Participation in physical activities for children with cerebral palsy: feasibility and effectiveness of physical activity on prescription.

Only 11 children were studied, and they were selected to represent different groups, so results may not apply to all children with cerebral palsy. There was no randomisation or comparison group described, so changes cannot be separated from time, development, family effort, or other support. The intervention combined physical activity on prescription, motivational interviewing, written agreements, logbooks, physiotherapist support, and self-selected activities, so the contribution of any single component cannot be separated. Outcome measures were inconvenient or problematic: the International Physical Activity Questionnaire was difficult and not validated for children with cerebral palsy, the heart-rate monitor slipped, accelerometers disturbed some children, and one child refused monitors. Physical activity measurements were not all collected in the same week, and accelerometer analysis depended on varying days of monitoring. Two authors were active in the intervention, which the paper says might imply bias. The Gross Motor Function Measure 66 may not detect change in children with mild cerebral palsy because they can already score 100% at baseline. For three children with profound intellectual disability, parents chose activities, so child preference was not fully direct.

Do not conclude that physical activity on prescription alone caused improvement. The children also received motivational interviewing, written agreements, logbooks, physiotherapist support, and self-selected activities, and there was no control group, so the contribution of any single component cannot be separated.