Barriers and Facilitators to Physical Activity in Individuals with Cerebral Palsy
Introduction[edit | edit source]
Cerebral Palsy is the most common childhood physical disability that results from an injury in a developing fetal or infant brain[1]. Its presentation varies between individuals; ranging from musculoskeletal, cognitive, communication, and/or behavioural problems[2]. With the increasing survival rate of children with CP, the number of adults with CP increases. However, adult morbidity and mortality rates due to cardiovascular, cerebrovascular, and cancer diseases are higher in the CP population than in general population. Although the reason for that remains unclear, there is a possibility that reduced physical activity levels in the CP population is partly responsible for the higher mortality and morbidity rates[3]. The evidence of benefits of regular physical activity (PA) in preventing the abovementioned diseases as well as in improving physical and mental health status are well-established[4].
There have been many studies examining barriers and facilitators to physical activity participation in the general population and in individuals with disabilities. For more information about physical activity in individuals with disability, please click here. For more information about physical activity, sport, and recreation for young people with disability, please click here.
This page summarizes several studies that examined the barriers and facilitators to physical activity participation in individuals with Cerebral Palsy across different age groups. Two studies included children and adolescents with CP as their participants[5][6]; two studies included children and adolescents with CP and their parents[7][8]; one study included adults with CP[9]; while one study included adults with CP and their caregivers[10]. The individuals with CP included in those studies have varying degrees of severity; from score I to V of Gross Motor Function Classification Scale (GMFCS), from none until profound intelectual disability, with or without communication difficulty, and with varying levels of mobility.
From all of the reported factors affecting PA participation, the barriers and facilitators of PA can be categorized into physiological, psychological, and environmental factors. The followings are factors that affect PA participation of children, adolescents, and adults with CP. Other factors that are only reported in a specific age group will be discussed later.
Factors Affecting PA Participation in Children, Adolescents, and Adults with Cerebral Palsy[edit | edit source]
Physiological Factors[edit | edit source]
Barrier: Pain as a result of physical activity or other treatment
Facilitator: Positive physical effect of exercise/physical activity
Psychological Factors[edit | edit source]
Barriers:
1. Poor understanding of benefits and importance of physical activity
2. Negative self-conscious thoughts
Facilitators:
1. Good understanding of benefits and importance of physical activity
2. Enjoyment from physical activity and positive feelings as the result of exercise
3. Physical activity that improves self-efficacy
Environmental Factors[edit | edit source]
Barriers:
1. Caregiver’s lack of awareness of the importance of physical activity
2. Caregiver’s overprotection
3. General ignorance of the specific needs of the CP population
4. Lack of adaptive resources
Facilitators:
1. Caregiver’s awareness of the importance of physical activity
2. Caregiver’s support and involvement in physical activity participation
3. Social acceptance and inclusion of the CP population
4. Availability of adaptive resource and competent service providers with regards to sufficient knowledge about CP and disability
- ↑ Krigger K. Cerebral palsy: An overview. Am Fam Physician 2006;73(1):91-100.
- ↑ Proposed definition and classification of cerebral palsy, april 2005. Developmental Medicine & Child Neurology 2005;47(8):571-.
- ↑ Strauss D, Cable W, Shavelle R. Causes of excess mortality in cerebral palsy. Developmental Medicine & Child Neurology 1999;41(9):580-5.
- ↑ Warburton D, Nicol CW, Bredin S. Health benefits of physical activity: The evidence. Cmaj 2006;174(14):801-809.
- ↑ Lauruschkus K, Nordmark E, Hallström I. 'It's fun, but ...' children with cerebral palsy and their experiences of participation in physical activities. Disabil Rehabil 2015 02/15;37(4):283-9.
- ↑ 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. J Health Psychol 2016 02;21(2):152-63.
- ↑ Verschuren O, Wiart L, Hermans D, Ketelaar M. Identification of facilitators and barriers to physical activity in children and adolescents with cerebral palsy. J Pediatr 2012 09;161(3):488-94.
- ↑ Shimmell LJ, Gorter JW, Jackson D, Wright M, Galuppi B. 'It's the participation that motivates him': Physical activity experiences of youth with cerebral palsy and their parents. Phys Occup Ther Pediatr 2013 11;33(4):405-20.
- ↑ Sandström K, Samuelsson K, Öberg B. Prerequisites for carrying out physiotherapy and physical activity - experiences from adults with cerebral palsy. Disabil Rehabil 2009 02;31(3):161-9.
- ↑ Heller T, Ying G, Rimmer J, Marks BA. Determinants of exercise in adults with cerebral palsy. Public Health Nursing 2002;19(3):223-31.
