Segmental Colectomy in Ulcerative Colitis.

BACKGROUND: Segmental colectomy in ulcerative colitis is performed in select patients who may be at increased risk for postoperative morbidity. OBJECTIVE: To identify patients with ulcerative colitis who underwent segmental colectomy and assess their postoperative and long-term outcomes. DESIGN: Retrospective case series. SETTING: A tertiary care IBD center. PATIENTS: Patients with ulcerative colitis who underwent surgery between 1995 and 2022. INTERVENTION: Segmental colectomy. MAIN OUTCOME MEASURES: Postoperative complications, early and late colitis, metachronous cancer development, completion proctocolectomy-free survival rates, and stoma at follow-up. RESULTS: Fifty-five patients were included (20 [36.4%] women; age 67.8 (57.4-77.1) years at surgery; BMI 27.7 (24.2-31.1) kg/m 2 ; median follow-up 37.3 months). Thirty-two patients (58.2%) had ASA score of 3, 48 (87.3%) had at least 1 comorbidity, and 48 (87.3%) had Mayo endoscopic subscores of 0 to 1. Patients underwent right hemicolectomy (n = 28; 50.9%), sigmoidectomy (n = 17; 30.9%), left hemicolectomy (6; 10.9%), low anterior resection (n = 2; 3.6%), or a nonanatomic resection (n = 2; 3.6%) for endoscopically unresectable polyps (n = 21; 38.2%), colorectal cancer (n = 15; 27.3%), symptomatic diverticular disease (n = 13; 23.6%), and stricture (n = 6; 10.9%). Postoperative complications occurred in 16 patients (29.1%; n = 7 [12.7%] Clavien-Dindo class III-V). Early and late postoperative colitis rates were 9.1% and 14.5%, respectively. Metachronous cancer developed in 1 patient. Four patients (7.3%) underwent subsequent completion proctocolectomy with ileostomy. Six patients (10.9%) had a stoma at follow-up. Two- and 5-year completion proctocolectomy-free survival rates were 91% and 88%, respectively. LIMITATIONS: Retrospective study and small sample size. CONCLUSIONS: Segmental colectomy in ulcerative colitis is associated with low postoperative complication rates, symptomatic early colitis and late colitis rates, metachronous cancer development, and the need for subsequent completion proctocolectomy. Therefore, it can be safe to consider select patients, such as the elderly with quiescent colitis and other indications, for colectomy. See Video Abstract . COLECTOMA SEGMENTARIA EN LA COLITIS ULCEROSA: ANTECEDENTES:La colectomía segmentaria en la colitis ulcerosa se realiza en pacientes seleccionados que pueden tener un mayor riesgo de morbilidad posoperatoria.OBJETIVO:Identificar pacientes con colitis ulcerosa sometidos a colectomía segmentaria y evaluar sus resultados postoperatorios y a largo plazo.DISEÑO:Serie de casos retrospectivos.AMBIENTE:Un centro de atención terciaria para enfermedades inflamatorias intestinales.PACIENTES:Pacientes con colitis ulcerosa intervenidos quirúrgicamente entre 1995 y 2022.INTERVENCIÓN(S):Colectomía segmentaria.PRINCIPALES MEDIDAS DE RESULTADO:Complicaciones postoperatorias, colitis temprana y tardía, desarrollo de cáncer metacrónico, tasas de supervivencia sin proctocolectomía completa y estoma en el seguimiento.RESULTADOS:Se incluyeron cincuenta y cinco pacientes [20 (36,4%) mujeres; 67,8 (57,4-77,1) años de edad al momento de la cirugía; índice de masa corporal 27,7 (24,2-31,1) kg/m2; mediana de seguimiento 37,3 meses]. La puntuación ASA fue III en 32 (58,2%) pacientes, 48 (87,3%) tenían al menos una comorbilidad y 48 (87,3%) tenían una subpuntuación endoscópica de Mayo de 0-1. Los pacientes fueron sometidos a hemicolectomía derecha (28, 50,9%), sigmoidectomía (17, 30,9%), hemicolectomía izquierda (6, 10,9%), resección anterior baja (2, 3,6%) o resección no anatómica (2, 3,6%) para; pólipos irresecables endoscópicamente (21, 38,2%), cáncer colorrectal (15, 27,3%), enfermedad diverticular sintomática (13, 23,6%) y estenosis (6, 10,9%). Se produjeron complicaciones postoperatorias en 16 (29,1%) pacientes [7 (12,7%) Clavien-Dindo Clase III-V]. Las tasas de colitis posoperatoria temprana y tardía fueron del 9,1% y el 14,5%, respectivamente. Un paciente desarrolló cáncer metacrónico. A 4 (7,3%) pacientes se les realizó posteriormente proctocolectomía completa con ileostomía. Seis (10,9%) pacientes tenían estoma en el seguimiento. Las tasas de supervivencia sin proctocolectomía completa a dos y cinco años fueron del 91% y 88%, respectivamente.LIMITACIONES:Estudio retrospectivo, tamaño de muestra pequeño.CONCLUSIONES:La colectomía segmentaria en la colitis ulcerosa se asocia con bajas tasas de complicaciones postoperatorias, tasas de colitis sintomática temprana y tasas de colitis tardía, desarrollo de cáncer metacrónico y la necesidad de una posterior proctocolectomía completa. Por lo tanto, puede ser seguro considerar pacientes seleccionados, como los ancianos con colitis inactiva y otras indicaciones de colectomía. (Traducción-Dr. Yolanda Colorado ).

How to do a laparoscopic-assisted endoscopic 'clean sweep' for small bowel polyp clearance in Peutz Jeghers syndrome.

We demonstrate the technical details of laparoscopic-assisted endoscopic 'clean sweep' for small bowel polyp clearance in Peutz Jeghers Syndrome. A 'clean sweep' reduces the risk for future recurrences but was previously performed with an open technique. A minimally invasive approach is safe, reduces bowel trauma and has good postoperative outcomes.

Physical Activity Among Young Children With Disabilities: A Systematic Review.

Physical activity (PA) in the early years is foundational for growth and development and associated with numerous health benefits. However, the prevalence of PA participation among the pediatric population with disabilities is less clear. This systematic review aimed to synthesize the existing literature on PA levels of young children (0-5.99 years) with disabilities. Empirical quantitative studies were collected from seven databases and reference hand searching; 21 studies were included in the review. PA levels varied widely based on disability type and measurement strategies, but overall, PA levels were low. Future research should address the underrepresentation of measurement and reporting of the PA levels of young children with disabilities.

The role of thriving in mental health among people with intellectual and developmental disabilities during the COVID-19 pandemic in Canada.

BACKGROUND: The COVID-19 pandemic has had a negative impact on the mental health of people with intellectual and developmental disabilities. Numerous pandemic-related stressors experienced by people with intellectual and developmental disabilities may have impacted their ability to thrive, which has been linked to mental health outcomes. The current study examined the associations among COVID-19 stressors, thriving, and mental health problems among youth and adults with intellectual and developmental disabilities. METHOD: Caregivers of 159 people with intellectual and developmental disabilities between 12 and 35 years of age from Canada completed an online questionnaire. RESULTS: A mediation analysis revealed that COVID-19 stressors were positively associated with mental health problems, and that thriving partially mediated this association. CONCLUSION: Our findings suggest that experiences of thriving may be an important target for mental health support for people with intellectual and developmental disabilities.

Operative management of anastomotic leak after sigmoid colectomy for left-sided diverticular disease: Ileostomy creation may be as safe as colostomy creation.

AIM: The management of anastomotic leak after sigmoid colectomy for diverticular disease has not been well defined. Specifically, there is a lack of literature on optimal types of reoperations for leaks. The aim of this study was to describe and compare reoperative approaches and their postoperative outcomes. METHODS: We performed a retrospective cohort study using the NSQIP Colectomy Module (2012-2019) and single-institution chart review. Patients with diverticular disease who underwent elective sigmoid colectomy were included. Primary outcomes were anastomotic leak requiring reoperation and management of anastomotic leak. RESULTS: Of 37,471 patients who underwent sigmoid colectomy for diverticular disease, 1003 (2.7%) suffered an anastomotic leak, of whom 583 underwent reoperation. Of the 572 patients who were not initially diverted and underwent reoperation for leak, 302 (52.8%) were managed with stoma creation - 200 (35.0%) with colostomy and 102 (17.8%) with ileostomy. The remaining 47.2% underwent colectomy with reanastomosis, suturing of large bowel, and drainage. There were no differences in length of stay, readmission, or mortality between patients who underwent ileostomy or colostomy at reoperation (p > 0.05). Single-institution analysis demonstrated that 100% of patients with ileostomies underwent subsequent ileostomy closure, compared to 60% of patients with colostomies. CONCLUSIONS: In patients who suffer anastomotic leaks after sigmoid colectomy for diverticular disease and undergo reoperations, ileostomy at the time of reoperation appears to be safe, with comparable results to colostomy. Ileostomies were more frequently closed than colostomies. When faced with a colorectal anastomotic leak, ileostomy creation may be considered.

Expert Appraisal of the 2022 Canadian Para Report Card on Physical Activity for Children and Adolescents With Disabilities.

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada.

We want more! Examining the perceived training and information needs of health and fitness practitioners about disability and physical activity.

A lack of disability-specific knowledge among practitioners poses a significant barrier to physical activity (PA) participation for persons with physical disabilities (PWPDs). This study aimed to identify perceived training needs of health and fitness practitioners to support PA for PWPDs. Canadian health and fitness practitioners (n = 115; 81% female) completed an online survey. More specialized training and access to information about PA for PWPDs are needed. In-person training, webinars, and lived experiences of PWPDs are recommended.

An exploration of perceived social isolation among persons with spinal cord injury in Ontario, Canada: a qualitative study.

PURPOSE: To advance the understanding of perceived social isolation among persons with spinal cord injury (SCI), the objectives of the present study were to explore: (1) experiences of perceived social isolation and (2) factors that contribute to perceived social isolation. METHODS: Interpretive description qualitative methodology was used to conduct semi-structured interviews with 30 individuals with SCI from across Ontario (Canada) from November 2016 to August 2017. Data were analyzed using thematic analysis. RESULTS: Participants identified disruption to social networks that seemed to impact perceived social isolation. Five major themes were identified: (1) impact on structure and frequency of social network; (2) importance of feeling heard; (3) importance of employment, hobbies, and sports; (4) need to improve physical accessibility and built environment; and (5) individual characteristics. Changes in quality of social networks, rather than size, contributed to greater feelings of perceived social isolation. The built environment, maintenance of employment, hobbies, and sports, social media, and technology use, as well as individual traits, were also found to impact perceived social isolation. CONCLUSION: Future research should focus on the development of programs to help maintain or improve social network quality for persons with SCI to minimize the impact of perceived social isolation.IMPLICATIONS FOR REHABILITATIONPerceived social isolation, resulting from physical and environmental barriers, is a challenge that is faced by many individuals who are living in the community with a spinal cord injury (SCI).Rehabilitation and community programs should utilize an individualized approach to find solutions to challenges faced by this population to prevent the effects of perceived social isolation.Education on how to adapt to changes in social network, together with the provision of access to peer-to-peer support groups, and SCI specific return to work or leisure programs, is recommended as an essential component of rehabilitation.

A Qualitative Study of the System-level Barriers to Bariatric Surgery Within the Veterans Health Administration.

OBJECTIVE: To characterize system-level barriers to bariatric surgery from the perspectives of Veterans with severe obesity and obesity care providers. SUMMARY OF BACKGROUND DATA: Bariatric surgery is the most effective weight loss option for Veterans with severe obesity, but fewer than 0.1% of Veterans with severe obesity undergo it. Addressing low utilization of bariatric surgery and weight management services is a priority for the veterans health administration. METHODS: We conducted semi-structured interviews with Veterans with severe obesity who were referred for or underwent bariatric surgery, and providers who delivered care to veterans with severe obesity, including bariatric surgeons, primary care providers, registered dietitians, and health psychologists. We asked study participants to describe their experiences with the bariatric surgery delivery process in the VA system. All interviews were audio-recorded and transcribed. Four coders iteratively developed a codebook and used conventional content analysis to identify relevant systems or "contextual" barriers within Andersen Behavioral Model of Health Services Use. RESULTS: Seventy-three semi-structured interviews with veterans (n = 33) and providers (n = 40) throughout the veterans health administration system were completed. More than three-fourths of Veterans were male, whereas nearly three-fourths of the providers were female. Eight themes were mapped onto Andersen model as barriers to bariatric surgery: poor care coordination, lack of bariatric surgery guidelines, limited primary care providers and referring provider knowledge about bariatric surgery, long travel distances, delayed referrals, limited access to healthy foods, difficulties meetings preoperative requirements, and lack of provider availability and/or time. CONCLUSIONS: Addressing system-level barriers by improving coordination of care and standardizing some aspects of bariatric surgery care may improve access to evidence-based severe obesity care within VA.

Physical activity and life satisfaction among individuals with spinal cord injury: Exploring loneliness as a possible mediator.

Context: There has been no known research investigating the association between leisure time physical activity (LTPA), loneliness, and life satisfaction among people with spinal cord injury or dysfunction (SCI/D). The relationship between these constructs is worthy of consideration given the positive health impacts of LTPA, the negative health impacts of loneliness, and heightened negative effects of loneliness on life satisfaction for individuals with SCI/D.Objectives: To examine the relationship between LTPA and loneliness, and examine loneliness as a possible mediator of the relationship between LTPA and life satisfaction among individuals with SCI/D.Design and Participants: Community dwelling individuals with SCI/D (N = 170) participated in a telephone-based survey as part of a larger project.Measures: LTPA (i.e. The Leisure Time Physical Activity Questionnaire-SCI, UCLA Loneliness Scale-3, and the Life Satisfaction Questionnaire-11 were administered to the participants.Results: Significant bivariate relationships were observed between LTPA and life satisfaction (r = .18, P = .02), LTPA and loneliness (r = -.15, P = .045), and loneliness and life satisfaction (r = -.69, P < .001). Mediation analyses suggest that loneliness significantly mediated the relationship between LTPA and life satisfaction (indirect effect = .003, 95% bootstrap CI = .0004 to .0062, CSI = .113).Conclusion: This was the first study to show evidence of a negative association between LTPA and loneliness among people with SCI/D, and to establish a conceptual model for understanding the potential mediating role of loneliness in the relationship between LTPA and life satisfaction among people with SCI/D.

Mesenteric Excision and Exclusion for Ileocolic Crohn's Disease: Feasibility and Safety of an Innovative, Combined Surgical Approach With Extended Mesenteric Excision and Kono-S Anastomosis.

INTRODUCTION: Ileocolic resection for Crohn's disease traditionally does not include a high ligation of the ileocolic pedicle, and most commonly is performed with a stapled side-to-side ileocolic anastomosis. The mesentery has recently been implicated in the pathophysiology of Crohn's disease. Two techniques have been developed and are associated with reduced postoperative recurrence: the Kono-S anastomosis that excludes diseased mesentery and extended mesenteric excision that resects diseased mesentery. We aimed to assess the technical feasibility and safety of a novel combination of techniques: mesenteric excision and exclusion. TECHNIQUES: This initial report is a single-center descriptive study of consecutive adults who underwent mesenteric excision and exclusion for primary or recurrent ileocolic Crohn's disease from September 2020 to June 2021. Medication exposure and endoscopic balloon dilation before surgery were recorded. Phenotype was classified using the Montreal Classification. Thirty-day outcomes were reported. A video of the mesenteric excision and exclusion including the Kono-S anastomosis is presented. RESULTS: Twenty-two patients with ileocolic Crohn's disease underwent mesenteric excision and exclusion: 100% had strictures, 59% had fistulas, 81% were on biologics, and 27% had previous ileocolic resection(s). Seventy-two percent underwent laparoscopic procedures, a mesenteric defect was closed in 86%, omental flaps were fashioned in 77%, and 3 patients were diverted. Median operative time was 175 minutes. Median postoperative stay was 4 days. At 30 days, there were 2 readmissions for reintervention: 1 seton placement and 1 percutaneous drainage of a sterile collection. There were no cases of intra-abdominal sepsis or anastomotic leak. CONCLUSIONS: Mesenteric excision and exclusion represents an innovative, progressive, and promising approach that appears to be highly feasible and safe. Further study is warranted to determine if mesenteric excision and exclusion is associated with reduced postoperative recurrence of ileocolic Crohn's disease.

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review.

BACKGROUND: Physical activity (PA) messages have demonstrated success in targeting parent support for PA. However, little research exists to inform the development and dissemination of optimally effective PA messages targeting parents. A synthesis of existing literature is necessary to inform message development and dissemination strategies. Unique considerations for parents of children with disabilities (CWD) should be identified given a need for inclusive PA messaging that consider the needs of CWD and their families. METHODS: Systematic scoping methodologies included a peer-reviewed literature search and expert consultation to identify literature regarding PA messages targeting parents, and considerations for parents of CWD. RESULTS: Thirty-four articles that met eligibility criteria were included for examination. Twenty-eight studies were identified regarding the PA messages targeting parents; six themes and 12 subthemes emerged from these articles. Six studies were identified regarding unique considerations for parents of CWD; three themes and four subthemes emerged from these articles. CONCLUSIONS: Through knowledge synthesis, this research can contribute to a knowledge translation process to inform practice guidelines for the development and dissemination of PA messages targeting parents, while also providing unique considerations for PA messages targeting parents of CWD.

Integrating needs-supportive delivery into a laboratory-based randomised controlled trial for adolescent girls with overweight and obesity: Theoretical underpinning and 12-week psychological outcomes.

When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity.

Examination of the Relationships Among Social Networks and Loneliness on Health and Life Satisfaction in People with Spinal Cord Injury/Dysfunction.

OBJECTIVE: To examine the associations among social networks and loneliness on health and life satisfaction in adults with chronic spinal cord injury/dysfunction (SCI/D). DESIGN: Cross-sectional telephone survey study. SETTING: Tertiary spinal cord injury rehabilitation center in Ontario, Canada. PARTICIPANTS: Community-dwelling adults with chronic SCI/D (N=170). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The main outcome measures were the Short-Form 36 to assess health and the Life Satisfaction-11 to assess life satisfaction. RESULTS: A hierarchical regression model predicting physical health accounted for 24% (P<.001) of the variance. The only social network variable to significantly contribute to the model was having a higher proportion of network members living in one's household (P<.05). A model predicting mental health accounted for 44% (P<.001) of the variance, with having a higher proportion of network members living in one's household (P<.05) and lower feelings of loneliness (P<.001) associated with better mental health. Finally, the model predicting life satisfaction accounted for 62% (P<.001) of the variance, with lower greater levels of social network intimacy (P<.01) and lower feelings of loneliness (P<.001) being significant predictors. CONCLUSIONS: These findings highlight the importance of having access to network members in one's home for better physical and mental health after SCI/D as well as the negative association between loneliness and mental health and life satisfaction. There is a need for approaches to ensure that people with SCI/D in the community feel supported to mitigate feelings of loneliness to optimize their health and wellbeing.

Physical activity and loneliness among adolescents with disabilities: Examining the quality of physical activity experiences as a possible moderator.

BACKGROUND: Adolescents with disabilities (AWD) often report higher loneliness levels than adolescents without disabilities, as they frequently encounter barriers to social participation. A negative relationship between physical activity (PA) and loneliness has been established outside of AWD populations, while few studies have examined this association among AWD. Research investigating the relationship between PA and loneliness has not systematically examined aspects of PA experiences that may influence this relationship. OBJECTIVES: The objectives of this study were to: a) examine the direct relationship between PA and loneliness among AWD, and b) examine the quality of PA experiences, as framed within a quality participation conceptualization, as a possible moderator of the relationship between PA and loneliness. METHODS: This study was a cross-sectional sub-analysis of data from The National Physical Activity Measurement Study. Participants included 40 Canadian adolescents, age 10-17, with any type of disability who completed a series of questionnaires either online or via telephone/video interview. RESULTS: PA and loneliness were not significantly related at the bivariate level (r = -0.10, p = .54), but quality of PA participation significantly moderated the relationship between PA and loneliness (95% C.I. = 0.002-0.019, p = .02). These results suggest that greater PA rates were significantly and negatively associated with loneliness among AWD who reported experiencing high quality PA experiences. CONCLUSIONS: This research can be used as evidence to inform mechanistic studies with causal data to provide more robust findings on the possible value of high-quality PA experiences to mitigate feelings of loneliness among AWD.

An examination of objective social disconnectedness and perceived social isolation among persons with spinal cord injury/dysfunction: a descriptive cross-sectional study.

PURPOSE: To describe objective social disconnectedness and perceived social isolation post-spinal cord injury/dysfunction (SCI/D), and to examine associations among social disconnectedness and social isolation by sociodemographic and clinical characteristics. MATERIALS AND METHODS: A telephone-based questionnaire was administered to 170 community dwelling individuals with a SCI/D. Social disconnectedness was measured by social network size, composition, and frequency of contact. Social isolation was measured using the revised three item UCLA Loneliness Scale. RESULTS: Of the 170 participants, the majority were men (n = 136, 80%), had a traumatic injury (n = 149, 87.6%), and had incomplete tetraplegia (n = 58, 34%). The mean network size was 3.86 (SD = 2.0) of a maximum seven. The mean loneliness score for the sample was 4.93 (SD = 1.87). Factors associated with lower feelings of loneliness included being married, living with a higher proportion of network members, and being employed. Size of networks was not significantly associated with feelings of loneliness. CONCLUSIONS: This study highlights the vulnerability for perceived social isolation among persons with SCI/D. The size of network does not seem to matter as much as the frequency and quality of social interactions. Findings reinforce the complexity of social disconnectedness and the importance in understanding the various indicators of social disconnectedness as they relate to social isolation. IMPLICATIONS FOR REHABILITATION Social relationships have been shown to be a vital component of optimal health and well-being. Individuals with a spinal cord injury/dysfunction are faced with a number of challenges in developing and maintaining social relationships and community participation. Rehabilitation professionals should encourage opportunities for social inclusion, employment and community participation to optimize health and well-being for this population.

A cross-sectional examination of the 24-hour movement behaviours in Canadian youth with physical and sensory disabilities.

BACKGROUND: Canada's 24-Hour Movement Guidelines for Children and Youth provide daily recommendations for physical activity (PA), screen time, and sleep for optimal health. The appropriateness of such guidelines for youth with disabilities remains unknown. OBJECTIVE: To cross-sectionally examine the 24-h movement behaviours and guideline adherence in youth (ages 12-21 years) with physical and sensory disabilities. METHODS: 54 youth with physical and sensory disabilities completed two, 24-h recalls to assess PA, sedentary behaviour, and sleep. Descriptive statistics were used to analyze behavioural patterns and guideline adherence. Gender and age differences were tested using analyses of variance and logistic regressions. RESULTS: 55.5%, 13.0%, and 53.7% of the sample met the individual guidelines for PA, sedentary behaviour, and sleep, respectively. 3.7% of the sample met all three movement guidelines. No significant gender or age differences in guideline achievement were found. Over a 24-h period, youth spent 77 (59) minutes engaging in moderate to vigorous PA, 252 (120) minutes engaging in sedentary activity, and 546 (90) minutes sleeping. Boys reported significantly more time (adjusted Mdifference = 11 min) playing passive video games than girls. CONCLUSION: Overall, our sample of youth with physical and sensory disabilities falls far short of meeting the Canadian 24-Hour Movement Guidelines for Children and Youth. The low proportion of youths' time spent engaging in sport and active play is concerning, highlighting the importance of creating access to these types of PA experiences for this population. Future population-based research is needed among children and youth with all types of disabilities to build an evidence-base of their movement behaviours.

Factors Associated with Participation in Physical Activity Among Canadian School-Aged Children with Autism Spectrum Disorder: An Application of the International Classification of Functioning, Disability and Health.

We have a limited understanding of the socioenvironmental factors associated with participation in physical activity among school-aged children with autism spectrum disorder (ASD), particularly regarding how the school environment may influence their participation. Using the International Classification of Functioning, Disability and Health (ICF) as a framework, this study examined the effect of body functions and structure, activity, and personal factors on in-school physical activity; and whether in-school physical activity, considered a socioenvironmental factor, is associated with out-of-school physical activity (i.e., participation) among elementary school-aged children (6-13 years of age) with ASD. Parents of 202 children with ASD (78.2% boys; Mage = 9.4 years) completed an online survey, as part of a larger study, to assess their child's functioning and physical activity in- and out-of-school. Results indicated that the majority of children (85.1%) did not meet physical activity guidelines. In-school physical activities significantly predicted out-of-school physical activities including leisure-time moderate-to-vigorous physical activity (R2 = 0.27, F(10,154) = 5.67, p < 0.001) and meeting the physical activity guidelines (R2 = 0.23, Χ2 (10) = 31.9, p < 0.001). These findings underscore the importance of supporting children with ASD to be physically active in school, which may impact physical activity levels out-of-school.

Examining the relationship between parent physical activity support behaviour and physical activity among children and youth with autism spectrum disorder.

LAY ABSTRACT: Children and youth with autism spectrum disorder engage in less physical activity than neurotypically developing peers. This may be due to factors associated with autism spectrum disorder at the individual and environmental level that can make physical activity participation more challenging. Parent support is a known determinant of physical activity among children and youth; however, limited research has explored the relationship between parent physical activity support behaviour and child physical activity behaviour within the autism spectrum disorder population. The purpose of this study was to examine the relationship between parent physical activity support behaviour and physical activity levels of children and youth with autism spectrum disorder. Parents (n = 201) of school-aged children and youth with autism spectrum disorder completed measures of parent physical activity support (intentions, behavioural regulation, support behaviour), as well as their child's physical activity behaviour. The results showed that parent's intentions to provide physical activity support were associated with their support behaviour for their child's physical activity (e.g. encouragement, being active together). Parents who followed through with their intentions to provide support reported using behavioural regulation strategies such as goal setting and planning more often. Finally, the results showed parent physical activity support behaviour was positively associated with child physical activity behaviour. Findings suggest parents play an instrumental role in the physical activity behaviour of children and youth with autism spectrum disorder. Family-level interventions targeting parents' behavioural regulation strategies to provide physical activity support may be an effective strategy to increase physical activity in children and youth with autism spectrum disorder.