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Results From Spain’s 2022 Para Report Cards on Physical Activity of Children and Adolescents With Disabilities

José Francisco López-Gil, Susana Aznar, Blanca Roman-Viñas, Javier Brazo-Sayavera, Rocío Izquierdo-Gómez, Sabina Barrios-Fernández, Olga Rodríguez Ferrán, and Salome Aubert

This report aims to provide a better understanding of physical activity (PA) and related factors among Spanish children and adolescents living with disabilities. The 10 indicators used for the Global Matrix on Para Report Cards of children and adolescents living with disabilities were evaluated based on the best available data in Spain. An analysis of strengths, weaknesses, opportunities, and threats based on data provision was drafted by three experts and critically reviewed by the authorship team to provide a national perspective for each evaluated indicator. Government was the indicator with the highest grade (C+), followed by Sedentary Behaviors (C−), School (D), Overall PA (D−), and Community & Environment (F). The remaining indicators received an incomplete grade. There were low levels of PA in Spanish children and adolescents living with disabilities. Yet, opportunities to improve the current surveillance of PA among this population exist.

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Effects of a Conventional Treatment Plus Scapular Exercises Program in Patients With Chronic Lateral Elbow Tendinopathy: A Pre−Post Single-Group Study

Héctor Gutiérrez-Espinoza, Evelin Estrella-Flores, Iván Cuyul-Vásquez, Rene Jorquera-Aguilera, José Francisco López-Gil, and Felipe Araya-Quintanilla

Background: Weakness of the shoulder girdle muscles has been reported in patients with chronic lateral elbow tendinopathy. The aim of this study was to assess the short- and long-term effects of a conventional treatment plus scapular exercises program in patients with chronic lateral elbow tendinopathy. Methods: A single-group prestudy and poststudy were conducted. The primary outcome was the Patient-Rated Tennis Elbow Evaluation questionnaire score. Secondary outcomes were grip strength; Disabilities of the Arm, Shoulder, and Hand questionnaire score; Visual Analogue Scale score at rest and at grip, and presence of scapular dyskinesis. Results: A total of 65 patients (72.3% females), with a mean age of 41.8 years, were analyzed. At the end of 6 weeks, the results showed clinically and statistically significant differences (P < .05). At 1-year follow-up, the differences were: Patient-Rated Tennis Elbow Evaluation −31 points (P < .001); grip strength +33.6% (P < .001); Disabilities of the Arm, Shoulder, and Hand −34.2 points (P < .001); Visual Analogue Scale at rest −2.5 cm (P < .001); and Visual Analogue Scale at grip −2.3 cm (P < .001). Conclusion: At the end of 6 weeks and at 1-year follow-up, conventional treatment plus scapular exercises program showed statistically and clinically significant differences in all functional outcomes assessed in patients with lateral elbow tendinopathy.

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“WOT” Do We Know and Do About Physical Activity of Children and Adolescents With Disabilities? A SWOT-Oriented Synthesis of Para Report Cards

Yeshayahu Hutzler, Sharon Barak, Salomé Aubert, Kelly Arbour-Nicitopoulos, Riki Tesler, Cindy Sit, Diego Augusto Santos Silva, Piritta Asunta, Jurate Pozeriene, José Francisco López-Gil, and Kwok Ng

The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.

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Global Matrix of Para Report Cards on Physical Activity of Children and Adolescents With Disabilities

Kwok Ng, Cindy Sit, Kelly Arbour-Nicitopoulos, Salomé Aubert, Heidi Stanish, Yeshayahu Hutzler, Diego Augusto Santos Silva, Mary-Grace Kang, José Francisco López-Gil, Eun-Young Lee, Piritta Asunta, Jurate Pozeriene, Piotr Kazimierz Urbański, Nicolas Aguilar-Farias, and John J. Reilly

This is an overview of the results from 14 countries or jurisdictions in a Global Matrix of Para Report Cards on physical activity (PA) of children and adolescents with disabilities. The methodology was based on the Active Healthy Kids Global Alliance’s Global Matrix 4.0. Data were aligned with 10 indicators (Overall PA, Organized Sport, Active Play, Active Transport, Physical Fitness, Sedentary Behavior, Family & Peers, Schools, Community & Environment, and Government) to produce Para Report Cards. Subsequently, there were 139 grades; 45% were incomplete, particularly for Active Play, Physical Fitness, and Family & Peers. Collectively, Overall PA was graded the lowest (F), with Schools and Government the highest (C). Disability-specific surveillance and research gaps in PA were apparent in 14 countries or jurisdictions around the world. More coverage of PA data in Para Report Cards is needed to serve as an advocacy tool to promote PA among children and adolescents with disabilities.

Open access

Promoting Physical Activity Among Children and Adolescents With Disabilities: The Translation of Policy to Practice Internationally

Cindy Sit, Salomé Aubert, Catherine Carty, Diego Augusto Santos Silva, José Francisco López-Gil, Piritta Asunta, Yves Palad, Roselle Guisihan, Jeongmin Lee, Kelly P. Arbour Nicitopoulos, Leigh M. Vanderloo, Heidi Stanish, Justin Haegele, Piotr K. Urbański, Jurate Pozeriene, Yeshayahu Hutzler, and Kwok Ng

Background: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice. Methods: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared. Results: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D−) and the government indicator (C+) was found in the Para Report Card data. Conclusions: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.

Open access

Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries

Salomé Aubert, Joel D. Barnes, Iryna Demchenko, Myranda Hawthorne, Chalchisa Abdeta, Patrick Abi Nader, José Carmelo Adsuar Sala, Nicolas Aguilar-Farias, Susana Aznar, Peter Bakalár, Jasmin Bhawra, Javier Brazo-Sayavera, Mikel Bringas, Jonathan Y. Cagas, Angela Carlin, Chen-Kang Chang, Bozhi Chen, Lars Breum Christiansen, Candice Jo-Anne Christie, Gabriela Fernanda De Roia, Christine Delisle Nyström, Yolanda Demetriou, Visnja Djordjic, Arunas Emeljanovas, Liri Findling Endy, Aleš Gába, Karla I. Galaviz, Silvia A. González, Kylie D. Hesketh, Wendy Yajun Huang, Omphile Hubona, Justin Y. Jeon, Danijel Jurakić, Jaak Jürimäe, Tarun Reddy Katapally, Piyawat Katewongsa, Peter T. Katzmarzyk, Yeon-Soo Kim, Estelle Victoria Lambert, Eun-Young Lee, Sharon Levi, Pablo Lobo, Marie Löf, Tom Loney, José Francisco López-Gil, Juan López-Taylor, Evelin Mäestu, Agus Mahendra, Daga Makaza, Marla Frances T. Mallari, Taru Manyanga, Bojan Masanovic, Shawnda A. Morrison, Jorge Mota, Falk Müller-Riemenschneider, Laura Muñoz Bermejo, Marie H. Murphy, Rowena Naidoo, Phuong Nguyen, Susan Paudel, Željko Pedišić, Jorge Pérez-Gómez, John J. Reilly, Anne Kerstin Reimers, Amie B. Richards, Diego Augusto Santos Silva, Pairoj Saonuam, Olga L. Sarmiento, Vedrana Sember, Mohd Razif Shahril, Melody Smith, Martyn Standage, Gareth Stratton, Narayan Subedi, Tuija H. Tammelin, Chiaki Tanaka, Riki Tesler, David Thivel, Dawn Mahube Tladi, Lenka Tlučáková, Leigh M. Vanderloo, Alun Williams, Stephen Heung Sang Wong, Ching-Lin Wu, Paweł Zembura, and Mark S. Tremblay

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.