Frame Running for Exercise and Participation for Children and Young People With Physical Disabilities

Functional mobility will be assessed using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) Mobility domain. The PEDI-CAT Mobility domain provides a scaled score ranging from 20 to 80, with higher scores indicating better functional mobility.

Endurance will be assessed using the 6-Minute Frame Running Test, in which the child propels a frame runner for six minutes while aiming to cover the greatest possible distance. The outcome is the total distance covered in meters and reflects aerobic capacity and functional endurance during frame-based running. Higher distances indicate better endurance performance.

Running speed will be assessed using the 10-Meter Frame Running Sprint Test. In this test, the child covers a distance of 10 meters as quickly as possible from a stationary start using a frame runner. The outcome is sprint time measured in seconds and reflects speed, acceleration, and explosive mobility during frame-based running. Lower sprint times indicate better performance.

Functional strength will be assessed using the 1-Minute Sit-to-Stand Test, in which the child performs as many sit-to-stand repetitions as possible within one minute. The outcome is the total number of completed repetitions and reflects lower-limb strength, muscular endurance, and functional capacity relevant for daily activities. Higher scores indicate greater functional strength.

Walking capacity will be assessed using the 1-Minute Walk Test, which measures the distance a child can walk within one minute. The outcome is total walking distance measured in meters and provides an indicator of functional mobility, walking endurance, and walking pace. Greater distances indicate better walking capacity.

Functional performance will be assessed using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT). The Daily Activities, Social/Cognitive, and Responsibility domains evaluate a child's functional abilities in self-care and daily tasks, social interaction and cognitive functioning, and the degree of independence and responsibility for managing daily life tasks, respectively. Each domain is reported as a scaled score ranging from 20 to 80. Higher scores indicate better functional performance across all domains.

Health-related quality of life will be assessed using the Pediatric Quality of Life Inventory (PedsQL), a validated pediatric patient-reported outcome measure covering physical, emotional, social, and school functioning. Scores range from 0 to 100, with higher scores indicating better health-related quality of life.

Participation will be assessed using the Children's Assessment of Participation and Enjoyment/Preferences for Activities of Children (CAPE-PAC). The CAPE-PAC evaluates children's participation in everyday recreational, social, physical, and skill-based activities. Participation diversity is measured as the number of different activities performed, with scores ranging from 0 to 55. Participation intensity reflects how frequently activities are performed and is scored on a scale from 1 to 7, with higher scores indicating more frequent participation. Higher scores indicate greater participation diversity and intensity.

The psychosocial impact of assistive device use will be assessed using the Psychosocial Impact of Assistive Devices Scale (PIADS). The PIADS evaluates perceived psychosocial impact across three domains: Competence, Adaptability, and Self-Esteem. Items are rated on a 5-point Likert scale ranging from 1 (Never) to 5 (Always). Domain scores are calculated as summed scores, with ranges of 7-35 for Competence, 3-15 for Adaptability, and 5-25 for Self-Esteem. Higher scores indicate a more positive psychosocial impact of assistive device use.

Perceived exertion will be assessed using the Rating of Perceived Exertion-Pediatric Scale (RPE-P) immediately before and after completion of the 6-Minute Frame Running Test. The RPE-P is a child-appropriate subjective rating scale of perceived effort, with scores ranging from 1 to 10. Higher scores indicate greater perceived exertion.

Training activity patterns will be documented using a participant-reported training diary completed after each training session, with parental assistance if needed.

The diary records session date, session duration, training location (club-based or home-based), and perceived training intensity rated on a numeric scale ranging from 0 to 10, with higher scores indicating higher perceived training intensity. In addition, participants rate their overall experience of the training session using a 5-point ordinal scale ranging from 1 ("Poor training") to 5 ("Best training").

The diary is used to descriptively assess training adherence, training dose, participant-reported intensity, and subjective training experience across the study period.

Coaches will complete a structured trainer log after each training session to document key characteristics of the training sessions. The log captures information relevant to the delivery and conduct of the intervention, including session participation, implementation of planned content, overall training demands, deviations from the planned session, and any adverse events. These data will be summarized descriptively to characterize intervention implementation and safety over the course of the study.

Daily physical activity will be objectively assessed using a thigh-mounted SENS motion® accelerometer. Accelerometer data provide objective estimates of physical activity levels and movement patterns, allowing assessment of habitual daily physical activity.