Perceived barriers and facilitators for increasing the physical activity of adolescents and young adults with cerebral palsy: a focus group study.

PURPOSE: Identifying the factors impacting physical activity (PA) among adolescents and young adults with cerebral palsy (CP).

METHODS

Four focus groups were conducted, with a total of 22 participants with CP, aged 14-24 years, Gross Motor Function Classification (GMFCS) I-III. Our qualitative analysis drew on grounded theory and used Atlas software.

RESULTS

Findings revealed four categories of factors impacting PA: (1) Musculoskeletal-pain and additional impairments related to activity limitations; (2) knowledge and exercising skills, and life skills such as problem-solving, decision-making, planning and organizing; (3) availability: lack of transportation, professional guidance, adapted and community-based programs, especially enjoyable activities; (4) social support from professionals (mainly physiotherapists) and peer support with socializing opportunities. Many opposed parental involvement. Those who attended special education schools and had moderate to severe learning disabilities saw PA as an opportunity for social contacts, limited by lack of availability. Those in mainstream schools with mild to no learning disabilities used PA for relieving pain and preserving function, limited by difficulty balancing PA and life goals.

CONCLUSIONS

Service providers should inculcate knowledge and active-living skills during the transition to adulthood. Professional guidance needed to ensure inclusion in communal PA and offer adapted programs for young people with CP.IMPLICATIONS FOR REHABILITATIONThere is a need for ongoing, accessible, adapted, community-based physical activity programs for young adults with CP guided by skilled professionals that can provide them with opportunities for enjoyable activities involving social interactions.When planning treatment interventions for children and young individuals with CP, healthcare providers should be aware of past therapeutic experiences and in collaboration with parents, are encouraged to be sensitive to possible tensions which may exist regarding their body care.Healthcare and educational professionals should provide young people with CP and their families with theoretical and practical knowledge about physical activity and its health benefits, as well as information about exercise options.Developing life skills in young adults with CP is important for helping them to effectively engage in physical activity and develop the competencies needed to achieve long term physical care.