Organized physical activity and sedentary behaviors in children and adolescents with autism spectrum disorder,cerebral palsy,and intellectual disability

BACKGROUND There is little data on physical activity(PA),organized PA(OPA),and sedentary behaviors in autism spectrum disorders(ASD)and other neurodevelopmental disorders in developing countries.AIM To examine OPA,non-OPA,and sedentary behaviors and their associated factors in children and adolescents with ASD,cerebral palsy(CP),and intellectual disability(ID).METHODS A total of 1020 children and adolescents with ASD,CP,and ID were assessed regarding the child and family information as well as the Children’s Leisure Activities Study Survey.RESULTS The results showed that the OPA level was significantly lower than non-OPA in all groups.Furthermore,the OPA level was significantly lower in the CP group compared to ASD and ID groups(P<0.001).Also,moderate(P<0.001),vigorous(P<0.05),and total(P<0.001)physical activity levels were significantly different between all three groups,with the values being higher in the ASD group compared to the other two.The mean of the total sedentary behavior duration in the ASD group(1819.4 min/week,SD:1680)was significantly lower than in the CP group(2687 min/week,SD:2673)(P=0.007)but not ID group(2176 min/week,SD:2168.9)(P=0.525).CONCLUSION Our findings remark on the participation rate of PA,OPA,and sedentary behaviors of children and adolescents with ASD,CP,and ID in a developing country.In contrast,the need for developing standards of PA/OPA participation in neurodevelopmental disorders is discussed.

Investigating the Relationships among Leisure, Coping, and Personal Growth among People with Physical Disabilities

Little information exists with regard to the relationship between leisure and coping mechanisms among people with physical disabilities.The purpose of this study is to investigate the relationships among leisure,coping,and personal growth among people with physical disabilities living in the U.S.Using a purposive sampling strategy,121 participants completed all 3 instruments:assessment of leisure and recreation involvement,coping strategy indicator,and personal growth.Frequency,descriptive analysis,Pearson correlations,and path analysis were utilized to test the relationship between leisure involvement,coping strategies,and personal growth.There were statistically significant direct effects of leisure involvement and avoidance-withdrawal coping strategies on personal growth.The effects of social support seeking coping strategies and problem-solving coping strategies on personal growth were not statistically significant.Results also indicated that leisure involvement had significant direct effects on social support seeking,avoidance-withdrawal,and problem-solving coping strategies.The results demonstrated that leisure engagement was associated with coping strategies and personal growth.In particular,leisure engagement had direct effects on problem-solving coping,social seeking coping,and avoidance/withdrawal coping as well as a direct effect on personal growth.

Access to Supportive Health Services for People with Physical Disabilities: A Case of Health Facilities in Singida Rural District, Tanzania

Background: It is estimated that above one billion people (15%) of the world’s populations are living with disabilities. The poor and unfriendly infrastructure at health facilities is the core challenge for people with physical disabilities in accessing healthcare. This study aimed to explore at what extent the existing infrastructure and design of health facilities in Singida rural district, Tanzania supports people with physical disabilities to access healthcare. Methods: A cross sectional health facility-based assessment of all thirty-two functioning health facilities in the district was done between June and December 2020 using observational checklist and key informants’ interviews consist of measurement procedures of the architectural condition of health facilities. Observation checklist was designed based on standard of health facilities in Tanzania, national guideline for safe care standards for dispensaries, health centers and district hospital of 2014 and national guideline for water, sanitation and hygiene in healthcare facilities of 2017. Data were analyzed by SPSS-26 using descriptive statistics to obtain frequencies tables, percentage and figure. Qualitative data were analyzed by using NVivo-12 software. Results: The study revealed that there was no signage, entrance area, parking and toilets designated for people with physical disabilities in all health facilities. There was no special seat, examination table/bed and special weight scale for people with physical disabilities in all facilities. Also, the doors were not wide enough to support wheelchair user to maneuver in all health centers and dispensaries. In addition, door handles were not user friendly for wheelchair users. In fact, only the hospital and health centers had wheelchairs while 27 (96.4%) of all dispensaries had no wheelchairs. Furthermore, ramp and pathways were not available in all dispensaries. All health facilities had stairs but the challenge was most of the staircases had no floor located before the steps. Conclusion: The study revealed that the infrastructures in most healthcare facilities pose challenges to people with physical disabilities when they access healthcare services. These findings call for need of improving health facilities’ infrastructure to accommodate people with physical disabilities and this should be given a priority.

Disability progression among leprosy patients released from treatment:a survival analysis

Background:Leprosy can be cured,but physical disability(PD)as a result of the infection can progress in the postrelease from treatment phase.This study evaluated the likelihood of,and factors associated with,the progression of the PD grade post-release from treatment among leprosy patients treated in Cáceres-MT,Brazil in the period 2000 to 2017.Methods:A retrospective cohort study and survival analysis were performed in the hyperendemic municipality of Cáceres in the state of Mato Grosso.The study population consisted of newly diagnosed leprosy patients released from treatment between January 1,2000 and December 31,2017.The main outcome was the progression of the PD grade with regard to probability and time;and the evaluated covariates included clinical,operational and demographic variables.The Cox proportional risk model was used to estimate the risk ratio(Hazard Ratios)of the covariates.Both an univariate and a multivariate analysis were implemented,with 95%confidence intervals.Results:The mean time for progression of the PD grade was 162 months for PB and 151 months for MB leprosy patients.The survival curve showed that 15 years after the release from treatment,the probability of PD grade progression was 35%,with no difference between PB and MB or age groups.Leprosy reactions and registered medical complaints of any kind during treatment were identified as risk factors with Hazard Ratios of 1.6 and 1.8 respectively.Conclusions:People released from treatment as cured of leprosy are susceptible to worsening of the PD,especially those who have had complications during multi-drug therapy treatment.This indicates that leprosy patients should be periodically monitored,even after the successful completion of multidrug therapy.