Active mobility, active participation: a systematic review of modified ride-on car use by children with disabilities

Abstract

Background

Modified ride-on cars (MROC) are a low-cost option to provide self-directed mobility to children with mobility limitations, in lieu of or as a precursor to other powered mobility devices.

Objectives

We appraised evidence to (1) describe and categorize MROC study characteristics, (2) synthesize existing knowledge of children’s use of MROCs and (3) frame outcomes within the International Classification of Functioning, Disability and Health (ICF) framework.

Methods

Articles were identified through four electronic databases: Medline, CINAHL, PsycNET, and Web of Science. We included all published, peer-reviewed studies involving MROC use. Relevant data were extracted, and articles were appraised using the American Academy of Cerebral Palsy and Developmental Medicine criteria for group and single-subject designs.

Results

23 studies met inclusion criteria of 204 titles identified from 1980 to 2021. Study designs included case studies, case series, group designs, and qualitative research, but only three studies were rated evidence level III or higher. Children with a range of disabilities used MROCs across multiple settings, including the home, hospital, and community, though use and adherence varied widely. Positive impacts were reported on a range of outcomes related to the ICF framework, with an emphasis on activity and participation.

Conclusions

MROC studies have primarily addressed activity and participation, with most studies suggesting increased functional mobility and social interactions due to MROC use. More robust research designs with larger samples are needed in order to develop evidence-based strategies for MROC use.

IMPLICATIONS FOR REHABILITATION

• Physical and occupational therapists may consider using MROCs as a therapeutic tool or accessible play opportunity as part of a multi-modal approach to increase children’s mobility, family engagement, and participation in community life.

• Personal (e.g., child’s enjoyment) and environmental factors (e.g., caregiver attitudes and stress) must be considered when developing plans of MROC use.

Keywords:

• disabled children
• mobility limitation
• wheelchairs
• play and playthings
• social participation

Disclosure statement

The authors report no conflict of interest, financial or otherwise.

Data availability statement

There is no data set associated with this study.

Additional information

Funding

Support for Dr. Feldner’s time was funded by the NIH National Centre for Advancing Translational Science under Award Number KL2 TR002317.