Majnemer Annette, Shevell Michael, Law Mary, Birnbaum Rena, Chilingaryan Gevorg, Rosenbaum Peter, Poulin Chantal
School of Physical and Occupational Therapy, McGill University, Montreal, Canada.
Dev Med Child Neurol. 2008 Oct;50(10):751-8. doi: 10.1111/j.1469-8749.2008.03068.x.
The objective of this study was to characterize participation in leisure activities in children with cerebral palsy (CP) and identify determinants of greater involvement. Ninety-five children of school age (9y 7mo [SD 2y 1mo]) with CP were recruited, and participation was evaluated with the Children's Assessment of Participation and Enjoyment in a subset (67/95; 42 males, 25 females) who could actively participate in completion of the assessment. Most had mild motor dysfunction (Gross Motor Function Classification System: 59% level I, 23% level II, 18% levels III-V) and had a spastic subtype of CP (23 hemiplegia, 17 diplegia, 16 quadriplegia, 11 other). Biomedical, child, family and environmental predictor variables were considered in the analysis. Results demonstrated that these children were actively involved in a wide range of leisure activities and experienced a high level of enjoyment. However, involvement was lower in skill-based and active physical activities as well as community-based activities. Mastery motivation and involvement in rehabilitation services enhanced involvement (intensity and diversity) in particular leisure activities, whereas cognitive and behavioral difficulties, activity limitations, and parental stress were obstacles to participation.
本研究的目的是描述脑瘫（CP）儿童参与休闲活动的情况，并确定更高参与度的决定因素。招募了95名学龄期（9岁7个月[标准差2岁1个月]）的CP儿童，对其中能够积极参与评估的一个子集（67/95；42名男性，25名女性）进行了儿童参与和享受情况评估。大多数儿童有轻度运动功能障碍（粗大运动功能分类系统：59%为I级，23%为II级，18%为III - V级），且为痉挛型CP（23例偏瘫，17例双瘫，16例四肢瘫，11例其他）。分析中考虑了生物医学、儿童、家庭和环境预测变量。结果表明，这些儿童积极参与各种休闲活动，并体验到高度的愉悦感。然而，在基于技能的活动、积极的体育活动以及社区活动中的参与度较低。掌握动机和参与康复服务可提高在特定休闲活动中的参与度（强度和多样性），而认知和行为困难、活动受限以及父母压力是参与的障碍。
