Environmental factors associated with participation and its related concepts among children and youth with cerebral palsy: a rapid review

Purpose To provide an overview of environmental factors associated with participation and participation-related constructs in children and youth with cerebral palsy (CP). Methods A rapid review following the principles from scoping methodology was performed with a literature search in September 2019. The CINAHL, Embase, Ovid MEDLINE and PsychINFO databases were searched to identify original articles which addressed participation in children and youth (aged 0-18) with CP. Results In total, 9511 unique articles were identified, of which 34 met all inclusion criteria. Many different measures for environmental factors were used. Most common environmental factors associated with participation (i.e., attendance and involvement) were family ecology, type of school, and parental stress. Regarding participation-related constructs (activity competence, sense of self and preferences), most common factors were parental stress and the physical environment. Conclusions While environmental factors are found to be associated with participation attendance and activity competence in children with CP, there is a lack of research of environmental factors in relation to both participation involvement and other participation-related constructs. To increase impact in clinical practice, future research should involve structured assessments of the environment and focus more on modifiable factors, to help service providers develop treatment paradigms needed for meaningful participation outcomes.