Sedentary behavior and children with physical disabilities: a scoping review

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Purpose The aim of this review was to summarize research regarding sedentary behavior in children with physical disabilities related to (1) sedentary behavior patterns, (2) measurement of sedentary behavior, and (3) current state of the evidence regarding the effectiveness of interventions. Methods A scoping review was conducted using established scoping review methodology. Articles were eligible for inclusion if participants were 0–18 years of age, had physical disabilities, and the focus of the research was on sedentary behavior patterns, measurement of sedentary behavior or evaluation of interventions to decrease sedentary behavior. Results The majority of included studies (n = 36) were observational and described sedentary behavior patterns (n = 29), primarily with children with cerebral palsy (n = 22). Accelerometry was frequently used to measure sedentary behavior for ambulatory children; however, questionnaires, surveys and interviews were also used. Few studies (n = 3) conducted to evaluate interventions for decreasing sedentary behavior were included; existing evidence does not support effectiveness of strategies to reduce sedentary behavior in children with physical disabilities. Few studies addressed sedentary behavior in younger children or children who use wheelchairs. Conclusions Evaluation of interventions to decrease sedentary behavior in children with physical disabilities is needed. Future research should also address measurement of physical activity with children who use wheelchairs as their primary method of mobility. Implications for rehabilitation Intervention strategies to decrease sedentary behavior are increasingly discussed; however, additional research is needed to evaluate effectiveness. Strategies for addressing sedentary behavior should expand to include consideration of lengths of sedentary bouts and breaks from sedentary behavior, and not just focus on total sedentary time. Research in this area has focused on ambulatory children; a greater research emphasis on children who are non-ambulatory is warranted. Agreement and consistent use of accelerometry protocols is recommended to advance this body of research.