Effects of a Play-Based Physical Activity Programme
on Enjoyment Among Children with Cerebral Palsy:
A Randomised Wait-List Controlled Trial
B.Balachandar, P. Swarnakumari
Academia and Society, Vol. 12, No. 2, 2026.
DOI: https://doi.org/10.6025/aas/2025/12/2/31-43
Link: https://www.dline.info/aas/fulltext/v12n2/aasv12n2_3.pdf
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 < 0.001), whereas the Wait-List
Control group showed minimal improvement (+0.90 ± 0.91; p < 0.001).
Between-group comparison revealed a large and statistically significant
difference in change scores (mean difference = 8.58; p < 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.