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Flores MB, Ardolino EM, J Manella K. Current Trends for Children With Spina Bifida: A Survey of Pediatric Physical Therapists. Pediatr Phys Ther 2024:00001577-990000000-00088. [PMID: 38830058 DOI: 10.1097/pep.0000000000001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
PURPOSE To describe contemporary physical therapy practice and management of children with spina bifida (SB) in the context of the International Classification of Functioning, Disability, and Health (ICF) framework. METHODS A descriptive, cross-sectional electronic survey was sent to US pediatric physical therapy clinics and posted in the American Physical Therapy Association Pediatrics newsletter. Data were analyzed using content analysis. Codes were compared, refined, and condensed into categories. RESULTS A total of 163 participants were included. Most assessments evaluated the ICF Activity component. Most frequently reported ICF components: impairments = decreased strength (17.9%), activity limitations = limited walking (22.5%), and participation restrictions = restricted socializing/playing with peers or siblings (22.6%). The most prevalent intervention was strength training. CONCLUSIONS Physical therapists (PTs) in the United States are performing assessments and interventions supported by available evidence; however, knowledge translation and more research are needed to support best practices in PT management of children with SB.
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Affiliation(s)
- Megan B Flores
- Department of Physical Therapy (Drs Flores and Ardolino), Baylor University, Waco, Texas; Doctor of Physical Therapy Program (Manella), Nova Southeastern University - Tampa Bay Regional Campus, Clearwater, Florida
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2
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Seemüller S, Beck F, Reimers AK. Physical activity of children and adolescents who use a wheelchair: a systematic review. BMC Public Health 2023; 23:2479. [PMID: 38082282 PMCID: PMC10714460 DOI: 10.1186/s12889-023-17201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78-115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.
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Affiliation(s)
- Selina Seemüller
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Franziska Beck
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anne Kerstin Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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3
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Arbour-Nicitopoulos KP, Mitra R, Sharma R, Moore SA. Outdoor Physical Activity and Play Among Canadian Children and Youth With Disabilities During the COVID-19 Pandemic: Findings From the National Physical Activity Measurement Study. Adapt Phys Activ Q 2023; 40:571-586. [PMID: 36750116 DOI: 10.1123/apaq.2022-0080] [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: 04/20/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 02/09/2023] Open
Abstract
This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play.
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Affiliation(s)
| | - Raktim Mitra
- School of Urban and Regional Planning, Ryerson University, Toronto, ON,Canada
| | - Ritu Sharma
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON,Canada
| | - Sarah A Moore
- School of Health and Human Performance, Dalhousie University, Halifax, NS,Canada
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Pituch E, Rushton PW, Culley K, Houde M, Lahoud A, Lettre J, Routhier F. Exploration of pediatric manual wheelchair confidence among children, parents, and occupational therapists: a qualitative study. Disabil Rehabil Assist Technol 2023; 18:1229-1236. [PMID: 34806519 DOI: 10.1080/17483107.2021.2001059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Manual wheelchair (MWC) confidence is a predictor of adult life-space mobility and social participation. To date, scientific literature specific to pediatric MWC confidence is scarce which prevents in-depth understanding. The objective of this study was to explore the perceptions of pediatric MWC users (PMWU), parents, and occupational therapists regarding pediatric MWC confidence. METHODS Five focus groups were conducted with PMWUs (n = 12) and occupational therapists (n = 9), and semi-structured interviews were conducted with parents of PMWUs (n = 2). Inductive thematic analysis was performed following verbatim transcription of audio recorded material. RESULTS Three overarching themes were identified across PMWUs, parents, and occupational therapists: (1) "MWC confidence is not a clinical priority" depicted the construct's varying level of clinical priority and perceived abstractness; (2) "MWC confidence is both a child and parent consideration" revealed nuances between the PMWU's MWC confidence and the parents' perception of the PMWU's MWC confidence; and (3) "Opportunities to develop MWC confidence are context-specific" contrasted afforded and unafforded opportunities to experience independent MWC mobility. CONCLUSIONS Pediatric MWC confidence is an important aspect of wheelchair use that is shaped by a multitude of factors in PMWU's lives. This new area of pediatric study provides support for the need to measure this important construct.IMPLICATIONS FOR REHABILITATIONThis study is the first to explore children's, parents', and occupational therapists' perceptions of pediatric MWC confidence.Pediatric MWC confidence impacts MWC use in a multifaceted fashion.Future studies should consider the development and validation of a self-report measure to assess pediatric MWC confidence.
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Affiliation(s)
- Evelina Pituch
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montréal, Canada
| | - Paula W Rushton
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Kim Culley
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Martine Houde
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Alexandra Lahoud
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, Canada
- Centre Hospitalier Universitaire Sainte-Justine Research Centre, Montréal, Canada
| | - Josiane Lettre
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
| | - François Routhier
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City, Canada
- Department of Rehabilitation, Université Laval, Quebec City, Canada
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5
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Best KL, Rushton PW, Sheriko J, Arbour-Nicitopoulos KP, Dib T, Kirby RL, Lamontagne ME, Moore SA, Ouellet B, Routhier F. Effectiveness of wheelchair skills training for improving manual wheelchair mobility in children and adolescents: protocol for a multicenter randomized waitlist-controlled trial. BMC Pediatr 2023; 23:485. [PMID: 37752480 PMCID: PMC10521483 DOI: 10.1186/s12887-023-04303-8] [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: 04/27/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Self-directed mobility during childhood can influence development, social participation, and independent living later in life. For children who experience challenges with walking, manual wheelchairs (MWCs) provide a means for self-directed mobility. An effective MWC skills training program exists for adults, but controlled trials have not yet been documented in children and adolescents. This paper outlines the protocol for a multi-centre randomized wait-list controlled trial. The primary objective is to test the hypothesis that children and adolescents who receive MWC skills training will have higher MWC skills capacity compared to children and adolescents in the control group who receive usual care. The secondary objectives are to explore the influence of MWC skills training in children and adolescents (MWC use self-efficacy and satisfaction with participation in meaningful activities), and parents (perceived MWC skills); and to measure retention three months later. METHODS A multi-centre, parallel-group, single-blind randomized wait-list controlled trial will be conducted. A sample of 60 children and adolescents who use MWCs will be recruited in rehabilitation centres, specialized schools, and the communities of three Canadian cities. Participants will be randomized (1:1) to the experimental (Wheelchair Skills Training Program [WSTP]) or wait-list control group (usual care). Performance-based and self-report measures will be completed at baseline (T1), three months (post-intervention, T2), and three months post-intervention (T3). The primary outcome will be MWC skills capacity post-intervention. Secondary outcomes will be MWC use self-efficacy and satisfaction with participation of the child/adolescent, and parent-perceived MWC skills. The WSTP will consist of 12 sessions, 45-60 min each, delivered 1-2 times per week by trained personnel with health professions education. Training will be customized according to the child's baseline skills and participation goals that require the use of the MWC. The wait-list control group will receive usual care for 3 months and then receive the WSTP after completing T2 evaluations. Data will be analysed using ANCOVA (controlling for baseline scores). DISCUSSION MWC skills training may be one way to improve self-directed mobility and related outcomes for children and adolescents. The results of this multi-centre randomized wait-list controlled trial will allow for the effectiveness of the intervention to be evaluated in a variety of clinical contexts and geographical regions. TRIAL REGISTRATION ClinicalTrials.gov: NCT05564247, Version October 3, 2022.
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Affiliation(s)
- K L Best
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada.
| | - P W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - J Sheriko
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - K P Arbour-Nicitopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, M5S 2W6, Canada
| | - T Dib
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
- CHU Sainte-Justine Research Center, Marie Enfant Rehabilitation, Montréal, QC, H1T 1C9, Canada
| | - R L Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, B3H 4K4, Canada
| | - M E Lamontagne
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - S A Moore
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - B Ouellet
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
| | - F Routhier
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, QC, G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé Et de Services Sociaux de La Capitale-Nationale, 525 Wilfrid-Hamel Boulevard, Quebec City, QC, G1M 2S8, Canada
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Tucker S, Heneghan NR, Gardner A, Rushton A, Alamrani S, Soundy A. Factors Influencing Participation in Physical Activity, Sports, and Exercise in Children and Adolescents with Spinal Pain or Spinal Conditions: A Systematic Review and Meta-Ethnography. Behav Sci (Basel) 2023; 13:486. [PMID: 37366738 DOI: 10.3390/bs13060486] [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: 03/23/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This review identifies factors influencing participation in sports, exercise, and physical activity in those aged 18 or under with spinal pain or spinal conditions. Trends or differences between discrete sub-populations are identified. METHODS A meta-ethnographic review was undertaken. Qualitative papers were identified and appraised using the JBI checklist. Thematic trends were mapped onto the biopsychosocial model and subthemes identified. Uniqueness was calculated and the confidence in the evidence was evaluated using the GRADE-CERQual tool. RESULTS Data were gathered from nine qualitative papers (384 participants). Three themes were identified: (1) biological: physical challenges and bladder and bowel care; (2) psychological: perceptions of differences to peers, struggle, anger, sadness, adjustment, and acceptance; and (3) sociological: influence of friends, social acceptance, negative attitudes from others, and the influence of their disability on family routine. CONCLUSIONS Sociological factors were most influential on exercise participation alongside related psychological and biological factors. Adolescents over 14 years offered greater critical insight compared to the younger children. Results are best applied to neuromuscular conditions with further robust evidence required in paediatric musculoskeletal spinal pain.
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Affiliation(s)
- Susanna Tucker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Adrian Gardner
- Spinal Surgery, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham B31 2AP, UK
| | - Alison Rushton
- School of Physical Therapy, Western University Canada, London, ON N6A 3K7, Canada
| | - Samia Alamrani
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
- Physical Therapy Department, University of Tabuk, Tabuk 47512, Saudi Arabia
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK
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Tucker S, Heneghan NR, Alamrani S, Rushton A, Gardner A, Soundy A. Barriers and facilitators of physical function, activity, sports and exercise in children and adolescents with spinal pain: a protocol for a systematic review and meta-ethnography. BMJ Open 2023; 13:e063946. [PMID: 36927588 PMCID: PMC10030483 DOI: 10.1136/bmjopen-2022-063946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Spinal pain is one of the leading causes of disability, with the incidence of adolescent back pain estimated at 20%. Multiple barriers influence exercise participation in adolescents. However, there remains a lack of literature surrounding patients' choice to exercise, perceived barriers and facilitators of exercise, and their relationship to participant demographics. The aim of this systematic review with meta-ethnography will be to identify the barriers and facilitators of exercise participation among adolescents with thoracic or lower back pain (LBP). The secondary aim will be to identify any trends in barriers and facilitators of exercise between different demographic groups within children or adolescents under 18 years. METHODS AND ANALYSIS The seven-phase process identified by Noblit and Hare's meta-ethnography approach will be used. A comprehensive electronic search of databases (AMED, CINAHLplus, EMBASE, MEDLINE, SCOPUS, Nursing & Allied Health, PubMed, PsycINFO, SPORTDiscus, Social Science Database) will be completed during April 2022. Grey literature using reference lists, websites and search engines will also be searched in accordance with Peer Review of Electronic Search Strategies (PRESS) guidelines. Inclusion criteria include: (A) qualitative studies, (B) participants under 18 years experiencing thoracic or LBP, (C) identification of barriers and facilitators of exercise participation in exercise, sports or physical activity and (D) primary research. This systematic review with meta-ethnography review aims to generate theories of behaviours and interpret significance across multiple studies. This process aims to develop future physiotherapeutic behavioural interventions, inform service provision and identify possible future research questions. ETHICS AND DISSEMINATION No ethical approval was required due to the nature of using previously published work to form a systematic review paper. This systematic review and meta-ethnography will be disseminated through both conference presentations and journal publications. No funding was received for this review. PROSPERO REGISTRATION NUMBER CRD42022314796.
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Affiliation(s)
- Susanna Tucker
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Nicola R Heneghan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samia Alamrani
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- School of Physical Therapy, Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Adrian Gardner
- Spinal Surgery, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Andrew Soundy
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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8
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Ouellet B, Best KL, Wilson D, Miller WC. Exploring the Influence of a Community-Based Peer-Led Wheelchair Skills Training on Satisfaction with Participation in Children and Adolescents with Cerebral Palsy and Spina Bifida: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11908. [PMID: 36231211 PMCID: PMC9564843 DOI: 10.3390/ijerph191911908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Peer-led approaches improve satisfaction with participation, wheelchair skills and wheelchair use self-efficacy in adults, but the evidence is limited in children. This pilot study aimed to explore the influence of community-based, peer-led, group wheelchair training program (i.e., Seating To Go) on satisfaction with participation (primary outcome), wheelchair skills, and wheelchair use self-efficacy in children and adolescents with cerebral palsy and spina bifida. METHODS A single group pre-post design was used. Invitations were shared online and diffused by clinicians and advocacy and provider groups to recruit a convenience sample of eight pediatric wheelchair users. Participants completed the Seating To Go program in groups that were facilitated by adult wheelchair users. Satisfaction with participation (Wheelchair Outcome Measure-Young People), wheelchair skills (Wheelchair Skills Test), wheelchair use self-efficacy (Wheelchair Use Confidence Scale), and perceived wheelchair skills capacity (Wheelchair Skills Test Questionnaire; proxy rating: parents) were evaluated before and after the Seating To Go program. Descriptive statistics and nonparametric longitudinal data analysis were conducted to explore changes in all outcomes from baseline to post-intervention. RESULTS Pediatric wheelchair users (ranging in age from 5 to 15 years) and their parents reported statistically significant improvements in satisfaction with participation. The improvements in wheelchair skills and wheelchair confidence were also statistically significant, but not the parents' perception of their children's wheelchair skills. CONCLUSIONS A community-based peer-led approach to wheelchair skills training seems promising for improving wheelchair outcomes in pediatric wheelchair users. Further controlled studies with larger samples are warranted.
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Krista L. Best
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec City, QC G1V 0A6, Canada
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre Intégré Universitaire en Santé et en Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Deb Wilson
- Seating To Go—Geneva Healthcare, Hamilton 3204, New Zealand
| | - William C. Miller
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC V6T 2B5, Canada
- G.F. Strong Rehabilitation Centre—Rehabilitation Research Lab, Vancouver, BC V5Z 2G9, Canada
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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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10
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Ouellet B, Rushton PW, Côté AA, Fortin-Haines L, Lafleur E, Paré I, Barwick M, Kirby RL, Robert MT, Routhier F, Dib T, Burrola-Mendez Y, Best KL. Evaluation of pediatric-specific resources to support utilization of the Wheelchair Skills Training Program by the users of the resources: a descriptive qualitative study. BMC Pediatr 2022; 22:500. [PMID: 36002816 PMCID: PMC9402274 DOI: 10.1186/s12887-022-03539-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's ability to engage in meaningful activities is positively influenced by their ability to move independently. Preliminary evidence in children suggests that wheelchair skills training improves wheelchair skills, which are important for independent mobility. The Wheelchair Skills Training Program is a standardized program to teach wheelchair skills. However, it is underutilized in pediatric rehabilitation settings. To increase its utilization, 3 pediatric-specific Wheelchair Skills Training Program resources related to indoor skills were developed (i.e., a storybook, four instructional posters, and a training workbook). This study aimed to describe occupational therapists' (OTs) and pediatric manual wheelchair users' (PMWUs) perceived satisfaction with the storybook, instructional posters and training workbook, and to explore their perceptions regarding the usability, relevance, and feasibility of these resources in pediatric rehabilitation settings. METHODS A descriptive qualitative design was used. Convenience samples of OTs and PMWUs were recruited in a rehabilitation center and affiliated schools. A focus group with OTs and semi-structured interviews with PMWUs were conducted by videoconference to obtain participants' feedback on the resource prototypes and suggestions for improvement. Data were deductively analyzed using the Framework method. RESULTS Eight OTs and 5 PMWUs expressed general satisfaction with the resources, describing them as usable, relevant, and feasible to integrate into wheelchair skills training with novice wheelchair users and younger children. All OTs and 3 PMWUs expressed the desire to use the resources for wheelchair skills training. Two PMWUs perceived the resources were not relevant to them because they already mastered the skills. The participants suggested minor modifications for improving the resources (e.g., more action in the story, increased precision of illustrations related to the characters' position in the wheelchair). CONCLUSION OTs and PMWUs were satisfied with the resources, perceiving them to be applicable for training wheelchair skills among young children and novice wheelchair users. The resources represent a concrete solution to facilitate the use of the Wheelchair Skills Training Program in pediatric rehabilitation settings. Additional resources are needed to better reach older and more experienced PMWUs (i.e., of intermediate and advanced skill levels).
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Affiliation(s)
- Béatrice Ouellet
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada. .,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada.
| | - Andrée-Anne Côté
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | | | - Emma Lafleur
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Isabelle Paré
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada
| | - Melanie Barwick
- University of Toronto, Toronto, ON, Canada.,SickKids Research Institute, Toronto, ON, Canada
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, NS, Canada
| | - Maxime T Robert
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Tatiana Dib
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada.,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada
| | - Yohali Burrola-Mendez
- School of Rehabilitation, Université de Montréal, Montréal, QC, Canada.,CHU Sainte-Justine Research Center, 5200, rue Bélanger Est, Montréal, QC, H1T 1C9, Canada
| | - Krista L Best
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, QC, Canada
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Petronic Markovic I, Nikolic D, Stahl M, Tederko P, Hdyrya O, Negrini S, Zampolini M, Kiekens C. Evidence-based position paper of the UEMS PRM on the role of Physical and Rehabilitation Medicine (PRM) physician in the management of children and adults with spinal dysraphism. Eur J Phys Rehabil Med 2022; 58:511-519. [PMID: 35575455 PMCID: PMC9980507 DOI: 10.23736/s1973-9087.22.07536-0] [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: 11/08/2022]
Abstract
Spinal dysraphism (SD) or spina bifida (SB) is a congenital deformity that results from embryonic neural tube closure failure during fetal development. This evidence-based position paper represents the official position of the European Union through the UEMS PRM Section. This paper aims to evaluate the role of the physical and rehabilitation medicine (PRM) physician and PRM practice for children and adults with spinal dysraphism. A systematic literature review and a consensus procedure involved all European countries delegates represented in the UEMS PRM section through a Delphi process. The systematic literature review is reported together with thirty-two recommendations resulting from the Delphi procedure. The professional role of the PRM physician requires specific expertise in the treatment of patients with SD to plan, lead and monitor the rehabilitation process in an interdisciplinary setting and to participate in the assessment of the needs of these patients in the transitional phase from childhood to adulthood, with particular attention to the activity limitation and participation restriction.
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Affiliation(s)
- Ivana Petronic Markovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Department of Physical Medicine and Rehabilitation, University Children's Hospital, Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia - .,Department of Physical Medicine and Rehabilitation, University Children's Hospital, Belgrade, Serbia
| | - Minna Stahl
- National Center for Pediatric and Adolescent Pain Management and Research, New Children's Hospital, HUS, Helsinki, Finland
| | - Piotr Tederko
- Department of Rehabilitation, Medical University of Warsaw, Warsaw, Poland
| | - Oksana Hdyrya
- Department of Rehabilitation and Alternative Medicine, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Stefano Negrini
- La Statale University, Milan, Italy.,IRCCS Galeazzi Orthopedic Institute, Milan, Italy
| | - Mauro Zampolini
- Department of Rehabilitation, San Giovanni Battista Hospital, Foligno, Perugia, Italy
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12
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Bolster EAM, van Gessel C, Welten M, Hermsen S, van der Lugt R, Kotte E, van Essen A, Bloemen MAT. Using a Co-design Approach to Create Tools to Facilitate Physical Activity in Children With Physical Disabilities. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:707612. [PMID: 36188842 PMCID: PMC9397745 DOI: 10.3389/fresc.2021.707612] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022]
Abstract
Introduction: There is a lack of effective interventions available for Pediatric Physical Therapists (PPTs) to promote a physically active lifestyle in children with physical disabilities. Participatory design methods (co-design) may be helpful in generating insights and developing intervention prototypes for facilitating a physically active lifestyle in children with physical disabilities (6–12 years). Materials and methods: A multidisciplinary development team of designers, developers, and researchers engaged in a co-design process–together with parents, PPTs, and other relevant stakeholders (such as the Dutch Association of PPTs and care sports connectors). In this design process, the team developed prototypes for interventions during three co-creation sessions, four one-week design sprint, living-lab testing and two triangulation sessions. All available co-design data was structured and analyzed by three researchers independently resulting in themes for facilitating physical activity. Results: The data rendered two specific outcomes, (1) knowledge cards containing the insights collected during the co-design process, and (2) eleven intervention prototypes. Based on the generated insights, the following factors seem important when facilitating a physically active lifestyle: a) stimulating self-efficacy; b) stimulating autonomy; c) focusing on possibilities; d) focusing on the needs of the individual child; e) collaborating with stakeholders; f) connecting with a child's environment; and g) meaningful goal setting. Conclusion: This study shows how a co-design process can be successfully applied to generate insights and develop interventions in pediatric rehabilitation. The designed prototypes facilitate the incorporation of behavioral change techniques into pediatric rehabilitation and offer new opportunities to facilitate a physically active lifestyle in children with physical disabilities by PPTs. While promising, further studies should examine the feasibility and effectivity of these prototypes.
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Affiliation(s)
- Eline A. M. Bolster
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, Netherlands
- *Correspondence: Eline A. M. Bolster
| | - Christa van Gessel
- Co-design Research Group, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Maxime Welten
- Research Group Participation and Urban Development, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Sander Hermsen
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, Netherlands
- OnePlanet Research Center, Imec the Netherlands, Wageningen, Netherlands
| | - Remko van der Lugt
- Co-design Research Group, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | | | - Anita van Essen
- Co-design Research Group, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Manon A. T. Bloemen
- Research Group Lifestyle and Health, Utrecht University of Applied Sciences, Utrecht, Netherlands
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13
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Bray N, Kolehmainen N, McAnuff J, Tanner L, Tuersley L, Beyer F, Grayston A, Wilson D, Edwards RT, Noyes J, Craig D. Powered mobility interventions for very young children with mobility limitations to aid participation and positive development: the EMPoWER evidence synthesis. Health Technol Assess 2021; 24:1-194. [PMID: 33078704 DOI: 10.3310/hta24500] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND One-fifth of all disabled children have mobility limitations. Early provision of powered mobility for very young children (aged < 5 years) is hypothesised to trigger positive developmental changes. However, the optimum age at which to introduce powered mobility is unknown. OBJECTIVE The aim of this project was to synthesise existing evidence regarding the effectiveness and cost-effectiveness of powered mobility for very young children, compared with the more common practice of powered mobility provision from the age of 5 years. REVIEW METHODS The study was planned as a mixed-methods evidence synthesis and economic modelling study. First, evidence relating to the effectiveness, cost-effectiveness, acceptability, feasibility and anticipated outcomes of paediatric powered mobility interventions was reviewed. A convergent mixed-methods evidence synthesis was undertaken using framework synthesis, and a separate qualitative evidence synthesis was undertaken using thematic synthesis. The two syntheses were subsequently compared and contrasted to develop a logic model for evaluating the outcomes of powered mobility interventions for children. Because there were insufficient published data, it was not possible to develop a robust economic model. Instead, a budget impact analysis was conducted to estimate the cost of increased powered mobility provision for very young children, using cost data from publicly available sources. DATA SOURCES A range of bibliographic databases [Cumulative Index to Nursing and Allied Health Literature (CINHAL), MEDLINE, EMBASE™ (Elsevier, Amsterdam, the Netherlands), Physiotherapy Evidence Database (PEDro), Occupational Therapy Systematic Evaluation of Evidence (OTseeker), Applied Social Sciences Index and Abstracts (ASSIA), PsycINFO, Science Citation Index (SCI; Clarivate Analytics, Philadelphia, PA, USA), Social Sciences Citation Index™ (SSCI; Clarivate Analytics), Conference Proceedings Citation Index - Science (CPCI-S; Clarivate Analytics), Conference Proceedings Citation Index - Social Science & Humanities (CPCI-SSH; Clarivate Analytics), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) Database and OpenGrey] was systematically searched and the included studies were quality appraised. Searches were carried out in June 2018 and updated in October 2019. The date ranges searched covered from 1946 to September 2019. RESULTS In total, 89 studies were included in the review. Only two randomised controlled trials were identified. The overall quality of the evidence was low. No conclusive evidence was found about the effectiveness or cost-effectiveness of powered mobility in children aged either < 5 or ≥ 5 years. However, strong support was found that powered mobility interventions have a positive impact on children's movement and mobility, and moderate support was found for the impact on children's participation, play and social interactions and on the safety outcome of accidents and pain. 'Fit' between the child, the equipment and the environment was found to be important, as were the outcomes related to a child's independence, freedom and self-expression. The evidence supported two distinct conceptualisations of the primary powered mobility outcome, movement and mobility: the former is 'movement for movement's sake' and the latter destination-focused mobility. Powered mobility should be focused on 'movement for movement's sake' in the first instance. From the budget impact analysis, it was estimated that, annually, the NHS spends £1.89M on the provision of powered mobility for very young children, which is < 2% of total wheelchair service expenditure. LIMITATIONS The original research question could not be answered because there was a lack of appropriately powered published research. CONCLUSIONS Early powered mobility is likely to have multiple benefits for very young children, despite the lack of robust evidence to demonstrate this. Age is not the key factor; instead, the focus should be on providing developmentally appropriate interventions and focusing on 'movement for movement's sake'. FUTURE WORK Future research should focus on developing, implementing, evaluating and comparing different approaches to early powered mobility. STUDY REGISTRATION This study is registered as PROSPERO CRD42018096449. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology programme and will be published in full in Health Technology Assessment; Vol. 24, No. 50. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Nathan Bray
- School of Health Sciences, Bangor University, Bangor, UK.,Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Niina Kolehmainen
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jennifer McAnuff
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Tanner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lorna Tuersley
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Fiona Beyer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Aimee Grayston
- Children's Services, Leeds Community Healthcare NHS Trust, Leeds, UK
| | - Dor Wilson
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rhiannon Tudor Edwards
- School of Health Sciences, Bangor University, Bangor, UK.,Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Jane Noyes
- School of Health Sciences, Bangor University, Bangor, UK
| | - Dawn Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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14
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van Engelen L, Ebbers M, Boonzaaijer M, Bolster EAM, van der Put EAH, Bloemen MAT. Barriers, facilitators and solutions for active inclusive play for children with a physical disability in the Netherlands: a qualitative study. BMC Pediatr 2021; 21:369. [PMID: 34454470 PMCID: PMC8401178 DOI: 10.1186/s12887-021-02827-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 07/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Children with physical disabilities (PD) are less physically active than typically developing peers. The most important contributor to physical activity for primary school-aged children is outside play and therefore this should be part of every child’s life. However, children with PD experience multiple barriers to participation in playgrounds. Despite recent improvements in the accessibility of Dutch playgrounds, the participation of children with PD has not increased. This study aims to explore facilitators, barriers and solutions influencing the participation of children with PD in Dutch outdoor playgrounds, from parents’ and professionals’ perspectives. Methods Twelve semi-structured interviews with parents of children with PD aged 2–12 years and five focus group meetings with professionals working with these children were conducted. To ensure data saturation, we performed three member-check meetings. Two independent researchers analyzed the data using an inductive thematic approach. Results Similar barriers, facilitators and solutions were mentioned by parents and professionals. Three main themes were identified: the emotional barrier versus the physical barrier, play as a part of an inclusive society and the role of professionals in facilitating active inclusive play. The most important personal factors were physical and social problems experienced when children with PD wanted to join outdoor play. Interestingly, parents and professionals believed the social barrier was far more important than the physical one. The most important environmental factor was that the Dutch society is not sufficiently inclusive. Conclusions According to both parents and professionals, the most important barrier to active inclusive outdoor play was social, hindering the participation of children with PD in play with typically developing peers. To overcome such problems, professionals should take an active role in empowering children with PD and their parents. Furthermore, it is important to introduce outdoor active play early, so it becomes part of normal daily life. In addition, a change in the mindset of typically developing children and their parents seems essential to achieve true inclusive active play. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02827-5.
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Affiliation(s)
- L van Engelen
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - M Ebbers
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - M Boonzaaijer
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | - E A M Bolster
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands.,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands
| | | | - M A T Bloemen
- HU University of Applied Sciences Utrecht, Institute of Human Movement Studies, Master Pediatric Physiotherapy, Utrecht, The Netherlands. .,HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre Healthy and Sustainable Living, Utrecht, The Netherlands.
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15
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Qi J, Cai JH, Meng X. Impact of the Paralympic Games on the Beliefs of Children with Physical Disabilities Engaging in Sports and Physical Activities: A Chinese Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147296. [PMID: 34299749 PMCID: PMC8307629 DOI: 10.3390/ijerph18147296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this qualitative study was to explore the beliefs of Chinese children with physical disabilities engaging in sports and physical activity (PA), and the impact of the Paralympic Games on these beliefs. Five Chinese children with physical disabilities (female = 2, male = 3) were recruited for participating in the workshops of the Paralympic Games and PA, and received individual semi-structured interviews before and after the workshop implementations. Interview transcripts were analysed and presented as descriptive summaries. Three themes emerged based on the analysis of the participants' interview data: (1) shocked, knowledgeable, and useful; (2) willingness to try, and (3) hope to obtain support. Results indicated that children with physical disabilities in this study acknowledged the positive outcomes of participating in the workshops of the Paralympic Games on the sports and PA engagement attitude change. However, children with disabilities also expressed that they need more related knowledge and information. The results of the study revealed that impairment and contextual factors (i.e., lack of support from family and physical education teachers, unsafe environments, and negative attitudes of peers without disabilities) were barriers to sports and PA engagement among children with physical disabilities in this study.
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16
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Davoli GBDQ, Chaves TC, Lopes M, Martinez EZ, Sobreira CFDR, Graham HK, Mattiello-Sverzut AC. The cross-cultural adaptation, construct validity, and intra-rater reliability of the functional mobility scale in Brazilian Portuguese for children and adolescents with spina bifida. Disabil Rehabil 2021; 44:4862-4870. [PMID: 33879009 DOI: 10.1080/09638288.2021.1913650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to perform a cross-cultural adaptation of the Functional Mobility Scale (FMS) to Brazilian Portuguese and analyse its construct validity and intra-rater reliability in a sample of caregivers of children and adolescents with spina bifida (SB). MATERIAL AND METHODS The cross-cultural adaptation followed five stages: two forward translations, synthesis, back-translation, committee review and pre-testing (n = 20). Construct validity was assessed by comparing the FMS with the classifications of Hoffer and Schoenmakers (n = 40). Intra-rater reliability was assessed by comparing the ratings of 14 caregivers, on two occasions. Kendall's tau correlation coefficient was used to test the construct validity of the FMS, while the kappa coefficient was used to test intra-rater reliability. RESULTS Caregivers reported no difficulties with completing the FMS in Brazilian Portuguese. Construct validity tests showed positive correlations between the distances of 5 m (house), 50 m (school) and 500 m (community) in the FMS and the classifications of Hoffer (τ = 0.84; τ = 0.90; τ = 0.68; p < 0.01) and Schoenmakers (τ = 0.83; τ = 0.89; τ = 0.76; p < 0.01), respectively. Excellent intra-rater reliability (kappa = 0.9-1.0) was found for all three distances in the FMS. CONCLUSIONS The FMS in Brazilian Portuguese showed acceptable intra-rater reliability and construct validity when used to measure the mobility level of patients with SB. We recommend its use in clinical practice and research.Implications for RehabilitationA valid and reliable instrument for assessing the mobility of patients with SB;A cross-cultural and adapted FMS in Brazilian Portuguese;An instrument for therapeutic and functional approaches outside the clinicalsetting;The FMS in the Brazilian Portuguese online version shows mistranslations.
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Affiliation(s)
| | - Thais Cristina Chaves
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Mariane Lopes
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Edson Zangiacomi Martinez
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - H Kerr Graham
- Department of Orthopaedics, Royal Children's Hospital, University of Melbourne, Victoria, Australia
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17
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Sol ME, Verschuren O, Horemans H, Westers P, Visser-Meily JMA, De Groot JF. The effects of wheelchair mobility skills and exercise training on physical activity, fitness, skills and confidence in youth using a manual wheelchair. Disabil Rehabil 2021; 44:4398-4407. [PMID: 33874820 DOI: 10.1080/09638288.2021.1907456] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To evaluate the effects of a combination of wheelchair mobility skills (WMS) training and exercise training on physical activity (PA), WMS, confidence in wheelchair mobility, and physical fitness. METHODS Youth using a manual wheelchair (n = 60) participated in this practice-based intervention, with a waiting list period (16 weeks), exercise training (8 weeks), WMS training (8 weeks), and follow-up (16 weeks). Repeated measures included: PA (Activ8), WMS (Utrecht Pediatric Wheelchair Mobility Skills Test), confidence in wheelchair mobility (Wheelchair Mobility Confidence Scale), and physical fitness (cardiorespiratory fitness, (an)aerobic performance) and were analysed per outcome parameter using a multilevel model analyses. Differences between the waiting list and training period were determined with an unpaired sample t-test. RESULTS Multilevel model analysis showed significant positive effects for PA (p = 0.01), WMS (p < 0.001), confidence in wheelchair mobility (p < 0.001), aerobic (p < 0.001), and anaerobic performance (p < 0.001). Unpaired sample t-tests underscored these effects for PA (p < 0.01) and WMS (p < 0.001). There were no effects on cardiorespiratory fitness. The order of training (exercise before WMS) had a significant effect on confidence in wheelchair mobility. CONCLUSIONS A combination of exercise and WMS training appears to have significant positive long-term effects on PA, WMS, confidence in wheelchair mobility, and (an)aerobic performance in youth using a manual wheelchair.Implications for rehabilitationExercise training and wheelchair mobility skills (WMS) training can lead to a sustained improvement in physical activity (PA) in youth using a manual wheelchair.These combined trainings can also lead to a sustained increase in WMS, confidence in wheelchair mobility, and (an)aerobic performance.More attention is needed in clinical practice and in research towards improving PA in youth using a manual wheelchair.
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Affiliation(s)
- Marleen E Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Henricus Horemans
- Department of Rehabilitation Medicine, Erasmus MC University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Paul Westers
- Department of Biostatistics and Research Support, Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janke F De Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
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18
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Pilusa S, Myezwa H, Potterton J. 'I forget to do pressure relief': Personal factors influencing the prevention of secondary health conditions in people with spinal cord injury, South Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1493. [PMID: 33824916 PMCID: PMC8008043 DOI: 10.4102/sajp.v77i1.1493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/25/2020] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Across the lifespan, people with spinal cord injury (SCI) may experience preventable secondary health conditions (SHCs) such as pressures sores, muscle spasms and urinary tract infections (UTIs). Some factors influencing prevention of SHCs include social support, poor access to care and the prevention style of individuals. There is limited research on these factors. OBJECTIVE To explore personal factors influencing the prevention of SHCs in people with SCI. METHOD An explorative qualitative study included participants recruited in an outpatient department at a rehabilitation hospital. Semi-structured interviews were conducted with patients with SCI. Interviews were transcribed verbatim. Data analysis was conducted using content analysis. RESULTS Seventeen individuals with SCI were interviewed. From the interview analysis, six personal factors were identified, namely, socio-economic status; mental well-being (forgetfulness, beliefs, attitude); lack of knowledge of SHCs and prevention; lifestyle choices and practising prevention care; patient activation (self-management, problem-solving, resilience, self-awareness, help-seeking behaviour) and owning an appropriate assistive device. CONCLUSION Socio-economic status, mental well-being, knowledge of SHCs and prevention care, behaviour patterns, patient activation and owning an appropriate assistive device can influence prevention of SHCs. To enhance patient-oriented care, a model of care for people with SCI should consider these factors when developing prevention strategies. Future research could look into identifying environmental factors that influence the prevention of SHCs in people with SCI. CLINICAL IMPLICATIONS Tailored prevention strategies need to be developed, health professionals must ask patients about individual factors that may be barriers or facilitators to preventing secondary health conditions.
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Affiliation(s)
- Sonti Pilusa
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne Potterton
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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19
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Jennings M, Guilfoyle A, Green J, Cleary Y, Gowran RJ. Octopus Watch Fosters Family Resilience by Enhancing Occupational Engagement for Children with Spina Bifida and/or Hydrocephalus: Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228316. [PMID: 33182784 PMCID: PMC7697938 DOI: 10.3390/ijerph17228316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Children with spina bifida and/or hydrocephalus (SB&/H) often experience difficulties with activities of daily living (ADLs) due to impaired executive functioning, increasing sedentary behaviours. The HeyJoy Octopus watch, a child-friendly icon-based smartwatch could be used as an enabler to promote purposeful ADLs (i.e., goal-orientated ADLs). OBJECTIVE to investigate the effectiveness of the Octopus watch in promoting purposeful ADLs for children living with SB&/H (<8 years). METHODS Mixed-methods engaging parents and children in four phases: (1) Administered demographic questionnaire, semi-structured interview, childhood executive functioning inventory (CHEXI) and the Canadian occupational performance measure (COPM); focus group one introducing the study, information pack using smartwatch and photovoice data collection methods. (2) Measured baseline movement for four days with smartwatch without using functions. (3) Measured activity for 16-days while using the smartwatch. (4) Re-administered assessments and conducted a second focus group based on photovoice narratives. RESULTS movement data recorded for four participants, three of four showed mean activity increase (36%). N-of-1 analyses found one participant showed clear improvement (p = 0.021, r2 = 0.28). Mean inhibition decreased by 16.4%, and mean change in COPM performance and satisfaction scores were 2.1 and 2.4, respectively. The photovoice narrative focus group supports findings evidenced with improved daily routines. CONCLUSIONS The Octopus watch is an innovative early intervention that can promote purposeful ADLs, fostering family resilience by enhancing occupational engagement. Further research is required.
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Affiliation(s)
- Mark Jennings
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - Aoife Guilfoyle
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, V94 T9PX Limerick, Ireland; (M.J.); (A.G.)
| | - James Green
- School of Allied Health, Faculty of Education and Health Sciences, Physical Activity for Health (PAfH), Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Yvonne Cleary
- Technical Communication and Instructional Design, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Rosemary Joan Gowran
- Discipline Occupational Therapy, School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology (HIST), University of Limerick, V94 T9PX Limerick, Ireland
- School of Health and Sports Science, University of the Sunshine Coast, Maroochydore DC QLD 4558, Australia
- Assisting Living and Learning (ALL), Institute Maynooth University, Maynooth, W23 VP22 Co. Kildare, Ireland
- Correspondence:
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20
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Gabrielsson H, Hultling C, Cronqvist A, Asaba E. Views on everyday life among adults with spina bifida: an exploration through photovoice. Int J Qual Stud Health Well-being 2020; 15:1830702. [PMID: 33146083 PMCID: PMC7646545 DOI: 10.1080/17482631.2020.1830702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to actively integrate expertise of persons living with spina bifida, to explore conditions embedded in their everyday life. This was important because young adults with spina bifida risk not being able to fully participate in the community on equal terms and in accordance with their own preferences. Photovoice, a community-based participatory research approach, was utilized to engage participants through dialogue and photography. An exhibition was created to share results with community and stakeholders. An overarching theme that characterized the experiences of the group was, “an adaptation for us, but it works for no one”. Findings are presented as: “Accessibility—a never-ending project,” “Tensions of a normative view,” and “Power to influence.” Findings integrated everyday life metaphors photographically depicted by broken elevators, unsafe transportation, closed doors and not experiencing real opportunities of involvement. Tensions in everyday life experienced by persons living with spina bifida can inform conditions relevant and necessary to support community participation, particulary among persons living with disability.
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Affiliation(s)
- Hanna Gabrielsson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University , Örebro, Sweden.,Department of Health Care Sciences, Ersta Sköndal Bräcke University College , Stockholm, Sweden.,Spinalis, SCI Unit, RehabStation Stockholm , Stockholm, Sweden
| | - Claes Hultling
- Spinal Foundation , Stockholm, Sweden.,Sophiahemmet College , Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Karolinska Institutet , Stockholm, Sweden
| | - Agneta Cronqvist
- Department of Health Care Sciences, Ersta Sköndal Bräcke University College , Stockholm, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Science and Society (NVS), Division of Occupational Therapy, Karolinska Institutet , Stockholm, Sweden.,Unit for Research, Education, and Development, Stockholms Sjukhem Foundation , Stockholm, Sweden.,Occupational Science and Occupational Therapy Research Group, Lunds University , Lund, Sweden
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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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22
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Lai B, Davis D, Narasaki-Jara M, Hopson B, Powell D, Gowey M, Rocque BG, Rimmer JH. Feasibility of a Commercially Available Virtual Reality System to Achieve Exercise Guidelines in Youth With Spina Bifida: Mixed Methods Case Study. JMIR Serious Games 2020; 8:e20667. [PMID: 32880577 PMCID: PMC7499165 DOI: 10.2196/20667] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Access to physical activity among youth with spina bifida (SB) is much lower than it is for children without disability. Enjoyable home-based exercise programs are greatly needed. OBJECTIVE Our objective is to examine the feasibility of a virtual reality (VR) active video gaming system (ie, bundle of consumer-available equipment) to meet US physical activity guidelines in two youth with SB. METHODS Two youth with SB-a 12-year-old female and a 13-year-old male; both full-time wheelchair users-participated in a brief, 4-week exercise program using a popular VR head-mounted display: Oculus Quest (Facebook Technologies). The system included a Polar H10 (Polar Canada) Bluetooth heart rate monitor, a no-cost mobile phone app (VR Health Exercise Tracker [Virtual Reality Institute of Health and Exercise]), and 13 games. The intervention protocol was conducted entirely in the homes of the participants due to the coronavirus disease 2019 (COVID-19) pandemic. The VR system was shipped to participants and they were instructed to do their best to complete 60 minutes of moderate-intensity VR exercise per day. Exercise duration, intensity, and calories expended were objectively monitored and recorded during exercise using the heart rate monitor and a mobile app. Fatigue and depression were measured via self-report questionnaires at pre- and postintervention. Participants underwent a semistructured interview with research staff at postintervention. RESULTS Across the intervention period, the total average minutes of all exercise performed each week for participants 1 and 2 were 281 (SD 93) and 262 (SD 55) minutes, respectively. The total average minutes of moderate-intensity exercise performed per week for participants 1 and 2 were 184 (SD 103) (184/281, 65.4%) and 215 (SD 90) (215/262, 82.1%) minutes, respectively. One participant had a reduction in their depression score, using the Quality of Life in Neurological Disorders (Neuro-QoL) test, from baseline to postintervention, but no other changes were observed for fatigue and depression scores. Participants reported that the amount of exercise they completed was far higher than what was objectively recorded, due to usability issues with the chest-worn heart rate monitor. Participants noted that they were motivated to exercise due to the enjoyment of the games and VR headset as well as support from a caregiver. CONCLUSIONS This study demonstrated that two youth with SB who used wheelchairs could use a VR system to independently and safely achieve exercise guidelines at home. Study findings identified a promising protocol for promoting exercise in this population and this warrants further examination in future studies with larger samples.
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Affiliation(s)
- Byron Lai
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Drew Davis
- Division of Pediatric Rehabilitation Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mai Narasaki-Jara
- Department of Kinesiology, California Polytechnic State University Pomona, Pomona, CA, United States
| | - Betsy Hopson
- Division of Pediatric Neurosurgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Danielle Powell
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Marissa Gowey
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Brandon G Rocque
- Division of Pediatric Neurosurgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - James H Rimmer
- Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
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Wenger I, Schulze C, Lundström U, Prellwitz M. Children's perceptions of playing on inclusive playgrounds: A qualitative study. Scand J Occup Ther 2020; 28:136-146. [PMID: 32857665 DOI: 10.1080/11038128.2020.1810768] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Inclusive playgrounds aim to enable all children to participate and be socially included on playgrounds through the way they are designed. However, knowledge is lacking about how children with and without disabilities perceive playing on inclusive playgrounds and whether these playgrounds lead to more social inclusion. AIMS/OBJECTIVES The study explores the experiences of children, with and without disabilities, of playing on inclusive playgrounds. MATERIAL AND METHODS Semi-structured interviews and observations were conducted on six inclusive playgrounds in Switzerland. Overall, 32 children aged 7-12 years participated; 14 children had a disability while 18 children did not. A qualitative content analysis was used for data analysis. RESULTS The children's experiences of playing on an inclusive playground resulted in the creation of three categories describing: how children with and without disabilities experience play activities on inclusive playgrounds; invisible barriers on inclusive playgrounds; and the fact that children with disabilities have recommendations for the design of inclusive playgrounds. CONCLUSIONS AND SIGNIFICANCE The results showed that achieving inclusion on a playground is complex and must be considered as a transaction among different environments. For occupational therapists, this could mean that, to support play as an activity on inclusive playgrounds, intervention is necessary at the community and political levels.
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Affiliation(s)
- Ines Wenger
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.,School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Christina Schulze
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | | | - Maria Prellwitz
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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24
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Relationship Between Motor Level and Wheelchair Transfer Ability in Spina Bifida: A Study From the National Spina Bifida Patient Registry. Arch Phys Med Rehabil 2020; 101:1953-1960. [PMID: 32682935 DOI: 10.1016/j.apmr.2020.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To identify the specific features that contribute to the variability in baseline wheelchair transfer and the changes in transfer ability (gain or loss) over time for a large cohort of patients with spina bifida (SB) in the National Spina Bifida Patient Registry. DESIGN Longitudinal cohort study. SETTING A total of 35 United States outpatient SB clinic sites. PARTICIPANTS Individuals (N=1687) with SB ages 5-73 (median, 13.33) years who were therapeutic ambulators or nonambulators. INTERVENTION Not applicable. MAIN OUTCOME MEASURE Ability to transfer from a wheelchair to another level surface. RESULTS Bayesian Network Analysis was used to reduce the initial variable set to the following predictors: SB subphenotype, motor level, age, insurance, sex, race, ethnicity, surgical procedures, and number of visits. We used a multinomial logistic model with Wald Chi-square analysis of effects to examine the relationships between transfer ability and predictors. A total of 295 of 1687 eligible patients (17.56%) with myelomeningocele (MMC) and 6 of 58 eligible patients (10.32%) with non-MMC experienced changes in transfer ability during the period of the study. For those with MMC and non-MMC, the highest number of individuals exhibiting changes in motor level had changes from thoracic to high-lumbar, high-lumbar to thoracic, high-lumbar to midlumbar, and midlumbar to high-lumbar lesion levels. Results of the Bayesian Network Analysis revealed that motor level was the predominant factor associated with baseline transfer ability followed by age. The combination of SB sub phenotype, motor level, age, insurance status, number and type of surgical procedures, and time point accurately classified the loss, gain, or no change in transfer ability 82.7% of the time. CONCLUSIONS Motor level was the predominant factor associated with baseline transfer ability, and the change in transfer ability was directly related to a corresponding change in motor level that might be explained by changes in muscle strength of the iliopsoas and quadriceps.
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26
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Lobelo F, Muth ND, Hanson S, Nemeth BA. Physical Activity Assessment and Counseling in Pediatric Clinical Settings. Pediatrics 2020; 145:peds.2019-3992. [PMID: 32094289 DOI: 10.1542/peds.2019-3992] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Physical activity plays an important role in children's cardiovascular health, musculoskeletal health, mental and behavioral health, and physical, social, and cognitive development. Despite the importance in children's lives, pediatricians are unfamiliar with assessment and guidance regarding physical activity in children. With the release of the 2018 Physical Activity Guidelines by the US Department of Health and Human Services, pediatricians play a critical role in encouraging physical activity in children through assessing physical activity and physical literacy; providing guidance toward meeting recommendations by children and their families; advocating for opportunities for physical activity for all children in schools, communities, and hospitals; setting an example and remaining physically active personally; advocating for the use of assessment tools and insurance coverage of physical activity and physical literacy screening; and incorporating physical activity assessment and prescription in medical school curricula.
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Affiliation(s)
| | - Natalie D Muth
- Children's Primary Care Medical Group, Carlsbad, California; and
| | - Sara Hanson
- Nutrition and Health Sciences Program, Laney Graduate School and Exercise is Medicine Global Research and Collaboration Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Blaise A Nemeth
- American Family Children's Hospital and School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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27
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Lankhorst K, de Groot J, Takken T, Backx F. Sports participation related to injuries and illnesses among ambulatory youth with chronic diseases: results of the health in adapted youth sports study. BMC Sports Sci Med Rehabil 2020; 11:36. [PMID: 31890227 PMCID: PMC6915977 DOI: 10.1186/s13102-019-0145-5] [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] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022]
Abstract
Background Although sports participation leads to important health enhancement for youth with chronic diseases or physical disabilities (CDPD), it may pose an increased risk for injury or illness. This study investigated the incidence, type, severity and risks to (sports-related) injuries and illnesses among ambulatory youth with CDPD. Methods Over a 12-month period, every 2 weeks, the characteristics of injuries and illnesses were registered by an online questionnaire and phone-based interview. Physical activity level was measured with the Activ8 during 1 week. Complete data was available of 103 youngsters with CDPD (61 boys, 42 girls), with a mean age of 14.4 (SD = 2.7) years. The personal characteristics, the injury and illness rates per 1000 h of PA were investigated per group of organized sports participation per week (0, 1 or ≥ 2 times p/wk). Results Almost half of the youngsters sustained one or more injuries (46%) or illnesses (42%) during 1 year. The injury rate per 1000 h of PA between 0, 1 and ≥ 2 times per week of sports participation was 0.84, 1.88, 133 respectively and the illness rate were 1.87, 1.88 and 1.18 respectively. Differences between the rates were not statically significant. Most reported health problems had no subsequent restriction (49%) or other minor consequences (21%) in school, physical education or sports participation. Most reported health problems were contusions (41%) at the lower extremity (74%) and flu plus fever (58%). Conclusions Participation in sports ≥2 times per week does not pose a significant increased risk in the incidence of injury or illness per 1000 h of PA in youth with CDPD compared to their peers who participate less frequent (once weekly) and compared to non-sports participants. Athletes who participate in sports at least twice weekly get injured mostly during their sporting activities, while peers who do participate in sports once a week or not at all, get injured during less intense physical activities during physical eduction lessons, ADL or non-organized sports and play in leisure time. The social impact of injuries or illnesses was limited.
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Affiliation(s)
- Kristel Lankhorst
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janke de Groot
- 1Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, P.O. Box 85083, 3508AB, Utrecht, The Netherlands.,3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.,4Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, the Netherlands
| | - Tim Takken
- 3Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frank Backx
- 2Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
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Melo FAPD, Munster MDAV. Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas: uma alternativa de avaliação para pessoas com deficiência física. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2020. [DOI: 10.1590/rbce.42.2018.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O estudo teve como objetivo apresentar o Protocolo Avaliativo de Iniciação Esportiva em Cadeira de Rodas - PAIE-CR e verificar em quais áreas dos componentes motores (habilidades motoras fundamentais e capacidades físicas), um programa de iniciação esportiva em cadeira de rodas exerceu influência, antes e após a intervenção proposta. A intervenção foi composta por 24 sessões. Participaram desse estudo três crianças (6 a 10 anos) com deficiência física, comprometimento nos membros inferiores. O PAIE-CR é composto por nove testes divididos em quatro grupos de componentes: estabilização; locomoção; manipulação e combinados. Acredita-se que o instrumento oportuniza o acompanhamento e permite avaliar os componentes inerentes à iniciação esportiva em cadeira de rodas do educando.
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Sol ME, de Groot JF, Zwinkels M, Visser-Meily JMA, Kruitwagen CLJJ, Verschuren O. Utrecht Pediatric Wheelchair Mobility Skills Test: Reliability, Validity, and Responsiveness in Youths Using a Manual Wheelchair. Phys Ther 2019; 99:1098-1106. [PMID: 30939199 DOI: 10.1093/ptj/pzz061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 01/01/2019] [Indexed: 02/09/2023]
Abstract
BACKGROUND The assessment of wheelchair mobility skills (WMS) in youths using a manual wheelchair is important. More information is needed regarding the psychometric properties of the newly developed Utrecht Pediatric Wheelchair Mobility Skills Test (UP-WMST). OBJECTIVE The purpose of this study was to evaluate the reliability, content validity, construct validity, and responsiveness of the UP-WMST 2.0 in youths using a manual wheelchair. DESIGN This was a repeated-measurements, cross-sectional study. METHODS A total of 117 children and adolescents who use a manual wheelchair participated in this study. The UP-WMST 2.0 contains the same 15 WMS items as the original UP-WMST but has an adaptation of the scoring method. Test-retest reliability was estimated in 30 participants. Content validity was assessed through floor and ceiling effect analyses. Construct validity was assessed through hypothesis testing. Preliminary estimates of responsiveness were assessed in 23 participants who participated in a WMS training program. RESULTS Test-retest reliability analysis showed weighted Cohen kappa coefficients ranging from 0.63 to 0.98 for all but 1 item. The total UP-WMST 2.0 score had an intraclass correlation coefficient of 0.97. No floor or ceiling effects were detected. Independent-sample t test analysis confirmed our hypotheses regarding direction and difference in scores between age and diagnostic groups. Within-group analysis in the responsiveness study showed a positive significant change in UP-WMST 2.0 score (8.3 points). LIMITATIONS The small sample size used in the responsiveness study was a limitation of this study. CONCLUSIONS This study provided evidence of the test-retest reliability, content, and construct validity of the UP-WMST 2.0. It also provided initial evidence of the responsiveness of the UP-WMST 2.0 for measuring change in WMS in youths using a manual wheelchair.
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Affiliation(s)
- Marleen E Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands; and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Janke F de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht; and Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, the Netherlands
| | - Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht; and De Hoogstraat Rehabilitation
| | - J M Anne Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht; Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht; and De Hoogstraat Rehabilitation
| | - Cas L J J Kruitwagen
- Department of Biostatistics and Research Support, Julius Center, University Medical Center Utrecht
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht; and De Hoogstraat Rehabilitation
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Bakaniene I, Prasauskiene A. Patterns and predictors of participation in children and adolescents with spina bifida. Disabil Rehabil 2019; 42:3771-3779. [PMID: 31050564 DOI: 10.1080/09638288.2019.1610510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Participation is defined as involvement and engagement in all life situations and is seen as an essential condition for children's development. Here, we analyzed the patterns and predictors of participation for Lithuanian children and adolescents with spina bifida (SB).Material and methods: A cross-sectional design was employed. Parents of children aged 5-18 years with SB (n = 99) completed the Participation and Environment Measure for Children and Youth. Information about children's health conditions and functional issues was also collected. Descriptive statistics were used to analyze participation patterns, and multiple linear regression analyses were employed to identify the significant explanatory factors in each setting.Results: Participation restriction was mainly observed in preschool/school and the community settings. The environmental factors consistently explained at least one dimension of participation across all settings. Intellectual abilities had a substantial effect on participation in the home and preschool/school setting, whereas the contribution of bowel incontinence was observed in the preschool/school setting.Conclusions: Our findings highlight the role of intellectual functioning, bowel continence, and the environmental factors in explaining participation of children with SB across different settings and, therefore, demonstrate the need for more supports and environmental modifications (especially for those who have lower level of cognitive abilities), as well as interventions targeting improved bowel continence.Implications for rehabilitationChildren with spina bifida had low levels of participation in the community and preschool/school settings.The most important predictors for participation were intellectual abilities, bowel continence, and the environmental factors.Practitioners should pay more attention to environmental modifications (especially for children who have lower level of cognitive abilities) as primary targets of interventions aimed at promoting participation.Strategies to improve bowel continence could improve participation in the preschool/school setting.
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Affiliation(s)
- Indre Bakaniene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Audrone Prasauskiene
- Department of Children's Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Sol ME, Bloemen MAT, Verschuren O, Rushton PW, Visser-Meily JMA, de Groot JF. Wheelchair Mobility Confidence Scale for Dutch youth using a manual wheelchair. Disabil Rehabil Assist Technol 2019; 15:684-691. [DOI: 10.1080/17483107.2019.1604832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- M. E. Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- De Hoogstraat Rehabilitation, Special Needs School, Utrecht, The Netherlands
| | - M. A. T. Bloemen
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - O. Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - P. W. Rushton
- École de réadaptation, Université de Montréal, Montréal, Canada
| | - J. M. A. Visser-Meily
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - J. F. de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
- Netherlands Institute for Healthcare Services Research (NIVEL), Utrecht, The Netherlands
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Stahlhut M, Esbensen BA, Larsen JL, Bisgaard AM, Downs J, Nordmark E. Facilitators and Barriers of Participation in "Uptime" Activities in Girls and Women With Rett Syndrome: Perspectives From Parents and Professionals. QUALITATIVE HEALTH RESEARCH 2019; 29:609-619. [PMID: 30304998 DOI: 10.1177/1049732318803358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rett syndrome (RTT) is a rare neurodevelopmental disorder usually affecting females. It is associated with intellectual and multiple disabilities leading to a high level of dependency in all aspects of daily living including participation in physical activities. This study explored facilitators and barriers to "uptime" (non-sedentary) activities in Danish girls and women with RTT as perceived by parents and professionals using focus groups. Through thematic analysis, one central theme emerged: a constant balance to do the best thing for the girl or woman. Within the central theme, five subthemes of facilitators and barriers were identified relating to the individual and the physical, organizational, social, and attitudinal environments. Environmental barriers can be reduced through policy and management-level changes in health promotion and strong advocacy of physical activity by health professionals. Targeting both facilitators and barriers of "uptime" activities enables the planning and implementing of health-promoting interventions in individuals with RTT.
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Affiliation(s)
- Michelle Stahlhut
- 1 Center for Rett Syndrome, Rigshospitalet, Glostrup, Denmark
- 2 Health Sciences Center, Lund University, Lund, Sweden
| | - Bente Appel Esbensen
- 3 Copenhagen Center for Arthritis Research, Rigshospitalet, Glostrup, Denmark
- 4 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Jenny Downs
- 4 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- 5 Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Eva Nordmark
- 2 Health Sciences Center, Lund University, Lund, Sweden
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Exercise in Children with Disabilities. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-0213-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Huegel M, Otieno S, Kenyon LK. Validity of the WST and the WST-Q in children with spina bifida: a pilot project. Disabil Rehabil Assist Technol 2019; 14:744-750. [DOI: 10.1080/17483107.2018.1550114] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Micah Huegel
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Sango Otieno
- Department of Statistics, Grand Valley State University, Allendale, MI, USA
| | - Lisa K. Kenyon
- Department of Physical Therapy, Grand Valley State University, Grand Rapids, MI, USA
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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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Participation of Children with Spina Bifida: A Scoping Review Using the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) as a Reference Framework. ACTA ACUST UNITED AC 2018; 54:medicina54030040. [PMID: 30344271 PMCID: PMC6122101 DOI: 10.3390/medicina54030040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/13/2022]
Abstract
Background and objectives. Participation is a fundamental right of the child, regardless of his health status. Assessing and supporting the participation of children with spina bifida (SB) presents a significant challenge for practitioners. The purpose of this study was to examine what is known about the participation of children with SB. Materials and Methods. The framework for scoping reviews from Arksey & O’Malley was used. A literature search in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (Medline), PsychINFO and the Education Resources Information Centre (ERIC) databases retrieved 136 papers, 10 of which met the criteria for inclusion and were selected for analysis. Synthesis of the results on participation within occupational domains of leisure, school and community, and factors influencing participation of children with SB was performed. Results. All the included studies were non-experimental and used cross-sectional, population-based or qualitative design. Most studies analysed social participation or participation in physical activities, except one that focused on school participation. Data from these studies have shown that children with SB experience greater participation restrictions compared to their typical peers or children with other chronic diseases. The participation was mainly affected by contextual factors. Relationships between pathology and participation were not sufficiently validated. Conclusions. There is little research on the participation of children with SB. Future studies must consider contextual factors and interventions facilitating or impeding participation.
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Gilboa Y, Fuchs R. Participation Patterns of Preschool Children With Intellectual Developmental Disabilities. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2018; 38:261-268. [PMID: 29649939 DOI: 10.1177/1539449218766888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We aim to examine the pattern of participation of children with intellectual developmental disabilities (IDD) or global developmental delay (GDD) in comparison with typically developing preschoolers. In addition, to identify environmental and personal factors associated with their participation, 20 children with mild to moderate GDD or IDD, and 24 age- and gender-matched controls, aged 3 to 6 years, were assessed using the Assessment of Preschool Children's Participation and the Environmental Restriction Questionnaire. Significant differences were found between the groups, both for general scales of participation and for each activity area. For the IDD/GDD group, participation was significantly negatively correlated with environmental restrictions at home. For the control group, participation was correlated with demographic variables. Typically developing children participate at a higher frequency and in a more diverse range of activities compared with children with IDD/GDD. Associations between participation and contextual factors varied depending on the child's health condition.
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Burghard M, de Jong NB, Vlieger S, Takken T. 2017 Dutch Report Card +: Results From the First Physical Activity Report Card Plus for Dutch Youth With a Chronic Disease or Disability. Front Pediatr 2018; 6:122. [PMID: 29761094 PMCID: PMC5937055 DOI: 10.3389/fped.2018.00122] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background: The Dutch Active Healthy Kids (AHK) Report Card+ (RC+) consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for youth (< 18 years) with a chronic disease or disability. The aim of this article is to summarize the results of the Dutch RC+. Methods: Nine indicators were graded using the AHK Global Alliance RC development process, which includes a synthesis of best available research, surveillance, policy and practice findings, and expert consensus. Two additional indicators were included: weight status and sleep. Results: Grades assigned were: Overall Physical Activity, D; Organized Sports Participation, B-; Active Play, C-; Active Transportation, A-; Sedentary Behavior, C; Sleep C; For Weight Status, Family and Peers, School, Community and Built Environment, Government Strategies, and Investments all INC. Conclusions: The youth with disabilities spend a large part of the day sedentary, since only 26% of them met the PA norm for healthy physical activity. Potential avenues to improve overall physical activity are changing behaviors regarding sitting, screen time, and active play. The Netherlands is on track regarding PA opportunities for youth with disabilities, however they are currently not able to participate unlimited in sports and exercise.
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Affiliation(s)
- Marcella Burghard
- Shared Utrecht Pediatric Exercise Research Lab, Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Nynke B de Jong
- Shared Utrecht Pediatric Exercise Research Lab, Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Selina Vlieger
- Shared Utrecht Pediatric Exercise Research Lab, Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Tim Takken
- Shared Utrecht Pediatric Exercise Research Lab, Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, Netherlands
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Zwinkels M, Verschuren O, Balemans A, Lankhorst K, Te Velde S, van Gaalen L, de Groot J, Visser-Meily A, Takken T. Effects of a School-Based Sports Program on Physical Fitness, Physical Activity, and Cardiometabolic Health in Youth With Physical Disabilities: Data From the Sport-2-Stay-Fit Study. Front Pediatr 2018; 6:75. [PMID: 29632853 PMCID: PMC5879083 DOI: 10.3389/fped.2018.00075] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/12/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate the effects of a school-based once-a-week sports program on physical fitness, physical activity, and cardiometabolic health in children and adolescents with a physical disability. METHODS This controlled clinical trial included 71 children and adolescents from four schools for special education [mean age 13.7 (2.9) years, range 8-19, 55% boys]. Participants had various chronic health conditions including cerebral palsy (37%), other neuromuscular (44%), metabolic (8%), musculoskeletal (7%), and cardiovascular (4%) disorders. Before recruitment and based on the presence of school-based sports, schools were assigned as sport or control group. School-based sports were initiated and provided by motivated experienced physical educators. The sport group (n = 31) participated in a once-a-week school-based sports program for 6 months, which included team sports. The control group (n = 40) followed the regular curriculum. Anaerobic performance was assessed by the Muscle Power Sprint Test. Secondary outcome measures included aerobic performance, VO2 peak, strength, physical activity, blood pressure, arterial stiffness, body composition, and the metabolic profile. RESULTS A significant improvement of 16% in favor of the sport group was found for anaerobic performance (p = 0.003). In addition, the sport group lost 2.8% more fat mass compared to the control group (p = 0.007). No changes were found for aerobic performance, VO2 peak, physical activity, blood pressure, arterial stiffness, and the metabolic profile. CONCLUSION Anaerobic performance and fat mass improved following a school-based sports program. These effects are promising for long-term fitness and health promotion, because sports sessions at school eliminate certain barriers for sports participation and adding a once-a-week sports session showed already positive effects for 6 months. CLINICAL TRIAL REGISTRATION This trial was registered with the Dutch Trial Registry (NTR4698).
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Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Sports, De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands
| | - Astrid Balemans
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam Public Health, VU University Amsterdam, Amsterdam, Netherlands
| | | | - Saskia Te Velde
- HU University of Applied Sciences Utrecht, Utrecht, Netherlands
| | | | - Janke de Groot
- HU University of Applied Sciences Utrecht, Utrecht, Netherlands.,Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, Netherlands.,Department of Rehabilitation, Physical Therapy Science and Sports, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tim Takken
- Child Development and Exercise Center, University Medical Center Utrecht, Utrecht, Netherlands
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40
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Bloemen M, Van Wely L, Mollema J, Dallmeijer A, de Groot J. Evidence for increasing physical activity in children with physical disabilities: a systematic review. Dev Med Child Neurol 2017; 59:1004-1010. [PMID: 28374442 DOI: 10.1111/dmcn.13422] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2017] [Indexed: 11/27/2022]
Abstract
AIM To summarize the best evidence of interventions for increasing physical activity in children with physical disabilities. METHOD A systematic review was conducted using an electronic search executed in Academic Search Elite, Academic Search Premier, CINAHL, Embase, MEDLINE, PEDro, PsychINFO, and SPORTDiscus up to February 2016. The selection of articles was performed independently by two researchers according to predetermined eligibility criteria. Data extraction, methodological quality, and levels of evidence were independently assessed by two researchers using a data-collection form from the Cochrane Collaboration and according to the guidelines of the American Academy for Cerebral Palsy and Developmental Medicine. RESULTS Seven studies were included. Five randomized controlled trials ranged from strong level I to weak level II studies, and two pre-post design studies were classified as level IV. There is level I evidence for no effect of physical training on objectively measured physical activity, conflicting level II evidence for interventions with a behavioural component on the increase of objectively measured physical activity directly after the intervention, and level II evidence for no effect during follow-up. Results are limited to children with cerebral palsy as no other diagnoses were included. INTERPRETATION Increasing physical activity in children with physical disabilities is very complex and demands further development and research.
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Affiliation(s)
- Manon Bloemen
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Leontien Van Wely
- Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Jurgen Mollema
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Annet Dallmeijer
- Department of Rehabilitation Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands
| | - Janke 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
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Abstract
PURPOSE OF REVIEW Obesity is a common comorbidity in individuals with spina bifida. Carrying excess weight exacerbates the inherent health challenges associated with spina bifida, impedes the individual's ability to self-manage their condition, and creates further challenges for family members and caregivers. This manuscript provides a narrative review of key issues for understanding and prevention of obesity in persons with spina bifida within the context of the social ecological model. RECENT FINDINGS Specific variables related to obesity and spina bifida include individual factors (i.e., body composition and measurement issues, energy needs, eating patterns, physical activity, and sedentary activity) family factors (i.e., parenting/family, peers), community factors (i.e., culture, built environment, healthcare and healthcare providers, and school), and societal factors (i.e., policy issues). Due to the complex etiology of obesity and its increased prevalence in individuals with spina bifida, it is critical to initiate prevention efforts early with a multifactorial approach for this at-risk population. Increased research is warranted to support these efforts.
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Affiliation(s)
- Michele Polfuss
- College of Nursing, University of Wisconsin-Milwaukee, 1921 E. Hartford Avenue, Milwaukee, WI, 53211, USA.
- Department of Nursing Research, Children's Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI, 53201-1997, USA.
| | - Linda G Bandini
- University of Massachusetts Medical School, 55 Lake Avenue North S3-324B, Worcester, MA, 01655, USA
- Department of Health Sciences, Boston University, 635 Commonwealth Ave, Boston, MA, 02115, USA
| | - Kathleen J Sawin
- Department of Nursing Research, Children's Hospital of Wisconsin, 9000 W. Wisconsin Avenue, Milwaukee, WI, 53201-1997, USA
- Self-Management Science Center, College of Nursing, University of Wisconsin-Milwaukee, 1921 E. Hartford Avenue, Milwaukee, WI, 53211, USA
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Sol ME, Verschuren O, de Groot L, de Groot JF. Development of a wheelchair mobility skills test for children and adolescents: combining evidence with clinical expertise. BMC Pediatr 2017; 17:51. [PMID: 28193204 PMCID: PMC5307781 DOI: 10.1186/s12887-017-0809-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 02/07/2017] [Indexed: 12/01/2022] Open
Abstract
Background Wheelchair mobility skills (WMS) training is regarded by children using a manual wheelchair and their parents as an important factor to improve participation and daily physical activity. Currently, there is no outcome measure available for the evaluation of WMS in children. Several wheelchair mobility outcome measures have been developed for adults, but none of these have been validated in children. Therefore the objective of this study is to develop a WMS outcome measure for children using the current knowledge from literature in combination with the clinical expertise of health care professionals, children and their parents. Methods Mixed methods approach. Phase 1: Item identification of WMS items through a systematic review using the ‘COnsensus-based Standards for the selection of health Measurement Instruments’ (COSMIN) recommendations. Phase 2: Item selection and validation of relevant WMS items for children, using a focus group and interviews with children using a manual wheelchair, their parents and health care professionals. Phase 3: Feasibility of the newly developed Utrecht Pediatric Wheelchair Mobility Skills Test (UP-WMST) through pilot testing. Results Phase 1: Data analysis and synthesis of nine WMS related outcome measures showed there is no widely used outcome measure with levels of evidence across all measurement properties. However, four outcome measures showed some levels of evidence on reliability and validity for adults. Twenty-two WMS items with the best clinimetric properties were selected for further analysis in phase 2. Phase 2: Fifteen items were deemed as relevant for children, one item needed adaptation and six items were considered not relevant for assessing WMS in children. Phase 3: Two health care professionals administered the UP-WMST in eight children. The instructions of the UP-WMST were clear, but the scoring method of the height difference items needed adaptation. The outdoor items for rolling over soft surface and the side slope item were excluded in the final version of the UP-WMST due to logistic reasons. Conclusions The newly developed 15 item UP-WMST is a validated outcome measure which is easy to administer in children using a manual wheelchair. More research regarding reliability, construct validity and responsiveness is warranted before the UP-WMST can be used in practice. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0809-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marleen Elisabeth Sol
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Postbus 12011, Utrecht, 3501 AA, The Netherlands. .,Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. .,De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| | - Olaf Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.,De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | | | - Janke Frederike de Groot
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Heidelberglaan 7, Postbus 12011, Utrecht, 3501 AA, The Netherlands.,Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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MO O. A Multidisciplinary Approach to the Assessment and Management of Pre-school Age Neuro-developmental Disorders: A Local Experience. CLINICAL JOURNAL OF NURSING CARE AND PRACTICE 2017; 1:001-012. [DOI: 10.29328/journal.hjncp.1001001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ross SM, Bogart KR, Logan SW, Case L, Fine J, Thompson H. Physical Activity Participation of Disabled Children: A Systematic Review of Conceptual and Methodological Approaches in Health Research. Front Public Health 2016; 4:187. [PMID: 27656639 PMCID: PMC5011128 DOI: 10.3389/fpubh.2016.00187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 08/23/2016] [Indexed: 01/23/2023] Open
Abstract
Physical activity (PA) participation is widely recognized as a critical component of health and development for disabled and non-disabled children. Emergent literature reflects a paradigm shift in the conceptualization of childhood PA as a multi-dimensional construct, encompassing aspects of physical performance, and self-perceived engagement. However, ambiguity remains around how participation as a health construct is integrated into PA research. The primary objective of the present mini-review is to critically examine current conceptual and methodological approaches to evaluating PA participation among disabled children. We conducted a systematic review of contemporary literature (published between 2000 and 2016). Seventeen articles met inclusion criteria, and their research approach was classified into guiding framework, definition of the key construct, and measurement used. The primary guiding framework was the international classification of functioning, disability and health. An explicit definition of PA participation was absent from all studies. Eight studies (47%) operationalized PA and participation as independent constructs. Measurements included traditional performance-based aspects of PA (frequency, duration, and intensity), and alternative participation measures (subjective perception of involvement, inclusion, or enjoyment). Approximately 64% of included articles were published in the past 2 years (2014-2016) indicating a rising interest in the topic of PA participation. Drawing from the broader discussion of participation in the literature, we offer a working definition of PA participation as it pertains to active, health-associated behaviors. Further description of alternative approaches to framing and measuring PA participation are offered to support effective assessment of health status among disabled children.
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Affiliation(s)
- Samantha Mae Ross
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University , Corvallis, OR , USA
| | - Kathleen R Bogart
- Disability and Social Interaction Lab, School of Psychological Science, Oregon State University , Corvallis, OR , USA
| | - Samuel W Logan
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University , Corvallis, OR , USA
| | - Layne Case
- College of Communication and Education, Chico State Autism Clinic, California State University , Chico, CA , USA
| | - Jeremiah Fine
- Social Mobility Lab, College of Public Health and Human Sciences, Oregon State University , Corvallis, OR , USA
| | - Hanna Thompson
- Disability and Social Interaction Lab, School of Psychological Science, Oregon State University , Corvallis, OR , USA
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Jirikowic TL, Kerfeld CI. Health-Promoting Physical Activity of Children Who Use Assistive Mobility Devices: A Scoping Review. Am J Occup Ther 2016; 70:7005180050p1-7005180050p11. [DOI: 10.5014/ajot.2016.021543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Children with physical disabilities who use assistive mobility devices (AMDs) are at risk for obesity and other secondary health conditions. Habitual physical activity is one lifestyle factor that may prevent obesity and contribute to overall health, and an active lifestyle in childhood improves prospects for lifelong healthy behaviors. Child, family, and environmental facilitators and barriers influence health-promoting physical activity (HPPA) for children without disabilities, but comparable models and levels of understanding for children who use AMDs are lacking. In this scoping review, we identified a similar set of child, family, and environmental facilitators and barriers relevant to HPPA participation among children who use AMDs. Noted gaps in the literature included limited reporting of AMD use, inconsistent HPPA definitions, and inadequate measurement tools for children who are nonambulatory. The identified child, family, and environmental factors provide a framework for occupational therapy practitioners and interprofessional teams to develop HPPA opportunities and interventions for an underserved population.
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Affiliation(s)
- Tracy L. Jirikowic
- Tracy L. Jirikowic, PhD, OTR/L, FAOTA, is Associate Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle;
| | - Cheryl I. Kerfeld
- Cheryl I. Kerfeld, PhD, PT, is Acting Assistant Professor, Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
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Zwinkels M, Verschuren O, Lankhorst K, van der Ende-Kastelijn K, de Groot J, Backx F, Visser-Meily A, Takken T. Sport-2-Stay-Fit study: Health effects of after-school sport participation in children and adolescents with a chronic disease or physical disability. BMC Sports Sci Med Rehabil 2015; 7:22. [PMID: 26445674 PMCID: PMC4594646 DOI: 10.1186/s13102-015-0016-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 09/23/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Children and adolescents with a chronic disease or physical disability have lower fitness levels compared to their non-disabled peers. Low physical fitness is associated with reduced physical activity, increased cardiovascular diseases, and lower levels of both cognitive and psychosocial functioning. Moreover, children and adolescents with a chronic disease or physical disability participate less in both recreational and competitive sports. A variety of intervention studies have shown positive, but only temporary, effects of training programs. Next to issues related to the chronic condition itself, various personal and environmental factors play a key role in determining the extent to which they participate in sports or physical activities. Due to these barriers, sport participation in the immediate after-school hours seems to be a feasible solution to get these children and adolescents physical active structurally. To investigate if an after school sport program can sustain the positive effects of an intervention, a standardized interval training will be given to improve physical fitness levels. High-intensity Interval Training (HIT) is superior to moderate-intensity continuous training in improving physical fitness in patients with chronic diseases. Therefore, the Sport-2-Stay-Fit study will investigate whether after school sport participation can increase the sustainability of a HIT program in children and adolescents with a chronic disease or physical disability. METHODS The Sport-2-Stay-Fit study is a clinical controlled trial. A total of 74 children and adolescents in the age of 6-19 years with a chronic disease or physical disability will be included. This could be either a cardiovascular, pulmonary, metabolic, musculoskeletal or neuromuscular disorder. Both children and adolescents who are ambulatory or propelling a manual wheelchair will be included. All participants will follow a HIT program of eight weeks to improve their physical fitness level. Thereafter, the intervention group will participate in sport after school for six months, while the control group receives assessment only. Measurements will take place before the HIT, directly after, as well as, six months later. The primary objective is anaerobic fitness. Secondary objectives are agility, aerobic fitness, strength, physical activity, cardiovascular health, cognitive functioning, and psychosocial functioning. DISCUSSION If effective, after school sport participation following a standardized interval training could be implemented on schools for special education to get children and adolescents with a chronic disease or physical disability active on a structural basis. TRIAL REGISTRATION This trial is registered at the Dutch Trial Register #NTR4698.
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Affiliation(s)
- Maremka Zwinkels
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands
| | - Kristel Lankhorst
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Karin van der Ende-Kastelijn
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Janke de Groot
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Research Group Lifestyle and Health, Institute of Human Movement Studies, University of Applied Sciences, Utrecht, the Netherlands
| | - Frank Backx
- Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Anne Visser-Meily
- Center of Excellence for Rehabilitation Medicine and Brain Center Rudolf Magnus, De Hoogstraat Rehabilitation and University Medical Center Utrecht, Utrecht, the Netherlands ; Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Takken
- Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, Utrecht, the Netherlands ; Child Development and Exercise Center, University Medical Center Utrecht, Wilhelmina Children's Hospital, P.O. Box 85090, 3508 AB Utrecht, the Netherlands
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