Barriers and facilitators to participate in physical activity for children and adolescents with Cerebral Palsy: A systematic literature review from 2009-2019

Sammanfattning: Background: Children and adolescents with Cerebral Palsy [CP] are not as physically active as their typically developing peers, which contributes to reduced physical fitness. Previous studies about participating in physical activity [PA] and disability in general have identified barriers and facilitators. However, less research has been performed targeting persons with CP, the most common physical disability in childhood. Previous studies mainly focused on the parental perspectives of their child with CP. Aim: This systematic review aimed to identify and critically review the existing literature on barriers to and facilitators for children and adolescents with CP to participate in PA. Method: A literature search was carried out in four online databases for social and health sciences to select peer-reviewed qualitative articles, identifying barriers to and facilitators for children and adolescents with CP to participate in PA. Studies were identified following the pre-established selection criteria, resulting in eight qualitative studies.  Results: Various personal and environmental factors were identified working as either barriers or facilitators, and yielded into two sub-categories and codes for personal and environmental factors. Sub-categories of identified barriers and facilitators within personal factors were physical abilities to participate in physical activity and psychological factors, and acceptance and relationships and possibilities to participate in PA within environmental factors. Conclusion: Children and adolescents with CP are facing many personal and environmental barriers and facilitators to participate in PA. Further research is needed to develop an awareness program about CP to work with them, and to investigate the number of individuals required in a team to give this group the time and attention they need to master their skills.