title: Factors impacting participation in sports for children with limb absence: a qualitative study.
abstract: BACKGROUND
  Individuals with limb absence benefit from participating in sports. While barriers and facilitators affecting sport participation are well documented for adults, they have not been explored for children with limb absence.
  
  
  OBJECTIVE
  To identify the perceived factors impacting participation in sports according to children with limb absence and their parents.
  
  
  METHODS
  This study uses a descriptive qualitative study design. Nineteen participants, consisting of children and their parents, were recruited from an outpatient hospital clinic for semi-structured interviews. The 11 interviews were audio recorded and transcribed. Transcripts were then coded and analyzed using the DEPICT model. The thematic analysis was guided by the International Classification of Functioning, Disability, and Health framework.
  
  
  RESULTS
  Analysis of our participant interviews identified six themes as having an influence on sport participation: "functionality of prosthesis", "plan in advance", "know what I can do" (understanding capabilities), "it's like every stroke, 2 million questions" (stigma and the social environment), "love for the game" (love for sport), and "these things are an investment" (the investment involved).
  
  
  CONCLUSIONS
  The findings have the potential to inform the development and implementation of strategies to increase levels of participation in sports among children with limb absence. Information from this study may help to deepen the rehabilitation team's understanding of factors that impact engagement in sports among children with limb absence. Implications for Rehabilitation Children with limb absence present with unique barriers and facilitators to participating in sports, thus, what may be a facilitator or barrier for one child may not for another. Strategies to increase a child's participation in sports should consider both person and environmental factors. Rehabilitation professionals can play a crucial role in educating both families and the community on living and coping with a limb difference, services and community supports available, and the use of specialized prosthesis and attachments for sport participation.
authors.affiliation: a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada.
authors.forename: Batoul
authors.initials: B
authors.lastname: Sayed Ahmed
authors.affiliation: a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada.
authors.forename: Marena
authors.initials: M
authors.lastname: Lamy
authors.affiliation: a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada.|b Rehabilitation Sciences Institute, University of Toronto , Toronto , Canada.
authors.forename: Debra
authors.initials: D
authors.lastname: Cameron
authors.affiliation: a Department of Occupational Science and Occupational Therapy , University of Toronto , Toronto , Canada.|c Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Artero
authors.affiliation: c Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.
authors.forename: Sandra
authors.initials: S
authors.lastname: Ramdial
authors.affiliation: d Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Leineweber
authors.affiliation: d Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital , Toronto , Canada.|e Institute of Biomaterials and Biomedical Engineering, University of Toronto , Toronto , Canada.
authors.forename: Jan
authors.initials: J
authors.lastname: Andrysek
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000674:Amputees / Q000523:psychology / Q000534:rehabilitation; D001186:Artificial Limbs; D002170:Canada; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010290:Parents / Q000193:education*; D010358:Patient Participation; D036301:Qualitative Research; D064846:Sports for Persons with Disabilities / Q000193:education / Q000706:statistics & numerical data
keywords: Children; amputations; disability; limb absence; participation; sports