Brooke Adair

'Participation': a systematic review of language, definitions, and constructs used in intervention research with children with disabilities.

Improving participation of children with disabilities is a priority; however, the participation construct lacks clarity. This systematic review investigated how researchers defined ‘participation’ and the language used in participation intervention research.

The effect of interventions aimed at improving participation outcomes for children with disabilities : a systematic review

Enhancement of participation has been described as the ultimate outcome for health and educational interventions. The goal of this systematic review was to identify and critically appraise studies that aimed to improve the participation outcomes of children with disabilities.

Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study

Introduction Hand-held dynamometry (HHD) has never previously been used to examine isometric muscle power. Rate of force development (RFD) is often used for muscle power assessment, however no consensus currently exists on the most appropriate method of calculation. The aim of this study was to examine the reliability of different algorithms for RFD calculation and to examine the intra-rater, inter-rater, and inter-device reliability of HHD as well as the concurrent validity of HHD for the assessment of isometric lower limb muscle strength and power. Methods 30 healthy young adults (age: 23±5yrs, male: 15) were assessed on two sessions. Isometric muscle strength and power were measured using peak force and RFD respectively using two HHDs (Lafayette Model-01165 and Hoggan microFET2) and a criterion-reference KinCom dynamometer. Statistical analysis of reliability and validity comprised intraclass correlation coefficients (ICC), Pearson correlations, concordance correlations, standard error of measurement, and minimal detectable change. Results Comparison of RFD methods revealed that a peak 200ms moving window algorithm provided optimal reliability results. Intra-rater, inter-rater, and inter-device reliability analysis of peak force and RFD revealed mostly good to excellent reliability (coefficients ≥ 0.70) for all muscle groups. Concurrent validity analysis showed moderate to excellent relationships between HHD and fixed dynamometry for the hip and knee (ICCs ≥ 0.70) for both peak force and RFD, with mostly poor to good results shown for the ankle muscles (ICCs = 0.31–0.79). Conclusions Hand-held dynamometry has good to excellent reliability and validity for most measures of isometric lower limb strength and power in a healthy population, particularly for proximal muscle groups. To aid implementation we have created freely available software to extract these variables from data stored on the Lafayette device. Future research should examine the reliability and validity of these variables in clinical populations.

Participation trajectories: impact of school transitions on children and adolescents with cerebral palsy

To describe participation trajectories, and impact of school transitions on those trajectories, of children with cerebral palsy (CP).

Associations between lower limb strength and gait velocity following stroke: a systematic review.

Abstract Objective: The aim of this systematic review was to identify literature examining associations between isometric strength and gait velocity following stroke. Methods: An electronic search was performed using six online databases. Targeted searching of reference lists of included articles and three relevant journals was also performed. Two independent reviewers identified relevant articles, extracted data and assessed the methodological quality of included articles. Inclusion criteria involved studies that assessed univariate correlations between gait velocity and isometric strength of individual lower limb muscle groups in a stroke population. Results: Twenty-one studies were included for review. The majority of included studies had a relatively small sample size. After accounting for sample size and methodological quality, the knee extensors showed poor-to-moderate correlations with gait velocity while the ankle dorsiflexors showed the strongest association with gait velocity. Conclusions: Current evidence suggests that the strength of the ankle dorsiflexors has a stronger correlation to gait velocity compared with other lower limb muscle groups. Consequently, a focus on increasing ankle dorsiflexor strength to improve gait velocity following stroke may be beneficial. However, due to limitations of the research identified, further research is needed to determine the associations between lower limb strength and gait velocity following stroke.

Kinematic gait deficits at the trunk and pelvis: characteristic features in children with hereditary spastic paraplegia.

To examine the kinematic gait deviations at the trunk and pelvis of children with hereditary spastic paraplegia (HSP).

Assessment of isometric muscle strength and rate of torque development with hand-held dynamometry: Test-retest reliability and relationship with gait velocity after stroke

Isometric rate of torque development examines how quickly force can be exerted and may resemble everyday task demands more closely than isometric strength. Rate of torque development may provide further insight into the relationship between muscle function and gait following stroke. Aims of this study were to examine the test-retest reliability of hand-held dynamometry to measure isometric rate of torque development following stroke, to examine associations between strength and rate of torque development, and to compare the relationships of strength and rate of torque development to gait velocity. Sixty-three post-stroke adults participated (60 years, 34 male). Gait velocity was assessed using the fast-paced 10 m walk test. Isometric strength and rate of torque development of seven lower-limb muscle groups were assessed with hand-held dynamometry. Intraclass correlation coefficients were calculated for reliability and Spearmans rho correlations were calculated for associations. Regression analyses using partial F-tests were used to compare strength and rate of torque development in their relationship with gait velocity. Good to excellent reliability was shown for strength and rate of torque development (0.82-0.97). Strong associations were found between strength and rate of torque development (0.71-0.94). Despite high correlations between strength and rate of torque development, rate of torque development failed to provide significant value to regression models that already contained strength. Assessment of isometric rate of torque development with hand-held dynamometry is reliable following stroke, however isometric strength demonstrated greater relationships with gait velocity. Further research should examine the relationship between dynamic measures of muscle strength/torque and gait after stroke.

Sustained participation in community-based physical activity by adolescents with cerebral palsy: a qualitative study

Abstract Purpose: Short-term physical activity programs may encourage adolescents with cerebral palsy to participate in physical activity but how to sustain their involvement is not well known. This qualitative study aimed to identify facilitators that successfully sustain physical activity participation by adolescents with cerebral palsy. Materials and methods: Adolescents (12–18 years) with cerebral palsy [Gross Motor Function Classification System (GMFCS) levels I–V, without moderate-severe intellectual disability] who participated in regular physical activity were eligible, as well as one parent and an individual who facilitated their physical activity. Data were gathered using semi-structured interviews; verbatim transcripts were analysed using inductive thematic analysis within individuals (n = 15), triads (n = 5), and across participant groups (adolescents, parents and facilitators). Results: Five triads participated (male adolescents, 13–16 years, GMFCS levels I–III). Seven themes emerged: getting started, wanting to succeed, a sense of belonging, the coach is important, endorsement to continue, endorsement to support and being passionate. The themes were synthesized into the Framework for Sustained Participation, which describes the interaction among themes. Conclusions: The Framework for Sustained Participation highlights strategies that may be useful for adolescents, parents, sports facilitators, clinicians and researchers to help ambulatory male adolescents with cerebral palsy continue to participate in physical activity. Implications for rehabilitation Sustaining participation in physical activity has the potential to enhance long-term health benefits of young people with cerebral palsy. Key facilitators of sustained physical activity in adolescents with cerebral palsy included tailoring the activity, getting the right coach and the adolescents’ desire for health and fitness. The Framework of Sustained Participation may assist clinicians and facilitators who work with young people with cerebral palsy to structure their support in ways that will successfully sustain the adolescents’ participation in physical activity.

Measures used to quantify participation in childhood disability and their alignment with the family of participation-related constructs: a systematic review

We aimed to identify measures used to assess the participation of disabled children and to map the measures’ content to the family of participation‐related constructs (fPRC) to inform future research and practice.

Characteristics Influencing Diversity of Participation of Children in Activities Outside School

OBJECTIVE. A cross‐sectional survey was conducted to determine which personal and environmental characteristics influenced diversity of participation in activities outside school for typically developing children and adolescents. METHOD. Four hundred twenty‐two (215 boys) typically developing Australian children (mean = 11.0 yr) completed the Childrens Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activity of Children to describe their participation on five activity types: Recreational, Active Physical, Social, Self‐Improvement, and Skill‐Based. Linear regression analyses were conducted. RESULTS. Predictors of participation diversity were age and preference for Recreational (aR2 = .44); preference for Active Physical (aR2= .19); gender, school type, and preference for Social (aR2 = .19); preference for Skill‐Based (aR2 = .25); and gender, school style, socioeconomic score, and preference for Self‐Improvement (aR2 = .24). CONCLUSION. Preference plays a key role in determining the diversity of participation in activities outside school. &NA; Preference was found to be a key factor in diversity of participation in activities outside school among 422 typically developing Australian children.