Tracking activity-based therapy for people living with spinal cord injury or disease: insights gained through focus group interviews with key stakeholders.

PURPOSE: The development of a tool to track participation in activity-based therapy (ABT) for people with spinal cord injury or disease (SCI/D) was identified as a priority of the Canadian ABT Community of Practice. The objective of this study was to understand multi-stakeholder perspectives on tracking ABT participation across the continuum of care. MATERIALS AND METHODS: Forty-eight individuals from six stakeholder groups (persons living with SCI/D; hospital therapists; community trainers; administrators; researchers; and funders, advocates and policy experts) were recruited to participate in focus group interviews. Participants were asked open-ended questions concerning the importance of and parameters around tracking ABT. Transcripts were analyzed using conventional content analysis. RESULTS: Themes reflected the Who, What, Where, When, Why and How of tracking ABT. Participants described the importance of involving hospital therapists, community trainers and individuals with SCI/D in tracking ABT to capture both subjective and objective parameters across the continuum of care and injury trajectory. Digital tracking tools were favoured, although paper-based versions were regarded as a necessity in some circumstances. CONCLUSIONS: Findings highlighted the importance of tracking ABT participation for individuals with SCI/D. The information may guide the development of ABT practice guidelines and support the implementation of ABT in Canada.

Tracking the details of activity-based therapy (ABT) sessions and programs across the continuum of care and injury trajectory may provide important information to support the development of ABT practice guidelines and implementation strategies.Tracking objective and subjective parameters are needed to provide a comprehensive description of an ABT session and program.Clinicians and individuals with spinal cord injury or disease (SCI/D) should both be able to track ABT to accommodate all settings and types of data.Digital tracking tools, such as an app, may provide an accessible, versatile and efficient way of tracking ABT.

Evidence-Informed Recommendations for Community-Based Organizations Developing Physical Activity Information Targeting Families of Children and Youth With Disabilities.

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation.

A scoping Review of Tools to Evaluate Existing Playgrounds for Inclusivity of Children with Disabilities.

Introduction: Children with disabilities may be unable engage playground spaces due to barriers exacerbating exclusion. Therefore, clarity on how to evaluate existing playgrounds for inclusivity of children with disabilities is required. Methods: A scoping review was undertaken to explore auditing tools. Results: Fourteen white and grey literature resources were identified. The term "inclusion" was operationalized differently across tools, primarily focusing on physical accessibility. Characteristics of the tools were synthesized into 13 inclusive design recommendations for playgrounds. Two tools showed promise, evaluating 12/13 recommendations. Discussion: The results of this review provide guidance on existing tools for evaluating playgrounds for inclusion for community stakeholders and researchers. Systematic Review Registration: https://osf.io/rycmj.

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.

Providing Insights into the Challenges of Implementing Activity-Based Therapy in Canada: A Comparative Analysis Using Focus Group Interviews with Key Interest Groups.

Background: Activity-based therapy (ABT) has emerged as a therapeutic approach that may promote neurorecovery and reduce secondary complications in people living with spinal cord injury or disease (SCI/D). In spite of the numerous health benefits, adoption of ABT into practice has been limited across the Canadian care continuum. Objectives: This study aimed to understand the challenges of implementing ABT in Canada for people living with SCI/D through the perspectives of key interest groups. Methods: Researchers, hospital therapists, community trainers, administrators, persons living with SCI/D, and advocates, funders, and policy experts who had knowledge of and/or experience with ABT participated in focus group interviews to share their perspectives on the barriers to ABT practice. Interviews were analyzed using conventional content analysis followed by a comparative analysis across groups. Results: The 48 participants identified six key challenges: (1) challenge of gaps in knowledge/training, (2) challenge of standardizing ABT, (3) challenge of determining the optimal timing of ABT, (4) challenge of defining, characterizing, and achieving high dosage and intensity, (5) challenge of funding ABT, and (6) challenge of measuring participation and performance in ABT. A comparative analysis found some challenges were emphasized by certain groups, such as the cost of ABT for persons with SCI/D, lack of education and training in ABT for therapists and trainers, minimal evidence to develop guidelines for researchers and advocates, and funding ABT programs for administrators. Conclusion: Participants highlighted several challenges that limit ABT practice. Strategies to address these challenges will support successful implementation of ABT in Canada.

Playground Inclusivity for Children With a Disability: Protocol for a Scoping Review.

BACKGROUND: Although playgrounds are designed to promote outdoor play, children with disabilities may be unable to engage in these spaces due to intrinsic and extrinsic factors. Previous research has examined inclusive/accessible playground design when developing new playgrounds; however, it is unclear if there is a best-practice tool for evaluating the inclusivity of existing playground structures. OBJECTIVE: A scoping review of both peer-reviewed and grey literature will be employed to explore evaluation tools for playground inclusivity, to enable the participation of children with disabilities. METHODS: The conduct of this study will adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A search for peer-reviewed research studies will be conducted in the following electronic databases: MEDLINE, Scopus, CINAHL, and Embase. Grey literature will be examined via a three-step process: (1) a search in the Canadian Health Research Collection Database; (2) a targeted Google search; and (3) reference list searching. Titles, abstracts, keywords, and full texts of identified studies will be independently screened for inclusion by two reviewers. A synthesis of included articles will describe the publication and auditing tool details. A summary of the findings will highlight the types of playgrounds measured, types of disability considered, measures of inclusion used, and psychometric properties. RESULTS: Database searches for peer-reviewed articles were completed in December 2021. A total of 1471 unique records were returned after the removal of 559 duplicate records. Full texts of 167 studies meeting eligibility criteria will be reviewed. The peer-reviewed research search will guide the grey literature search. The scoping review is planned for completion in 2022. CONCLUSIONS: A rigorous search of the literature will determine the availability of tools for evaluating existing playground structures for the inclusivity of children with disabilities. The results will inform recommendations on tool applications, and applicable knowledge translation activities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/37312.

A Scoping Review of Evidence-Informed Recommendations for Designing Inclusive Playgrounds.

Background: Playgrounds provide children with many sensory, motor, and socioemotional experiences that are critical to child development. Unfortunately, playgrounds also represent an environment where children with disabilities experience barriers to accessing play. Structures and materials that are prominently found in almost all playground designs (e.g., swings, slides, sand) can present as obstacles for many children with disabilities to engage in independent play. Aims: This scoping review engaged in the empirical literature to address the research question, "What are the evidence-informed recommendations for designing inclusive playgrounds to enable participation for children with disabilities?" Consideration was given not only to the physical design of playgrounds, but also the playgrounds' surrounding built and social environments. Methods: A systematic search of Medline, PsycINFO, CINAHL, EMBase, ERIC and Scopus was conducted. Only peer-reviewed literature published in English between January 1990 and January 2021, with a primary focus on inclusive playground structure design related to any type of disability were included. Data extraction included the study author(s), year of publication, country of origin, purpose, disability types considered, methods, sample characteristics and key findings. Key findings were synthesized into evidence-informed recommendations, which were later collated, using inductive content analysis, into five broader thematically congruent groups. Results: Thirty-five studies were included using case study (n = 17); observational (n = 6); survey (n = 5); experimental (n = 4); and multiple study (n = 3) designs. Thirteen evidence-based recommendations and one promising practice were categorized into five broad playground elements: entry points; surfacing and paths; features to foster inclusive play; staffing/supervision; and design process. Conclusion: These recommendations build upon previous design-based best-practices that focused exclusively on the physical design of the playground. Our recommendations have implications for how future playgrounds should be designed to maximize usability and inclusiveness and the overall playground experiences for children with disabilities.

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.

Program conditions that foster quality physical activity participation experiences for people with a physical disability: a systematic review.

Background: Due to the numerous barriers people with a physical disability face to being physically active, emphasis in practice and research is often placed on creating opportunities for participation. As such, the quality of the experience is often ignored once an individual is participating.Purpose: An understanding of how to create quality physical activity experiences is critical to foster enjoyable and sustained participation. The aim of this systematic review was to identify intervention and/or program conditions that may foster key elements that shape quality participation (QP) experiences.Methods: In all, 24 qualitative and 6 quantitative studies met inclusion criteria. The results of the qualitative studies were synthesized using thematic analysis.Results: The synthesis identified two program conditions as important for fostering QP elements: (1) group-based programing: participating with peers can be linked to belongingness and mastery and (2) leadership: knowledgeable instructors may foster mastery and autonomy. The quantitative studies lacked variability in program conditions and QP elements, which precluded associating specific conditions with elements of a quality experience.Conclusions: Although the qualitative findings highlight two program conditions which may foster QP elements, overall, evaluations of physical activity interventions involving people with disabilities rarely include experiential aspects of participation.Implications for rehabilitationGroup-based programming and leadership are two program conditions that may foster elements of quality participation.Physical activity organizers need to consider group composition. Physical activity programs should consist of peers with a disability, as appropriate, in order to promote belongingness.Physical activity programs should provide disability-specific training to leaders or seek leaders with disability-specific knowledge, in addition to physical activity knowledge and skills.

A systematic scoping review: Resources targeting the training and education of health and recreation practitioners to support physical activity among people with physical disabilities.

BACKGROUND: Health and recreation practitioners play an important role in promoting and supporting leisure time physical activity (LTPA) among persons with physical disabilities (PWPD), yet many practitioners lack training and education to provide the basic knowledge, skills, and resources necessary.1 Little is known about existing LTPA information and training resources for health and recreation practitioners and there has been no known systematic effort to identify existing resources. OBJECTIVE: The purpose of the current study was to engage systematic scoping methodologies to identify resources that target the training and education of health and recreation practitioners to promote and support LTPA among PWPD. To further analyze the identified resources, an assessment of quality was conducted. METHODS: Systematic scoping review methodologies were employed, which included searches of academic and grey literature, online materials (i.e., Google search) and expert consultation. RESULTS: Several (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality. CONCLUSION: The paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD. RESULTS: Several (N = 46) resources were identified from academic, government and non-government, and professional organizations. Most resources were targeted to a specific PWPD population. The resources were of high technical quality. CONCLUSION: The paper serves as a listing of existing resources for practitioners working with PWPD in LTPA settings. The review provides a catalyst for action in further research and practice regarding the analysis, design, development, implementation and evaluation of optimally effective resources targeting practitioners to promote and support LTPA among PWPD.

The prevalence of obesity in children and young people with Down syndrome.

BACKGROUND: Overweight and obesity is a growing concern among individuals with intellectual disabilities; however, little is known about the prevalence among children and youth with Down syndrome (CYDS). The purpose of this study was to determine the prevalence of overweight/obesity among CYDS in South West Ireland. METHODS: This cross-sectional study measured height and weight of 61 CYDS aged 4-16 years. Body mass index (BMI) was calculated and percentage body fat (PBF) was measured using bio-electrical impendence analysis (BIA). RESULTS: Using the International Obesity Task Force BMI cut-offs, 51.6% of males and 40% of females were overweight/obese compared to 32% and 14.8%, respectively, using PBF. The mean PBF for males was 18.76 versus females 22.38 (p < .05). There is a higher prevalence of overweight/obesity, particularly in males, compared to the general population of children. CONCLUSIONS: The difference in estimation of overweight/obesity between BMI and BIA has implications for research and clinical practice.

Simulating Others' Realities: Insiders Reflect on Disability Simulations.

The purpose of this interpretative phenomenological analysis study was to explore the meaning persons who experience disability ascribed to disability simulations as a pedagogical tool. Reflective writing, one-on-one interviews, and field notes were used to gather information on disability simulation use in a required postsecondary kinesiology course. Seven people who use wheelchairs full time (3 men, 4 women), ranging in age from 28 to 44 yr (average age = 36) shared their perspectives. The thematic analysis revealed 3 themes. The theme "Disability Mentors Required" revealed the participants' collective questioning of their absence from the design and implementation of disability simulations. "Life Is Not a Simulation" illustrated the juxtaposition of disability reality and disability simulations. "Why Are They Laughing?" contrasted the use of fun as a strategy to engage students against the risk of distracting them from deeper reflection. Through the lens of ableism, the importance of disability representation in the development and implementation of disability simulations was affirmed as a means to deepen pedagogical reflexiveness of their intended use.

Understanding dignity: experiences of impairment in an exercise facility.

Dignity, as an essential quality of being human, has been overlooked in exercise contexts. The aim of this interpretative phenomenological study was to understand the meaning of dignity and its importance to exercise participation. The experiences of 21 adults (11 women and 10 men) from 19 to 65 yr of age who experience disability, who attended a specialized community exercise facility, were gathered using the methods of focus-group and one-on-one interviews, visual images, and field notes. The thematic analysis revealed 4 themes: the comfort of feeling welcome, perceptions of otherness, negotiating public spaces, and lost autonomy. Dignity was subjectively understood and nurtured through the respect of others. Indignities occurred when enacted social and cultural norms brought dignity to consciousness through humiliation or removal of autonomy. The specialized exercise environment promoted self-worth and positive self-beliefs through shared life experiences and a norm of respect.

Mating and Memory : Can Mating Cues Enhance Cognitive Performance?

The literature on sexual selection and the social brain hypothesis suggest that human cognition and communication evolved, in part, for the purpose of displaying desirable cognitive abilities to potential mates. An evolutionary approach to social cognition implies that proximate mating motives may lead people to display desirable mental traits. In signaling such traits, one can increase the likelihood of attracting a potential mate. Two experiments demonstrated that exposure to mating cues-highly attractive opposite-sex faces-led people to display enhancements in declarative memory-a process underlying a variety of abilities such as resource acquisition, intelligence, and creativity. Experiment 1 showed that men (but not women) displayed enhanced memory for details of a story that was presented during exposure to highly attractive opposite-sex faces. Experiment 2 demonstrated that heightened displays of declarative memory reflect an enhancement in retrieval rather than in encoding. Findings contribute to the literatures on human mating and cognitive performance and provide novel insight into links between social processes and basic cognition.

An environmental scan of weight assessment and management practices in paediatric spina bifida clinics across Canada.

UNLABELLED: Childhood obesity is a global health concern, but children with spina bifida in particular have unique interacting risk factors for increased weight. PURPOSE: To identify and explore current clinical practices around weight assessment and management in pediatric spina bifida clinics. METHODS: An online, self-report survey of healthcare professionals (HCPs) was conducted in all pediatric spina bifida clinics across Canada (15 clinics). Summary and descriptive statistics were calculated and descriptive thematic analysis was performed on free text responses. RESULTS: 52 responses across all 15 clinics indicated that weight and height were assessed and recorded most of the time using a wide variety of methods, although some HCPs questioned their suitability for children with spina bifida. Weight and height information was not routinely communicated to patients and their families and HCPS identified considerable barriers to discussing weight-related information in consultations. CONCLUSION: Despite weight and height reportedly being measured regularly, HCPs expressed concern over the lack of appropriate assessment and classification tools. Communication across multi-disciplinary team members is required to ensure that children with weight-related issues do not inadvertently get overlooked. Specific skill training around weight-related issues and optimizing consultation time should be explored further for HCPs working with this population.

Negotiated meanings of disability simulations in an adapted physical activity course: learning from student reflections.

Disability simulations have been used as a pedagogical tool to simulate the functional and cultural experiences of disability. Despite their widespread application, disagreement about their ethical use, value, and efficacy persists. The purpose of this study was to understand how postsecondary kinesiology students experienced participation in disability simulations. An interpretative phenomenological approach guided the study's collection of journal entries and clarifying one-on-one interviews with four female undergraduate students enrolled in a required adapted physical activity course. The data were analyzed thematically and interpreted using the conceptual framework of situated learning. Three themes transpired: unnerving visibility, negotiating environments differently, and tomorrow I'll be fine. The students described emotional responses to the use of wheelchairs as disability artifacts, developed awareness of environmental barriers to culturally and socially normative activities, and moderated their discomfort with the knowledge they could end the simulation at any time.

Motivated social categorization: fundamental motives enhance people's sensitivity to basic social categories.

This article presents an evolutionary framework for identifying the characteristics people use to categorize members of their social world. Findings suggest that fundamental social motives lead people to implicitly categorize social targets based on whether those targets display goal-relevant phenotypic traits. A mate-search prime caused participants to categorize opposite-sex targets (but not same-sex targets) based on their level of physical attractiveness (Experiment 1). A mate-guarding prime interacted with relationship investment, causing participants to categorize same-sex targets (but not opposite-sex targets) based on their physical attractiveness (Experiment 2). A self-protection prime interacted with chronic beliefs about danger, increasing participants' tendency to categorize targets based on their racial group membership (Black or White; Experiment 3). This work demonstrates that people categorize others based on whether they display goal-relevant characteristics reflecting high levels of perceived desirability or threat. Social categorization is guided by fundamental evolved motives designed to enhance adaptive social outcomes.

Connecting through summer camp: Youth with visual impairments find a sense of community.

The social meaning of a one-week residential summer sports camp to young people with visual impairments is described. The experiences of 13 youths (7 females and 6 males) with visual impairments (3 B1, 1 B2, and 9 B3) between 9 and 15 years of age were gathered using the phenomenological methods of focus groups, conversational interviews, and field notes. The thematic analysis revealed three themes: connected, reaching out, and resisting and acquiescing. Experiences of group membership and shared emotional connection to others with visual impairments surfaced in a supportive sport context although resistance to others' assumptions of ability was evident. The theory of psychological sense of community (McMillan & Chivas, 1986) provided the conceptual framework for interpreting the findings.