Environmental factors affecting the occupations of children with physical disabilities

Law, Mary; Haight, Murray; Milroy, Beth Moore; Willms, Dennis; Stewart, Debra; Rosenbaum, Peter

doi:10.1080/14427591.1999.9686455

Cited by 95 publications

(97 citation statements)

References 14 publications

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“…These findings are similar to those found in other studies that have focused on social participation in children and youth with ABI [54] or other disabilities [8,9].…”

Section: Nature and Extent Of Participation And Child-related And Envsupporting

confidence: 92%

“…Managing daily schedules may be par- ticularly restricted in children and youth with ABI due to the cognitive problems that they often experience, but it is also likely that they are not given the opportunity to manage their own schedules or routines in part because caregivers and professionals take on this role. Also similar to findings in the present study, the children with disabilities in the study conducted by Law et al [8] were restricted in their involvement in active recreation and community socialization activities. Furthermore, the children with disabilities in Brown and Gordon's [9] study, primarily children with cerebral palsy and spina bifida, participated in less social engagements, active recreation, household tasks and community activities than children without disabilities.…”

Section: Nature and Extent Of Participation And Child-related And Envsupporting

confidence: 89%

“…In a qualitative study of children with physical disabilities (ages 3-12), Law et al [8] found that the children's participation to a large extent occurred mainly due to the structure and efforts provided by parents. Brown and Gordon's [9] study of the activity patterns of children (ages [6][7][8][9][10][11][12][13][14][15][16][17][18][19] with and without disabilities also found that parents played a significant role in structuring daily life for their children regardless of whether their child had a disability or not. Managing daily schedules may be par- ticularly restricted in children and youth with ABI due to the cognitive problems that they often experience, but it is also likely that they are not given the opportunity to manage their own schedules or routines in part because caregivers and professionals take on this role.…”

Section: Nature and Extent Of Participation And Child-related And Envmentioning

confidence: 99%

“…Full participation of individuals as active and productive members of society is the ultimate aim of rehabilitation and a targeted outcome of the current health agenda in the USA [6]. Participation in home, school and community activities is an essential aspect of child development and has been associated with improved quality of life outcomes for children and youth with and without disabilities [7][8][9]. It is through participation that children and youth acquire knowledge and skills needed to interact, work and live with others [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: a follow-up study

2004

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“…These findings are similar to those found in other studies that have focused on social participation in children and youth with ABI [54] or other disabilities [8,9].…”

Section: Nature and Extent Of Participation And Child-related And Envsupporting

confidence: 92%

Section: Nature and Extent Of Participation And Child-related And Envsupporting

confidence: 89%

Section: Nature and Extent Of Participation And Child-related And Envmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: a follow-up study

2004

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“…A physical environment, societal attitudes and supportive services can provide physical assistance, guidance and broader opportunities for activity. [109][110][111][112] Often, the strategies that we develop to manage chronic disease created additional burdens of work for patients, leading to poor adherence and clinical outcomes, as well as wasted resources. 113,114 Minimally disruptive medicine should identify this burden, encourage improved co-ordination of care and design, or prioritise care from the patient perspective.…”

Section: Modelling Process: Developing Programme Theorymentioning

confidence: 99%

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation

Hind

Parkin

Whitworth

et al. 2017

Health Technol Assess

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BackgroundDuchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent.ObjectivesTo assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work.DesignParallel-group, single-blind, randomised pilot trial with nested qualitative research.SettingSix paediatric neuromuscular units.ParticipantsChildren with DMD aged 7–16 years, established on corticosteroids, with a North Star Ambulatory Assessment (NSAA) score of 8–34 and able to complete a 10-m walk without aids/assistance. Exclusions: > 20% variation between baseline screens 4 weeks apart and contraindications.InterventionsParticipants were allocated on a 1 : 1 ratio to (1) optimised, manualised LBT (prescribed by specialist neuromuscular physiotherapists) or (2) the same plus manualised AT (30 minutes, twice weekly for 6 months: active assisted and/or passive stretching regime; simulated or real functional activities; submaximal exercise). Semistructured interviews with participants, parents (n = 8) and professionals (n = 8) were analysed using Framework analysis. An independent rater reviewed patient records to determine the extent to which treatment was optimised. A cost-impact analysis was performed. Quantitative and qualitative data were mixed using a triangulation exercise.Main outcome measuresFeasibility of recruiting 40 participants in 6 months, participant and therapist views on the acceptability of the intervention and research protocols, clinical outcomes including NSAA, independent assessment of treatment optimisation and intervention costs.ResultsOver 6 months, 348 children were screened – most lived too far from centres or were enrolled in other trials. Twelve (30% of target) were randomised to AT (n = 8) or control (n = 4). People in the AT (n = 8) and control (n = 2: attrition because of parental report) arms contributed outcome data. The mean change in NSAA score at 6 months was –5.5 [standard deviation (SD) 7.8] for LBT and –2.8 (SD 4.1) in the AT arm. One boy suffered pain and fatigue after AT, which resolved the same day. Physiotherapists and parents valued AT and believed that it should be delivered in community settings. The independent rater considered AT optimised for three out of eight children, with other children given programmes that were too extensive and insufficiently focused. The estimated NHS costs of 6-month service were between £1970 and £2734 per patient.LimitationsThe focus on delivery in hospitals limits generalisability.ConclusionsNeither a full-scale frequentist randomised controlled trial (RCT) recruiting in the UK alone nor a twice-weekly open-ended AT course delivered at tertiary centres is feasible. Further intervention development research is needed to identify how community-based pools can be accessed, and how families can link with each other and community physiotherapists to access tailored AT programmes guided by highly specialised physiotherapists. Bayesian RCTs may be feasible; otherwise, time series designs are recommended.Trial registrationCurrent Controlled Trials ISRCTN41002956.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 27. See the NIHR Journals Library website for further project information.

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Wheelchairs for children under 12 with physical impairments

Jackie¹,

Casey²,

McKeown³

et al. 2012

Cochrane Database of Systematic Reviews

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Environmental factors affecting the occupations of children with physical disabilities

Cited by 95 publications

References 14 publications

Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: a follow-up study

Social participation of children and youth with acquired brain injuries discharged from inpatient rehabilitation: a follow-up study

Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation

Wheelchairs for children under 12 with physical impairments

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