RESUMEN
Background: Cerebral palsy is a group of permanent disorders of development in movement and posture causing various limitations. India has a prevalence of 2.95 CP children per 1000 children. Participation is important for overall development. Participation is influenced by factors around the child and family. Environmental factors include social support, accessibility, accommodation, and availability of facilities. There is dearth of literature about what environmental barriers prevent individuals with cerebral palsy from attaining participation in Indian surroundings. Thus, the aim was to find the environmental barriers faced to participation. Methods: Parents of 30 children with CP from Pune participated in the study. Convenience sampling was used to onboard them. Ethical clearance, informed consent and assent were taken. They had to fill out the CHIEF questionnaire- Craig’s hospital inventory of environmental factors and the therapist determined the GMFCS and MACS level of the child. Results: Barriers to participation as reported by parents were 48.07% in the policies subscale, 23.47% in the physical/structural subscale, 4.55% in the school subscale, 34.29% in the attitude/support subscale and 37.86% in the services/assistance subscale. Conclusions: The results showed barriers to participation were most common in the policies subscale and the services and assistance subscale. Policymakers and administrative heads in sectors across government, transport, and educational institutes need to take the requirements of children with cerebral palsy into consideration.
RESUMEN
Abstract The main goal of the present study was to document the participation of preschool children at home and in the community setting, describing the differences between eligible children with support of Special Education Service and/or of the Early Intervention System and noneligible children, in three main dimensions: child functioning, child participation and perceived environmental barriers. Data about child functioning was collected through preschool teachers and about participation and barriers through parents. Sociodemographic data was also collected. Forty preschool teachers and 116 children (and their parents) participated in this study. Forty-two children were eligible and had support from Special Education Service and/or of the Early Intervention System. The results showed that eligible children have lower levels of functionality, participate less frequently and are less involved in the activities at home and in the community setting and that their parents perceive more environmental barriers in both settings. The results were analysed considering the Biopsychosocial Model.
Resumo O presente estudo tem como objetivo descrever a participação de crianças entre os três e cinco anos de idade em casa e na comunidade, comparando crianças elegíveis e com apoio da Educação Especial e/ou do Sistema Nacional de Intervenção Precoce para a Infância com crianças não elegíveis e sem apoio, em três dimensões: funcionalidade da criança, participação da criança e perceção de barreiras ambientais em ambos os contextos. Os dados acerca da funcionalidade da criança foram recolhidos com recurso às educadoras de infância e da participação e barreiras ambientes com recurso aos pais. Informações sociodemográficas também foram recolhidas. Neste estudo, participaram 40 educadoras de infância e 116 crianças (e os seus pais), das quais 42 eram elegíveis e tinham apoio da Educação Especial e/ou do Sistema Nacional de Intervenção Precoce para a Infância. Os resultados indicaram que as crianças elegíveis e com apoio apresentam níveis mais baixos de funcionalidade, participam menos frequentemente e estão menos envolvidas nas atividades de casa e da comunidade e que os seus pais percebem mais barreiras ambientais nos contextos. Os resultados foram analisados e discutidos à luz do Modelo Biopsicossocial.
RESUMEN
Out-of-home mobility is necessary for accessing commodities, making use of neighborhood facilities, and participation in meaningful social, cultural, and physical activities. Mobility also promotes healthy aging as it relates to the basic human need of physical movement. Mobility is typically assessed either with standardized performance-based tests or with self-reports of perceived difficulty in carrying out specific mobility tasks. Mobility declines with increasing age, and the most complex and demanding tasks are affected first. Sometimes people cope with declining functional capacity by making changes in their way or frequency of doing these tasks, thus avoiding facing manifest difficulties. From the physiological point of view, walking is an integrated result of the functioning of the musculoskeletal, cardio-respiratory, sensory and neural systems. Studies have shown that interventions aiming to increase muscle strength will also improve mobility. Physical activity counseling, an educational intervention aiming to increase physical activity, may also prevent mobility decline among older people. Sensory deficits, such as poor vision and hearing may increase the risk of mobility decline. Consequently, rehabilitation of sensory functions may prevent falls and decline in mobility. To promote mobility, it is not enough to target only individuals because environmental barriers to mobility may also accelerate mobility decline among older people. Communities need to promote the accessibility of physical environments while also trying to minimize negative or stereotypic attitudes toward the physical activity of older people.