Physical activity in children and adolescents with cerebral palsy in Arabic speaking countries: a scoping review

Background: Cerebral palsy (CP) is the most common cause of childhood physical disability. Encouraging participation in physical activity (PA) is a core physiotherapy practice. Much of the research on PA in children with CP has been conducted in Europe, the USA and Australia however many factors including geography and culture, have an impact on PA participation. It is important to assess current knowledge of PA in children with CP in Arabic-speaking countries since they represent a distinct group that share many common cultural, social, religious, and dietary habits.

Purpose: ​This scoping review aims to describe the extent and nature of the available evidence addressing PA in children aged 0-18 years with CP in Arabic-speaking countries. Specifically:1. What are the patterns of PA in children with CP in Arabic-speaking countries?2. What influences participation in PA for children with CP?3. What interventions aiming to increase the PA of children with CP in Arabic-speaking countries have been reported in the literature to date?

Methods: This scoping review used Arksey and O’Malley’s five-stage framework. Firstly, research questions were specified. Secondly, potentially relevant studies were identified using a systematic search. Search terms were identified using the population (children with CP aged 0-18 years), concepts (PA) and context (studies that provide information about any aspect of PA in Arabic-speaking countries) approach. OVID MEDLINE, EMBASE, PsychInfo and CINAHL databases were searched from January 2000 to August 2022. Thirdly, retrieved studies were independently screened by two reviewers against pre-defined inclusion criteria. Fourthly, data from included papers were charted independently by two reviewers using the Joanna Briggs Institute data extraction tool. Finally, results were collated, summarised and reported.

Results: Five articles met the inclusion criteria. Studies included participants resident in Israel, Jordan and Palestine. Four were cross-sectional studies and one was a randomised controlled trial. PA patterns were reported in two studies with significant differences in activity duration, number of events, diversity and intensity between children with CP of different functional levels, and between children with CP and their typically developing peers, noted. Two studies reported on factors influencing participation in PA. Frequency of participation was associated with a number of variables including the child’s age, sex, school attendance, body weight and motor ability. The intervention study included in the review reported improvements in PA levels and mobility, and that group training was preferred to individual training.

Conclusion(s): Very few studies that describe patterns of PA and interventions to increase PA participation in children with CP in Arabic-speaking countries have been conducted. Findings in relation to patterns of PA were similar to those reported internationally. No studies sought to explore child and family preferences for physical activities, nor investigate in more details the pattern of PA in this population.

Implications: This scoping review evidences the need for further investigation of PA patterns, preferences, and barriers and facilitators to PA participation in children with CP resident in Arabic-speaking countries to inform the development of culturally appropriate interventions to increase PA participation in this population.