention strategies, and provide recommendations for future studies. Methods A literature review of articles published in English and French between 1990 and April 2020 was conducted. Results Obese adolescents with myelomeningocele have an increased prevalence of components of the metabolic syndrome. Children and adolescents with myelomeningocele have decreased aerobic fitness and muscular strength, decreased lean mass, and increased fat mass, all of which, when combined with higher levels of physical inactivity, put them at higher risk of developing metabolic syndrome and cardiovascular diseases. Conclusion Until more research is conducted, addressing weight-related challenges and promoting healthy habits (such as optimal activity levels) could be easily integrated into yearly myelomeningocele clinics. An actionable suggestion might be to systematically weigh and measure children in these clinics and utilize the results and trends as a talking point with the parents and children. The follow-up appointments could also be used to develop physical activity goals and monitor progress. We recommend that the health care practitioner tasked with this intervention (physician, nurse, etc.) should be aware of locally available accessible sports platforms and have knowledge of motivational interviewing to facilitate removal of perceived barriers to physical activity.
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Affiliation(s)
| | - Camille Costa
- Shriners Hospitals for Children-Canada, Montreal, Quebec, Canada
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Volfson Z, McPherson AC, Tomasone JR, Faulkner GE, Arbour-Nicitopoulos KP. Examining factors of physical activity participation in youth with spina bifida using the Theoretical Domains Framework. Disabil Health J 2020; 13:100922. [DOI: 10.1016/j.dhjo.2020.100922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/22/2020] [Accepted: 03/29/2020] [Indexed: 01/22/2023]
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Wingo BC, Yang D, Davis D, Padalabalanarayanan S, Hopson B, Thirumalai M, Rimmer JH. Lessons learned from a blended telephone/e-health platform for caregivers in promoting physical activity and nutrition in children with a mobility disability. Disabil Health J 2020; 13:100826. [PMID: 31416771 PMCID: PMC6901757 DOI: 10.1016/j.dhjo.2019.100826] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/16/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Children with physical disabilities report higher rates of sedentary lifestyle and unhealthy dietary patterns than non-disabled peers. These behaviors can increase comorbidities, caregiver burden, and healthcare costs. Innovative interventions are needed to assist caregivers of children with physical disabilities improve health behaviors. OBJECTIVE /Hypothesis: The purpose of this pilot study was to test the usability and preliminary efficacy of an e-health and telecoaching intervention compared to telecoaching alone. METHODS Parent/child dyads (n = 65) were randomized into either the e-health and telephone group (e-HT) or the telephone only group (TO). All participants received regular calls from a telecoach, and the e-HT group received access to a website with personalized weekly goals for diet and physical activity, and access to resources to meet these goals. At the conclusion of the intervention, participants in the e-HT group were asked to complete a semi-structured interview to discuss the usability of the e-health platform. RESULTS Fifty of the 65 randomized dyads (77%) completed all baseline measures and had at least one intervention call. Forty families (80% of those that started the intervention) completed the study (50% spina bifida, 24% mobility limitation, diagnosis not reported). Age of the children ranged from 6 to 17 years old. Both groups had high adherence to scheduled phone calls (e-HT (n = 17): 81%, TO (n = 23): 86%); however no significant differences in dietary intake or physical activity were seen within or between groups. Primary themes to emerge from qualitative interviewers were: the platform should target children rather than parents, parents valued the calls more than the website, and schools need to be involved in interventions. CONCLUSIONS E-health interventions are a promising way to promote healthy behaviors in children with physical disability, but technology must be balanced with ease of use for parents while also engaging the child.
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Affiliation(s)
- Brooks C Wingo
- Department of Occupational Therapy, University of Alabama at Birmingham, SHPB 353, 1720 2nd, Ave South, Birmingham, AL, 35294, USA; UAB/Lakeshore Research Collaborative, SHPB 331, 1720 2nd Ave South, Birmingham, AL, 35294, USA.
| | - Dershung Yang
- BrightOutcome, Inc, 1110 Lake Cook Road, Suite 167, Buffalo Grove, IL, 60089, USA.
| | - Drew Davis
- University of Alabama at Birmingham, Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, Dearth Tower, 5601 McWane, 1600 7th Ave South, Birmingham, AL, 35233-1711, USA.
| | | | - Betsy Hopson
- University of Alabama at Birmingham, Department of Pediatrics, Division of Pediatric Rehabilitation Medicine, Dearth Tower, 5601 McWane, 1600 7th Ave South, Birmingham, AL, 35233-1711, USA.
| | - Mohanraj Thirumalai
- UAB/Lakeshore Research Collaborative, SHPB 331, 1720 2nd Ave South, Birmingham, AL, 35294, USA; Department of Health Services Administration, University of Alabama at Birmingham, SHPB 590E, 1720 2nd, Ave South, Birmingham, AL, 35294, USA.
| | - James H Rimmer
- UAB/Lakeshore Research Collaborative, SHPB 331, 1720 2nd Ave South, Birmingham, AL, 35294, USA.
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Nowak AM, Molik B, Marszałek J. Anaerobic performance among children with spina bifida. J Sports Med Phys Fitness 2019; 60:132-139. [PMID: 31343148 DOI: 10.23736/s0022-4707.19.09883-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Children and adolescents with spina bifida demonstrate less physical activity. Most of them are wheelchair users. It is important to control their physical fitness for instance their anaerobic performance. They need anaerobic performance to daily activities like transfers that require short and high intensity movements. The aim of this study was to assess anaerobic performance among children with spina bifida and to evaluate their results in relation to normative values from able-bodied peers, as well as to find appropriate, easy and feasible field-based tests measuring anaerobic performance of children with spina bifida in non-laboratory settings. METHODS Ninety-five children and adolescents with spina bifida were divided according to gender and age (four male and four female groups) and performed the 30-second Wingate Anaerobic Test (WAnT), the handgrip test and the chest pass test. The Kolmogorov-Smirnov test, the Kruskal-Wallis test, the Mann-Whitney U-test, the Pearson correlation (P<0.05) and Effect Size were applied in this study. RESULTS Differences in MP, PP, rMP and rPP between age groups were found. A significant and strong correlation of the 30-second WAnT results (MP, PP) with the handgrip test and the chest pass test was found (P<0.01; r>0.7). CONCLUSIONS In conclusion, anaerobic performance of children with spina bifida varies depending on the age group and is "very poor" compared to anaerobic performance of their able-bodied peers. The chest pass test may be a good non-laboratory test to be used to indirectly assess anaerobic performance of children with spina bifida.
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Affiliation(s)
- Agnieszka M Nowak
- Department of Physiotherapy, Jozef Pilsudski University of Physical Education, Warsaw, Poland -
| | - Bartosz Molik
- Department of Physiotherapy, Jozef Pilsudski University of Physical Education, Warsaw, Poland
| | - Jolanta Marszałek
- Department of Physiotherapy, Jozef Pilsudski University of Physical Education, Warsaw, Poland
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Bloemen MAT, van den Berg-Emons RJG, Tuijt M, Nooijen CFJ, Takken T, Backx FJG, Vos M, de Groot JF. Physical activity in wheelchair-using youth with spina bifida: an observational study. J Neuroeng Rehabil 2019; 16:9. [PMID: 30642361 PMCID: PMC6332897 DOI: 10.1186/s12984-018-0464-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 11/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Even though typically developing youth are already at risk for physical inactivity, youth with spina bifida may be even at higher risk as a consequence of their reduced mobility. No objective data is available for youth with spina bifida who use a manual wheelchair, so the seriousness of the problem is unknown. The purpose of this observational study was to quantify physical activity in wheelchair-using youth with spina bifida and evaluate the intensity of activities. METHODS Fifty-three children and adolescents (5-19 years) with spina bifida who use a manual wheelchair for daily life, long distances or sports were included. To assess time spent in several types of activities VitaMove data of 34 participants were used and were presented as time spent sedentary and time spent physically active. This was compared to reference data of typically developing youth. To assess time spent in several intensities Actiheart data of 36 participants were used. The intensities were categorized according to the American College of Sports Medicine, ranging from very light intensity to near to maximal intensity. Data of 25 participants were used to combine type of activity and intensity. RESULTS Children and adolescents with spina bifida who use a manual wheelchair were more sedentary (94.3% versus 78.0% per 24 h, p < 0.000) and less physically active (5.0% versus 12.2% per 24 h, p < 0.000) compared to typically developing peers. Physical activity during weekend days was worse compared to school days; 19% met the Guidelines of Physical Activity during school days and 8% during weekend days. The intensities per activity varied extensively between participants. CONCLUSIONS Children and adolescents with spina bifida who use a manual wheelchair are less physically active and more sedentary than typically developing youth. The physical activity levels on school days seem to be more favorable than the physical activity levels on a weekend day. The low levels of physical activity need our attention in pediatric rehabilitation practice. The different intensities during activities indicate the importance of individually tailored assessments and interventions.
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Affiliation(s)
- Manon A T Bloemen
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.
| | | | - Matthijs Tuijt
- Research Group Human Movement and Adaptation, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Carla F J Nooijen
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tim Takken
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank J G Backx
- Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marleen Vos
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Janke F de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.,Quality and Organization of Care, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
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McPherson AC, Ball GD, Maltais DB, Swift JA, Cairney J, Knibbe TJ, Krog K. A Call to Action: Setting the Research Agenda for Addressing Obesity and Weight-Related Topics in Children with Physical Disabilities. Child Obes 2016; 12:59-69. [PMID: 26716496 PMCID: PMC4753575 DOI: 10.1089/chi.2015.0119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pediatric obesity is a world-wide challenge. Children with physical disabilities are particularly at risk of obesity, which is worrisome because obesity can result in serious secondary conditions that decrease health status, reduce independence, and increase impact on healthcare systems. However, the determinants of obesity and the health promotion needs of children with physical disabilities are relatively unexplored compared with their typically developing peers. METHODS This white paper describes a Canadian multi-stakeholder workshop on the topic of obesity and health in children with physical disabilities and provides recommendations for future research in this understudied area. RESULTS Seventy-one knowledge gaps identified by attendees using a modified nominal group technique clustered into six themes: (1) early, sustained engagement of families; (2) rethinking determinants of obesity and health; (3) maximizing impact of research; (4) inclusive integrated interventions; (5) evidence-informed measurement and outcomes; and (6) reducing weight biases. Attendees worked together to develop research plans in more detail for three areas identified through consensus as high priority: "early, sustained engagement of families;" "rethinking determinants of obesity and health;" and "evidence informed measurement and outcomes." CONCLUSIONS Using the workshop described here as a call to action, Canadian researchers are now well positioned to work toward a greater understanding of weight-related topics in children with physical disabilities, with the aim of developing evidence-based and salient obesity prevention and treatment approaches.
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Affiliation(s)
- Amy C. McPherson
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Geoff D.C. Ball
- Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Désirée B. Maltais
- Department of Rehabilitation, Laval University, Québec City, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Québec, Canada
| | - Judy A. Swift
- School of Biosciences, The University of Nottingham, Nottingham, United Kingdom
| | - John Cairney
- Departments of Family Medicine, Psychiatry and Behavioral Neurosciences, and Kinesiology, Hamilton, Ontario, Canada
- CanChild Center for Studies in Childhood Disability, Hamilton, Ontario, Canada
- INCH Lab, McMaster University, Hamilton, Ontario, Canada
| | - Tara Joy Knibbe
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Kim Krog
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto. Toronto, Ontario, Canada
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McDonald ML, Huang A, Proudfoot JA, Le JT, Chiang GJ, Bush RA. Association of Obesity, BMI, and Hispanic Ethnicity on Ambulatory Status in Children with Spinal Dysraphism followed near the California-Mexico Border. J Health Care Poor Underserved 2016; 27:1956-1969. [PMID: 27818449 PMCID: PMC5147503 DOI: 10.1353/hpu.2016.0173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE Evaluate the relationship between body mass index (BMI), overweight status (OW), or obesity (OB) and ambulatory status in a predominantly Hispanic population of children with spinal dysraphism (SD). METHODS Retrospective data were extracted from records of 272 children and youth aged 0-24 years with a diagnosis of SD. Body mass index (BMI) and OW / OB rates were calculated for children 0-3 years, 4-11 years, and adolescents older than 11. RESULTS Ethnicity was predominantly Hispanic (65.4%). No difference in mean BMI or OW / OB rate was found between ambulation groups (p = .20; p = .72). Mean BMI and OW / OB rate increased with increasing age in all groups (p < .001; p = .02). Forty-four percent of patients were OW / OB, which was greater among Hispanics (48.2%) compared with non-Hispanics [(35.2%), p = .03]. Female gender was a risk factor for increased BMI among Hispanics (p = .00). CONCLUSION Despite no difference in ambulatory status, increasing BMI and OW / OB are associated with Hispanic ethnicity and increasing age.
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Personal and environmental factors to consider when aiming to improve participation in physical activity in children with Spina Bifida: a qualitative study. BMC Neurol 2015; 15:11. [PMID: 25886148 PMCID: PMC4336512 DOI: 10.1186/s12883-015-0265-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/20/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Youth with spina bifida (SB) are less fit and active than other groups with childhood disability. While recent studies have shown benefits of exercise training, the increased fitness levels do not sustain or lead to increased levels of physical activity (PA) in these children. Therefore, it seems important to explore which factors are associated with participation in PA (or lack of) in youth with SB. The objective of this study is to describe both personal and environmental factors that are important for participation in physical activity as experienced by these children and their parents, in order to better develop intervention strategies to improve participation in PA in youth with SB. METHODS Eleven semi-structured interviews with parents of children with SB aged 4-7 years, nine focus groups with youth with SB (n = 33, age 8-18 years) and eight focus groups with their parents (n = 31) were conducted, recorded and transcribed verbatim. Two independent researchers analyzed the data. Central themes for physical activity were constructed, using the model for Physical Activity for Persons with a Disability (PAD model) as a background scheme. RESULTS Data showed that youth with SB encountered both personal and environmental factors associated with participation in PA on all levels of the PAD model. Bowel and bladder care, competence in skills, sufficient fitness, medical events and self-efficacy were important personal factors. Environmental factors that were associated with physical activity included the contact with and support from other people, the use of assistive devices for mobility and care, adequate information regarding possibilities for adapted sports and accessibility of playgrounds and sports facilities. CONCLUSIONS Our findings suggest that a variety of both personal and environmental factors were either positively or negatively associated with participation in PA. An individual approach, assessing possibilities rather than overcoming barriers within and surrounding the child may be a good starting point when setting up intervention programs to improve participation in PA. Therefore, assessment of both personal and environmental factors associated with physical activity should be standard care within multidisciplinary intervention programs aimed to encourage healthy active lifestyles in youth with SB.
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Stark C, Hoyer-Kuhn HK, Semler O, Hoebing L, Duran I, Cremer R, Schoenau E. Neuromuscular training based on whole body vibration in children with spina bifida: a retrospective analysis of a new physiotherapy treatment program. Childs Nerv Syst 2015; 31:301-9. [PMID: 25370032 DOI: 10.1007/s00381-014-2577-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 10/20/2014] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Spina bifida is the most common congenital cause of spinal cord lesions resulting in paralysis and secondary conditions like osteoporosis due to immobilization. Physiotherapy is performed for optimizing muscle function and prevention of secondary conditions. Therefore, training of the musculoskeletal system is one of the major aims in the rehabilitation of children with spinal cord lesions. INTERVENTION AND METHODS The neuromuscular physiotherapy treatment program Auf die Beine combines 6 months of home-based whole body vibration (WBV) with interval blocks at the rehabilitation center: 13 days of intensive therapy at the beginning and 6 days after 3 months. Measurements are taken at the beginning (M0), after 6 months of training (M6), and after a 6-month follow-up period (M12). Gait parameters are assessed by ground reaction force and motor function by the Gross Motor Function Measurement (GMFM-66). Sixty children (mean age 8.71 ± 4.7 years) who participated in the program until February 2014 were retrospectively analyzed. RESULTS Walking velocity improved significantly by 0.11 m/s (p = 0.0026) and mobility (GMFM-66) by 2.54 points (p = 0.001) after the training. All changes at follow-up were not significant, but significant changes were observed after the training period. Decreased contractures were observed with increased muscle function. CONCLUSION Significant improvements in motor function were observed after the active training period of the new neuromuscular training concept. This first analysis of the new neuromuscular rehabilitation concept Auf die Beine showed encouraging results for a safe and efficient physiotherapy treatment program which increases motor function in children with spina bifida.
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Affiliation(s)
- C Stark
- Children's Hospital, University of Cologne, Cologne, Germany,
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Marques A, Maldonado I, Peralta M, Santos S. Exploring psychosocial correlates of physical activity among children and adolescents with spina bifida. Disabil Health J 2014; 8:123-9. [PMID: 25091554 DOI: 10.1016/j.dhjo.2014.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/03/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND To enhance physical activity of children with spina bifida, it is important to investigate the correlates of physical activity to support the development of interventions to promote active lifestyles. OBJECTIVE This study aimed to identify psychosocial correlates of physical activity among children and adolescents with spina bifida. METHODS A survey was conducted with 31 students (15 boys), aged 10-17 years with spina bifida. A questionnaire was used to collect data of physical activity, demographic and psychosocial variables (attitudes, sports goal orientation and perceptions). Unadjusted and adjusted binary logistic regressions were performed to examine the relationship of psychosocial factors and physical activity participation. Data were collected in 2013. RESULTS Only 38.7% reported to participate in both organized and non-organized physical activity. Results showed no relationship between participation in organized and non-organized physical activity and psychosocial correlates. The result of the adjusted regression analysis show that perception of competence (OR = 9.55, 1.06-85.99, p < 0.05) was the only variable positively associated with participation in non-organized physical activity. CONCLUSIONS Most of the participants reported that they did not participate in physical activity regularly. Psychosocial variables were not related with physical activity, except perception of competence. Studies with bigger samples are needed, focused on the same and in others factors to identify the predictors of physical activity of young people with spina bifida.
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Affiliation(s)
- Adilson Marques
- Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz-Quebrada, Lisbon, Portugal.
| | - Inês Maldonado
- Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz-Quebrada, Lisbon, Portugal
| | - Miguel Peralta
- Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz-Quebrada, Lisbon, Portugal
| | - Sofia Santos
- Faculty of Human Kinetics, University of Lisbon, Estrada da Costa, 1499-002 Cruz-Quebrada, Lisbon, Portugal
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