Sonja Mensch

123 The relationship between motor abilities and quality of life DISCUSSION This first specific study into the effect of motor abilities on quality of life (QoL) of children with severe multiple disabilities (SMD) shows that a relatively higher level of motor abilities is significantly related to higher QoL. Motor ability is most strongly correlated to the QoL dimension ‘physical well-being’ and to a lesser extent to the dimensions ‘development’ and ‘activities’. Multiple regression analyses showed significant independent relationships between motor abilities and QoL for almost all domains of motor abilities. Quality of life is an important aim of treatment for children with SMD. The results of our study show that different motor abilities have a relation to QoL that is not explained by GMFCS level. Supporting children in improving their motor abilities, which enables them to have more sense of control over their environment, can thus contribute to QoL. This study gives a clear justification for the assumption that stimulation of motor abilities, even for those children with a very low level, is most likely to promote their sense of well-being. As QoL is considered a multidimensional construct; in literature no consensus on the relevant domains or the content of the QoL domains exists (Tsoi et al. 2012). In a review of Albers et al. 29 questionnaires on QoL were found, various domains such as physical, psychological, social, spiritual, emotional, communicative and material aspects have been identified as domains that are of importance to a person’s total well- being (Albers et al. 2010). In our study positive relationships were found between the QoL domains ‘physical well-being’, ‘development’ and ‘activities’ and motor abilities. In contrast, no significant relationships were found between motor abilities and the QoL domains ‘material well-being’, ‘communication & influence’ and ‘socio-emotional well- being’. The QoL domains that were found to be positively correlated to the level of motor ability in our study seem relevant to the study population. Although QoL is a broad concept with many possible domains, it is important to predetermine your goal of measuring it in a specific population. The three QoL domains ‘physical well-being’, ‘development’ and ‘activities’ correlate positively with motor abilities in this population, but that is not to say that the same will be true in another population. Our findings are consistent with earlier studies, where motor abilities are associated with QoL in other groups of children with disabilities. In a study of Dickinson et al. the authors found that children with Cerebral Palsy with poorer walking ability had poorer physical well-being scores (Dickinson et al. 2007) and Shelly et al. concluded that physical well-being domains (f.e. abilities in participation and using arms and legs) of QoL are more strongly associated with functioning in general than psychosocial well- being domains (Shelly et al. 2008). Schoenmakers et al. showed that in children with Spina Bifida being able to move independently appeared to be much more important for daily life function and quality of life than other medical indicators of the disorder