Organized community sport participation in children and youth with physical disability: a scoping review protocol

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Pollock doi: https://doi.org/10.1101/2025.09.07.25335284 Karen Davies 1 The Motion Lab, Sunny Hill Health Centre at BC Children’s Hospital, Vancouver Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia , Vancouver BC, Canada Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Karen Davies Mitchell Barran 2 Faculty of Medicine, University of British Columbia , Vancouver BC, Canada Find this author on Google Scholar Find this author on PubMed Search for this author on this site Colleen Pawliuk 3 Department of Pediatrics, University of British Columbia , Vancouver BC, Canada Find this author on Google Scholar Find this author on PubMed Search for this author on this site Tiago Choi 4 Faculdade de Medicina, Universidade de São Paulo , São Paulo, São Paulo, Brazil Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Tiago Choi Bruna Schilbach Pizzutto 4 Faculdade de Medicina, Universidade de São Paulo , São Paulo, São Paulo, Brazil Find this author on Google Scholar Find this author on PubMed Search for this author on this site Patricia Moreno Grangeiro 5 Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo , São Paulo, São Paulo, Brazil Find this author on Google Scholar Find this author on PubMed Search for this author on this site Courtney L. Pollock 6 Department of Physical Therapy, Faculty of Medicine, University of British Columbia , Vancouver Canada ; Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute , Vancouver BC, Canada Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Courtney L. Pollock For correspondence: courtney.pollock{at}ubc.ca Abstract Full Text Info/History Metrics Data/Code Preview PDF Abstract Children and youth living with physical disability have less opportunities to participate in meaningful organized physical activities in their communities than their typically developing peers. Equitable access to community sport programs that aim to support the health, social participation, and well-being of these children and youth is required. Frameworks for program implementation and evaluation offer practical tools for supporting quality participation. Limited research exists demonstrating the practical application of these conceptual model frameworks. The objective of this scoping review is to understand the extent and type of evidence in relation to organized community sport participation in children and youth with physical disabilities. This review will consider studies that explore organized sport participation for children and youth up to 25 years with physical disability in all geographical areas. Children and youth with only a cognitive disability, developmental disability, or the absence of a physical disability will be excluded. The databases to be searched include MEDLINE (Ovid), Embase (Ovid), SportDiscus (EBSCO), CINAHL (EBSCO), PEDro, Global Index Medicus and Google Scholar. Sources of unpublished studies and grey literature will also be searched. No language or publication date restrictions will be placed on the search. Two independent reviewers will perform title and abstract screening, and retrieval and assessment of full-text citations. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion or with a third reviewer. A narrative synthesis of the results will be presented in conjunction with a tabular and/or graphic format. Introduction Every child has the right to participate in sports, yet it can be challenging for children and youth with physical disabilities to find meaningful sport participation opportunities in their community. The European Sports Charter defines sport as “ all forms of physical activity which, through casual or organized participation, are aimed at maintaining or improving physical fitness and mental well-being, forming social relationships or obtaining results in competition at all levels.” [ 1 ] Participation in sport provides health benefits and improves health outcomes for children and youth with physical disabilities,[ 2 ] promoting achievement of fine and gross motor skills, sport-specific physical ability, increased fitness, mobility, muscular strength, and opportunities for social network development.[ 3 - 5 ] Positive social experiences and meaningful connections enhance and promote participation in physical activity for youth with physical disabilities.[ 6 ] Despite these positive benefits and the well documented facilitators that enable sport participation for these children and youth, families and caregivers report a number of persistent environmental barriers. These include, but are not limited to, financial burden, transportation challenges, lack of information about existing programs, and physical accessibility.[ 6 , 7 ] The World Health Organization describes disability as an inherent part of the human experience; the outcome of the interaction between an experienced health condition and/or impairment and circumstances associated with the environment and personal factors.[ 8 ] The minimum estimated global prevalence of children and adolescents younger than 20 years living with a disability is between 266 to 291.3 million (10.1-11.3%).[ 9 ] For youth ages 15-24 years, the prevalence is less clear. Children and youth with disabilities participate less in physical activity and recreation than their typically developing peers and are less likely to meet international guidelines for physical activity and sedentary behaviour.[ 5 , 10 - 14 ] Further, children and adolescents with disability participate less, and with less diversity, frequency and intensity, in team or non-team sports when compared to their peers with typical development.[ 15 , 16 ] They are also more likely to play informal or casual games at home than more formal or organized sports in their community, even if sports are their preferred activities.[ 15 , 16 ] Limited evaluation of current community sport programs indicates the need for program implementation and evaluation frameworks to support quality participation for these children and youth. The Canadian Disability Participation Project (CDPP) is a national organization that aims to improve quality participation in community-based sport and optimize outcomes of participation among children, youth and adults experiencing disability in collaboration with community sport partners.[ 17 ] They developed the Quality Parasport Participation Framework (QPPF) to identify quality experiences in sport using six building blocks: autonomy, belongingness, challenge, engagement, mastery, and meaning.[ 18 , 19 ] These building blocks are aligned with the barriers and facilitators of community-based sport participation for children and youth with physical disabilities and can be evaluated at the physical, program, and social environment levels. The RE-AIM Framework - R each for intended population; E ffectiveness of implementation; A doption by community; Implementation consistency, costs, adaptations; and M aintenance of intervention effects – has also been utilized to provide a comprehensive evaluation of public health programs.[ 20 ] Informed by this framework, Lawrason et al[ 21 ] have created a toolkit for applying the dimensions of RE-AIM in local community-based physical activity contexts for evidence-informed program evaluation. A recent systematic review with meta-analysis identifying health outcomes for children and youth with physical disability participating in sports and physical recreation has identified several gaps in the literature.[ 2 ] They found that existing quantitative studies focused more on therapeutic and impairment models. Investigation of outcomes focused on participation occurring in community settings and more natural environments, to align with the goal of increasing health and inclusion for this population, is warranted.[ 2 ] Further, most reviews studied all physical activities together, leading to a lack of understanding regarding the effectiveness of activity in the individual therapy, exercise training, sport or recreation settings.[ 2 ] Primarily most population data describing physical activity participation in children and youth with disability also derives from high-income countries.[ 22 ] Evidence on the influence of physical activity among these children and youth remains limited. [ 2 , 22 ] To our knowledge, no reviews have included a grey literature search on this topic to capture programs in middle- or lower-income countries and identify programs that already exist in communities around the world. A preliminary search of PROSPERO, MEDLINE, Open Science Framework and Google Scholar was conducted and no current or in-progress scoping reviews or systematic reviews on the topic were identified. Therefore, to further address the current gaps in the literature, the purpose of this scoping review is to systematically map and synthesize the level of evidence related to program evaluation of community sport participation globally in children and youth living with physical disability. A secondary aim is to further evaluate the perceived barriers and facilitators for community sport program implementation using framework evaluation. Review questions What is the level of evidence related to program evaluation of community sport participation in children and youth up to 25 years of age with physical disabilities globally? What are the perceived barriers and facilitators for community sport program implementation? Inclusion and exclusion criteria Participants This scoping review will consider studies that include children and youth up to 25 years of age with physical disabilities. Children and youth with only a cognitive disability, developmental disability, or the absence of a physical disability will be excluded. For this review, physical disability is defined broadly as the outcome of the interaction between a child or youth’s long-term physical health condition and their personal and environmental factors.[ 8 ] Concept This review will consider studies that explore organized sport participation for children and youth with physical disabilities. We will include studies with organized sport participation in a school setting but will exclude any school-based therapy interventions. Studies that describe adapted equipment, injury management, or para-athletics classification without addressing participation will be excluded. Unorganized sport, physical activity, and recreation studies will also be excluded. Context This review will consider studies from all geographic areas and will have a global scope. Types of sources This scoping review will consider quantitative, qualitative, and mixed methods study designs for inclusion. In addition, systematic reviews and un-published text and opinion papers will be considered for inclusion in the proposed scoping review. Protocols and/or clinical trial registries that do not include results will be excluded. Methods The proposed scoping review will be conducted in accordance with the Joanna Briggs Institutes (JBI) methodology for scoping reviews [ 23 ] and will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).[ 24 ] This protocol was developed in accordance with PRISMA for Protocols [ 25 ] (Supplement 1). Search strategy The search strategy will aim to locate both published and unpublished primary studies. An initial limited search of MEDLINE (Ovid) and SportDiscus (EBSCO) was undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles, were used to develop a full search strategy for MEDLINE (Ovid; see Supplement 2). The search strategy, including all identified keywords and index terms, will be adapted for each included information source. The key words and index terms included were based on the experience of the authors and preliminary testing of the index terms. The reference lists of articles included in the review will be screened for additional papers using Web of Science Core Collection. Articles from any language and those published from database inception to present will be included. We will search MEDLINE (Ovid), Embase (Ovid), SportDiscus (EBSCO), CINAHL (EBSCO), PEDro, Global Index Medicus and Google Scholar. Sources of unpublished studies and grey literature to be searched include: ProQuest Dissertations & Theses Citation Index (Web of Science), Open Access Theses and Dissertations (OATD), Papers First (WorldCat FirstSearch), Proceedings (WorldCat FirstSearch), PolicyCommons, Google, Biblioteca Virtual de Saúde (BVS) and Biblioteca Digital de Teses e Dissertações (BDTD). Study/Source of evidence selection Following the search, all identified records will be collated and uploaded into Covidence (Veritas Health Innovation, Melbourne, Australia) and duplicates removed. Following a pilot test, titles and abstracts will then be screened by two independent reviewers for assessment against the inclusion criteria for the review. Potentially relevant papers will be retrieved in full. The full text of selected citations will be assessed in detail against the inclusion criteria by two independent reviewers. Reasons for exclusion of full-text papers that do not meet the inclusion criteria will be recorded and reported in the scoping review. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion or with a third reviewer. The results of the search will be reported in full in the final scoping review and presented in a PRISMA flow diagram.[ 26 ] Data extraction Data will be extracted from papers included in the scoping review by two independent reviewers using a data extraction tool developed by the reviewers. The data extracted will include specific details about the study design and methods, participants, sport and context characteristics, outcomes defined by the RE-AIM and QPPF frameworks, barriers and facilitators of implementation, integration models, and other key elements relevant to the review questions. A draft extraction tool is provided (see Supplement 3). The draft data extraction tool will be modified and revised as necessary during the process of extracting data from each included paper. Modifications will be detailed in the full scoping review. Any disagreements that arise between the reviewers will be resolved through discussion or with a third reviewer. Authors of papers will be contacted to request missing or additional data, where required. Data analysis and presentation Two frameworks will guide the critique of studies found in the scoping review; 1) RE-AIM Framework;[ 20 ] Reach of the program; Effectiveness of implementation; Adoption by community members; Implementation of support strategies; and Maintenance of success and and 2) the Quality Parasport Participation Framework (QPPF).[ 17 ] We will share a narrative synthesis of the results and tables and/or graphs as appropriate in accordance with the review objectives and questions. Data Availability All relevant data from this study will be made available upon study completion. Supplement 1: PRISMA for Protocols Checklist Supplement 2: Search Strategy Ovid MEDLINE(R) ALL View this table: View inline View popup Supplement 3: Data Extraction Instrument The chart headings to extract data are as follows: Authors, year of publication, and country of origin Study title, aims, design, and duration Research question or objective, measured outcome, and tools of measurement Implementation framework or integration model Study population and total number of participants Organized sport type, frequency, and duration Identified facilitators and barriers of implementation Summary of findings References 1. ↵ Council of Europe, Recommendation CM/Rec(2021)5 of the Committee of Ministers to member States on the Revised European Sports Charter . Adopted on 13 October 2021 . 2. ↵ West K , Hassett L , Oliveira JS , et al. Effects of sport and physical recreation on health-related outcomes among children and young people with physical disability: systematic review with meta-analysis . BMJ Open Sport Exerc . 2025 ; 11 : e002350 . doi: 10.1136/bmjsem-2024-002350 . OpenUrl Abstract / FREE Full Text 3. ↵ Sañudo B , Sánchez-Oliver AJ , Fernández-Gavira J , Gaser D , Stöcker N , Peralta M et al. Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review . Sports Med Open . 2024 ; 10 ( 1 ): 54 . doi: 10.1186/s40798-024-00722-8 . OpenUrl CrossRef PubMed 4. Lundberg NR , Taniguchi S , McCormick BP , Tibbs C. Identity negotiating: redefining stigmatized identities through adaptive sports and recreation participation among individuals with a disability . J Leis Res . 2011 ; 43 : 205 – 25 . OpenUrl 5. ↵ Smith B , Rigby B , Netherway J , Wang W , Dodd-Reynolds C , Oliver E , Bone L and Foster C. Physical activity for general health in disabled children and disabled young people: summary of a rapid evidence review for the UK Chief Medical Officers’ update of the physical activity guidelines . Department of Health and Social Care: London, UK . 2022 . 6. ↵ Mckenzie G , Willis C , Shields N. Barriers and facilitators of physical activity participation for young people and adults with childhood-onset physical disability: a mixed methods systematic review . Dev Med Child Neurol . 2021 ; 63 ( 8 ): 914 – 924 . doi: 10.1111/dmcn.14830 . OpenUrl CrossRef PubMed 7. ↵ Elipe-Lorenzo P , Diez-Fernández P , RuibalLista B and López-García S ( 2025 ) Barriers faced by people with disabilities in mainstream sports: a systematic review . Front. Sports Act. Living 7 : 1520962 . doi: 10.3389/fspor.2025.1520962 OpenUrl CrossRef PubMed 8. ↵ Global report on health equity for persons with disabilities. Geneva: World Health Organization ; 2022 9. ↵ Olusanya BO , Kancherla V , Shaheen A , Ogbo FA , Davis AC . Global and regional prevalence of disabilities among children and adolescents: Analysis of findings from global health databases . Front Public Health . 2022 ; 10 : 977453 . doi: 10.3389/fpubh.2022.977453 . OpenUrl CrossRef PubMed 10. ↵ Arbour-Nicitopoulos KP , Bassett-Gunter RL , James ME , Latimer-Cheung AE , Moore SA , Voss C et al. Canadian children and youth with disabilities are not meeting the 24-Hour Movement Guidelines: Cross-sectional results from the national physical activity measurement (NPAM) study for children and youth with disabilities . Disabil Health J. In press . 2025 April 29. Doi.org/ 10.1016/j.dhjo.2025.101842 . OpenUrl CrossRef 11. Hao , Y. , Zhou , X. , Razman , R. et al. Compliance with the 24-hour movement behaviour guidelines among children and adolescents with disabilities: a systematic review and meta-analysis . BMC Public Health . 2024 ; 24 : 2357 . doi: 10.1186/s12889-024-19842-7 OpenUrl CrossRef PubMed 12. Urbanski PK , Zembura P , Ng K , Korcz A. Physical activity of children and adolescents with disabilities in Poland - First Para Report Card . J Exerc Sci Fit . 2024 ; 22 ( 2 ): 111 – 16 . OpenUrl PubMed 13. Woodmansee C , Hahne A , Imms C , Shields N. Comparing participation in physical recreation activities between children with disability and children with typical development: A secondary analysis of matched data . Res Dev Disabil . 2016 ; 49-50 : 268 – 76 . doi: 10.1016/j.ridd.2015.12.004 . OpenUrl CrossRef 14. ↵ WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization ; 2020 . 15. ↵ Woodmansee C , Hahne A , Imms C , Shields N. Comparing participation in physical recreation activities between children with disability and children with typical development: A secondary analysis of matched data . Res Dev Disabil . 2016 ; 49-50 : 268 – 76 . doi: 10.1016/j.ridd.2015.12.004 . OpenUrl CrossRef 16. ↵ Law M , King G , King S , Kertoy M , Hurley P , Rosenbaum P , Young N , Hanna S. Patterns of participation in recreational and leisure activities among children with complex physical disabilities . Dev Med Child Neurol . 2006 ; 48 ( 5 ): 337 – 42 . doi: 10.1017/S0012162206000740 . OpenUrl CrossRef PubMed Web of Science 17. ↵ Canadian Disability Participation Project ( 2018 ). Evidence-based strategies for building quality participation in sports for children, youth, and adults with a disability . University of British Columbia, Kelowna, BC . 18. ↵ Martin Ginis KA , Evans MB , Mortenson WB , Noreau L. Broadening the conceptualization of participation of persons with physical disabilities: a configurative review and recommendations . Arch Phys Med Rehabil . 2017 ; 98 : 395 – 402 . OpenUrl CrossRef PubMed 19. ↵ Evans MB , Shirazipour CH , Allan V , Zanhour M , Sweet SN , Martin Ginis KA , et al. Integrating insights from the parasport community to understand optimal experiences: the Quality Parasport Participation Framework . Psychol Sport Exerc . 2018 ; 37 : 79 – 90 . OpenUrl 20. ↵ Glasgow RE , Vogt TM , Boles SM . Evaluating the public health impact of health promotion interventions: the RE-AIM framework . Am J Public Health . 1999 ; 89 ( 9 ): 1322 – 7 . doi: 10.2105/ajph.89.9.1322 . OpenUrl CrossRef PubMed Web of Science 21. ↵ Lawrason SVC , DaSilva P , Michalovic E , Latimer-Cheung A , Tomasone JR , Sweet S , et al. Using mixed methods and partnership to develop a program evaluation toolkit for organizations that provide physical activity programs for persons with disabilities . Res Involv Engagem . 2024 ; 10 ( 1 ): 91 . doi: 10.1186/s40900-024-00618-7 . OpenUrl CrossRef PubMed 22. ↵ Martin Ginis KA , van der Ploeg HP , Foster C , Lai B , McBride CB , Ng K , et al. Participation of people living with disabilities in physical activity: a global perspective . Lancet . 2021 ; 398 : 443 – 55 . OpenUrl CrossRef PubMed 23. ↵ Peters MDJ , Godfrey C , McInerney P , Munn Z , Tricco AC , Khalil , H. Scoping Reviews ( 2020 ). Aromataris E , Lockwood C , Porritt K , Pilla B , Jordan Z , editors. JBI Manual for Evidence Synthesis. JBI ; 2024 . Available from: https://synthesismanual.jbi.global . doi: 10.46658/JBIMES-24-09 OpenUrl CrossRef 24. ↵ Tricco AC , Lillie E , Zarin W , O’Brien KK , Colquhoun H , Levac D , et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The PRISMA-ScR Statement . Ann Intern Med . 2018 ; 169 ( 7 ): 467 – 73 OpenUrl CrossRef PubMed 25. ↵ Moher D , Shamseer L , Clarke M , Ghersi D , Liberati A , Petticrew M , Shekelle P , Stewart LA . Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015 statement . Syst Rev . 2015 ; 4 ( 1 ): 1 . doi: 10.1186/2046-4053-4-1 . OpenUrl CrossRef PubMed 26. ↵ Page MJ , McKenzie JE , Bossuyt PM , Boutron I , Goffmann TC , Mulrow CD , et al. The SMA 2020 statement: an updated guideline for reporting systematic reviews . BMJ . 2021 ; 372 :n71 View the discussion thread. Back to top Previous Next Posted September 08, 2025. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. NOTE: Your email address is requested solely to identify you as the sender of this article. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. 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