Safety strategies for everyday community physical activity by adults with cerebral palsy and high support needs: A...

This qualitative case series explores safety strategies used by adults with cerebral palsy with high support needs and co-occurring complexities during community-based physical activity. Five participants (mean age 30 years, female n = 2; Gross Motor Function Classification System [GMFCS] level IV n = 1; GMFCS level V n = 4) who completed two interviews and were observed participating in their usual physical activity (warm water exercise n = 3; gym exercise n = 1; sing-and-dance group n = 1) were included in the study. Data were analysed deductively and coded to eight safety strategies identified a priori (medical prescreening, education, familiarization [practice], adapted equipment, fatigue monitoring, physiological monitoring, physical assistance, supervision), with further inductive analysis within the physical assistance category. All participants were active with paid support people. Seven of eight strategies were in use, and an additional strategy of 'programme monitoring' was developed. Physical assistance was the dominant strategy, with inductive analysis identifying four purposes of physical assistance, and the key attributes of support people. No adverse events were reported although gaps were identified in participants' understanding of safety strategies and how strategies were monitored and adapted in the absence of health professional involvement. Discrepancies between evidence and practice highlighted opportunities for clinicians to promote physical activity literacy around safety monitoring in community physical activity settings.