Facilitators and barriers to participation in physical activities in children and adolescents living with cerebral palsy: a scoping review

Abstract

Purpose

This scoping review aimed to synthetize personal and environmental facilitators and barriers to participation in physical activities among youths living with cerebral palsy.

Methods

A systematic literature search was performed in five databases: CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane, WEB OF SCIENCE. The studies were selected by two independent researchers based on inclusion and exclusion criteria. A semi-quantitative evaluation assessed the consistency of results for a given variable. Variables displaying consistent associations were classified based on the Physical Activity for people with Disability Model.

Results

The electronic search yielded 10 795 articles, of which 57 were included. The main barriers to physical activity identified were motor impairments (30 studies), older age (15 studies), pain (6 studies), attendance in regular school (6 studies), and communication problems (4 studies). Barriers such as upper limb impairment and visual deficit were less frequently studied, while cognitive attributes, adapted physical environments and positive attitude, and family support were identified as facilitators.

Conclusion

Personal and environmental factors influencing physical activities behaviors among youths living with cerebral palsy are multiple and complex since they interact with each other. Rehabilitation interventions need to adopt a person-based approach to address barriers and reinforce facilitators.

IMPLICATIONS FOR REHABILITATION:

• Physical activity participation among youths with cerebral palsy is a multidimensional phenomenon, dependent on different personal and environmental factors.

• Gross motor impairments, communication problems, and pain were the most common personal factors limiting physical activity participation.

• Environmental factors consistently associated with physical activity participation were school settings, physical environment such as transportation, and social and family support and attitude.

• Rehabilitation interventions to promote an active lifestyle should consider not only personal factors but their interaction with the child’s environment.

Keywords:

• Active lifestyle
• behavior change
• youths
• developmental disability
• personal factors
• environmental factors

Acknowledgments

M. A. received doctoral scholarships from the Université Laval Research Chair in Cerebral Palsy and the Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) and the Fonds de recherche Québec - Santé (FRQS). Y. C. received a postdoctoral fellowship from the FRQS. E. T. received a postdoctoral fellowship from Université Laval Research Chair in Cerebral Palsy. C. M. is the Holder of the Université Laval Research Chair in Cerebral Palsy and is an Emeritus research scholar from the FRQS.

Disclosure statement

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

Additional information

Funding

Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS) scholarship; Fonds de recherche Québec Santé (FRQS) scholarship;Université Laval Research Chair in Cerebral Palsy scholarship.