Environmental factors associated with participation and its related concepts among children and youth with cerebral palsy: a rapid review

Abstract

Purpose

To provide an overview of environmental factors associated with participation and participation-related constructs in children and youth with cerebral palsy (CP).

Methods

A rapid review following the principles from scoping methodology was performed with a literature search in September 2019. The CINAHL, Embase, Ovid MEDLINE and PsychINFO databases were searched to identify original articles which addressed participation in children and youth (aged 0–18) with CP.

Results

In total, 9511 unique articles were identified, of which 34 met all inclusion criteria. Many different measures for environmental factors were used. Most common environmental factors associated with participation (i.e., attendance and involvement) were family ecology, type of school, and parental stress. Regarding participation-related constructs (activity competence, sense of self and preferences), most common factors were parental stress and the physical environment.

Conclusions

While environmental factors are found to be associated with participation attendance and activity competence in children with CP, there is a lack of research of environmental factors in relation to both participation involvement and other participation-related constructs. To increase impact in clinical practice, future research should involve structured assessments of the environment and focus more on modifiable factors, to help service providers develop treatment paradigms needed for meaningful participation outcomes.

IMPLICATIONS FOR REHABILITATION

• Family ecology, type of school, and parental stress were the most common factors associated with participation.

• Future research should focus on modifiable factors associated with participation outcomes.

• Modifiable environmental factors associated with participation included parental stress, family activity and type of school.

• In clinical practice, environmental factors are to be assessed in a more systematic way in relation to current or future participation restrictions.

Keywords:

• Cerebral palsy
• participation
• attendance
• involvement
• environmental factors
• ICF

Acknowledgements

We thank Andrea McLellan, librarian at McMaster University, who provided support and expertise in conducting the literature search. Dr. Gorter holds the Scotiabank Chair in Child Health Research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was performed as part of a Medical Research Training of the first author (JvdK, University Medical Centre Utrecht, The Netherlands) at CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Canada (2019).