Effects of a 12 week community-based high-level mobility programme on sustained participation in physical activity by adolescents with cerebral palsy: a single subject research design study

Figures & data

Table 1. Participant demographics and summary of study participation.

ID	Demographic characteristics							Study participation
	Age (years)	Topography	GMFCS	MACS	CFCS	FMS	School	Attendance HLMP /24	Adverse events at HLMP	Completion of activity diaries and goal rating
1	13	Spastic L hemi	I	II	I	6,6,6	PS	23	Nil	Full − 56 weeks
2	13	Spastic L hemi	I	II	I	6,6,6	PS	23	1x ankle sprain	Full − 58 weeks
3	14	Spastic R hemi	I	III	I	6,6,6	SS	23	1x collision in relay	Full − 56 weeks
4	15	Spastic R hemi	I	II	I	6,6,6	SS	2	Nil	30/42 weeks^a
5	16	Hypotonic R hemi	I	II	II	6,6,6	SS in supported learning unit	23	Nil	Full − 58 weeks
6	11	Spastic Diplegia	II	I	I	5,5,5	PS	22	2x slipped on wet grass	Full − 56 weeks
7	14	Ataxic-hypotonia R hemi	II	I	II	5,5,5	SS Reader writer for exams	21	1x slipped on wet grass 2x ankle sprain	Full − 56 weeks
8	16	Spastic R hemi	II	II	II	5,5,5	SS in supported learning class	20	1x calf muscle cramp	Full until 48 weeks^b

Note. ID, study participant number (A = 1–8). The authors note that A5 has a reported diagnosis of hypotonic hemiplegia. Whilst hypotonia is not recognised under the Surveillance of Cerebral Palsy in Europe (SCPE) [36,37], hypotonia is an accepted classification based on clinically descriptive criteria in Australia [38] and New Zealand Cerebral Palsy Registers [39,40]. A7 has a diagnosis of ataxic-hypotonia which is recognised under SCPE as ataxia [36,37] and ataxic-hypotonia has also been recognised as a distinct cerebral palsy subtype [41].

y: age rounded to years; CFCS: Communication Function Classification System; FMS: Functional Mobility Scale; FMS 6: independent on all surfaces; FMS 5: independent on level surface; GMFCS: Gross Motor Functional Classification System; MACS: Manual Ability Classification System; PS: mainstream primary school; L: left, R: right, SS: mainstream secondary school; Full: 56 weeks of data collection. ^aData collection finished at 42 weeks for A4 due to social reasons during COVID; ^bData collection finished at 48 weeks as A8 left New Zealand.

Table 2. Overall goal attainment for all participants in all study phases.

Goal	Intervention (12 weeks)		Follow-up (12 weeks)		COVID (12 weeks)		Post-lockdown follow-up (16 weeks)
	# Goals achieved / #set	# Participants achieved goals / #set	# Goals achieved / #set	# Participants achieved goals / #set	# Goals achieved / #set	# Participants achieved goals / #set	# Goals achieved / #set	# Participants achieved goals / #set
Attendance	4/8	3/7^a	4/8	3/7	5/7^b	5/7	2/7	2/6^d
Involvement	6/9^c	6/8	8/9	7/8	7/8^b	7/8	6/8	6/7
Physical skill	11/15^c	7/8	9/16^e	6/8	9/16	6/8	9/16	6/7

Note. # = number; Data report number of goals achieved at GAS score of 0 or above compared to number set, and the number of participants achieving goals in each phase compared to number who set goals in that phase.

^a Attendance goal set by seven participants only.

^b Some goals became unachievable during the COVID period or an activity was out of season, leading to number of goals varying.

^c Some participants set more than one goal in each category.

^d A4 provided no data during the post-lockdown phase leading to fewer goals and participants for each goal.

^e A3 added a physical goal after the HLMP, resulting in 16 total goals.

Figure 1. Weekly frequency (times participated) and diversity (number of different activities) of physical activity for each participant across phases.

Note. The multiple baseline period varied from 4 to 6 weeks based on recruitment date. Data were intended to be collected weekly. Y axis variable increments due to large variation in number of sessions of physical activity participated in each week (frequency). Zero scores for frequency and diversity reflect injury, illness, no activity, or need for a week of rest. Gaps in frequency and diversity figures indicate no data returned. Data collection ended at week 42 for A4 and week 47 for A8. HLMP: High level mobility programme; COVID: COVID lockdown period in New Zealand

Figure 2. Time spent physically active (minutes/week) for each participant across phases.

Note. The multiple baseline period varied from 4 to 6 weeks based on recruitment date. Data were intended to be collected weekly. Y axis displayed in increments of 100 minutes of participating in physical activity/week. Zero scores for duration reflect injury, illness, no activity or need for a week of rest. Gaps in duration figures indicate no data returned. Data collection ended at week 42 for A4 and week 47 A8. Dashed line represents 420 minutes, which is the minimum recommended duration of moderate-vigorous physical activity per week for children with cerebral palsy. HLMP: High level mobility programme; COVID: COVID lockdown period in New Zealand.

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