Children and adolescents with disabilities (CAWD) represent 11% of Israeli children and adolescents. The 10 core indicators of the Global Matrix on Para Report Cards of physical activity (PA) of CAWD were used to create the 2022 Israeli Para Report Card. A panel of four experts reviewed resources and synthesized evidence of PA behaviors and policies for CAWD in Israel, converted the data to grades, and charted subcategories of language, sex, and disability across population. Data sources were surveys, reports, and memberships in sport federations and clubs. Among CAWD, levels of participation in daily PA were poor (<20%; Grade F), and participation of CAWD in sports was even lower (<10%; Grade F). A lack of environmental infrastructure may explain the low levels of participation. Females, Arabic speakers, and physiological CAWD need particular attention. Establishing governmental policies and interventions is required to increase overall PA and participation in sports among CAWD.
Yeshayahu Hutzler, Riki Tesler, Avinoam Gilad, Kwok Ng, and Sharon Barak
Salomé Aubert, Charlotte Verdot, Gilles Thöni, and Jérémy Vanhelst
The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France.
Jeongmin Lee, Kitaek Oh, Jihee Min, Seon-Young Goo, Eun-Young Lee, Kyoung June Yi, Jinmoo Heo, Joon-Sung Lee, Dong-il Kim, Wonsang Shin, Kwon-il Kim, Yeonsoo Kim, and Justin Y. Jeon
South Korea has developed its first Para Report Card on physical activity (PA) for children and adolescents with disabilities. Five national surveillance databases were used to evaluate PA indicators based on the benchmarks and grading rubric provided by Active Healthy Kids Global Alliance. Report card evaluation committees were invited to grade and assess the results using strengths, weaknesses, opportunities, and threats analysis. Five indicators (overall PA, D+; organized sports and PA, D−; active transportation, D−; physical fitness, D+; and government, A+) and one additional indicator (sleep, C−) were assigned a letter grade. The other five indicators were graded as incomplete. The Para Report Card revealed a significant gap between the behavioral-indicator grades (D− to D+) and the policy-indicator grade (A+), suggesting that government strategies and investment have not yet been translated into behavioral PA among children and adolescents with disabilities.
Kelly P. Arbour-Nicitopoulos, Nicholas Kuzik, Leigh M. Vanderloo, Kathleen A. Martin Ginis, Maeghan E. James, Rebecca L. Bassett-Gunter, Daniela Ruttle, Pinder DaSilva, Katerina Disimino, Christine Cameron, Mike Arthur, Keiko Shikako, and Amy E. Latimer-Cheung
This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada.
P. Asunta, K. Kämppi, K. Ng, A. Saari, and T. Tammelin
Finland’s 2022 Para Report Card on Physical Activity for Children and Adolescents With Disabilities includes a summary of results and grades for 10 physical activity indicators and highlights how these grades are interpreted by stakeholders. The disability classification was based on the UNICEF/Washington Group on Disability Statistics measure, Generalized Anxiety Disorder (GAD7) measure, or education status. Data between 2017 and 2021 were reviewed by 24 physical activity specialists using benchmarks adapted for data on disabilities from the Active Healthy Kids Global Alliance. The grades were assigned as follows: Overall Physical Activity, C+; Organized Sport, C; Active Play, D; Active Transportation, B; Family and Peers, C+; School, B; Community and Environment, C−; Government, A−; sedentary behavior and physical fitness were graded as incomplete. Stakeholder focus-group discussions highlighted the need for multidisciplinary cooperation and increasing competence of specialists working with children to promote a physically active lifestyle for all children.
Lee T. Atkins, Michael Lowrey, Sarah Reagor, Kirsten Walker, and Dhalston Cage
Research indicates that increasing trunk flexion may optimize patellofemoral joint loading. However, this postural change could cause an excessive Achilles tendon force (ATF) and injury risk during movement. This study aimed to examine the effects of increasing trunk flexion during stair ascent on ATF, ankle biomechanics, and vertical ground reaction force in females. Twenty asymptomatic females (age: 23.4 [2.5] y; height: 1.6 [0.8] m; mass: 63.0 [12.2] kg) ascended stairs using their self-selected and flexed trunk postures. Compared with the self-selected trunk condition, decreases were observed for peak ATF (mean differences [MD] = 0.14 N/kg; 95% confidence interval [CI], 0.06 to 0.23; Cohen d = −1.2; P = .003), average rate of ATF development (MD = 0.25 N/kg/s; 95% CI, 0.07 to 0.43; Cohen d = −0.9; P = .010), ankle plantar flexion moment (MD = 0.08 N·m/kg; 95% CI, 0.03 to 0.13; Cohen d = −1.1; P = .005), and vertical ground reaction force (MD = 38.6 N/kg; 95% CI, 20.3 to 56.90; Cohen d = −1.8; P < .001). Increasing trunk flexion did not increase ATF. Instead, this postural change was associated with a decreased ATF rate and magnitude and may benefit individuals with painful Achilles tendinopathy.
Diego Augusto Santos Silva and Carolina Fernandes da Silva
Brazil is a country member of the Para Report Card, and Brazilian researchers have frequently published information on physical activity of children and adolescents. The current study aimed to analyze the policies for the promotion of adapted physical activity to Brazilian children and adolescents with disabilities. Official government information on adapted physical activity was analyzed from the official websites. Policies were analyzed based on the Para Report Card benchmarks, and after that we used the principles of SWOT (strengths, weaknesses, opportunities, and threats) to analyze the information. Adapted physical activity is not the main focus of any of the many policies to promote physical activity for children and adolescents. Based on the Para Report Card initiative, the score for this indicator in Brazil is D. Brazil needs to develop specific policies to promote physical activity adapted to the pediatric population with disabilities.
Justin A. Haegele
Kwok Ng, Sean Healy, Wesley O’Brien, Lauren Rodriguez, Marie Murphy, and Angela Carlin
For the first time, data on children and adolescents with disabilities in Ireland are reported based on the Active Healthy Kids Global Alliance Para Report Card methodology. The most recent data from the last 10 years were used in the grading process (A+ to F), and indicators with insufficient data were graded as incomplete. Of the 10 indicators from the Global Matrix Para Report Cards, grades were assigned to Overall Physical Activity (F), Organized Sport (D), Active Transport (D−), Sedentary Behaviors (D−), Family & Peers (C), School (C−), Community & Environment (B−), and Government (B). Irish disability sport organizations were invited to assess the research-led audit and provided commentary around the final grading. The contextual discussion of the grades is presented through the lens of strengths, weaknesses, opportunities, and threats with the purpose being to provide direction for the reduction of physical activity disparities among children with disabilities.
Tess M.R. Carswell, Brenton G. Hordacre, Marc D. Klimstra, and Joshua W. Giles
Research addressing lower limb amputee gait and prosthetic design often focuses on men, despite female lower limb amputees having different risk factors and lower success with their prosthetics overall. It is widely agreed that sex differences exist in able-bodied gait, but research analyzing sex differences in amputee gait is rare. This study compared male and female transtibial amputee gait to ascertain potential sex differences. Forty-five transtibial amputees were asked to walk at their self-selected speed, and spatiotemporal gait data were obtained. Both the mean and variability metric of parameters were analyzed for 10 male and 10 female participants. For all participants, amputated limbs had a shorter stance time, longer swing time, and larger step length. Females had a 10% shorter stance time and 26% larger normalized step and stride length than males. Female participants also walked over 20% faster than male participants. Finally, significant interactions were found in the mean and variability metric of stride velocity, indicating greater variability in women. These findings suggest that sex differences exist in transtibial amputee gait, offering possible explanations for the different comorbidities experienced by female lower limb amputees. These results have major implications for female amputees and for sex-specific research, rehabilitation, and prosthetic design.