Skip to main content
Log in

Family Impact on Physical Activity Level and Participation of School-Age Children with Duchenne Muscular Dystrophy

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

Duchenne Muscular Dystrophy (DMD) is a devastating neuromuscular disease of childhood which is characterized by progressive muscle weakness that limits the functional activities of daily life in course of time and result in decreased quality of life. The benefits of increasing the physical activity (PA) level and participation on general health status in children with DMD was previously mentioned in literature. Parents have been reported to have an important impact on their child’s beliefs, attitudes, and behaviors in many dimensions of development throughout their lives. Studies showed that there was a significant correlation between parental impact and child’s PA level and participation in healthy children. The aim of this study was to investigate the family impact on PA level, interest in PA, and participation level of their school-age children with Duchenne Muscular Dystrophy (DMD). This cross-sectional, observational study included a total of 30 ambulatory children between 8 and 18 years of age (mean: 8.70 ± 0.84). Physical Activity Questionnaire for Older Children (PAQ-C) and pedometer were used to assess PA level of children while International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to determine the PA level of parents. Children’s Attraction to Physical Activity (CAPA), Pediatric Outcome Data Collection Instrument (PODCI), and Children’s Physical Activity Correlates (CPAC) questionnaires were also used to evaluate interest in PA, participation level, and family impact on PA level of children, respectively. Low-to-moderate correlations were determined between family impact sub-score of CPAC and PAQ-C, CAPA and PODCI while moderate correlation was found between PAQ-C and parents’ IPAQ-SF score (p < 0.05). This study revealed the importance of parents’ support and encouragement as well as their own PA habit in shaping their child’s behaviors and attitudes towards PA in an early-stage, school-aged DMD population. In order to achieve the goal of increasing PA level and participation of children with DMD, a family-centered rehabilitation approach may be more effective. Clinical Trial Registration Number NCT05209087; Date: 25.01.2022.

Highlights

  • School-age children with DMD had moderate PA and participation levels as well as moderate interest in PA.

  • Parents, especially the primary caregiver, had a significant impact on PA level and participation of DMD children.

  • The PA levels of the parents had an impact on the PA level of children with DMD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Arakelyan, S., Maciver, D., Rush, R., O’Hare, A., & Forsyth, K. (2020). Community‐based participation of children with and without disabilities. Developmental Medicine & Child Neurology, 62(4), 445–453.

    Article  Google Scholar 

  • Arteaga, D., Donnelly, T., Crum, K., Markham, L., Killian, M., Burnette, W. B., Soslow, J., & Buchowski, M. S. (2020). Assessing physical activity using accelerometers in youth with Duchenne muscular dystrophy. Journal of Neuromuscular Diseases, 7(3), 331–342.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bassett-Gunter, R., Tanna, S., Arbour-Nicitopoulos, K., Rhodes, R. E., & Leo, J. (2020). Understanding parent support for physical activity among parents of children and youth with disabilities: a behaviour change theory perspective. European Journal of Adapted Physical Activity, 13(2), 1–16.

    Article  Google Scholar 

  • Bayer, A. (2020). Modernleşme sürecinde aile: değişen annelik ve babalik. Tevilat, 1(1), 35–60.

    Google Scholar 

  • Beets, M. W., Cardinal, B. J., & Alderman, B. L. (2010). Parental social support and the physical activity-related behaviors of youth: a review. Health Education & Behavior, 37(5), 621–644.

    Article  Google Scholar 

  • Bendixen, R. M., Senesac, C., Lott, D. J., & Vandenborne, K. (2012). Participation and quality of life in children with Duchenne muscular dystrophy using the International Classification of Functioning, Disability, and Health. Health and Quality of Life Outcomes, 10(1), 1–9.

    Article  Google Scholar 

  • Birnkrant, D. J., Bushby, K., Bann, C. M., Alman, B. A., Apkon, S. D., Blackwell, A., Case, L. E., Cripe, L., Hadjiyannakis, S., & Olson, A. K. (2018). Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. The Lancet Neurology, 17(4), 347–361.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bloemen, M. A., Backx, F. J., Takken, T., Wittink, H., Benner, J., Mollema, J., & De Groot, J. F. (2015). Factors associated with physical activity in children and adolescents with a physical disability: a systematic review. Developmental Medicine & Child Neurology, 57(2), 137–148.

    Article  Google Scholar 

  • Brustad, R. J. (1993). Who will go out and play? Parental and psychological influences on children’s attraction to physical activity. Pediatric Exercise Science, 5(3), 210–223.

    Article  Google Scholar 

  • Can, S., Gündüz, N., Arslan, E., Biernat, E., Ersöz, G., & Kilit, B. (2016). Multi-instrument assessment of physical activity in female office workers. International Journal of Occupational Medicine and Environmental Health, 29(6), 937–945.

    Article  PubMed  Google Scholar 

  • Carey, H., & Long, T. (2012). The pediatric physical therapist’s role in promoting and measuring participation in children with disabilities. Pediatric Physical Therapy, 24(2), 163–170.

    Article  PubMed  Google Scholar 

  • Chien, C.-W., & Lin, C.-Y. (2021). Community participation of school-age children: who is at risk of restricted participation? Physical & Occupational Therapy In Pediatrics, 41(5), 447–463.

    Article  Google Scholar 

  • Cox, M. J., & Paley, B. (2003). Understanding families as systems. Current Directions in Psychological Science, 12(5), 193–196.

    Article  Google Scholar 

  • Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., Pratt, M., Ekelund, U., Yngve, A., & Sallis, J. F. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395.

    Article  PubMed  Google Scholar 

  • Crisafulli, S., Sultana, J., Fontana, A., Salvo, F., Messina, S., & Trifirò, G. (2020). Global epidemiology of Duchenne muscular dystrophy: an updated systematic review and meta-analysis. Orphanet Journal of Rare Diseases, 15(1), 1–20.

    Article  Google Scholar 

  • Daltroy, L. H., Liang, M. H., Fossel, A. H., & Goldberg, M. J. (1998). The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Journal of Pediatric Orthopaedics, 18(5), 561–571.

    Article  PubMed  Google Scholar 

  • Davidson, Z. E., Ryan, M. M., Kornberg, A. J., Walker, K. Z., & Truby, H. (2015). Strong correlation between the 6-minute walk test and accelerometry functional outcomes in boys with Duchenne muscular dystrophy. Journal of Child Neurology, 30(3), 357–363.

    Article  PubMed  Google Scholar 

  • Di Marino, E., Tremblay, S., Khetani, M., & Anaby, D. (2018). The effect of child, family and environmental factors on the participation of young children with disabilities. Disability and Health Journal, 11(1), 36–42.

    Article  PubMed  Google Scholar 

  • Diaz, K. (2020). Physical inactivity among parents of children with and without Down syndrome: the National Health Interview Survey. Journal of Intellectual Disability Research, 64(1), 38–44.

    Article  PubMed  Google Scholar 

  • Dilbay, N., Kerem Güne, M., & Aktan, T. (2013). Reliability and validity of Turkish version of Pediatric Outcome Data Collection Instrument (PODCI) for people with cerebral palsy. Turkish Journal of Physiotherapy Rehabilitation-Turk Fizyoterapi ve Rehabilitasyon Dergisi, 24(1), 118–126.

    Google Scholar 

  • Duan, D., Goemans, N., Takeda, S. I., Mercuri, E., & Aartsma-Rus, A. (2021). Duchenne muscular dystrophy. Nature Reviews Disease Primers, 7(1), 1–19.

    Article  Google Scholar 

  • Erdim, L., Ergün, A., & Kuğuoğlu, S. (2019). Reliability and validity of the Turkish version of the Physical Activity Questionnaire for Older Children (PAQ-C). Turkish Journal of Medical Sciences, 49(1), 162–169.

    Article  PubMed  PubMed Central  Google Scholar 

  • He, Q., Ha, A. S., Ng, J. Y., Cairney, J., & Bedard, C. (2022). Associations between parent perceived social cognitive factors and child objectively measured physical activity behaviors among preschool-aged children. Psychology of Sport and Exercise, 61, 102200.

    Article  Google Scholar 

  • Heutinck, L., Kampen, N. V., Jansen, M., & Groot, I. J. D. (2017). Physical activity in boys with Duchenne muscular dystrophy is lower and less demanding compared to healthy boys. Journal of Child Neurology, 32(5), 450–457.

    Article  PubMed  Google Scholar 

  • Jago, R., Davison, K. K., Brockman, R., Page, A. S., Thompson, J. L., & Fox, K. R. (2011). Parenting styles, parenting practices, and physical activity in 10-to 11-year olds. Preventive Medicine, 52(1), 44–47.

    Article  PubMed  PubMed Central  Google Scholar 

  • Jeannet, P.-Y., Aminian, K., Bloetzer, C., Najafi, B., & Paraschiv-Ionescu, A. (2011). Continuous monitoring and quantification of multiple parameters of daily physical activity in ambulatory Duchenne muscular dystrophy patients. European Journal of Paediatric Neurology, 15(1), 40–47.

    Article  PubMed  Google Scholar 

  • Kang, M., Bjornson, K., Barreira, T. V., Ragan, B. G., & Song, K. (2014). The minimum number of days required to establish reliable physical activity estimates in children aged 2–15 years. Physiological Measurement, 35(11), 2229.

    Article  PubMed  Google Scholar 

  • Kowalski, K. C., Crocker, P. R., & Faulkner, R. A. (1997). Validation of the physical activity questionnaire for older children. Pediatric Exercise Science, 9(2), 174–186.

    Article  Google Scholar 

  • Ku, B., MacDonald, M., Hatfield, B., & Gunter, K. B. (2020). Parental influences on parent-reported motor skills in young children with developmental disabilities. Disability and Health Journal, 13(3), 100910.

    Article  PubMed  Google Scholar 

  • Landfeldt, E., Edstroem, J., Buccella, F., Kirschner, J., & Lochmueller, H. (2018). Duchenne muscular dystrophy and caregiver burden: a systematic review. Developmental Medicine & Child Neurology, 60(10), 987–996.

    Article  Google Scholar 

  • Landry, B. W., & Driscoll, S. W. (2012). Physical activity in children and adolescents. PM&R, 4(11), 826–832.

    Article  Google Scholar 

  • Lee, M. H., Park, C., Matthews, A. K., & Hsieh, K. (2017). Differences in physical health, and health behaviors between family caregivers of children with and without disabilities. Disability and Health Journal, 10(4), 565–570.

    Article  PubMed  Google Scholar 

  • Li, R., Sit, C. H., Jane, J. Y., Duan, J. Z., Fan, T. C., McKenzie, T. L., & Wong, S. H. (2016). Correlates of physical activity in children and adolescents with physical disabilities: a systematic review. Preventive Medicine, 89, 184–193.

    Article  PubMed  Google Scholar 

  • Loprinzi, P. D., Schary, D. P., Beets, M. W., Leary, J., & Cardinal, B. J. (2013). Association between hypothesized parental influences and preschool children’s physical activity behavior. American Journal of Health Education, 44(1), 9–18.

    Article  Google Scholar 

  • Loprinzi, P. D., & Trost, S. G. (2010). Parental influences on physical activity behavior in preschool children. Preventive Medicine, 50(3), 129–133.

    Article  PubMed  Google Scholar 

  • Lott, D. J., Taivassalo, T., Senesac, C. R., Willcocks, R. J., Harrington, A. M., Zilke, K., Cunkle, H., Powers, C., Finanger, E. L., & Rooney, W. D. (2021). Walking activity in a large cohort of boys with Duchenne muscular dystrophy. Muscle & Nerve, 63(2), 192–198.

    Article  Google Scholar 

  • McDonald, C. M. (2002). Physical activity, health impairments, and disability in neuromuscular disease. American Journal of Physical Medicine & Rehabilitation, 81(11), S108–S120.

    Article  Google Scholar 

  • McDonald, C. M., McDonald, D. A., Bagley, A., Sienko Thomas, S., Buckon, C. E., Henricson, E., Nicorici, A., & Sussman, M. D. (2010). Relationship between clinical outcome measures and parent proxy reports of health-related quality of life in ambulatory children with Duchenne muscular dystrophy. Journal of Child Neurology, 25(9), 1130–1144.

    Article  PubMed  PubMed Central  Google Scholar 

  • McDonald, C. M., Widman, L. M., Walsh, D. D., Walsh, S. A., & Abresch, R. T. (2005). Use of step activity monitoring for continuous physical activity assessment in boys with Duchenne muscular dystrophy. Archives of Physical Medicine and Rehabilitation, 86(4), 802–808.

    Article  PubMed  Google Scholar 

  • Merder-Coskun, D., Kenis-Coskun, O., Celenlioğlu, A. E., Akman, M., Karadag-Saygi, E., & Uzuner, A. (2016). Reliability of cross-cultural adapted Turkish version of the Pediatric Outcomes Data Collection Instrument (PODCI). Journal of Pediatric Rehabilitation Medicine, 9(2), 101–105.

    Article  PubMed  Google Scholar 

  • Muñoz-Galiano, I. M., Connor, J. D., Gómez-Ruano, M. A., & Torres-Luque, G. (2020). Influence of the parental educational level on physical activity in schoolchildren. Sustainability, 12(9), 3920.

    Article  Google Scholar 

  • Murat, H. (2011). Basic statistics for health research. Omega Araştırma.

  • Norton, D. E., Froelicher, E. S., Waters, C. M., & Carrieri-Kohlman, V. (2003). Parental influence on models of primary prevention of cardiovascular disease in children. European Journal of Cardiovascular Nursing, 2(4), 311–322.

    Article  PubMed  Google Scholar 

  • Omron HJ-321 User Manual - Page 1 of 23. (n.d.). Manualsbrain.com. https://manualsbrain.com/en/manuals/1001586/.

  • Organization, W. H. (2007). International classification of functioning, disability, and health: children & youth version: ICF-CY. World Health Organization.

  • Pugliese, J., & Tinsley, B. (2007). Parental socialization of child and adolescent physical activity: a meta-analysis. Journal of Family Psychology, 21(3), 331.

    Article  PubMed  Google Scholar 

  • Rachele, J. N., Cuddihy, T. F., Washington, T. L., & McPhail, S. M. (2017). Adolescent’s perceptions of parental influences on physical activity. International Journal of Adolescent Medicine and Health, 29(3), 20150093.

    Google Scholar 

  • Rebold, M. J., Lepp, A., Kobak, M. S., McDaniel, J., & Barkley, J. E. (2016). The effect of parental involvement on children’s physical activity. The Journal of Pediatrics, 170, 206–210. https://doi.org/10.1016/j.jpeds.2015.11.072.

    Article  PubMed  Google Scholar 

  • Rhodes, R., Perdew, M., & Malli, S. (2020). Correlates of parental support of child and youth physical activity: a systematic review. International Journal of Behavioral Medicine, 27. https://doi.org/10.1007/s12529-020-09909-1.

  • Rimmer, J. A., & Rowland, J. L. (2008). Physical activity for youth with disabilities: a critical need in an underserved population. Developmental Neurorehabilitation, 11(2), 141–148.

    Article  PubMed  Google Scholar 

  • Saglam, M., Arikan, H., Savci, S., Inal-Ince, D., Bosnak-Guclu, M., Karabulut, E., & Tokgozoglu, L. (2010). International physical activity questionnaire: reliability and validity of the Turkish version. Perceptual and Motor Skills, 111(1), 278–284.

    Article  PubMed  Google Scholar 

  • Sasaki, J. E., da Silva, K. S., da Costa, B. G. G., & John, D. (2016). Measurement of physical activity using accelerometers. In Computer-assisted and web-based innovations in psychology, special education, and health (pp. 33–60). Academic Press.

  • Schaben, J. A., Welk, G. J., Joens-Matre, R., & Hensley, L. (2006). The predictive utility of the children’s physical activity correlates (CPAC) scale across multiple grade levels. Journal of Physical Activity and Health, 3(1), 59–69.

    Article  Google Scholar 

  • Scheers, T., Philippaerts, R., & Lefevre, J. (2012). Variability in physical activity patterns as measured by the SenseWear Armband: how many days are needed? European Journal of Applied Physiology, 112(5), 1653–1662.

    Article  PubMed  Google Scholar 

  • Siebert, E. A., Hamm, J., & Yun, J. (2017). Parental influence on physical activity of children with disabilities. International Journal of Disability, Development and Education, 64(4), 378–390.

    Article  Google Scholar 

  • Telford, R. D., Cunningham, R. B., & Telford, R. M. (2009). Day-dependent step-count patterns and their persistence over 3 years in 8–10-year-old children: the LOOK project. Annals of Human Biology, 36(6), 669–679.

    Article  PubMed  Google Scholar 

  • Trost, S. G., Pate, R. R., Freedson, P. S., Sallis, J. F., & Taylor, W. C. (2000). Using objective physical activity measures with youth: how many days of monitoring are needed? Medicine & Science in Sports & Exercise, 32(2), 426.

    Article  Google Scholar 

  • Trost, S. G., & Loprinzi, P. D. (2011). Parental influences on physical activity behavior in children and adolescents: a brief review. American Journal of Lifestyle Medicine, 5(2), 171–81.

    Article  Google Scholar 

  • Trost, S. G., Sallis, J. F., Pate, R. R., Freedson, P. S., Taylor, W. C., & Dowda, M. (2003). Evaluating a model of parental influence on youth physical activity. American Journal of Preventive Medicine, 25(4), 277–282.

    Article  PubMed  Google Scholar 

  • Vignos, P. J., Spencer, G. E., & Archibald, K. C. (1963). Management of progressive muscular dystrophy in childhood. Journal of the American Medical Association, 184(2), 89–96.

    Article  PubMed  Google Scholar 

  • Webber, K. J., & Loescher, L. J. (2013). A systematic review of parent role modeling of healthy eating and physical activity for their young African American children. Journal for Specialists in Pediatric Nursing, 18(3), 173–188.

    Article  PubMed  Google Scholar 

  • Welk, G. J. (1999). The youth physical activity promotion model: a conceptual bridge between theory and practice. Quest, 51(1), 5–23.

    Article  Google Scholar 

  • Welk, G. J., Wood, K., & Morss, G. (2003). Parental influences on physical activity in children: an exploration of potential mechanisms. Pediatric Exercise Science, 15(1), 19–33.

    Article  Google Scholar 

  • Yao, C. A., & Rhodes, R. E. (2015). Parental correlates in child and adolescent physical activity: a meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 1–38.

    Article  Google Scholar 

  • Zebracki, K., & Drotar, D. (2008). Pain and activity limitations in children with Duchenne or Becker muscular dystrophy. Developmental Medicine & Child Neurology, 50(7), 546–552.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by S. Z. and İ. A. G. The first draft of the manuscript was written by İ. A. G. and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to İpek Alemdaroğlu-Gürbüz.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hacettepe University (Number: GO 20/223, Date: 17.03.2020).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zorlu, S., Alemdaroğlu-Gürbüz, İ. Family Impact on Physical Activity Level and Participation of School-Age Children with Duchenne Muscular Dystrophy. J Child Fam Stud 32, 2983–2994 (2023). https://doi.org/10.1007/s10826-023-02634-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-023-02634-9

Keywords

Navigation