Participation in active play of children who use lower extremity prostheses: An exploratory questionnaire

Background: Through play, children develop motor, cognitive, social, and other life skills. Play barriers can impede physical and psychosocial benefits. Objectives: We describe participation in active play, fundamental movement skills, play environment characteristics, and potential play barriers for school-aged children (6-12years) who use lower extremity prostheses. Study design: Cross-sectional questionnaire study. Methods: A questionnaire was developed and administered online to parents of children 6-12years who use lower extremity prostheses. Questions focused on children's valued play activities, participation in active play, fundamental movement skills, body positions for play, and characteristics of play environments. Results: Parents (n=26) reported their children who use lower extremity prostheses participated in a range of activities including active play (e.g. playgrounds, swimming). Fundamental movement skill limitations were identified (e.g. walking long distances, running fast, hopping on one foot, and skipping). Mobility limitations with floor positions, movement transitions, and uneven or sloped surfaces were reported. Active play with equipment such as roller skating, climbing structures, and bicycling presented challenges. Conclusion: Parents of children who use lower extremity prostheses reported participation restrictions associated with mobility limitations, activity type, and built environment characteristics (e.g. surfaces and equipment). Challenges made it difficult for children who use lower extremity prostheses to keep up with peers in schools and communities. Clinical relevance Understanding potential barriers to participation in active play of children who use lower extremity prostheses may contribute to enhanced prosthetic design, rehabilitation strategies, universal design of play and built environments, and improved outcome measures ultimately enabling these children to participate fully in active play in diverse contexts.