Leisure and learning activities and stress in children with physical disabilities: The moderating role of psychological changes after wheelchair power-assist device use.

This study examined how leisure and learning activities are associated with stress in children with physical disabilities, and how psychological changes - specifically competence, adaptability, and self-esteem - following the use of a power-assist device (PAD) influence this relationship. The study involved 19 children using a PAD for their manual wheelchairs. We collected responses regarding daily activities and activity-related feelings over a period of five days using the day reconstruction method and assessed psychological changes after the use of PAD. The analysis revealed that leisure activities had a significant negative effect on stress; academic engagement did not demonstrate a similar impact. Participants' increased adaptability after using the PAD was related to lower stress levels. Moreover, children who reported minimal self-esteem changes after using the PAD were more likely to experience the positive impact of leisure on their stress levels. These findings emphasize both the importance of promoting leisure participation and the value of expanding access to assistive mobility technology, which together can reduce stress and foster psychological resilience in children with severe physical disabilities.