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<record>
  <title>Effects of a Play-Based Physical Activity Programme
on Enjoyment Among Children with Cerebral Palsy:
A Randomised Wait-List Controlled Trial</title>
  <journal>Academia and Society</journal>
  <author>B.Balachandar, P. Swarnakumari</author>
  <volume>12</volume>
  <issue>2</issue>
  <year>2026</year>
  <doi>https://doi.org/10.6025/aas/2025/12/2/31-43</doi>
  <url>https://www.dline.info/aas/fulltext/v12n2/aasv12n2_3.pdf</url>
  <abstract>Background: Children with cerebral palsy (CP) encounter substantial barriers
to participation in enjoyable physical activity, despite strong evidence that
enjoyment enhances motivation, engagement, and sustained participation.
Although play-based approaches are increasingly advocated in paediatric
rehabilitation, enjoyment is rarely examined as a primary outcome.
Objective: To evaluate the immediate effects of a structured play-based physical
activity programme on enjoyment among children with CP using the Physical
Activity Enjoyment Scale (PACES).
Methods:A randomized wait-list controlled trial was conducted with 84 children
aged 5–17 years with CP (GMFCS levels I–V). Participants were randomly
allocated to an Immediate Play group (n = 42) or a Wait-List Control group (n =
42), with stratification based on GMFCS level. The Immediate Play group received
a 12-week structured play-based physical activity programme comprising 36
sessions. Enjoyment was assessed before and after the intervention using PACES.
Within- and between-group differences were analysed using paired and
independent t-tests, and effect sizes were calculated.
Results:The Immediate Play group demonstrated a substantial increase in
enjoyment (mean change = +9.48 ± 3.11; p &lt; 0.001), whereas the Wait-List
Control group showed minimal improvement (+0.90 ± 0.91; p &lt; 0.001).
Between-group comparison revealed a large and statistically significant
difference in change scores (mean difference = 8.58; p &lt; 0.001), with an extremely
large effect size (Cohen’s d = 3.74).Conclusion: A structured play-based physical activity programme significantly
enhances enjoyment in children with cerebral palsy. Incorporating enjoyable,
child-centred play into rehabilitation may strengthen motivation and support
sustained participation in physical activity.</abstract>
</record>
