Barriers and facilitators to physical activity participation for children with physical disability: comparing and contrasting the views of children, young people, and their clinicians

Abstract

Clinicians should determine both parent and young person commitment to a physical activity before enrolment. Lack of commitment can act as a barrier to physical activity and a more appropriate intervention could focus on increasing awareness of the benefits of being active, drawing on a Stages of Change based model of service delivery. Implications for rehabilitation Rehabilitation professionals seeking to increase physical activity participation for young people with physical disability should discuss readiness and motivation to change prior to any activity/sports referral. Different behaviour change processes are required for young people and for their parents and both are important to achieve physical activity participation. Regular monitoring is important to identify on-going physical and psychological barriers to participation, even for those who were already active. Clinicians should be aware that teenagers may be more ready to be active as they develop greater independence and should raise awareness of the benefits of physical activity.

Parent and Clinician Perspectives on the Participation of Children with Cerebral Palsy in Community-Based Football: A Qualitative Exploration in a Regional Setting

“…Aligning with previous findings, the current study indicated that prior exposure to football via parental and/or sibling involvement in PA was a facilitator for participation [14,22]. This further compounds the learned behaviour and modelling elements of participation proposed in the systematic review of PA participation in CP populations by Shields, Synnot and Barr [14].…”

“…Clinicians also identified that providing families and children with information on football as an option for an activity, alongside its benefits for them may encourage the child to participate. Similarly, Wright, Roberts, Bowman and Crettenden [22] also found that young people with CP were more likely to participate if they were aware of the benefits of PA participation, highlighting the important role of education and knowledge-building in supporting the sustained participation of children with CP in PA. Brunton [32] suggests that clinicians are well-placed to inform and educate children and families about the benefits of PA and options for participation in their community.…”

“…Sessions earlier in the week were seen to facilitate participation, as the child's energy levels would be higher than after a busy week at school. Activity limitations occurring in the context of physical and biological factors are indeed a significant barrier to participation in populations of children and adolescents with CP and physical disabilities more broadly [13,22]. Parents and clinicians in the current study proposed a range of environmental modifications to facilitate participation, including adapting the rules of the game to enable greater involvement for children with CP, introducing buddy systems, diversifying the nature of participation so children with CP had options to select different roles (e.g., umpiring), and modifications to the physical environment in which the game was played, including playing on half-size grounds, playing the game indoors on rainy days, introducing aids such as cones, and ensuring benches and chairs were available for children to rest.…”

“…Aligning with factors within the ICF framework, studies exploring PA participation have implicated personal, social, as well as environmental, policy and program-related facilitators and barriers for children and adolescents with CP [14,22]. There has a been a primary focus within the literature on exploring the factors influencing PA broadly in CP populations [23].…”

“…Furthermore, while emerging research is beginning to incorporate the perspectives of clinicians (who interact with children on a regular basis) on the factors influencing community PA participation in children with CP [22,24], there remains a primary focus on parent and child perspectives. While the perspectives of parents and children are vital, the dearth of perspectives of the broader system involved in the care and management of the child's health has hindered a holistic view of the factors influencing participation.…”