Physical activity in children with cerebral palsy in Saudi Arabia.

However, research from Arabic-speaking countries remains scarce, despite the influence of cultural and environmental contexts on PA behaviours. Addressing this gap is essential to develop inclusive, contextually relevant strategies that support PA participation.<br><br>Aims/Objectives: This study explored PA among children with CP aged 5–12 years in Saudi Arabia through three interconnected components.<br><br>Methodology: A scoping review was conducted to identify and map existing evidence on PA among children and adolescents with CP in Arabic-speaking countries.

This was followed by a convergent mixed-methods study comprising: (1) a cross-sectional survey examining PA patterns and preferences among children with CP (n=61) and TD peers (n=123) using validated tools; and (2) semi-structured interviews with families of children with CP (n=15) and paediatric physiotherapists (n=15) exploring perceived facilitators and barriers. Survey data were analysed descriptively, interview data thematically, and findings integrated narratively.<br><br>Results: The scoping review showed consistently low PA participation and increased sedentary behaviour (SB) among children with CP.

The review highlighted a lack of region-specific data capturing the full scope of PA patterns, preferences, and lived experiences, indicating a significant gap in the literature. Children with CP participated in informal, light-intensity, home-based PA and significantly less in moderate and vigorous PA than TD peers and were less likely to express a preference for PA (p<0.05). Physiotherapy was the most common structured PA.

Four qualitative themes were identified: (1) access and environment, (2) family, social and community support, (3) child’s development and activities, and (4) therapeutic and professional support. Integrated analysis showed PA was infrequent, low intensity, and limited in diversity, influenced by motor impairments and barriers such as inaccessible facilities, transport, social stigma, and limited professional guidance.<br><br>Conclusions/Implications: This study provides comprehensive insight into PA participation among Saudi children with CP, highlighting the need for culturally adapted, community-based strategies and enhanced physiotherapy education to promote inclusive PA and inform regional rehabilitation policy.<br><br><i>Thesis is embargoed until 31 December 2029</i>.<br>