Related Experiment Video
Updated: Jul 12, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Enhancing Physically Active Leisure Participation for Children With Cerebral Palsy: A Randomized Controlled Trial
Leanne Sakzewski1,2, Sarah Reedman3, Catherine Elliott4,5
1School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia.
Insights
A new therapy, Participate-CP, significantly improved physical activity and participation in children with cerebral palsy (CP). This therapy reduced barriers and enhanced community involvement for children with CP.
Area of Science:
- Pediatric Rehabilitation
- Therapeutic Interventions
- Childhood Disabilities
Background:
- Cerebral palsy (CP) significantly impacts children's ability to participate in physical activities.
- Existing therapies may not adequately address participation barriers in children with CP.
- Improving physical activity and leisure participation is crucial for the well-being of children with CP.
Purpose of the Study:
- To evaluate the effectiveness of a participation-focused therapy (Participate-CP) compared to usual care.
- To determine if Participate-CP enhances physical activity and leisure participation in children with CP.
- To assess the impact of Participate-CP on participation barriers and goal attainment.
Main Methods:
- A prospective, multisite waitlist randomized controlled trial was conducted.
- Participants included children aged 8-14 years with CP (GMFCS levels I-IV).
- Participate-CP involved weekly 60-minute sessions over 12 weeks, utilizing motivational interviewing and targeted strategies. Primary outcomes included the Canadian Occupational Performance Measure (COPM) and moderate-to-vigorous physical activity duration.
Main Results:
- Participate-CP demonstrated significant improvements in perceived participation goal performance (COPM).
- Children receiving Participate-CP showed increased average movement intensity and frequency of community participation (PEM-CY).
- The intervention led to a reduction in barriers to participation and improved goal attainment (GAS).
Conclusions:
- Participate-CP is an effective intervention for enhancing physically active leisure and community participation in children with CP.
- The therapy successfully reduced participation barriers and improved physical activity levels.
- These findings support the integration of participation-focused approaches in pediatric rehabilitation for CP.
Objectives:
To determine if a participation-focused therapy (Participate-CP) was more effective than usual care to improve participation in physically active leisure and physical activity for children with cerebral palsy (CP).
Methods:
This prospective, multisite waitlist randomized controlled trial included children with CP, aged 8 to 14 years, classified in Gross Motor Function Classification System (GMFCS) levels I-IV. Participate-CP comprised weekly, 60-minute sessions over 12 weeks using motivational interviewing and a toolbox of evidence-based therapy strategies targeting modifiable barriers to participation. Primary outcomes were the Canadian Occupational Performance Measure (COPM) and time spent in moderate-to-vigorous physical activity. Secondary outcomes were the Barriers to Participation in Physical Activities Questionnaire, Participation and Environment Measure for Children and Youth (PEM-CY), Motives for Physical Activities Measure, and Physical Activity Climate Questionnaire and Goal Attainment Scale (GAS).
Results:
A total of 110 children (mean age 10.4 years [SD, 1.6 years]; 60% boys; and GMFCS I = 58, II = 30, III = 8, and IV = 14) were assigned to Participate-CP (n = 56) or usual care (n = 54). There were no relevant baseline differences between groups. Participate-CP led to greater changes in perceived performance of participation goals (COPM: mean difference [MD], 2.75; 95% CI, 2.08-3.42; P < .001), greater average movement intensity (MD, 4.66; 95% CI, 0.50-8.82; P = .03), fewer barriers to participation (MD, 13.42; 95% CI, 1.69-25.14; P = .03), and greater frequency of community participation (PEM-CY: MD, 0.35; 95% CI, 0.02-0.68; P = .04) and expected goal attainment (GAS T score mean, 53.7; SD, 9.9). There were no differences between groups in the remaining measures.
Conclusion:
Participate-CP was confirmed as effective to improve the performance of physically active leisure goals, average movement intensity, frequency of community participation, and reduced barriers to participation.
