ABSTRACT
Children with physical disabilities are less physically active than children with typical development. How children's experiences of using walkers relates to their physical activity has not been studied previously. This study aimed to explore perspectives of walker use and their potential to increase physical activity. Four focus groups were conducted with children aged 7-10 (n = 3; 12.5%), aged 9-12 (n = 4; 16.7%), parents (n = 7; 29.2%) and paediatric physiotherapists (n = 10; 41.7%). Groups were audio recorded and transcribed. Data were analysed using framework analysis. An overarching concept of walkers needing flexibility to accommodate individual, interpersonal and environmental variability was underpinned by three themes: (a) contrasting drivers for use/non-use of walkers, (b) trade-offs, (c) acceptance of technology within walkers to increase physical activity. Participants were motivated by differing drivers: social for children, emotional for parents and professional for physiotherapists. These contrasting drivers create trade-offs, for example between quality of movement and independence. To maximise physical activity, walker prescribers and designers should prioritise drivers that motivate children and parents, ensuring goal setting is family-centred and participation orientated. Involving families in co-designing walkers is therefore important. Individual clinical assessment allows for identification of children's specific needs and how a child's, parent's and physiotherapist's goals may differ.
ABSTRACT
INTRODUCTION: Non-ambulant children and young people with physical disabilities are at high risk of experiencing negative health outcomes associated with sedentary time. A previous scoping review summarising evidence relating to sedentary behaviours of children with physical disabilities identified the need for validated methods of measuring physical activity of children who use wheelchairs and evaluation of interventions to reduce sedentary time. The scoping review did not assess the quality of evidence relating to this topic, therefore its validity remains unclear. No reviews focussing on non-ambulant children and young people up to the age of 25 years have been undertaken.The objectives of this systematic search and review are to:Identify all peer-reviewed articles relating to sedentary behaviour of non-ambulant children and young people.Categorise the articles according to study design and four subquestions relating to (i) measurement, (ii) patterns, (iii) associated risks and (iv) interventions to reduce sedentary time or behaviour.Critically appraise quality of the articles using established critical appraisal tools.Summarise the evidence for each subquestion. Describe its cumulative strength and identify knowledge gaps. METHODS AND ANALYSIS: This protocol was developed using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) checklist. The research questions, inclusion/exclusion criteria and search terms have been developed a priori using the 'Population, Concept and Context' framework. Online databases will be systematically searched to identify peer-reviewed articles published between 1996 and 2021. Two reviewers will screen, categorise and critically appraise the articles. Data extraction and analysis will be verified by the second reviewer.Results will be reported as a best evidence synthesis, with reference to the PRISMA checklist. ETHICS AND DISSEMINATION: Ethical approval is not required. The review will be submitted to an appropriate peer-reviewed journal. REGISTRATION: The review is registered on the Open Science Framework database. DOI: https://doi.org/10.17605/OSF.IO/SQXJB. Any protocol amendments will be recorded in the Open Science Framework database.
