Impacting Children's Physical and Mental Health Through Kinesiology Support in Clinical Care
Condition: Congenital Heart Defect; Chronic Pain; Concussion Post Syndrome; Cerebral Palsy; Neuromuscular Diseases; Physical Disability
MeSH terms: Cerebral Palsy; Neuromuscular Diseases; Post-Concussion Syndrome; Heart Defects, Congenital; Chronic Pain
Study type: Interventional

Summary: 
      Over the past four decades, it has become clear that childhood physical activity carries with
      it a myriad of beneficial effects. It is closely linked to quality of life and the recognized
      benefits include, but are not limited to, optimal growth and development, a healthier
      self-concept, enhanced peer socialization, and decreased anxiety and depression. Long term,
      an active lifestyle decreases the risk of many important physical and mental morbidities.
      Thus, the observation that children living with medical conditions and disabilities (MC&D)
      today, although surviving longer thanks to advances in medical care, are much less active
      than their peers is a matter of significant concern. Research indicates that the 350,000
      Ontario children with MC&D have lower levels of physical activity, higher screen time and
      more frequent sleep problems.

      While the reasons underlying this reality are complex, previous research has identified a
      substantial subset of children who are motivated to be active but lack the confidence to do
      so. Fear of pain, concern for MC&D exacerbation and a lack of confidence in individual
      physical movement capacity contribute to their hesitation. Clinical experience suggests that
      these children represent 50% to 70% of inactive patients. Research indicates that being
      motivated to make a change and having the confidence that the desired change can be achieved
      are the essential precursors upon which successful behaviour change initiatives are built.
      This randomized, controlled trial will explore whether group sessions with a Registered
      Kinesiologist lead to a direct bolstering of physical activity confidence, and in turn to
      increased and sustained physical activity in these children. Such an approach holds the
      promise of a nonpharmacologic, low cost and accessible means of enhancing health that shall
      be met with a high level of patient and family support while bringing a significant societal
      and medical return on investment.
    

Detailed description: 
      Children living with medical conditions are often unsure about engaging in active play with
      friends and peers. Some children are worried that physical activity will increase symptoms of
      their existing illness and increase overall pain. Other children are unable to keep up with
      peers, or perceive themselves as not good enough to play. This research study will
      investigate children with medical conditions or disabilities can be supported to become more
      confident in one' abilities to play actively with their friends. Children who come to our
      rehabilitation, long term concussion, chronic pain and cardiology clinics will be invited to
      participate in this project. Children who agree to participate will be assessed three times,
      in the 1st, 14th and 27th week of the study. During each assessment, children will be asked
      to complete a short questionnaire about activity preferences and motivation. The child will
      be given a small activity monitor, about the size of a toonie, which is worn on a belt around
      the waist. Each child will be asked to wear the monitor for 7 days before returning it to the
      investigators. After the 1st week of the study, a coin flip will decide the study group for
      each child. Children in the control group will only do the three assessment visits. Children
      selected for the exercise group will come to a group physical activity session that will be
      held once a week for 12 weeks. At each of the 12 sessions, children will be able to try some
      active games and sports that are suitable for their medical condition or disability. There
      will be a group of about 8 children, who have similar interests and concerns about physical
      activity, at each session. The 12 weekly sessions will each be 2.5 hours in length. The study
      will evaluate how the children's physical activity and confidence to be active change over
      the 27 weeks, and compare the changes that occur between the children who do or do not attend
      the 12 weekly physical activity sessions. The results will indicate whether the 12 weekly
      sessions effectively increase the physical activity confidence of children with medical
      conditions and disabilities.
    

Intervention name(s): Kinesiology Support
Intervention type(s): Behavioral
Intervention description(s): 12 week physical activity group led by Kinesiologist. The intervention will be used to increase confidence in the participants by providing physical activity education and a variety of activities.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Physical Activity; Activity Motivation; Activity Confidence; Children; Adolescents; Sleep; Screen Time