Feasibility of a Modified Ride-on Car Intervention on Play Behaviors during an Inclusive Playgroup.

AIMS: Children with mobility related disabilities often experience limited participation and access to social interactions. An emerging pediatric powered mobility device are modified ride-on cars that provide self-directed mobility experiences to children with disabilities. This study aimed to determine: (1) the feasibility of a modified ride-on car intervention during an inclusive playgroup, (2) the effect of a modified ride-on car intervention on the play behaviors of children with and without mobility related disabilities. METHOD: A single-subject research design was implemented. Thirteen children participated in a weekly inclusive playgroup. The five children with mobility related disabilities were provided modified ride-on cars during the intervention. Children's play behaviors were classified with Howes' Peer Play Scale. Intervention effects were examined using nonoverlap of all pairs (NAP). RESULTS: The intervention was feasible based on participants' good attendance, retention rates, and successful use of modified ride-on cars. Overall children did not experience significant changes in play behaviors, with a few exceptions for decreased solitary, and increased parallel play, and/or direct peer interaction, among children with mobility related disabilities. Future research could examine modified ride-on car use by children with mobility related disabilities focusing on changes in unique play interactions between children with and without disabilities.

Effects of strength training on mobility in adults with cerebral palsy: A systematic review.

BACKGROUND: Many adults with cerebral palsy report experiencing early-onset decline in mobility and independence. The role of strength training to combat this is not well understood. OBJECTIVE/HYPOTHESIS: To examine the effects of strength-training interventions on muscle strength and functional outcomes for adults with CP using the ICF framework. METHODS: A systematic review was conducted following standardized guidelines and using key words including: adults, cerebral palsy in combination with resistance or strength training, and ambulation and function related key words. Selection criteria included: (a) adults (mean age 18+ years) with CP, (b) strength training intervention, and (c) at least one activity or participation outcome measure. 26 retrieved articles were retained for full review. Data on strength training protocols were extracted and compared to national guidelines. Outcome measures were classified within ICF domains. RESULTS: Six articles met the inclusion criteria. These articles were of high research quality and consistent with recommended training protocols for adults with CP. Positive gains in muscle strength were reported across studies. Changes within the activity ICF dimension were inconsistent, with 2 of the 6 studies observing increases in self-selected walking speed. CONCLUSIONS: Findings indicate training benefits for adults with CP. However, a small sample (n = 111 across all included studies) and the absence of extended training regimens and follow-up hindered conclusive results. High consistency in training protocols and outcome measures allowed for critical discussion on key research questions regarding the impact of strength training and subsequent gains in function within ICF domains.

Physical Activity Participation of Disabled Children: A Systematic Review of Conceptual and Methodological Approaches in Health Research.

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.

Why We Move: Social Mobility Behaviors of Non-Disabled and Disabled Children across Childcare Contexts.

BACKGROUND: Social mobility is defined as the co-occurrence of self-directed locomotion and direct peer interaction. Social mobility is a product of dynamic child-environment interactions and thus likely to vary across contexts (e.g., classroom, gymnasium, and playground). PURPOSE: The purpose of this present study was to examine differences in children's social mobility: (1) across contexts by age and (2) between non-disabled and disabled children. METHOD: Participants (n = 55 non-disabled and three disabled children; Mage = 3.1 years, SD = 1.4) were video recorded within a university-based early learning center. Children were recorded for 20 min in each context: classroom, gymnasium, and playground. A 15-s momentary time sampling method was used to code social mobility, the simultaneous occurrence of self-directed locomotion, and direct peer interaction. This variable was calculated as percent time within each context. RESULTS: A planned Friedman's rank ANOVA (n = 55), stratified by age, indicated that older children (3-5 years old) differed across contexts in their social mobility [χ2(2) ~ 7.3-10.5, p < 0.025], whereas younger children (1-2 years old) were similar across contexts. Social mobility was significantly lower in the classroom compared with the playground and gymnasium (with no difference between the latter contexts) for older children. Visual analysis confirmed that disabled children (n = 3) engaged in substantially less time in social mobility (average 0-1%), compared with non-disabled, age-similar peers (2-3 years old average 1-12%) across all contexts. CONCLUSION: A substantial gap exists between non-disabled and disabled children for social mobility. There is an increase in magnitude and variability of social mobility around age three that suggests the gap between non-disabled and disabled children will continue to widen.