Impact of adapted folk games on activity and participation in individuals with cerebral palsy - an exploratory proof of concept study.

PURPOSE: This exploratory study aimed to evaluate the feasibility and preliminary impact of adapted traditional Indian folk games on physical activity (PA) and participation in individuals with cerebral palsy (CP) in low-resource settings.

MATERIALS AND

METHODS

A two-phase exploratory design was employed. Phase I involved the systematic adaptation of traditional games (e.g. THOTTATUM, GUTTE) using the CHANGE IT framework, tailoring equipment and rules to functional levels (GMFCS I-IV). In Phase II, 36 participants with CP (GMFCS I-IV) underwent a structured intervention using these adapted games. Outcome measures included are Brockport Physical Fitness [BPFT], Gross Motor Function Measure 88 and a functional HRQoL questionnaire covering physical, emotional, social, and school domains.

RESULTS

Post-intervention analysis of the total cohort showed significant improvements in handgrip strength and skinfold measurement. Significant positive shifts were observed in HRQoL domains, specifically physical (p < 0.05), emotional (p < 0.05), and school functioning. Qualitative feedback from parents and teachers corroborated these findings, noting improved activities of daily living (e.g. buttoning, brushing) and social interaction. Subgroup analysis indicated that while all levels benefitted, those at GMFCS Levels I-III showed the most pronounced gains in motor-related tasks.

CONCLUSIONS

Adapted traditional folk games serve as a feasible, culturally relevant, and cost-effective form of assistive technology and rehabilitation. This approach effectively bridges the gap in accessible physical education for individuals with CP in Low and Middle Income Countries (LMIC's), providing a scalable model for inclusive activity and participation.