Correlates Of Physical Activity Among Children And Adolescents With Visual Impairment

ObjectiveVisual Impairment(VI),including low vision and blindness,is defined as uncorrected low binocular vision or contraction of visual field caused by various reasons,affecting daily life and social participation.Vision loss is closely associated with negative outcomes in individual development,and youths with VI are facing difficulties in areas such as cognition,social interaction,and mobility.Due to sensory deficits and psychological disturbances,children,and adolescents with VI tend to keep lower physical activity than peers with normal sight and are more likely to maintain the sedentary lifestyle.Given that insufficient physical activity would increase health risks in various domains and early experiences can influence individual motivation and health behaviors later in life,identifying factors that influence physical activity of children and adolescents with VI is the initial step for developing appropriate promotion strategies.Based on the Physical Activity for people with a Disability Model that family environment and individual psychological factors are included as determinants of physical activity,this study selected parental support and student anxiety,to explore their relationship with physical activity in children and adolescents with VI,respectively.Moreover,a longitudinal design and cross-lagged analysis were used to clarify the temporal sequence between variables,aiming to provide a scientific reference for the development of intervention strategies to promote physical activity in children and adolescents with VI.MethodsA total of 72 children and adolescents with VI participated in this study,with an average age of 14.65±3.34 years,including 43 boys and 29 girls.According to the medical diagnosis records,there were 19 participants with congenital visual impairment and 53 participants with acquired visual impairment,32 participants with blindness and40 participants with low vision.Moderate-to-vigorous intensity physical activity(MVPA)and sedentary(SED)duration were measured using accelerometer,parental support and anxiety were investigated by self-reported Parental Support Questionnaire and Mental Health Test.This study was designed as a longitudinal follow-up survey,with participants completing measures of physical activity,parental support,and anxiety at the first phase(T1)and retesting the questionnaire two weeks later to identify the test-retest reliability.After a 12-week interval(T2),participants completed measures of physical activity,parental support,and anxiety again.Normality test,independent-sample t-test,Mann–Whitney U test and correlation analysis were performed on SPSS,cross-lagged analysis was performed on Mplus.Results(1)The average daily MVPA of children with VI was 27.31 minutes(T1)and28.27 minutes(T2),and the average daily SED was 782.61 minutes(T1)and 770.73minutes(T2).Boys with VI(T1=28.91 min,T2=29.39min),and low vision(T1=28.91 min,T2=29.39min)showed higher average daily MVPA than girls(T1=24.92 min,T2=26.61min)and blind youths(T1=25.31 min,T2=26.88min);girls’ average daily SED(T1=812.96 min,T2=790.23min)were significantly longer than boys(T1=762.15 min,T2=757.58 min,p<0.05).(2)The average score of parental support was 19.50(T1)and 19.06(T2),and anxiety was 34.82(T1)and 36.61(T2).Participants with low vision reported higher scores of parental support(T1=20.40,T2=20.25)and lower levels of anxiety(T1=32.38,T2=34.73)than blinds(parental support: T1=18.38,T2=17.56;anxiety: T1=37.88,T2=38.97,p<0.05).(3)After controlling for gender,age,VI cause,and VI degree,MVPA was significantly positively correlated with parental support(T1: r=0.291,T2: r=0.247,p<0.05),and negatively correlated with anxiety(T1: r=-0.372,T2: r=-0.391,p<0.01);SED was significantly negatively correlated with parental support(T1: r=-0.366,T2:r=-0.335,p<0.01),and positively correlated with anxiety(T1;r=0.316,T2: r=0.358;p<0.01).(4)Cross-lagged analysis showed that there was one significant cross-lagged path from MVPA to parental support,that is,MVPA could significantly predict parental support(β=0.30,p<0.01).In addition,Anxiety risk had a significant cross-lagged path on later SED(β=0.21,p<0.05).Conclusion(1)Physical activity of children and adolescents with VI is relatively low,their average MVPA daily duration does not reach the WHO recommendation for children and adolescents with disabilities.(2)A positive correlation between MVPA and parental support was found in children and adolescents with VI.(3)Anxiety has the predict effect on SED,which showed that the higher the risk of anxiety,the longer youths’ SED.It may be useful to ameliorate sedentary duration by decrease the risks of anxiety among children and adolescents with VI.