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Conceptualization of physical exercise and keeping fit by child wheelchair users and their parents
Jane Noyes1, Llinos Haf Spencer2, Nathan Bray3
1School of Social Sciences, Bangor University, UK.
Insights
Children who use wheelchairs and their families often misunderstand physical exercise benefits, even when active. Improved health education and screening are needed for better understanding and fitness management in disabled youth.
Area of Science:
- Pediatric Health
- Disability Studies
- Exercise Science
Background:
- Children with disabilities, particularly those with reduced mobility using wheelchairs, are at higher risk of being overweight and unfit.
- Current school-based health screening programs often exclude disabled children due to inaccessible measurement tools.
Purpose of the Study:
- To explore how children (aged 6-18) using wheelchairs and their families conceptualize physical exercise and fitness.
- To identify misconceptions about the purpose and outcomes of physical activity in this population.
Main Methods:
- A qualitative interview study was conducted over six months with children using wheelchairs and their families.
- Framework analysis, guided by the theory of planned behavior, was employed to analyze the data.
Main Results:
- Physically active children using wheelchairs and their parents underestimated their fitness levels and overestimated body fat.
- Children often confused physical exercise with therapeutic interventions (e.g., physiotherapy), misunderstanding its effects on strength, stamina, and fatigue.
- Social benefits were a primary motivator for exercise participation.
Conclusions:
- Proactive parental involvement can mitigate barriers to physical exercise for children using wheelchairs.
- Enhanced communication from healthcare professionals is crucial to clarify the distinction between exercise and therapy.
- Improvements are needed in health education policy, routine screening, physical education, and teacher training to better include children using wheelchairs.
Aim:
To gain a better understanding of how children aged 6-18 years who use wheelchairs and their families conceptualized physical exercise and keeping fit.
Background:
Disabled children with reduced mobility are commonly overweight and unfit. Nurse-led health screening programmes in schools commonly exclude disabled children if they cannot use standard weighing scales or stand against height measuring sticks.
Design:
Qualitative interview study at two time points over 6 months with children who use wheelchairs and their families.
Methods:
Framework analysis using the theory of planned behaviour.
Findings:
Mainly physically active participants were recruited (24 children and 23 parents) 2013-2014. Despite engaging in high levels of physical exercise, children were assessed as fit but had elevated body fat and did not realize how fit they were or that they were slightly overweight and nor did their parents. Children enjoyed the social benefits of exercise. Unlike their parents, children confused the purpose and outcomes of physical exercise with therapy (e.g. physiotherapy) and incorrectly understood the effects of physical exercise on body function and strength, preventing stiffness, increasing stamina and reducing fatigue. A new model was developed to show children's misconceptions.
Conclusions:
Proactive parents can overcome barriers to enable their children to benefit from physical exercise. Professionals need to increase communication clarity to improve children's understanding of therapy compared with physical exercise outcomes. Inclusion of children who use wheelchairs in health education policy; routine health screening; physical education classes and teacher training requires improvement. Body composition measurement is recommended, for which nurses will need training.
