Barriers impacting on participation in physical activity for children with osteogenesis imperfecta: a study of child and parent perspectives

Background: Physical activity is often recommended as part of the management plan for children with Osteogenesis Imperfecta (OI) in an effort to improve not only general health and wellbeing, but also bone health specifically. However, despite the importance of physical activity for children with OI, there has been no study to date that has examined factors that may impact on participation in physical activity in this population. Only one study to date has examined physical activity specifically in children with OI, and this study included only 14 participants.
Purpose: This study aimed to answer the following questions: (1) What barriers impact on participation in physical activity in children with osteogenesis imperfecta (OI), from child and parent perspectives? (2) Is there congruence between the barriers identified by children and their parents? (3) Is there any association between the reported barriers and the amount of physical activity undertaken by these children?
Methods: This study was a cross­sectional, observational study undertaken as part of a larger project ­ The OI Active Study. Child and parent specific questionnaires were used to identify attitudes and frequency of barriers to physical activity. Objective physical activity measures were recorded for seven consecutive days using the Actigraph GT3XE to record average daily moderate­vigorous physical activity (MVPA), and the ActivPAL to record average daily step count, and sedentary time.
Results: Data collection for this study is currently continuing, due for completion in December 2016. To date there are 52 participants enrolled in the study. Preliminary data analysis was conducted on 27 participants, aged 7­17 years, with a confirmed diagnosis of OI. Children reported an average of 8 barriers, with advice from a health care professional to avoid physical activity for safety reasons (70%) being the most frequently identified. For parents, fear that physical activity will cause their child pain (78%) or to fracture (78%) were the most frequently reported barriers. There was a moderate correlation between overall frequency of barriers reported by children and their parents (T_b = .327, p = .024) but no significant correlation between the frequency of barriers identified by
children or parents and average daily MVPA (T_b = ­.053, p = .784, T_b = ­.122, p = .524 respectively). Full data analysis will be presented at the conference.
Conclusions: This is the first study to examine barriers to physical activity in an OI population, and the largest to objectively assess physical activity levels in children with OI. Further conclusions will be presented at the conference following analysis of the full data set.
Implications: Preliminary results suggest health professionals should closely consider how physical activity recommendations are delivered to families to ensure children with OI understand how to maximise physical activity while maintaining safety, and to reduce parent fears.
Key words: Physical activity; Osteogenesis imperfecta; Barriers
Funding provided by the Osteogenesis Imperfecta Society of Australia.
Ethics approval was gained from the Sydney Children ́s Hospital Network and from Macquarie University Human Ethics Committee (Medical Sciences).