"I do like the activities which I can do " Leisure participation experiences of children with movement impairments.

AIM: To explore in depth the leisure participation experiences of children with movement impairments. METHODS: We used Interpretative Phenomenological Analysis approach to interpret and understand the experiences of 22 children with movement impairments, aged between 6 and 12 years. Children expressed their views through flexible child-centred methods of data collection that allowed the children to draw, paint, use stickers, and demonstrate their leisure activities and equipment while communicating about their experiences. RESULTS: Children participated in leisure activities of their choice, and expressed positive experience of fun, challenge, independence and achievement. The choice of activities depended on a combination of the motor functioning of the individual child, inspiration and support from families, friends and health professionals, as well as the possibility of adaptations and availability of community programmes. At times children felt disappointed and avoided some activities due to associated negative experience such as injury, fear, non-inclusion and the difficulty they had experienced in adapting and performing certain activities. CONCLUSION: Families, therapists and community service providers such as disability organisations could enhance leisure participation experiences by suggesting and creating opportunities that could increase children's choices of leisure activities. Implications for rehabilitation Children's choice of activities, places and friends is important for positive experiences of fun, achievement, challenge, independence and motivation in leisure participation. Families and health professionals could assist children make appropriate choices for leisure activities that depends on factors such as motor abilities, adaptations and availability of activities in the community. In the community, widening the options for leisure activities such as non-competitive adaptive sports and indoor sports for children with variable levels of movement impairment could improve leisure participation experiences.

A Child-centered Method of Interviewing Children with Movement Impairments.

AIMS: Children are increasingly included in qualitative research and new methods for interviewing children are emerging. The aim of this article is to describe and discuss the strategies of a child-centered method of data collection for interviewing children with movement impairments to explore their leisure participation experiences. METHODS: A study was conducted using an Interpretative Phenomenological Approach (IPA) to explore leisure participation experiences of children with movement impairments aged 6 to 12 years. Various strategies, guided by children, were used to facilitate children's active involvement in the interview process. RESULTS: Twenty-two children (mean age 8.7 years) participated in the interview study, most of them in the presence of their parents or guardian (18 children) and some of them (9 children) with their siblings present. Children enjoyed and were actively engaged in the interview process. Along with talking, 19 children did drawings, 5 children used stickers, 4 children played quiet games, six children shared pictures of their leisure activities, and 16 children physically demonstrated some of their leisure activities, environment, and equipment. CONCLUSIONS: A wide range of data collection strategies facilitated children to communicate their leisure participation experiences and to represent children's views without being overly influenced by parental views.

Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

PURPOSE: New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. METHOD: We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. RESULTS: The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. CONCLUSIONS: Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

Leisure Participation Patterns of Children With Movement Impairments in New Zealand.

PURPOSE: To investigate the leisure participation patterns of children with movement impairments in New Zealand. METHODS: A cross-sectional survey was conducted with children with movement impairments aged 6 to 12 years using the Children's Assessment of Participation and Enjoyment questionnaire. Descriptive statistics were used to analyze the data. RESULTS: Children participated in an average of 57.3% of activities, with a greater number and frequency of recreational, social, and self-improvement activities as compared with skill-based and physical activities. Children performed nearly 50% of activities with family and 13% of activities with friends. Approximately 50% of activities were performed at home and 50% of activities were performed outside the home. CONCLUSIONS: Children with movement impairments participated in diverse leisure activities. However, reduced involvement in physical activities needs further investigation to identify the actual level of physical exertion, barriers faced, and how increased opportunities for regular physical activity could be instigated.

Association between motor functioning and leisure participation of children with physical disability: an integrative review.

AIM: The aim of this integrative review is to synthesize the evidence of association between motor functioning and leisure participation of children with physical disability. METHOD: We conducted a systematic electronic search of key databases from the period 1 January 2001 to 30 April 2014 using relevant keywords. The Mixed Method Appraisal Tool was used to assess the quality of the qualitative and quantitative studies included and carried out in children with physical disability aged 6 to 12 years. We synthesized and compared information from both type of studies to identify the extent, and way by which, motor functioning influences leisure participation. RESULTS: Thirty-five studies were included and analyzed for this review. Twenty-four studies used quantitative and 11 studies used qualitative methodology. We identified the association between motor functioning and six dimensions of participation including diversity, intensity, context, preferences, enjoyment and quality of participation. Motor functioning was found to have a weak to moderate association with involvement in specific leisure activity types and dimensions. We developed a conceptual framework to illustrate the influence of motor functioning on leisure participation from this review. INTERPRETATION: Whether motor functioning poses a barrier to leisure participation for children with physical disability appears to depend on the functional movement required to participate in a particular leisure activity.