Evidence for increasing physical activity in children with physical disabilities: a systematic review

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.

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

“…Recommendations to concurrently increase moderate to vigorous physical activity and replace sedentary behavior with light physical activity have been proposed to improve health [263]. New trials indicate that physical activity interventions (including exercise, activity training, strength training, and behavioral change strategies) probably improve fitness [144], physical activity [142][143][144], ambulation [144], mobility [144], participation, and quality of life [142] (yellow lights, weak positive). However, they do not appear to improve gross motor skills (yellow light, weak negative) [96,144].…”

Wheelchair Mobility Confidence Scale for Dutch youth using a manual wheelchair

“…When looking at physical activity behaviour, studies have shown that youth (children and adolescents) using a manual wheelchair is more sedentary and less physically active than ablebodied peers [1][2][3] and peers with a disability who are ambulatory [4]. In a study of Dutch youth using a manual wheelchair, Bloemen et al [5] reported that youth with spina bifida was approximately 72 min physically active on a school day compared to 175 min of physical activity time for typically developing peers. To improve physical activity behaviour in youth with a disability, recent reviews concluded that interventions should not only focus on body functions and impairments, but also take personal factors, such as confidence and environmental factors, such as the importance of a good assistive device, into account [5,6].…”

Physical activity interventions for children and young people with cerebral palsy

“…We now have available two new systematic reviews on the effects of physical activity interventions in children and young people with cerebral palsy (CP) . Both reviews reveal a lack of evidence supporting the efficacy of interventions to increase and sustain habitual physical activities.…”

“…This bold statement could be criticized and may result in the typical call for more and better studies to show the desired beneficial effects. Indeed, the authors of both systematic reviews commented upon the inadequate reporting of complex interventions such as physical training, the selections of outcomes measures adopted, the lack of generalizability to conditions other than CP, and that more rigorous research is needed . However, considering that physical training in CP has been studied in trials for two decades, it is time to draw conclusions based on the knowledge accumulated to date.…”