Bloemen MAT1,2, Hermsen S3, Leeuwerke M2,3, van Eijk M1,2, Gras F4, Siben K5, Kotte E6, van Maren-Suir I7,8, Smits F9
1HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Research Centre for Healthy and Sustainable Living, Utrecht, Netherlands, 2HU University of Applied Sciences Utrecht, Master Program Physiotherapy, Specialisation Paediatric Physiotherapy, Utrecht, Netherlands, 3HU University of Apllied Sciences Utrecht, Research Group Cross-Media Communication in the Public Domain, Research Centre for Innovation in Business and Communication, Utrecht, Netherlands, 4Avans+, Master Pediatric Physical Therapy, Breda, Netherlands, 5HU University of Apllied Sciences Utrecht, Master Program Pedagogy, Utrecht, Netherlands, 6Fitkids Foundation, Amsterdam, Netherlands, 7HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Utrecht, Netherlands, 8Utrecht University, Faculty of Social and Behavioral Sciences, Department of Pedagogical and Educational Sciences, Utrecht, Netherlands, 9HU University of Apllied Sciences Utrecht, Research Group Participation and Urban Development, Research Centre for Social Innovation, Utrecht, Netherlands
Background: Increasing participation in daily physical activities, including sports participation, is an important goal during pediatric physical therapy in children with physical disabilities. Children with physical disabilities are less physically active than typically developing peers because they experience several barriers, both personal and external. This is a major problem because participation in physical activity has positive effects on the physical, cognitive and psychosocial development, as well as positive effects on the quality of life and overall health.
Purpose: The purpose of this study was to explore barriers, facilitators and solution strategies for participation in daily physical activity, including sporting activities, in children with physical disabilities from four perspectives: children with physical disabilities, parents from children with a physical disability, pediatric physical therapists and professionals in the sports domain.
Methods: This study has a descriptive qualitative design with a thematic analysis. Twelve children with a physical disability between six and twelve years old, 12 parents, 14 pediatric physical therapists and 13 professionals in the sports domain (care sport connectors, sports trainers, coaches) were included. Semi-structured interviews, using an interview guide, were conducted and all data were transcribed verbatim. Four researchers analyzed the data using an inductive strategy, including skeptical peer reviewing. Barriers, facilitators and solutions were coded and themes were constructed using the modified Physical Activity for person with a Disability model as a background scheme (adjusted PAD-model), in which the Persuasive by Design model was incorporated. First we analyzed data from the perspectives of the children, parents, pediatric physical therapists and professionals in the sports domain separately. Triangulation was achieved by comparing the themes between the children, parents, pediatric physical therapists and professionals in the sports domain.
Results: The large variety of barriers, facilitators and solutions show that participation of children with physical disabilities in daily physical activity is a complex problem. Motivation, fun, self-efficacy and a solution-oriented approach are important themes within the personal factors. Information regarding sports possibilities, the presence of (adapted) sports facilities in the direct living environment, the level of knowledge and experience of sports trainers and collaboration between pediatric physical therapists and care sport connectors are important themes within the environmental factors.
Conclusion(s): It is difficult for the pediatric physical therapist to optimal support the child and its parents, because of the multifactorial character of the underlying problem: a combination of psychological, physical and external factors. Looking at the personal factors, behavioral aspects like self-efficacy, motivation and being able to have a solution oriented mindset seem important facilitators. Furthermore, a successful collaboration between pediatric physical therapists and professionals in the sports domain seems essential and an important solution.
Implications: The implementation of behavioral change components in pediatric physical therapy interventions seems promising and necessary. Future research should design these interventions in co-design with children, parents and pediatric physical therapists. Furthermore, pediatric physical therapists should explore the possibilities to improve a structural collaboration with professionals in the sports domain. Future research should focus on how this collaboration can be stimulated and facilitated.
Keywords: Children with disabilities, physical activity, pediatric physical therapy
Funding acknowledgements: na
Purpose: The purpose of this study was to explore barriers, facilitators and solution strategies for participation in daily physical activity, including sporting activities, in children with physical disabilities from four perspectives: children with physical disabilities, parents from children with a physical disability, pediatric physical therapists and professionals in the sports domain.
Methods: This study has a descriptive qualitative design with a thematic analysis. Twelve children with a physical disability between six and twelve years old, 12 parents, 14 pediatric physical therapists and 13 professionals in the sports domain (care sport connectors, sports trainers, coaches) were included. Semi-structured interviews, using an interview guide, were conducted and all data were transcribed verbatim. Four researchers analyzed the data using an inductive strategy, including skeptical peer reviewing. Barriers, facilitators and solutions were coded and themes were constructed using the modified Physical Activity for person with a Disability model as a background scheme (adjusted PAD-model), in which the Persuasive by Design model was incorporated. First we analyzed data from the perspectives of the children, parents, pediatric physical therapists and professionals in the sports domain separately. Triangulation was achieved by comparing the themes between the children, parents, pediatric physical therapists and professionals in the sports domain.
Results: The large variety of barriers, facilitators and solutions show that participation of children with physical disabilities in daily physical activity is a complex problem. Motivation, fun, self-efficacy and a solution-oriented approach are important themes within the personal factors. Information regarding sports possibilities, the presence of (adapted) sports facilities in the direct living environment, the level of knowledge and experience of sports trainers and collaboration between pediatric physical therapists and care sport connectors are important themes within the environmental factors.
Conclusion(s): It is difficult for the pediatric physical therapist to optimal support the child and its parents, because of the multifactorial character of the underlying problem: a combination of psychological, physical and external factors. Looking at the personal factors, behavioral aspects like self-efficacy, motivation and being able to have a solution oriented mindset seem important facilitators. Furthermore, a successful collaboration between pediatric physical therapists and professionals in the sports domain seems essential and an important solution.
Implications: The implementation of behavioral change components in pediatric physical therapy interventions seems promising and necessary. Future research should design these interventions in co-design with children, parents and pediatric physical therapists. Furthermore, pediatric physical therapists should explore the possibilities to improve a structural collaboration with professionals in the sports domain. Future research should focus on how this collaboration can be stimulated and facilitated.
Keywords: Children with disabilities, physical activity, pediatric physical therapy
Funding acknowledgements: na
Topic: Paediatrics; Disability & rehabilitation
Ethics approval required: No
Institution: HU University of Applied Sciences
Ethics committee: Meidical Ethical Screening Committee
Reason not required: Study used interviews that had no emotional burden.
All authors, affiliations and abstracts have been published as submitted.
