Physical Activity, Sport and Recreation for Young People with Physical Disabilities: Difference between revisions

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== Introduction  ==
== Introduction  ==


=== Learning Outcomes  ===
Children should aim to take part in at least one hour of medium to hard intensity physical activity every day.<ref name="PAWHO">Physical Activity. World Health Organisation. Available from: http://www.who.int/mediacentre/factsheets/fs385/en/.  [Accessed 16th November 2016].</ref> Encouraging children to be active with the distractions of technology can often be difficult but even more so if the child has a disability or medical condition.  Guidance on how activities and exercises can be adapted can often be challenging that individuals living with disabilities were 82% more likely to take part in regular physical activity if a health professional advised it?<ref>Physical Activity and Health. Centres for Disease Control and Prevention. Available from: http://www.cdc.gov/physicalactivity/basics/pa-health/index.htm</ref>  
 
== Physical Activity  ==
 
=== What is Physical Activity and How Much is Enough For My Child?  ===
 
Did you know that Physical Activity (P.A) is any movement made by your body that uses energy? (WHO, 2016). So, thinking about what P.A is, how much would you think is actually enough..?<br>I’ll give you some help!&nbsp;;)
 
<br>Your child, as well as any other child should be doing at least one hour of medium to hard P.A daily. (WHO, 2016). These types of activities will increase your childs’ breathing and heart rate, which will warm up their body in preparation for further activities. Your child may also work up a sweat on hot days with this level of intensity.
 
<br>The more difficult activities may leave your child feeling out of breath during the activity - don’t worry, this in completely normal! An example of hard physical activities could be dancing, swimming or skateboarding, or other activities that your child would do on a daily basis, for example, walking or cycling. You should try to get your child to do some of these activities two or three times a week, to improve their aerobic capacity, cardiovascular health, bone health, muscle strength and their flexibility. (NICE GUIDELINES 2016).
 
<br>These guidelines are set out for both children living with and without disabilities, and those with medical conditions, provided suitable adaptations and modifications are put in place for each child based on their exercise capacity and any other special health/risk issues they may have. If your child has a disability, they should engage in regular physical activity based on their own abilities and should always avoid inactivity.  
 
<br>
 
If you are concerned about the amount and type of physical activity that would be suitable for your childs abilities click &lt;a href="https://health.gov/paguidelines/pdf/paguide.pdf"&gt;here&lt;/a&gt;,&nbsp;or if you are still unsure, you can get further information from your local G.P or a physiotherapist. Your G.P and also Physiotherapists will play a major role in promoting P.A options for you and your child with a disability.Would you believe that people with disabilities were 82% more likely to engage in P.A if a doctor or physiotherapist recommended it, ‘Centres for Disease Control and Prevention’ (2016).
 
<br>
 
===== In Summary  =====
 
*It is most important your child participates in an appropriate amount and type of P.A to suit their ability.
*Your child should begin slowly, based on their ability and current level of fitness, e.g. begin with 10 minutes of regular activity if your child has been inactive for some time, gradually increase the amount of time, followed by increasing the intensity of the activity
*Include aerobic activities to increase your childs’ breathing and heart rate
*Familiarise yourself with adaptations and modifications for your child, and be comfortable making alterations where necessary
*Always avoid your child being inactive, any P.A is better than none!
 
<br>  
 
=== More Benefits of Physical Activity!<br>  ===
 
Now, just incase we haven’t convinced you just yet to sign your child up (or yourself!) to some sort of P.A, here's a few more reasons why you should get those running shoes on, and get your body moving…!
 
[http://www.who.int/topics/physical_activity/en/ http://www.who.int/topics/physical_activity/en/]
 
<br>
 
*It boosts confidence and self-esteem, and makes you feel good and happy in yourself
*It helps to control weight - (so you wont feel as guilty for having that extra donut!)
*Improves gross and motor skill development, e.g. assists with writing (REF EMCK)
*Improves their ability to be competent in school and in P.A (REF EMCK)
*Increases their adjustment towards their feelings and emotions (REF EMCK)
*Improves muscular and cardiorespiratory fitness
*Improves bone and functional health
*Reduces the risk of falls and fractures
*Physically active wheelchair users tend to go to hospital less than those wheelchair users who don’t do P.A.
*Wheelchair athletes who do P.A have fewer pressure sores and kidney complications than wheelchair users who don’t do P.A
*P.A also has a lessening effect on challenging behaviour (Moon et al, 1982; Nishiyama et al, 1986; Lancioni et al, 1994 and 1998; Washburn et al, 2002; Nary et al, 2000 cited by Boland, 2005).
*P.A is important in maintaining fitness for daily living, reducing functional limitations, helps with independent living and preventing, delaying and reducing chronic illnesses and secondary conditions (Fentem, 1994).
 
<br>
 
=== What If My Child Has Cerebral Palsy? ===
 
You may want to consider the following if your child has cerebral palsy:
 
<br>Children with cerebral palsy are said to participate in lower levels of P.A than any other child, and they are beginning to show an increase in mobility problems as a result of this decreased P.A level. 2,3,4,5 Some of the things you might also want to remember if this is the case with your child, they are more likely to be less fit than others, more likely to have issues with their mobility down the line, and reduced muscle tone. However, not to worry, this can all be prevented by participating in regular activity weekly, rather sooner than later to avoid this inactivity creeping further into their teenage years!6 <br>“Physical activity stimulation program for children with cerebral palsy did not improve physical activity: a randomised trial “Leontien Van Wely, Astrid CJ Balemans, Jules G Becher, Annet J Dallmeijer (REFERENCES 2,3,4,5 &amp; 6 USED)<br><br>
 
=== What Can Happen If My Child Doesn't Exercise?  ===
 
Now take a look at some of the more serious health risks associated with inactivity, would make you think eh?
 
<br>
 
*Not having enough P.A is 1 of the 10 leading risk factors for death across the world and is on the rise in many countries, adding to the burden of NCDs (noncommunicable diseases, i.e cardiovascular disease, cancer and diabetes) and affecting general health worldwide.
*People with disabilities are three times more likely to have the above complications than those without disabilities, but thankfully aerobic P.A can help reduce the impact of these complications. http://www.cdc.gov/ncbddd/disabilityandhealth/pa.html
*People who are less active have a 20% to 30% increased risk of death compared to people who meet the above P.A recommendations.
*Inactivity can also lead to an increase in needing others, a decrease in socialising with friends and becoming more tired, feeling low or upset, putting on weight and an increase in pressure sores.
*Physical inactivity increases the risk of coronary heart and cerebrovascular diseases, type 2 diabetes mellitus, hypertension, stroke, several cancers (e.g. lung, prostate, breast, colon, others), osteoporosis/fractures, depression and dementia, among others.
 
===== Interested In Some Random Facts About Inactivity?  =====
 
*Globally, 1 in 4 adults is not active enough.
*More than 80% of the world's adult population doesn’t do enough physical activity.
*Policies to address insufficient physical activity are operational in only 56% of WHO Member States.
*WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.
*Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in 2010.
*Adolescent girls were less active than adolescent boys, with 84% vs. 78% not meeting WHO recommendations.
*Globally, around 23% of adults aged 18 and over were not active enough in 2010 (men 20% and women 27%).
*In high-income countries, 26% of men and 35% of women didn’t do enough physical activity, as compared to 12% of men and 24% of women in low-income countries.
*The drop in P.A is partly due to inaction during leisure time and sedentary behaviour on the job and at home.
*Likewise, an increase in the use of "passive" modes of transportation also contributes to insufficient physical activity.
 
<br>  
 
=== How Much Exercise Do Parents and Grandparents Need?  ===
 
So, after becoming aware of the importance of P.A and the effects of not being active enough, would this cause you to think about your own P.A levels? If so...here is some more information for parents and grandparents who want to spend time being physically active with their children and grandchildren!
 
<br>
 
===== Parents and Grandparents Aged 18-64 Years  =====
 
*Adults aged 18-64 should do at least 150 minutes of medium intensity, and at least 75 minutes of hard P.A throughout the week, or a combination of medium and hard activities.
*If you want to go that extra mile, adults should increase their medium intensity P.A to 300 minutes per week, or equivalent.
*Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.<br>
 
===== Parents and Grandparents Aged 65 Years and Above  =====
 
*Do at least 150 minutes of medium intensity P.A or at least 75 minutes of hard P.A throughout the week, or an equivalent combination of medium and hard activities.
*Again, to go that extra mile, you should increase medium intensity P.A to 300 minutes per week, or equivalent.
*If you consider yourself to have poor mobility, you should still perform P.A to improve your balance and prevent falls, 3 or more days per week.
*Muscle-strengthening activities should be done involving major muscle groups, 2 or more days a week.
*The intensity of different forms of P.A varies between people. In order for P.A to benefit your cardiorespiratory health, all activities should be performed in bouts of at least 10 minutes duration.<br><br>
 
<br>
 
== Barriers and Facilitators to Exercise - What Stops Me and What Helps Me  ==
 
=== Barriers: Things That Get In The Way  ===
 
So, you’re now aware of the importance and benefits of your child’s involvement in PA. It’s understood however things aren’t always easy and you may encounter a number of barriers when trying to engage your child in PA. Here are some you may come across...
 
===== Physical Barriers  =====
 
*Limitations of your child’s body may make participation in PA more difficult. This may include restricted range of motion at joints, reduced flexibilty and agility, along with reduced strength and endurance. Additionally your child may have difficulties with balance and coordination resulting in fear of falling while attempting to be physically active (Conchar et al. 2014). Each of these deficiencies may unfortunately demotivate your child to participate in PA.
*Pain and fatigue may also limit your child from being active. This can result from; wearing their assistive devices e.g. orthosis, from training, or from sitting for long periods (Conchar et al. 2014).
*Requiring more time to get outdoors during break times at school as a result of handling orthoses may come as an inconvenience to your child and inhibit them from using this time to be physically active with their peers (Lauruschkus et al. 2014).
*Physical strength and skill developed by your child may unfortunately be lost as a result of interruptions in training during recovery period after surgery (Conchar et al. 2014).
*As your child gets older, the gap in physical strength and agility increases between able bodied children and disabled athletes. With this, the skill gap also widens and sports become more competitive; potentially making it more difficult for your child to continue participating in mainstream activities (Conchar et al. 2014).
 
<br>
 
===== Psychosocial And Emotional Barriers  =====
 
*Embarrassment, vulnerability, disappointment and shame at appearing physically incapable are just some of the uncomfortable emotions your child may experience . These may lead to reduced confidence and self-esteem, along with frustration at taking longer to acquire a skill than their peers of typical development, resulting in avoidance of participation (Conchar et al. 2014).
*Social barriers including negative attitudes from parents, staff and peers can inhibit your child’s interest in PA (Jones, 2003). This may come in the form of teasing from other children, along with and/or lack of trained instructors/teachers skilled to adapt activities to suit your child and therefore often fearful to involve them in PA activities at school/clubs (Shields and Sinnot 2012) ....
*This can result in your child feeling singled out, isolated and forming the opinion of not being good enough; all of which make it more difficult to persevere at PA (Lauruschkus et al. 2014).
 
===== Cost and Environmental Barriers  =====
 
*Finding time in the midst of appointments with various therapists, school runs, caring for other children along with day-to-day duties poses as one of the main barriers to including PA in your child’s life.
*In conjunction with this, the extra expense of caring for a child with a disability, along with the decreased income due to working less to care for your child, means there is often little money leftover to spend on membership for various classes/clubs (Shields and Sinnot 2012).
*Sporting opportunities available for your child’s abilities, as well as those available in your local area are often poorly advertised. As a consequence to this lack of easy available information you may have to rely on word-of-mouth, as well as undertake your own research into the opportunities available for your child. (Jaarsma et al. 2014, Shields and Sinnot, 2012).
*Such sporting facilities that cater for your child’s needs are often lacking in local areas, posing as a fundamental barrier to PA . This may include lack of qualified staff willing to supervise PA for children with motor impairments in addition to lack of equipment to aid sports, especially as your child gets older e.g to aid swimming (Shields and Sinnot, 2016, Lauruschkus et al., 2014).
*Unfortunately local clubs and societies may also be faced with difficulties recruiting enough numbers to make up teams or finding other teams to compete against (Conchar et al. 2014) .
*With this comes the barrier of transport if living far away from such facilities and having to travel to introduce your child to such activities, which may not be easy access via public transport. (Conchar et al. 2014).
*One off programmes in addition to long waiting lists for specialised classes may also pose as a barrier to your child’s participation in PA (Shields and Sinnot, 2012).
*Specialised adaptive equipment for sports is also costly, making its availability very limited (Rimmer et al. 2004).
*Natural environmental barriers may also get in the way to accessing sporting facilities. These may include lack of curb cuts and ramps, doors being too narrow for wheelchair access, reception desks too high for communication with reception staff
*As a parent you may presume your child is meeting the PA daily requirements during free play time in pre-school. However much of the free play in pre-schools involves sedentary activities, thus care must be taken to include PA during after school time.
 
<br>
 
=== Facilitators: What Can Make It Easier ===
 
Find you can identify with some/many of these barriers? Here are some ways in which you can help engage your child in PA, along with motivators to being physically active. <br>
 
===== Personal Facilitators  =====
 
The health benefits of PA may not be motivating factor for young children to exercise. However finding an activity that provides fun and enjoyment is essential for facilitating and maintaining a physically active behaviour (Shields et al 2011). <br>The sensation of speed is something that children have reported as an enjoyable feeling, thus proving to be an internal motivator. Therefore providing your child the opportunity to experience this feeling, be it through running, swimming, dancing, cycling, rolling on a ball or bouncing on a trampoline can be a key start to introducing a physically active behaviour in your child (Lauruschkus et al, 2015).<br>The feeling of being physically capable, along with the sense of achieving mastery of their chosen activity is essential for increasing self-efficacy; a significant factor to adopting a physically active behaviour (Conchar et al, 2014).<br>Thus finding activities that your child can perform independently and feel they are good at provides them with a sense of pride and competency, motivating them to be physically active. <br>Additionally as children enjoy “showing off” every now and again, finding an activity/ playing games with a competitive character can often be a good way to get them involved in PA. <br>Desirable changes in body image along with improved body function, such as increased strength, agility and fitness can be a key motivator. This can enable enhanced mobility and thus become an essential motivating factor for your child as this allows them to; become more independent, provides them with a sense of ownership over their own bodies and may also reduce the need for O.T and Physiotherapy (Conchar et al, 2014).
 
===== Social Facilitators =====
 
*As a parent, and your child’s primary advocate, your support both practically and financially is a crucial influence on your child’s PA levels.
*Have you ever thought that your own PA beliefs and levels could have a direct influence on how physically active your child is?
*Research has reported that children (between the ages of 4 and 7) of active mothers are twice more likely to be active than children with inactive mothers, 3.5 times more likely with active fathers; while those with both parents who are physically active are almost 6 times more likely to be active than children of inactive parents! (Moore et al. 1991). As a parent you are perceived as significant role model to your child’s behaviours, thus, the value you place on PA will directly influence the level of your child’s participation in PA (Trost et al. 2003).
*So, you’ve managed to introduce a physically active lifestyle from a young age. Great! Maintaining this lifestyle however can be difficult as your child grows older. Parental support is also suggested to be a key contributor to maintenance of physically active habits (Dowda et al. 2007). Thus the importance you place on your child’s PA levels, along with the encouragement and support you give to their skills and talents is essential in facilitating your child to maintain an active behaviour. This involves your willingness and ability to provide transport to practices and competitions, showing support and acknowledging their achievements in order to aid participation (Conchar et al, 2014).
*As a parent, you are also in a privileged position of controlling your child’s daily schedule. Why not minimize screen time allowed during the day and encourage your child to go outside and play/ factor in time to go to the park/ to a class to include PA as a daily requirement. <br>Physically active habits of friends and siblings can also facilitate and promote your child’s participation in PA. Children enjoy belonging to something or someone. Thus activities with friends and family encourage PA as the social interaction provides; a sense of togetherness, of being accepted and noticed as part of a group and reduces the feeling of exclusion (Lauruschkus et al, 2015). It also provides children the opportunity to meet others with similar disabilities and most importantly to be seen as more than their disability! <br>
 
<br>
 
=== What To Remember  ===
 
Essentially, helping your child to be physically active boils down to considering the six-F-words of childhood disability!<br>
 
#Function - ways in which your child can be active
#Fun - find out what your child enjoys
#Family - exercise together to facilitate participation!
#Friends - PA encourages friendships, facilitating social development
#Fitness - awareness of benefits of PA is important and will help improve physical function.
#Future - Try not decide what is impossible. Don’t let opportunities pass by. Try, try, try!!!
 
<br>  
 
== Funding  ==
 
As mentioned, cost and funding is a huge barrier to taking part in sport and activity. This section will provide resources for you as parents that are interested in increasing the amount of physical activity/sport for yourself and your child.  
 
=== Funding In Scotland  ===
 
===== [http://www.sportsaidscotland.org.uk/athletes/nomination-process/ Sports Aid Scotland]  =====
 
This charity provides grants for talented sporting youngsters from the age of 12-22 and to disability athletes to the age of 45 who are competing at national level and have potential to represent Scotland at senior level. The grant is for travel and training costs.
 
===== [http://www.dreamitbelieveitachieveit.com/ Dream It Believe It Achieve It (DBA)] =====
 
DBA supports anyone with a physical disability regardless of their level from paralympains to complete beginners by offering financial help towards specialist equipment, training and competitions.<br>
 
 
Telephone: 0844 414 8288


===== [http://www.ecas-edinburgh.org ECAS Edinburgh] =====
<br>[[Image:Summarise.jpg]]  
=== Benefits of Physical Activity!  ===


You can apply for a transport grant to attend the activity classes which include tai chi, yoga and swimming that cost £1.15.
Physical activity is crucial for a child’s health an wellbeing, here are a few other benefits:


===== [http://takeabreakscotland.org.uk/applications/what-can-i-apply-for/ Take a Break]  =====
*Can help a child feel more confident about themselves!
*Can help to maintain a child's weight
*Can improve motor skills, so they may find it a bit easier to perform certain movements they may have struggled with before<ref name="emck">Emck C, Bosscher R, Beek P, Doreleijers T. Gross motor performance and self‐perceived motor competence in children with emotional, behavioural, and pervasive developmental disorders: a review. Developmental Medicine &amp; Child Neurology. 2009, Jul 1;51(7):501-17.</ref>
*Can improve their participation in school and P.E. classes<ref name="emck" />
*Can improve their mood<ref name="emck" />
*Can help improve their breathing
*Can improve their bone, muscle and heart health
*Can reduce the risk of falls and fractures
*Active wheelchair users are less likely to have pressure sores and kidney complications than those who don’t take part in much physical activity.
*Physical activity can also help a child with problems related to their behaviour<ref>Moone MS, Renzaglia A. Physical fitness and the mentally retarded: a critical review of the literature Journal of Special Education. 1982;16(16) 3: 269 -287.</ref><ref>Nishiyama S, Kuwahara T, Maatsudea I. Decreased bone density in severely handicapped children and adults with reference to the influence of limited mobility and anticonvulsant medication European Journal of Pediatrics. 1986; 144(5): 457-763.</ref><ref>Lancioni GE. Procedures for promoting independent activity in people with severe and profound learning disability: A brief review: Mental Handicap Research. 1994; 7 (3):237-256</ref><ref>Lancioni GE, O'Reilly MF. A review of research on physical exercise with people with severe and profound developmental disabilities. Research in Development Disabilities. 1998; 19(6): 477-492.</ref><ref>Washburn RA, Zhu W, McAuley E, Frogle M, Figonis SF. The physical Activity Scale for individuals with physical disabilities: Development and Evaluation. Archives of Physical Medicine and Rehabilitation. 2002; 83:193-200.</ref><ref>Nary DE, Froehlich AK, White GW. Accessibility of fitness facilities for persons with physical disabilities using wheelchairs. Topics in Spinal Cord Injury Rehabilitation. 2000; 6(1): 90-101.</ref><ref>Boland M. Health promotion and health promotion needs assessment of people attending disability services in the HSE, East Coast Area. Doctorate of Medicine, University College Dublin. 2005</ref>
*Physical activity plays an important part in maintaining good fitness and it lowers their chances of getting a lifelong illnesses and/or other health conditions.<ref>12. Fentem PH. Education and debate ABC of Sports Medicine: Benefits of exercise in health and disease. British Medical Journal. 1994;308:1291-1295.</ref> <br>


You can apply for a grant if you are a parent/carer of a disabled young person up to the age of 20 who lives at home. Take a break grants can be used for a break away, leisure activities/outings and sports equipment. Grants are usually from £200-400 and have been used previously for gym memberships, horse riding and football equipment.  
=== Benefits and Disadvantages o Physical Activity for Wheelchair Users ===
Manual wheelchair users often feel pain around their shoulders because shoulders are naturally made for moving around rather than for constantly lifting and pushing lots of weight!<ref name="fullerton">Fullerton HD, Borckardt JJ, Alfano AP. Shoulder pain: A comparison of wheelchair athletes and nonathletic wheelchair users. Med. Sci. Sports Exec. 2003. Vol 35, No 12, pp. 1958-1961.</ref> The day-to-day life of a person who uses a manual wheelchair often involves a lot of pushing and lifting; from pushing themselves around all day to lifting themselves into and out of their wheelchair. This means that any shoulder injury may limit the amount of things they can normally do for themselves.<ref name="fullerton" /><ref name="curtis">Curtis KA, Black K. Shoulder pain in female wheelchair basketball players. Journal of Orthopaedic &amp; Sports Physical Therapy. 1999. Vol, 29N No 4, pp. 225–231.</ref>


===== The Stanley Morrison Trust  =====
Many injuries can happen from carrying out a shoulder movement for a specific task that is difficult to complete. For example, lifting a very heavy object over the head or by repeatedly performing a normal movement so often that your joint begins to wear down.<ref name="fullerton" /> Activities like pushing a wheelchair for long distances or transferring in and out of a wheelchair many times throughout the day can cause an overuse injury.<ref name="fullerton" /><ref name="curtis" />


Supports charities and community groups by supporting activities that encourage young people to increase their participation in sporting activities. No exclusion criteria given.
Getting exercise through sports is a great way to help strengthen your child’s muscles. Making sure their muscles and joints are strong means they will have the best chance at living independently, and goes a long way to improving their overall wellbeing!<ref name="fullerton" /><ref name="curtis" />


Telephone: 0141 578 2252
It is important to minimise the risk of injury.  Some common problems that can occur and how to avoid them include:
* Skin
** Prevent blisters on hands with gloves
** Prevent wheel-burns by covering the area with protective material
** Decrease bruising by placing pads where needed, i.e. bony areas and retaining straps
** Cover blisters
* Swimming
** Protect skin
** Place mats at the poolside during transfers
** Protect the feet


===== [http://www.getkidsgoing.com/homepage.html Get Kids Going!]  =====
* Muscles and Joints
** Monitor for overuse
** Closely observe any muscle or joint pain
** Maintain flexibility with stretching
* Hyperthermia (High body temperature)
** Take into account temperature if exercising outdoors
** Encourage to drink lots of water
** Avoid direct sunlight
* Pressure Sores
** Use cushions and padding where needed
** Change position and shift weight regularly<br>


Provide disabled young people u to the age of 26 years old with funding for specialist wheelchairs to enable them to take part in disability sports. Open to all abilities from beginners to Paralympic level. The charity also gives sport grants from cost of training, travel, physiotherapy and competition fees.  
=== Risks of Inactivity  ===
Not taking part in enough physical activity is one of the biggest risk factors for death around the world.  Individuals with disabilities have a 3 times higher chance of having health-related problems than individuals who do not have disabilities.<ref name="ref14">Increasing Physical Activity among Adults with Disabilities. Centres for Disease Control and Prevention. Available from: http://www.cdc.gov/ncbddd/disabilityandhealth/pa.html</ref>  People who are less active have a 20-30% higher risk of death compared to people who are more active.  Physical inactivity can also lead to fatigue and depression, putting on more weight, becoming more dependent on others.  It also increases the risk of heart disease, type 2 diabetes, high blood pressure, stroke, pressure sores, weaker bones, depression and several cancers.<ref name="ref14" />
== Barriers and Facilitators to Exercise  ==
A  child’s disability may make taking part in physical activity more difficult as it may limit range of movement at joints, flexibility, agility, strength or endurance, and balance and coordination.<ref name="conchar">Conchar L, Bantjes J, Swartz L, Derman W. Barriers and facilitators to participation in physical activity: The experiences of a group of South African adolescents with cerebral palsy. Journal of health psychology. 2014 Mar 6:1359105314523305.</ref>  Any of these limitations, may demotivate a child from taking part in more activities as well as:
*Pain and/or fatigue may also limit a child from being active. It can often be due to overtraining, sitting for long periods or wearing their assistive devices such as an orthosis.<ref name="conchar" />


Email: info@getkidsgoing.com for application form&nbsp;  
*A child may take more time to go outdoors during school breaks if they have to handle and wear orthoses. They may see it as an inconvenience and may stop using this time to play outside with their friends.<ref name="lauruschkus">Lauruschkus K, Nordmark E, Hallström I. “It’s fun, but…” Children with cerebral palsy and their experiences of participation in physical activities. Disability and rehabilitation. 2014 Feb 13;37(4):283-9</ref>


===== [http://www.adammillichipfoundation.org/ The Adam Millichip Foundation]  =====
*Physical strength and skills that a child develops may be lost due to interruptions in training or recovery after surgery.<ref name="conchar" />


The foundation provide financial support to disabled people who want t improve their quality of life with the participation in sporting activities. To apply you should have – contact details, condition details, details of funding you require and a personal statement. Medical confirmation is also required by medical authority but can be provided later. Do not fund gym memberships.  
*As a child gets older, the gap between able-bodied children and disabled athletes in terms of physical strength and agility grows larger. With this, the skills gap also widens and sports become more competitive. As a result, it may become more difficult for a child to continue taking part in mainstream activities.<ref name="conchar" /> <br>


Telephone: 07866424286
=== Psychosocial and Emotional Barriers  ===


===== [http://www.richardoveralltrust.co.uk/index.html The Richard Overall Trust]  =====
*Embarrassment, vulnerability, disappointment and shame at appearing physically incapable are just some of the uncomfortable emotions a child may experience. These feelings may lower their confidence and self-esteem. They may also feel frustrated at taking longer to learn a new skill and as a result, may avoid taking part in certain activities altogether.<ref name="conchar" />


In memory of Richard who Duchenne Muscular Dystrophy to help disabled children and young people participate and enjoy sport. It provides funding for training, sports clothes, transport, specialist equipment and ticket to sport events. Applications can be made by UK individuals, groups, families and carers. Download application form with supporting evidence from Occupational therapist, physiotherapist, GP or teacher.  
*Negative attitudes from parents, staff and peers can hinder a child’s interest in physical activity.<ref name="jones">Jones DB. “Denied from a lot of places” barriers to participation in community recreation programs encountered by children with disabilities in Maine: perspectives of parents. Leisure/Loisir. 2003 Jan 1;28(1-2):49-69.</ref> It may come in the form of teasing from other children and/or teachers who lack training in adapting activities to suit your child needs. This also results in excluding them from taking part in school clubs and activities.<ref name="shields">Shields N, Synnot A. Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC pediatrics. 2012 Jan 19;16(1):1.</ref>


<br>  
*As a result, a child may feel singled out and alone. These feelings can sometimes lead them to believe they are not good enough and can make it more difficult for them to persevere with physical activity.<ref name="lauruschkus" />


=== Equipment Funding ===
=== Cost and Environmental Barriers ===


===== [http://www.danmaskelltennistrust.org.uk/apply-for-a-grant.html The Dan Maskell Tennis Trust]  =====
*Finding time in the midst of appointments with various therapists, school runs, caring for other children, along with day-to-day duties poses as one of the main barriers to including physical activity in a child’s life.&nbsp;With the extra expenses of caring for a child with a disability and fewer earnings due to taking on caring responsibilities instead of work, there is often little money leftover to spend on membership for various classes and clubs.<ref name="shields" />


The trust create opportunities for disabled people that wish to play tennis by providing grants for specialist wheelchairs for individuals and for clubs and special schools as well as running disability programmes. The application is completed online by downloading the form or printed and posted.  
*Sporting opportunities specific to a child’s abilities, as well as those available locally are often poorly advertised.<ref name="jaarsma">Jaarsma EA, Dijkstra PU, de Blécourt AC, Geertzen JH, Dekker R. Barriers and facilitators of sports in children with physical disabilities: a mixed-method study. Disability and rehabilitation. 2015 Aug 28;37(18):1617-25.</ref><ref name="shields" />


Dates of trustee meeting and deadlines:<br>15/03/16 (closing date for applications for 16th February)<br>6th June (closing date for 9th May applications)<br>27th September (closing date for applications 30th August)
*Sporting facilities that cater for a child’s needs may be often lacking in certain areas such as shortage of qualified staff willing to supervise activities for children with motor impairments and lack of equipment to aid sports, especially as a child gets older.<ref name="shields2">Shields N, Synnot A. Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC pediatrics. 2016 Jan 19;16(1):1.</ref><ref name="lauruschkus" />


===== [http://wheelpower.org.uk/WPower/index.cfm/what-we-do/wheel-appeal/ Wheel Appeal]  =====
*Unfortunately, local clubs and societies may also face difficulties such recruiting enough children to make up teams or finding other teams to play against.<ref name="conchar" /> &nbsp;


The wheel appeal provides new sport wheelchairs, training and coaching to enable disabled adults and children to take part in sport. It only funds manual sport wheelchairs, hand cycles and hockey sledges to a maximum grant of £1,500. Applicant could be asked to contribute £250 towards their equipment. To apply you need to sign up to wheelpowers’s free membership. All applications should be supported by a recognised sport club, school, sport body or spinal unit.  
*With this comes the barrier of transport. Living far away from such facilities and having to travel to introduce a child to such activities, may not be always be easy to access via public transport.<ref name="conchar" /> &nbsp;


===== [http://www.caudwellchildren.com/ Caudwell Children (Enable Sport)]  =====
*One off programmes as well as long waiting lists for specialised classes may also pose as a barrier to a child’s participation in physical activity.<ref name="shields" />


Provide funding for sports equipment for disabled children and young people under 19 years old. Applications only accepted where parental gross income is less than £45,000, evidence of sporting involvement is required from sport club/coach as well as conformation of disability from health professional.
*Specialised adaptive equipment for sports is also costly and not always readily available.<ref name="rimmer">Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. American journal of preventive medicine. 2004 Jun 30;26(5):419-25.</ref>


===== [http://www.theadamsontrust.co.uk/index.html The Adamson Trust]  =====
*Environmental barriers may also get in the way to accessing sporting facilities. These may include lack of curb cuts and ramps, doors being too narrow for wheelchair access and reception desks being too high to talk to staff.&nbsp;<br>


This charity help finance holidays and respite breaks for disabled children up to the age of 17. On the holidays there are adapted physical activities such abseiling and canoeing. The application form is short form that is on the website to complete but should be completed by 31/12/16 for the February meeting of the trustees.
=== Social Facilitators  ===


===== Holiday Grants  =====
*Studies have shown that children (aged 4-7) of physically active mothers are twice as likely to take part in physical activity than children with inactive mothers. The are also 3.5 times more likely to engage in physical activity if they have active fathers. Those with two active parents are almost 6 times more likely to be physically active than children of inactive parents.<ref name="moore">Moore LL, Lombardi DA, White MJ, Campbell JL, Oliveria SA, Ellison RC. Influence of parents' physical activity levels on activity levels of young children. The Journal of pediatrics. 1991 Feb 28;118(2):215-9.</ref> &nbsp;


Are you planning a holiday? And want more information about funding for respite holidays. Well head over to [[Disability-grant.org|disability-grant.org]] for holiday grants that are available for the whole family.  
*Encouraging parents to take an active interest in their child’s daily schedule. Suggest reducing screen time during the day and encouraging children to go outside and play. Factor in the time taken to go to the park or a class to include physical as a daily requirement.


*Habits of friends and siblings can also impact a child’s decision to take part in activities. Children enjoy belonging to something or someone; taking part in activities with family and friends can give them a feeling of togetherness and of being noticed and accepted as part of a group. It also gives them the opportunity to meet others with similar abilities and most importantly to be seen as more than their disability!
[[Image:6Fs.jpg|center]]


== Conclusion  ==


<h2> Physical Opportunities In Lothian  </h2>
Physical activity is hugely important for everyone, and children with physical disabilities are no exception. Unfortunately, children with disabilities are less active than their able-bodied peers and therefore encouraging their participation in sporting and recreational activities is vital.<ref name="shields2" /> In this online resource we have talked you through the various physical and psychological advantages of being physically active such as, but not limited to improvements in body function, heart and bone health, psychological wellbeing and social engagement.<ref name="shields2" /> &nbsp;
<p>As a parent, regardless of whether your child has a physical disability, you will often worry about how to provide the best opportunities for your child. By now, you should know that physical activity plays a very important part in every person’s life.
</p><p><i>Take a moment to think about how active you are as a family.</i>
</p><p>Every family is different. Some families lead very active lifestyles, but find it hard to include their child when taking part in certain activities. Others may be a lot less active and then the challenge becomes even greater.
</p><p>This section will explore a number of different sports and activities. It will also direct you to the opportunities out there for your child and family to become more physically active.
</p><p><img src="/images/b/ba/Wheelchair_Inclusivity.png" _fck_mw_filename="Wheelchair Inclusivity.png" alt="( ) Areadne. Towards the inclusive classroom: best practice [Picture]. 2015. Available from: http://www.areadne.eu/course/towards-the-inclusive-classroom-best-practice/ [Accessed on 23rd November 2016]" /><br />
</p>
<h3> Indoor Sports  </h3>
<h5> Swimming  </h5>
<p>Have you ever thought about swimming for your child, but were unsure whether swimming pools near you cater to the additional support needs your child may have? Edinburgh Leisure offers Disability Swim in three locations across Edinburgh. The information for these is as follows:
</p><p>Dalry Swim Centre: Wednesdays from 10:30am - 11:30am<br />Dumbrae Leisure Centre: Mondays from 11:00am - 12:00pm<br />Warrender Swim Centre: Mondays from 10:30am - 11:15am
</p><p>Prices: Standard £5, Discount card £3.75, Junior and Disability Discount card £2.50.<br /><br />
</p><p>Go to the <a href="Www.edinburghleisure.co.uk/activities/swimming-diving/swimming/disability-swim">Edinburgh Leisure website</a> and book!
</p>
<h5> Wheelchair Basketball  </h5>
<p>Does your child prefer a team-based sport perhaps? Why not give wheelchair basketball a try? Playing this fully inclusive, fast-paced game is a great way for your child to stay physically active, build their self-esteem and make new friends.  
</p><p>Hear what parents and kids have to say about wheelchair basketball:
</p><p><a _fcknotitle="true" href="{{#ev:youtube|YRw3ztn24MY}}">{{#ev:youtube|YRw3ztn24MY}}</a><br />
</p><p><br />
</p><p><br />
</p>


== Recent Related Research (from &lt;a href="http://www.ncbi.nlm.nih.gov/pubmed/"&gt;Pubmed&lt;/a&gt;)<br>  ==
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== References  ==
== References  ==


References will automatically be added here, see &lt;a href="Adding References"&gt;adding references tutorial&lt;/a&gt;.
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&lt;span class="fck_mw_references" _fck_mw_customtag="true" _fck_mw_tagname="references" /&gt;
[[Category:Sports Medicine]]
[[Category:Younger Athlete]]
[[Category:Occupational Health]]
[[Category:Queen Margaret University Project]]
[[Category:Current and Emerging Roles in Physiotherapy Practice]]

Latest revision as of 13:07, 22 May 2020

Original Editor - Dunika Dissanayake, Janan Kothari, Orla Corrigan, Rhianne Brisbane, Sinead Moloney and Vanessa Puzzuoli as part of the Queen Margaret University's Current and Emerging Roles in Physiotherapy Practice Project Top Contributors - Janan Kothari, Vanessa Puzzuoli, Dunika Dissanayake, Orla Corrigan, Sinead Moloney, Kim Jackson, Wanda van Niekerk, Rhianne Joy Brisbane, Michelle Lee, Amrita Patro, 127.0.0.1 and Rachael Lowe

Introduction[edit | edit source]

Children should aim to take part in at least one hour of medium to hard intensity physical activity every day.[1] Encouraging children to be active with the distractions of technology can often be difficult but even more so if the child has a disability or medical condition. Guidance on how activities and exercises can be adapted can often be challenging that individuals living with disabilities were 82% more likely to take part in regular physical activity if a health professional advised it?[2]


Summarise.jpg

Benefits of Physical Activity![edit | edit source]

Physical activity is crucial for a child’s health an wellbeing, here are a few other benefits:

  • Can help a child feel more confident about themselves!
  • Can help to maintain a child's weight
  • Can improve motor skills, so they may find it a bit easier to perform certain movements they may have struggled with before[3]
  • Can improve their participation in school and P.E. classes[3]
  • Can improve their mood[3]
  • Can help improve their breathing
  • Can improve their bone, muscle and heart health
  • Can reduce the risk of falls and fractures
  • Active wheelchair users are less likely to have pressure sores and kidney complications than those who don’t take part in much physical activity.
  • Physical activity can also help a child with problems related to their behaviour[4][5][6][7][8][9][10]
  • Physical activity plays an important part in maintaining good fitness and it lowers their chances of getting a lifelong illnesses and/or other health conditions.[11]

Benefits and Disadvantages o Physical Activity for Wheelchair Users[edit | edit source]

Manual wheelchair users often feel pain around their shoulders because shoulders are naturally made for moving around rather than for constantly lifting and pushing lots of weight![12] The day-to-day life of a person who uses a manual wheelchair often involves a lot of pushing and lifting; from pushing themselves around all day to lifting themselves into and out of their wheelchair. This means that any shoulder injury may limit the amount of things they can normally do for themselves.[12][13]

Many injuries can happen from carrying out a shoulder movement for a specific task that is difficult to complete. For example, lifting a very heavy object over the head or by repeatedly performing a normal movement so often that your joint begins to wear down.[12] Activities like pushing a wheelchair for long distances or transferring in and out of a wheelchair many times throughout the day can cause an overuse injury.[12][13]

Getting exercise through sports is a great way to help strengthen your child’s muscles. Making sure their muscles and joints are strong means they will have the best chance at living independently, and goes a long way to improving their overall wellbeing![12][13]

It is important to minimise the risk of injury. Some common problems that can occur and how to avoid them include:

  • Skin
    • Prevent blisters on hands with gloves
    • Prevent wheel-burns by covering the area with protective material
    • Decrease bruising by placing pads where needed, i.e. bony areas and retaining straps
    • Cover blisters
  • Swimming
    • Protect skin
    • Place mats at the poolside during transfers
    • Protect the feet
  • Muscles and Joints
    • Monitor for overuse
    • Closely observe any muscle or joint pain
    • Maintain flexibility with stretching
  • Hyperthermia (High body temperature)
    • Take into account temperature if exercising outdoors
    • Encourage to drink lots of water
    • Avoid direct sunlight
  • Pressure Sores
    • Use cushions and padding where needed
    • Change position and shift weight regularly

Risks of Inactivity[edit | edit source]

Not taking part in enough physical activity is one of the biggest risk factors for death around the world. Individuals with disabilities have a 3 times higher chance of having health-related problems than individuals who do not have disabilities.[14] People who are less active have a 20-30% higher risk of death compared to people who are more active. Physical inactivity can also lead to fatigue and depression, putting on more weight, becoming more dependent on others. It also increases the risk of heart disease, type 2 diabetes, high blood pressure, stroke, pressure sores, weaker bones, depression and several cancers.[14]

Barriers and Facilitators to Exercise[edit | edit source]

A child’s disability may make taking part in physical activity more difficult as it may limit range of movement at joints, flexibility, agility, strength or endurance, and balance and coordination.[15] Any of these limitations, may demotivate a child from taking part in more activities as well as:

  • Pain and/or fatigue may also limit a child from being active. It can often be due to overtraining, sitting for long periods or wearing their assistive devices such as an orthosis.[15]
  • A child may take more time to go outdoors during school breaks if they have to handle and wear orthoses. They may see it as an inconvenience and may stop using this time to play outside with their friends.[16]
  • Physical strength and skills that a child develops may be lost due to interruptions in training or recovery after surgery.[15]
  • As a child gets older, the gap between able-bodied children and disabled athletes in terms of physical strength and agility grows larger. With this, the skills gap also widens and sports become more competitive. As a result, it may become more difficult for a child to continue taking part in mainstream activities.[15]

Psychosocial and Emotional Barriers[edit | edit source]

  • Embarrassment, vulnerability, disappointment and shame at appearing physically incapable are just some of the uncomfortable emotions a child may experience. These feelings may lower their confidence and self-esteem. They may also feel frustrated at taking longer to learn a new skill and as a result, may avoid taking part in certain activities altogether.[15]
  • Negative attitudes from parents, staff and peers can hinder a child’s interest in physical activity.[17] It may come in the form of teasing from other children and/or teachers who lack training in adapting activities to suit your child needs. This also results in excluding them from taking part in school clubs and activities.[18]
  • As a result, a child may feel singled out and alone. These feelings can sometimes lead them to believe they are not good enough and can make it more difficult for them to persevere with physical activity.[16]

Cost and Environmental Barriers[edit | edit source]

  • Finding time in the midst of appointments with various therapists, school runs, caring for other children, along with day-to-day duties poses as one of the main barriers to including physical activity in a child’s life. With the extra expenses of caring for a child with a disability and fewer earnings due to taking on caring responsibilities instead of work, there is often little money leftover to spend on membership for various classes and clubs.[18]
  • Sporting opportunities specific to a child’s abilities, as well as those available locally are often poorly advertised.[19][18]
  • Sporting facilities that cater for a child’s needs may be often lacking in certain areas such as shortage of qualified staff willing to supervise activities for children with motor impairments and lack of equipment to aid sports, especially as a child gets older.[20][16]
  • Unfortunately, local clubs and societies may also face difficulties such recruiting enough children to make up teams or finding other teams to play against.[15]  
  • With this comes the barrier of transport. Living far away from such facilities and having to travel to introduce a child to such activities, may not be always be easy to access via public transport.[15]  
  • One off programmes as well as long waiting lists for specialised classes may also pose as a barrier to a child’s participation in physical activity.[18]
  • Specialised adaptive equipment for sports is also costly and not always readily available.[21]
  • Environmental barriers may also get in the way to accessing sporting facilities. These may include lack of curb cuts and ramps, doors being too narrow for wheelchair access and reception desks being too high to talk to staff. 

Social Facilitators[edit | edit source]

  • Studies have shown that children (aged 4-7) of physically active mothers are twice as likely to take part in physical activity than children with inactive mothers. The are also 3.5 times more likely to engage in physical activity if they have active fathers. Those with two active parents are almost 6 times more likely to be physically active than children of inactive parents.[22]  
  • Encouraging parents to take an active interest in their child’s daily schedule. Suggest reducing screen time during the day and encouraging children to go outside and play. Factor in the time taken to go to the park or a class to include physical as a daily requirement.
  • Habits of friends and siblings can also impact a child’s decision to take part in activities. Children enjoy belonging to something or someone; taking part in activities with family and friends can give them a feeling of togetherness and of being noticed and accepted as part of a group. It also gives them the opportunity to meet others with similar abilities and most importantly to be seen as more than their disability!
6Fs.jpg

Conclusion[edit | edit source]

Physical activity is hugely important for everyone, and children with physical disabilities are no exception. Unfortunately, children with disabilities are less active than their able-bodied peers and therefore encouraging their participation in sporting and recreational activities is vital.[20] In this online resource we have talked you through the various physical and psychological advantages of being physically active such as, but not limited to improvements in body function, heart and bone health, psychological wellbeing and social engagement.[20]  

References[edit | edit source]

  1. ↑ Physical Activity. World Health Organisation. Available from: http://www.who.int/mediacentre/factsheets/fs385/en/. [Accessed 16th November 2016].
  2. ↑ Physical Activity and Health. Centres for Disease Control and Prevention. Available from: http://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
  3. ↑ 3.0 3.1 3.2 Emck C, Bosscher R, Beek P, Doreleijers T. Gross motor performance and self‐perceived motor competence in children with emotional, behavioural, and pervasive developmental disorders: a review. Developmental Medicine & Child Neurology. 2009, Jul 1;51(7):501-17.
  4. ↑ Moone MS, Renzaglia A. Physical fitness and the mentally retarded: a critical review of the literature Journal of Special Education. 1982;16(16) 3: 269 -287.
  5. ↑ Nishiyama S, Kuwahara T, Maatsudea I. Decreased bone density in severely handicapped children and adults with reference to the influence of limited mobility and anticonvulsant medication European Journal of Pediatrics. 1986; 144(5): 457-763.
  6. ↑ Lancioni GE. Procedures for promoting independent activity in people with severe and profound learning disability: A brief review: Mental Handicap Research. 1994; 7 (3):237-256
  7. ↑ Lancioni GE, O'Reilly MF. A review of research on physical exercise with people with severe and profound developmental disabilities. Research in Development Disabilities. 1998; 19(6): 477-492.
  8. ↑ Washburn RA, Zhu W, McAuley E, Frogle M, Figonis SF. The physical Activity Scale for individuals with physical disabilities: Development and Evaluation. Archives of Physical Medicine and Rehabilitation. 2002; 83:193-200.
  9. ↑ Nary DE, Froehlich AK, White GW. Accessibility of fitness facilities for persons with physical disabilities using wheelchairs. Topics in Spinal Cord Injury Rehabilitation. 2000; 6(1): 90-101.
  10. ↑ Boland M. Health promotion and health promotion needs assessment of people attending disability services in the HSE, East Coast Area. Doctorate of Medicine, University College Dublin. 2005
  11. ↑ 12. Fentem PH. Education and debate ABC of Sports Medicine: Benefits of exercise in health and disease. British Medical Journal. 1994;308:1291-1295.
  12. ↑ 12.0 12.1 12.2 12.3 12.4 Fullerton HD, Borckardt JJ, Alfano AP. Shoulder pain: A comparison of wheelchair athletes and nonathletic wheelchair users. Med. Sci. Sports Exec. 2003. Vol 35, No 12, pp. 1958-1961.
  13. ↑ 13.0 13.1 13.2 Curtis KA, Black K. Shoulder pain in female wheelchair basketball players. Journal of Orthopaedic & Sports Physical Therapy. 1999. Vol, 29N No 4, pp. 225–231.
  14. ↑ 14.0 14.1 Increasing Physical Activity among Adults with Disabilities. Centres for Disease Control and Prevention. Available from: http://www.cdc.gov/ncbddd/disabilityandhealth/pa.html
  15. ↑ 15.0 15.1 15.2 15.3 15.4 15.5 15.6 Conchar L, Bantjes J, Swartz L, Derman W. Barriers and facilitators to participation in physical activity: The experiences of a group of South African adolescents with cerebral palsy. Journal of health psychology. 2014 Mar 6:1359105314523305.
  16. ↑ 16.0 16.1 16.2 Lauruschkus K, Nordmark E, Hallström I. “It’s fun, but…” Children with cerebral palsy and their experiences of participation in physical activities. Disability and rehabilitation. 2014 Feb 13;37(4):283-9
  17. ↑ Jones DB. “Denied from a lot of places” barriers to participation in community recreation programs encountered by children with disabilities in Maine: perspectives of parents. Leisure/Loisir. 2003 Jan 1;28(1-2):49-69.
  18. ↑ 18.0 18.1 18.2 18.3 Shields N, Synnot A. Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC pediatrics. 2012 Jan 19;16(1):1.
  19. ↑ Jaarsma EA, Dijkstra PU, de Blécourt AC, Geertzen JH, Dekker R. Barriers and facilitators of sports in children with physical disabilities: a mixed-method study. Disability and rehabilitation. 2015 Aug 28;37(18):1617-25.
  20. ↑ 20.0 20.1 20.2 Shields N, Synnot A. Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study. BMC pediatrics. 2016 Jan 19;16(1):1.
  21. ↑ Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. American journal of preventive medicine. 2004 Jun 30;26(5):419-25.
  22. ↑ Moore LL, Lombardi DA, White MJ, Campbell JL, Oliveria SA, Ellison RC. Influence of parents' physical activity levels on activity levels of young children. The Journal of pediatrics. 1991 Feb 28;118(2):215-9.
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