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To identify participation-focused measures used for young people with cerebral palsy (CP), evaluate their psychometric evidence, and map item content to the International Classification of Functioning, Disability, and Health (ICF), and family of Participation-Related Constructs (fPRC) frameworks. Four databases (PubMed, Embase, Web of Science, CINAHL) were searched for papers that involved young people with CP aged 15 to 25 years and reported original data from a participation measure. Each measure was examined for validity, reliability, responsiveness (using the COSMIN checklist), clinical utility, the inclusion of accessible design features, self- and/or proxy-report from people with communication support needs, and item content according to ICF and fPRC. Of 895 papers, 80 were included for review. From these, 26 measures were identified. Seven measures (27 papers/resources) were participation-focused, capable of producing a score for participation Attendance and/or Involvement. Of these, all measured Attendance (n = 7) but fewer than half measured Involvement (n = 3). Few included studies (37%) reported including some self-report of people with communication support needs. Participation measures for young people with CP are evolving but require more: (i) emphasis on measurement of involvement; (ii) investigation of psychometric properties; and (iii) adaptation to enable self-report by young people with communication support needs. Identifies seven participation-focused measures which are available for young people with cerebral palsy, all seven measure Attendance and three measure Involvement. Provides a decision-making tool to assist clinicians and researchers with the selection of participation-focused measures for young people with cerebral palsy. Recommends that more accessible self-report measures are needed which capture age-appropriate participation of young people with cerebral palsy. [ABSTRACT FROM AUTHOR]

This study explored the home-based participation of young people with cerebral palsy (CP) and described factors that make participation easier or harder. Fifteen young people with CP aged 15 to 26 years provided written reflections, photographs, or videos about their home-based participation experiences. Data were analyzed using reflexive thematic analysis. Self-reported reflections were grouped inductively into 129 codes, then 20 subthemes and 5 themes which emphasized CP characteristics, thoughts, emotions, equipment, environment, supports, and inclusion as important factors influencing home-based participation. Young people with CP largely described the home environment as an inclusive place to participate. [ABSTRACT FROM AUTHOR]

To identify specific factors influencing the participation experiences of young people with cerebral palsy (CP) aged 15 to 26 years. A three-round Delphi survey study design was used. Consumers (young people with CP and caregivers) and health professionals were asked to generate and then rate items influencing positive and negative participation experiences. Qualitative content analysis and descriptive statistics were used to classify items across the family of Participation-Related Constructs (fPRC) framework. Sixty-eight participants completed Round I (25 consumers, 43 health professionals). Round II resulted in a consensus for all but two items, with Round III not required. The fPRC construct with the most items rated as extremely important for positive participation experiences was Environment–Availability, and for negative participation, experiences were Environment-Acceptability for both adolescents and young adults. A consensus was reached on the most important items influencing the positive and negative participation experiences of young people with CP. These items should be prioritised when developing support services and allocating funding to improve the participation experiences of young people with CP. This study is reporting consumer and professional consensus on the factors promoting positive and negative participation for young people with cerebral palsy. Ensuring availability of appropriate activities and services is extremely important for enabling positive participation experiences. Promoting acceptable attitudes of others is extremely important for alleviating negative participation experiences. [ABSTRACT FROM AUTHOR]

Sports participation is an important goal for children with cerebral palsy classified at GMFCS Level I or II, however there are no studies of parent or physiotherapist perspectives on effectiveness or overall acceptability of transition-to-sports interventions. Parent and physiotherapist perspectives of Sports Stars: a novel, practitioner-led, peer-group sports intervention (Trial registration: ACTRN12617000313336) were collected from Sports Stars Session Reports (39 children, 6–12 years, GMFCS I = 11, II = 28, Female = 12), Fidelity Evaluations (28 children), and Perspectives Surveys (Parents = 29, female = 26; Physiotherapists = 8, female = 5). Outcomes were perceived impact on: (1) sports Participation (Attendance, Involvement), (2) sports Activity Competence across Physical, Social, Cognitive and Psychological Physical Literacy domains and (3) overall acceptability. Over 84% of children Attended most sessions. Physiotherapists rated session Involvement as high (median = 3/4). In Session Reports, physiotherapists recorded quantitative improvements in Physical and Cognitive performance and described improvements across all domains. Parents reported improvements across all domains, with comments focusing on Social and Psychological performance. All physiotherapists (8/8) and most parents (26/29) reported a community-based peer-group was the intervention design of choice for sports-focused goals. Parents and physiotherapists perceived Sports Stars, a practitioner-led, peer-group sports intervention, as effective and acceptable for children with cerebral palsy with sports-focussed goals. Parents and physiotherapists agree that Sports Stars improved sports Participation and Physical, Social, Psychological and Cognitive Activity Competence for children with cerebral palsy. Children with sports-focused goals should be offered practitioner-led, peer-group sports interventions in community environments. Therapists should design sports interventions with Physical, Cognitive, Social and Psychological content and outcomes. [ABSTRACT FROM AUTHOR]

To investigate the effectiveness of a practitioner-led, peer-group sports intervention for children with CP at GMFCS Level I–II. Children with CP (GMFCS I–II; 6–12 years) were randomised to Sports Stars or waitlist-control groups. Sports Stars included eight-weeks (eight hours) of physiotherapist-led, sports-specific gross motor activity training, sports education, teamwork development and confidence building. Sports participation was measured using self-identified participation goals (modified Canadian Occupational Performance Measure (mCOPM)). Physical competence was measured with mCOPM activity goals and high-level gross motor batteries (Test of Gross Motor Development (TGMD-2); GMFM-Challenge) and walking (Timed-Up-and-Go), running (Muscle Power Sprint Test; 10x5m Sprint Test), jumping (Standing Broad Jump; Vertical Jump) and throwing (Seated Throw) items. General participation and quality of life were also measured. Outcomes were measured pre, post and 12-weeks post-intervention. Data were analysed using linear mixed models. Fifty-four children were randomised into Sports Stars (n = 29; GMFCS I = 7, II = 22; male = 19; 8.9 ± 2 years) or waitlist-control groups (n = 25; GMFCS I = 10, II = 15; male = 14; 8.6 ± 2 years). The Sports Stars group improved sports participation and activity goals (mCOPM F = 5.49–10.29, p < 0.001) and sports-specific physical competence (TGMD-2, F = 3.45–5.19, p = 0.001–0.009) compared to the waitlist-control. Sports Stars is effective for improving sports-specific participation and physical competence for children with CP. Sports Stars improves performance and satisfaction in sports-specific participation and activity goals for ambulant children with CP. Sports Stars improves sports-specific physical activity competence in locomotor and object control skills. Sport-specific interventions should incorporate sport-specific gross motor activity training as well as sports education, confidence building and teamwork. [ABSTRACT FROM AUTHOR]

To investigate performance of children with cerebral palsy (CP) at GMFCS Levels I-II on sports-focussed gross motor assessments; and concurrent validity of mainstream and CP-specific high-level assessment batteries and field tests. Fifty-four children (6–12 years) with CP at GMFCS I-II completed the Test of Gross Motor Development-second edition, Gross Motor Function Measure-Challenge Module, Muscle Power Sprint Test (MPST), 10 × 5 m Sprint Test (10 × 5 mST), Vertical Jump, Broad Jump, and Seated Throw. Correlations between measures, age and mobility level, and group differences between age and mobility level were examined and content analysis performed. Children at GMFCS I demonstrated significantly higher gross motor assessment battery scores than children at GMFCS II (U = 73.5–109.0, p < 0.001). Performance improved with age for children at Level I but not II. Children with higher overall motor scores scored higher on running (MPST, 10 × 5 mST, r = –0.516 to –0.816, p < 0.001), jumping (Vertical Jump, Broad Jump, r = 0.499–0.774, p < 0.001) and throwing (Seated Throw, r = 0.341–0.500, p = 0.012 < 0.001) field tests. High-level gross motor assessments were achievable and appropriately challenging for children with CP at GMFCS I-II. Scores discriminated between performance and were associated with mobility level. Concurrent validity was established between gross motor assessment batteries, and locomotor field tests. For children with cerebral palsy at GMFCS I–II, sports-focussed assessments should be used to assess high-level gross motor function. The Gross Motor Function Measure-Challenge and Test of Gross Motor Development demonstrate no ceiling for children with cerebral palsy at GMFCS I–II. Single-item running and jumping field tests provide targeted skill assessment and estimate sports skills for children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Background: Tactile impairments are common in children with cerebral palsy (CP), however assessment is not routinely carried out by therapists. We investigated a multi-faceted Knowledge Translation intervention to improve Knowledge, remove Barriers and enhance Practice of tactile assessments by paediatric therapists. Method: Twelve therapists from a state-wide service for children with CP (seven physiotherapists, five occupational therapists; 12 female) received: written information, demonstration videos, a face-to-face workshop, equipment provision, and on-call mentoring. Therapists completed pre–post-intervention questionnaires reporting their perceived tactile assessment Knowledge, current Practices and implementation Barriers. Results: Following intervention, therapists improved Knowledge of correct (1) tactile impairment prevalence in children with CP (pre 3/12; post 9/12), (2) tactile assessment items (e.g. Registration – pre 1/12; post 9/12; Localisation – pre 2/12; post 10/12), and (3) equipment choice (e.g. Monofilaments – pre 1/12; post 10/12). Tactile assessment Practice improved slightly. All major clinician-level implementation Barriers were resolved and less obvious organisational-level Barriers were identified for follow-up. Conclusion: A 12-month multi-faceted Knowledge Translation intervention can improve tactile assessment Knowledge, resolve major clinician-level implementation Barriers, and identify less obvious organisational-level Barriers to be addressed to achieve maximum Practice improvement. Ongoing multi-faceted knowledge translation processes are essential for high-performing organisations. A multi-faceted knowledge translation intervention significantly improved paediatric therapists' knowledge of the items and equipment necessary for tactile assessment. A 12-month intervention can address clinician-level barriers of knowledge, confidence, and access to equipment and assist in the identification of less obvious organisational-level barriers. Consideration of motivational readiness for change, intervention timelines, monitoring of emergent barriers, and fitting tactile assessment into a broader assessment framework are critical for improving uptake of tactile assessment in practice. [ABSTRACT FROM AUTHOR]

Purpose: Many children with cerebral palsy (CP) are known to experience tactile impairments. Research evaluating specific interventions to manage this is, however, minimal. This paper seeks to consolidate current literature and provide a framework to help clinicians and researchers think strategically about tactile treatment selection and future research planning. Method: The framework is described via a novel analogy - “The Apartment Block Theory”. The theory describes the relative effectiveness of three intervention strategies aimed at overcoming a poorly responsive tactile system: (1) Pressing the buzzer - providing repeated passive tactile stimulation at the periphery; (2) Sneaking in the door - providing active tactile-enhanced motor training that capitalises on the opportunity to provide high-dose tactile input during motor interventions; and (3) Connecting another way - providing visually enhanced touch strategies with the aim of enhancing tactile function, which can be compared to phoning the apartment as an alternative to using the buzzer. Results: Using this theory, the paper describes which sub-groups of children with CP may benefit from each intervention strategy when considering their capabilities in visual, motor, and attention domains. Conclusions: This theory can assist clinicians to provide effective interventions and researchers to make informed future research decisions to optimise tactile function for children with CP. Implications for Rehabilitation: Although tactile impairments are reported to be common in children with cerebral palsy, very few successful interventions are reported in the literature. Visually enhanced touch is a successful strategy for treating tactile impairments in children with cerebral palsy who have sufficient vision and attention. Combining intentional tactile input with upper limb movement training may improve tactile function in children with cerebral palsy who have sufficient movement and attention. In children who have complex co-morbidities, including both visual and movement impairments, it may be necessary to consider providing passive tactile stimulation in tactile intervention. [ABSTRACT FROM AUTHOR]

AIM: This study reviewed interventions suitable for treating tactile dysfunction in children with cerebral palsy (CP). METHOD: A systematic review was conducted of six databases, searched for population: ('brain injury' OR 'cerebral palsy' OR 'stroke' OR 'cerebrovascular accident') and intervention: ('tactile' OR 'sensation'). Inclusion criteria were: (1) published after 1950 in English; (2) participants older than 4 years with brain injury; (3) upper limb intervention; and (4) examined tactile registration or perception. RESULTS: Of 2938 studies identified, 30 met the inclusion criteria. Results from included studies indicated that tactile function improved in adults with stroke after transfer enhanced training (t[47]=2.75, p=0.004), stimulus specific training (p<0.001), ice therapy (F=5.71, p=0.028), mirror therapy (F=7.7, p=0.009), and functional deafferentation using an anaesthetic cream (t=3.76; p<0.01). No intervention reported improvement in tactile dysfunction for children with CP. INTERPRETATION: Research is required to develop tactile interventions for children with CP that integrate methodology from effective approaches for adults after stroke. Stimulus specific training, transfer enhanced training, and mirror therapy are promising. Other approaches are less suitable for children because of invasiveness (electrical stimulation), safety (ice therapy), or limitation of bimanual function (eutectic mixture of local anaesthetics, pneumatic cuff). [ABSTRACT FROM AUTHOR]