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Celebi M, Cheng A, Sawatzky B, Mattie J, Borisoff J, Laskin JJ, Mortenson WB. Should I stay or should I go? An exploratory study comparing wheelchair-adapted rowing at home vs. in community gyms. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38949081 DOI: 10.1080/17483107.2024.2362895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/25/2024] [Indexed: 07/02/2024]
Abstract
PURPOSE Wheelchair users experience many barriers to physical activity as affordable and accessible exercise equipment options are limited. Thus, the home-based adapted rower (aROW) and gym-based aROW were developed. The objectives were to determine: 1) wheelchair users' preferences, perspectives, facilitators, and barriers to using the home-based versus the gym-based aROW, 2) perceived usability of the home and gym aROWs, and 3) recommendations to adapt the aROW further for home and community use. MATERIALS AND METHODS In this two-phase exploratory mixed-methods study, participants completed one month of using a home aROW, followed by one month of using a community gym aROW. After each phase, participants completed a semi-structured interview and the System Usability Scale (SUS) questionnaire. Interview data were analyzed using conventional content analysis and effect size comparing SUS data was calculated. RESULTS AND CONCLUSIONS Four categories were identified: what worked well, barriers to using the aROWs, what could be improved and important considerations. There was a large effect size in perceived usability between the aROWs with participants preferring the home aROW. Overall, rowing was enjoyable, and participants achieved positive physical outcomes. As preferences are individual, the home aROW provides wheelchair users with a potential choice between home or gym exercise.
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Affiliation(s)
- Mine Celebi
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Anika Cheng
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Bonita Sawatzky
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Johanne Mattie
- MAKE+ Applied Research, British Columbia Institute of Technology (BCIT), Burnaby, British Columbia, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- MAKE+ Applied Research, British Columbia Institute of Technology (BCIT), Burnaby, British Columbia, Canada
| | - James J Laskin
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute (VCHRI), Vancouver, British Columbia, Canada
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Castan A, Úbeda-Colomer J, Chamarro A, Vidal J, Benito-Penalva J, Sauri J. Socio-ecological Barriers to Leisure Time Physical Activity in Spanish Wheelchair Users With Spinal Cord Injury: Associations With Sociodemographic Characteristics and Functional Independence. Arch Phys Med Rehabil 2024; 105:1239-1246. [PMID: 38417776 DOI: 10.1016/j.apmr.2024.02.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE (1) To assess prevalence and severity of socio-ecological barriers to leisure time physical activity (LTPA) in a sample of adults with spinal cord injury (SCI); (2) to examine the association of these barriers with sociodemographic characteristics and functional independence (FI); and (3) to explore which socio-ecological levels of barriers might be associated with LTPA. DESIGN Cross-sectional study. SETTING Neurorehabilitation Hospital specialized in SCI. PARTICIPANTS 207 wheelchair users with SCI living in the community who attended a comprehensive check-up (22.7% women, 47.5±10.7 mean age; N=207). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The short version of the Barriers to Physical Activity Questionnaire for People with Mobility Impairments was used to measure socio-ecological barriers to LTPA. The Spinal Cord Independence Measure III was used to measure FI. The Physical Activity Recall Assessment for People with SCI was used to quantify LTPA. Several multiple linear regression models were computed to examine the associations between socio-ecological barriers and sociodemographic factors, LTPA and FI. RESULTS A high prevalence of barriers to LTPA was found. Seven of these barriers (2 intrapersonal, 3 organizational, and 2 community) were present for >60% of the participants. Intrapersonal and organizational barriers had a higher effect on participants with lower FI and women. Interpersonal barriers were higher for older participants and with lower FI, while community barriers were higher for unemployed participants. Finally, intrapersonal and interpersonal barriers were negatively associated with LTPA, and FI revealed as a moderator of the intrapersonal barriers-LTPA relation. CONCLUSIONS Given their high prevalence and their association with LTPA, the development of interventions targeting socio-ecological barriers to LTPA in people with SCI becomes crucial. The associations of these barriers with FI and sociodemographic characteristics should also be considered for these interventions to be as specific and effective as possible.
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Affiliation(s)
- Alex Castan
- Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona (UAB), Spain.
| | - Joan Úbeda-Colomer
- University of Valencia, Department of Physical Education and Sports, Valencia, Spain
| | - Andrés Chamarro
- Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona (UAB), Spain; Sports Research Institute, Autonomous University of Barcelona, Spain
| | - Joan Vidal
- Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Jesús Benito-Penalva
- Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Joan Sauri
- Institut Guttmann Neurorehabilitation Hospital, University Institute attached to the Autonomous University of Barcelona, Badalona, Spain; Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain; Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
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Khan AM, Lin P, Kamdar N, Mahmoudi E, Latham-Mintus K, Kobayashi L, Clarke P. Location Matters: The Role of the Neighborhood Environment for Incident Cardiometabolic Disease in Adults Aging With Physical Disability. Am J Health Promot 2024; 38:633-640. [PMID: 38236090 DOI: 10.1177/08901171241228017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE People aging with disability may be limited in their ability to engage in healthy behaviors to maintain cardiometabolic health. We investigated the role of health promoting features in the neighborhood environment for incident cardiometabolic disease in adults aging with physical disability in the United States. DESIGN Retrospective cohort study. SETTING Optum's Clinformatics® Data Mart Database (2007-2018) of administrative health claims. SUBJECTS ICD-9-CM codes were used to identify 15 467 individuals with a diagnosis of Cerebral Palsy, Spina Bifida, Multiple Sclerosis, or Spinal Cord Injury. MEASURES Cardiometabolic disease was identified using ICD-9-CM/ICD-10-CM codes over 3 years of follow-up. Measures of the neighborhood environment came from the National Neighborhood Data Archive and linked to individual residential ZIP codes over time. Covariates included age, sex, and comorbid health conditions. ANALYSIS Cox regression models estimated hazard ratios (HR) for incident cardiometabolic disease. Using a 1-year lookback period, individuals with pre-existing cardiometabolic disease were excluded from the analysis. RESULTS Net of individual risk factors, residing in neighborhoods with a greater density of broadband Internet connections (HR = .88, 95% CI: .81, .97), public transit stops (HR = .89, 95% CI: .83, .95), recreational establishments (HR = .89, 95% CI: .83, .96), and parks (HR = .88, 95% CI: .82, .94), was associated with reduced risk of 3-year incident cardiometabolic disease. CONCLUSION Findings identify health-promoting resources that may mitigate health disparities in adults aging with disability.
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Affiliation(s)
- Anam M Khan
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Paul Lin
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Neil Kamdar
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- University of MichiganCenter for Disability Health and Wellness, Ann Arbor, MI, USA
- Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Obstetrics and Gynecology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Elham Mahmoudi
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Kenzie Latham-Mintus
- Department of Sociology, Indiana University School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Lindsay Kobayashi
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor MI, USA
| | - Philippa Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- University of MichiganCenter for Disability Health and Wellness, Ann Arbor, MI, USA
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Bakhsh HR, Chippendale T, Al-Haizan N, Bin Sheeha BH. Assessment of park paths and trails to promote physical accessibility among wheelchair users in Saudi Arabia. Hong Kong J Occup Ther 2024; 37:42-51. [PMID: 38912101 PMCID: PMC11192433 DOI: 10.1177/15691861241254511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/28/2024] [Indexed: 06/25/2024] Open
Abstract
Background Individuals with mobility disabilities are less likely to meet physical activity standards and are at greater risk of developing non-communicable chronic diseases at earlier ages. Public parks are an essential resource for participation in physical activity. However, environmental factors may limit the participation of wheelchair users. The objective of this study was to evaluate the feasibility of using the Path Environment Audit Tool (PEAT) and to explore the wheelchair accessibility of five public parks in Saudi Arabia through descriptive analysis. Methods A descriptive study design was implemented to evaluate wheelchair accessibility features of five public parks in Riyadh, Saudi Arabia, and process, resource, and management assessments were conducted. Phone GPS-App Strava was used to track the segments and measure their distances. Results Audits in multiple parks using PEAT were time-consuming despite being user-friendly. The descriptive analysis of paths and trails across the five parks showed some positive features, such as adequate bollard/gate clearance, but the path slope and condition of the path surfaces were more variable. Conclusion This study is the first to examine wheelchair accessibility in public parks in Saudi Arabia. Preliminary audits of paths/trials in five public parks revealed the strengths and weaknesses of accessibility and features that promote physical activity participation for wheelchair users. These findings can guide future use of PEAT in large-scale studies and inform environmental modifications.
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Affiliation(s)
- Hadeel R Bakhsh
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - Tracy Chippendale
- Steinhardt School of Culture, Education, and Human Development, New York University, USA
| | - Najat Al-Haizan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Saudi Arabia
| | - Bodor H Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Saudi Arabia
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Barstow BA, Mohanraj S. Manufacturers perceptions of the barriers and facilitators of designing and producing accessible fitness equipment: A qualitative study. Assist Technol 2024:1-8. [PMID: 38805368 DOI: 10.1080/10400435.2024.2349171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 05/30/2024] Open
Abstract
A descriptive qualitative study was conducted to learn manufacturer perceptions of the barriers and facilitators of designing and producing accessible fitness equipment. Eight participants familiar with the ASTM International (formally the American Society for Testing and Materials) Universal Design of Fitness Equipment standards were interviewed via a virtual platform. Audio recorded interviews were transcribed verbatim and independently coded by two investigators using thematic analysis. Two primary themes emerged from the data, 1) Challenges and 2) Tipping the Scale. Challenges included a humanitarian versus a business model view, application of the ASTM International standards, lack of a market analysis, and safety and liability. Facilitators deemed appropriate to tip the scale include consideration of a carrot (reward) versus a stick (punitive measures), availability of a market analysis, ASTM International standard modifications and enlisting activism for cultural change and development of laws and policies to mandate inclusion of accessible fitness space and equipment. Legislative action appears to be a primary facilitator to increase the design, development, and availability of accessible equipment in fitness centers.
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Affiliation(s)
- Beth A Barstow
- Department of Occupational Therapy, The University of Alabama, Birmingham, USA
| | - Sangeetha Mohanraj
- School of Health Professions Research Collaborative, The University of Alabama, Birmingham, USA
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Rivera E, Smith C, Hesketh KD. Priority populations' experiences of the accessibility and inclusion of recreation centres: a qualitative study. BMC Public Health 2024; 24:205. [PMID: 38233836 PMCID: PMC10792860 DOI: 10.1186/s12889-023-17595-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Although the health benefits of physical activity are well documented, certain priority populations are often disproportionately insufficiently active and at higher risk of poor health. Recreation centres have the potential to provide accessible and supportive environments for physical activity for all. However, little is known about priority populations' experiences of these venues and their views of how accessibility and inclusion can be optimised. This study aimed to gain in-depth insights of recreation centre experiences and potential strategies for improving inclusion and accessibility amongst priority populations (women, older adults, ethnic minorities, persons living with disabilities/additional needs, individuals identifying as LGBTQIA+, low socio-economic position). METHODS This qualitative study (2021-2022) involved 18 semi-structured individual interviews with adult priority population users of recreation centres (50% 65 + years, 61.2% female) in one Melbourne municipality. Participants were asked to discuss their positive and negative experiences at the centres and to identify strategies for enhancing accessibility and inclusion. Interviews were audio-recorded and transcribed verbatim. Content analysis was performed for data analysis. RESULTS While many participants had positive views of the facilities and programs at the centres, as they met their needs, they also had suggestions for improving accessibility and inclusion. Similarly, most participants were happy with the communications, felt included, and perceived the culture positively. Those who did not feel included at the centres offered many potential strategies for changing the culture, modifying communications (e.g., signage), and establishing partnerships for better access and inclusion. CONCLUSIONS The present study adds to essential knowledge concerning priority populations' experiences of recreation centres. For recreation facilities that were generally perceived as having positive inclusion and accessibility, the findings nonetheless highlighted suggestions for further enhancement. These strategies may be useful more broadly for improving accessibility and inclusion, thereby promoting physical activity and ultimately health for all.
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Affiliation(s)
- Elise Rivera
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Locked Bag 20001, Geelong, VIC, 3220, Australia.
| | - Cynthia Smith
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Locked Bag 20001, Geelong, VIC, 3220, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, Locked Bag 20001, Geelong, VIC, 3220, Australia
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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Wilkinson A, Calder A, Elliott B, Rodger R, Mulligan H, Hale L, Perry M. Disabled People or Their Support Persons' Perceptions of a Community Based Multi-Sensory Environment (MSE): A Mixed-Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6805. [PMID: 37835075 PMCID: PMC10572127 DOI: 10.3390/ijerph20196805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/14/2023] [Accepted: 09/15/2023] [Indexed: 10/15/2023]
Abstract
Multi-sensory environments (MSEs) are specialised spaces purposely designed to stimulate the senses, whilst providing a calming and relaxing environment for leisure and enjoyment, predominantly intended for disabled people. Most MSEs are in institutions, hospitals, or educational settings, with a few in community-based settings. We explored disabled users' experiences of a community based MSE in a large metropolitan area in New Zealand, with a view to expanding access to MSE-type environments within the area. We used a convergent mixed method design with a web-based electronic survey (e-survey; n = 105), as well as semi-structured interviews (n = 14) with disabled MSE users (adults and children), who were supported, where necessary, by their support person/s. We collected the MSE users' demographics, frequency of use with respect to age, disability, and ethnicity, and experiences of the room, equipment, and accessibility. The participants and their support persons' perspectives about their experiences of using the MSE were represented by four themes: (i) Self-determination; (ii) Enhancing wellbeing opportunities; (iii) the MSE itself; (iv) Accessibility. While the MSE was considered positively, the MSE experience could be enhanced by addressing access challenges and broadening the scope of equipment to improve the usability and make it a more inclusive environment for all.
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Affiliation(s)
- Amanda Wilkinson
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Allyson Calder
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Beth Elliott
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Ryan Rodger
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Hilda Mulligan
- Canterbury Multi-Sensory Trust, Christchurch 8024, New Zealand;
| | - Leigh Hale
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
| | - Meredith Perry
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin 9054, New Zealand; (A.W.); (A.C.); (B.E.); (R.R.); (L.H.)
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Cunningham C, O'Donoghue G, Cosgrave S, Sands T, Leacy B, Markievicz I, Monaghan A, Shields N. Gym staff perspectives on disability inclusion: a qualitative study. Disabil Rehabil 2023; 45:441-448. [PMID: 35191365 DOI: 10.1080/09638288.2022.2036826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To explore gym staff perspectives on the inclusion of people with disability in the gym setting. MATERIALS AND METHODS Semi-structured interviews were conducted with 16 staff at four urban gym facilities, exploring perspectives on disability inclusion. An interpretive descriptive approach was adopted with reflexive thematic analysis of interview data and subsequent mapping of themes to the socioecological model. RESULTS Consistent with the socioecological model, the themes identified were "people with disability benefit from participation in gym settings" (personal); "positive interactions with people with disability" (interpersonal); "managing expectations of other gym users" (interpersonal); "inclusion is supported by a positive ethos, staff training and accessible facilities" (organisational); "people with disability lack awareness of inclusive exercise opportunities" (community); "desire to increase collaboration with healthcare professionals" (community); "access to transport can facilitate gym attendance" (community) and "local gym policy" (policy). CONCLUSION Although an overall ethos of inclusion was apparent, areas identified for enhancement were: awareness of gym services in the community; inter-sectoral collaboration with healthcare and disability organisations; comprehensive disability inclusion training; transport systems and accessibility; engaging people with disability in gym service planning. Implications for rehabilitationGym staff value collaboration with healthcare and rehab professionals to support inclusion of people with disability in exercise.Standardised disability inclusion training for gym staff is recommended.Individuals with disability should be empowered to contribute to the development of inclusive gym facilities and services.Rehab professionals have a role to play in raising awareness and advocating for inclusive exercise opportunities.
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Affiliation(s)
- Caitríona Cunningham
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Grainne O'Donoghue
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Sinead Cosgrave
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Tiarna Sands
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Brendan Leacy
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Igor Markievicz
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Andrew Monaghan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Nora Shields
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
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Development and Pilot Testing of the Disability Awareness Training and Education Program Among Community-Based Group Fitness Instructors. Adapt Phys Activ Q 2023; 40:323-346. [PMID: 36720236 DOI: 10.1123/apaq.2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/13/2022] [Accepted: 11/10/2022] [Indexed: 02/01/2023] Open
Abstract
Lack of disability awareness of fitness professionals is a well-established barrier to exercise participation among people with disabilities that is likely related to the lack of disability awareness training for group fitness instructors. The purposes of this study were to develop, implement, and evaluate a disability awareness training for group fitness instructors. A 90-min video training and resource manual were developed. We recruited 10 group fitness instructors from one recreation center to participate. Participants completed baseline, posttraining, and 2-month follow-up testing on survey-based outcomes including disability attitudes, confidence in exercise adaptations, and training satisfaction. Participants' confidence to adapt fitness classes was significantly improved; however, disability attitudes were high in the pretest and not significantly different posttraining. Semistructured interviews were conducted posttraining and revealed three themes: Formal disability training is needed, Managing inclusive class dynamics, and Training suggestions and satisfaction. This training demonstrated a feasible intervention for increasing disability awareness among community-based group fitness instructors.
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Herman C, Eisenberg Y, Vanderbom K, Tempio D, Gardner J, Rimmer J. Feasibility of Implementing Disability Inclusive Evidence-Based Health Promotion. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:82-92. [PMID: 36448761 PMCID: PMC10390329 DOI: 10.1097/phh.0000000000001671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
People with disabilities face a number of barriers to accessing and participating in evidence-based health promotion programs offered within the community. To address these barriers, the program implementation process needs to integrate disability inclusion throughout planning and implementation. The National Center on Health, Physical Activity and Disability's inclusive Community Implementation Process (NiCIP) provides a framework for implementers to systematically integrate strategies into their health promotion programs that increase inclusion while maintaining the fidelity the program. The NiCIP is a community-engaged process that brings key stakeholders together to guide the selection and implementation of data-driven solutions that promote inclusion in, and access to, health promotion programs. In this article, we first provide an overview of the NiCIP. Then, we present a case study exploring one community's experience using the NiCIP to implement a disability inclusive nutrition program within their community.
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Affiliation(s)
- Cassandra Herman
- Department of Disability and Human Development, University of Illinois at Chicago, Chicago, Illinois (Drs Herman and Eisenberg); Health Promotion and Injury Prevention, Butte County Public Health Department, Chico, California (Dr Vanderbom); Able South Carolina, Columbia, South Carolina (Ms Tempio); South Carolina Disability and Health Project, Columbia, South Carolina (Ms Gardner); and Dean's Office, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama (Dr Rimmer)
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Development of Aerobic Exercise Equipment Using Universal Design: Treadmill and Arm Ergometer. Healthcare (Basel) 2022; 10:healthcare10112278. [DOI: 10.3390/healthcare10112278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Exercise products based on universal design, which reduce restrictions on the exercise environment and ensure convenience and safe use, are beneficial for people with a disability; however, the current universal design only considers the preferences of the general population, which is not suitable for the disabled population. This results in the exclusivity of the sports facilities and supplies for people with a disability. Consequently, we explored the components of universal design and product satisfaction by considering users with disabilities and proposed the direction for designing extended universal exercise equipment that is suitable for them. Specifically, this study focuses on developing exercise equipment for people with a disability. Based on the results from the evaluation of acceptance and satisfaction of universal sports products for people with a disability using design thinking, we suggest the following. First, it is necessary to consider safety devices for exercise products. Second, the user interface should be improved in terms of convenience. Third, the ergonomic instrument design should be improved. Finally, the instrument design should be centered on user convenience.
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Monroe JC, Pae BJ, Kargl C, Gavin TP, Parker J, Perkins SM, Han Y, Klein J, Motaganahalli RL, Roseguini BT. Effects of home-based leg heat therapy on walking performance in patients with symptomatic peripheral artery disease: a pilot randomized trial. J Appl Physiol (1985) 2022; 133:546-560. [PMID: 35771219 PMCID: PMC9448284 DOI: 10.1152/japplphysiol.00143.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/22/2022] Open
Abstract
Few noninvasive therapies currently exist to improve functional capacity in people with lower extremity peripheral artery disease (PAD). The goal of the present study was to test the hypothesis that unsupervised, home-based leg heat therapy (HT) using water-circulating trousers perfused with warm water would improve walking performance in patients with PAD. Patients with symptomatic PAD were randomized into either leg HT (n = 18) or a sham treatment (n = 16). Patients were provided with water-circulating trousers and a portable pump and were asked to apply the therapy daily (7 days/wk, 90 min/session) for 8 wk. The primary study outcome was the change from baseline in 6-min walk distance at 8-wk follow-up. Secondary outcomes included the claudication onset-time, peak walking time, peak pulmonary oxygen consumption and peak blood pressure during a graded treadmill test, resting blood pressure, the ankle-brachial index, postocclusive reactive hyperemia in the calf, cutaneous microvascular reactivity, and perceived quality of life. Of the 34 participants randomized, 29 completed the 8-wk follow-up. The change in 6-min walk distance at the 8-wk follow-up was significantly higher (P = 0.029) in the group exposed to HT than in the sham-treated group (Sham: median: -0.9; 25%, 75% percentiles: -5.8, 14.3; HT: median: 21.3; 25%, 75% percentiles: 10.1, 42.4, P = 0.029). There were no significant differences in secondary outcomes between the HT and sham group at 8-wk follow-up. The results of this pilot study indicate that unsupervised, home-based leg HT is safe, well-tolerated, and elicits a clinically meaningful improvement in walking tolerance in patients with symptomatic PAD.NEW & NOTEWORTHY This is the first sham-controlled trial to examine the effects of home-based leg heat therapy (HT) on walking performance in patients with peripheral artery disease (PAD). We demonstrate that unsupervised HT using water-circulating trousers is safe, well-tolerated, and elicits meaningful changes in walking ability in patients with symptomatic PAD. This home-based treatment option is practical, painless, and may be a feasible adjunctive therapy to counteract the decline in lower extremity physical function in patients with PAD.
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Affiliation(s)
- Jacob C Monroe
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Byung Joon Pae
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Christopher Kargl
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Timothy P Gavin
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
| | - Jason Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana
| | - Susan M Perkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Yan Han
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana
| | - Janet Klein
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Raghu L Motaganahalli
- Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Bruno T Roseguini
- Department of Health and Kinesiology, Purdue University, West Lafayette, Indiana
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Heath GW, Levine D. Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10436. [PMID: 36012074 PMCID: PMC9408065 DOI: 10.3390/ijerph191610436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to promote health and prevent disease among people with disabilities. Addressing the core function of assessment, current physical activity epidemiology, and surveillance among people with disabilities across the globe highlights the paucity of surveillance systems that include physical activity estimates among people with disabilities. The status of valid and reliable physical activity measures among people with condition-specific disabilities is explored, including self-report measures along with wearable devices, and deficiencies in measurement of physical activity. The core functions of policy development and assurance are described in the context of community-based intervention strategies to promote physical activity among people with disabilities. The identification of research gaps in health behavior change, policy, and environmental approaches to promoting physical activity among people with disabilities is explored, along with recommendations based on the principles of inclusive and engaged research partnerships between investigators and the members of the disability community.
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Affiliation(s)
- Gregory W. Heath
- Public Health Program, Department of Health and Human Performance, University of Tennessee, Chattanooga, TN 37403, USA
- University of Tennessee Health Science Center College of Medicine Chattanooga, Chattanooga, TN 37403, USA
| | - David Levine
- Department of Physical Therapy, The University of Tennessee, Chattanooga, TN 37403, USA
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15
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Mitchell RJ, Ryder T, Matar K, Lystad RP, Clay-Williams R, Braithwaite J. An overview of systematic reviews to determine the impact of socio-environmental factors on health outcomes of people with disabilities. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1254-1274. [PMID: 34850472 DOI: 10.1111/hsc.13665] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/05/2021] [Accepted: 11/18/2021] [Indexed: 06/13/2023]
Abstract
People with disabilities are often subject to intersecting layers of social and economic disadvantage and other barriers that drive health inequity. As a result, they frequently experience worse health than people without disabilities, beyond the direct effects of their health condition or impairment. The aim of this overview of systematic reviews was to summarise the evidence on the impact of socio-environmental factors (i.e. social, physical or attitudinal) on the health outcomes of disabled people. A systematic search of five databases (MEDLINE, PsycINFO, Embase, CINAHL and Scopus) for English-language articles from January 2000 to April 2021 was conducted. Abstracts were screened by two reviewers and reviews were critically appraised. Key data were extracted by topic, population, disability type, critical appraisal method, socio-environmental themes and health outcomes. There were 23 systematic reviews identified examining adult (60.9%) or child and young (8.7%) disabled people, with 30.4% not specifying an age range. Reviews examined people with neurological or physical (39.1%), intellectual (17.4%), sensory (8.7%) or a range of (34.8%) disabilities. Three key health outcomes (i.e. access to healthcare, health-promoting behaviour and care quality) and several recurring socio-environmental themes related to the health outcomes of disabled people were identified. Disabled people encounter common social, physical and attitudinal factors that hinder their health outcomes in terms of access to services and quality healthcare. Many preventive health services were identified as either inaccessible or not meeting the needs of disabled people. Greater involvement of disabled people in service design and awareness raising is essential.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Tayhla Ryder
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Katia Matar
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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16
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The Gatekeepers to Fitness: A Correspondence Study to Examine Disabling Practices Among Fitness Center Personnel. Adapt Phys Activ Q 2022; 39:214-229. [PMID: 35065534 DOI: 10.1123/apaq.2021-0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/29/2021] [Accepted: 11/05/2021] [Indexed: 11/18/2022] Open
Abstract
Fitness centers may be an ideal setting for physical activity, yet qualitative findings suggest social-level barriers constrain access for people with disabilities. To further test this, I employed an online message correspondence study to investigate the effect of impairment status on the responsiveness of a national sample of fitness centers to requests for services. Email requests were sent to 800 fitness centers, of which 200 were tailored to each of the four investigative conditions (i.e., control, vision loss, spinal cord injury, or being autistic). The odds of receiving a positive response were 40.5% lower for individuals with vision loss (p = .011) and 33.3% lower for individuals with spinal cord injury (p = .055), as compared with individuals without an impairment. Specifically, the odds of receiving a positive response for personal training were 58.8% lower among individuals with vision loss (p = .003) and 41.1% lower for individuals with spinal cord injury (p = .065).
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Kadakia S, Stratton C, Wu Y, Feliciano J, Tuakli-Wosornu Y. The (In)Accessibility of YouTube Fitness Videos for Disabled Individuals Before and During the COVID-19 Pandemic: A Preliminary Application of a Text Analytics Approach. JMIR Form Res 2022; 6:e34176. [PMID: 35044305 PMCID: PMC8849230 DOI: 10.2196/34176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/31/2021] [Accepted: 01/14/2022] [Indexed: 01/16/2023] Open
Abstract
Background People with disabilities face barriers to in-person physical activity (PA), including a lack of adaptive equipment and knowledgeable instructors. Given this and the increased need for digital resources due to widespread COVID-19 lockdowns, it is necessary to assess the accessibility of digital fitness resources for people with disabilities. To investigate whether YouTube fitness content creators have made videos accessible to people with disabilities would be informative about access to PA during COVID-19 and could also provide insight into the feasibility of individuals who are disabled relying on YouTube for PA in a post–COVID-19 world. Objective This study aims to ascertain if disability-friendly PA videos on YouTube are accessible through searching general fitness terms and whether a change in the availability of accessible fitness resources for people with disabilities occurred on YouTube between before and during the COVID-19 pandemic on “Hospital/Medical Institutions,” “Individual(s),” and “Other(s)” channels. Secondary aims are to investigate if different categories of YouTube channels produce more accessible fitness content and highlight any disparities in disability-friendly PA content on YouTube. Methods A cross-sectional text analysis of exercise-related YouTube videos was conducted. The authors used Python (version 3.0) to access the YouTube database via its data application programming interface. Terms pertaining to PA that were searched on YouTube were at-home exercise, exercise at home, exercise no equipment, home exercise, home-based exercise, no equipment workout, and workout no equipment. Various elements (eg, view count and content generation) of the videos published between January 1 and June 30, 2019 (n=700), were compared to the elements of videos published between January 1 and June 30, 2020 (n=700). To capture a broad idea of disability-friendly videos on YouTube, videos were labeled “accessible” if they were found in the first 100 video results and if their title, description, or tags contained the following terms: para, paralympic, adaptive, adapted, disabled, disability, differently abled, disability-friendly, wheelchair accessible, and inclusive. Each video and channel were categorized as “Hospitals/Medical Institutions,” “Individuals,” or “Other(s).” Results The analysis revealed a statistically significant increase in viewership of fitness content on YouTube (P=.001) and in fitness content generated by Hospitals/Medical Institutions (P=.004). Accessible terms applicable to people with disabilities had minimal appearances in 2019 (21 videos) and 2020 (19 videos). None of the top viewed fitness videos that populated on YouTube from 2019 or 2020 were accessible. Conclusions The proportion of accessible disability-friendly videos remains diminutive relative to the prevalence of disability in the general population, revealing that disability-friendly videos are seldom findable on YouTube. Thus, the need for disability-friendly fitness content to be easily searched and found remains urgent if access to digital fitness resources is to improve.
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Affiliation(s)
- Shevali Kadakia
- Department of Computing and Mathematical Sciences, California Institute of Technology, Pasadena, US
| | - Catherine Stratton
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, US
| | - Yinfei Wu
- Department of Biostatistics, Yale School of Public Health, New Haven, US
| | - Josemari Feliciano
- Department of Biostatistics, Yale School of Public Health, New Haven, US
| | - Yetsa Tuakli-Wosornu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, US.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, 3471 Fifth Ave, Pittsburgh, US
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18
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Carlsson G, Slaug B, Schmidt SM, Norin L, Ronchi E, Gefenaite G. A scoping review of public building accessibility. Disabil Health J 2021; 15:101227. [PMID: 34716114 DOI: 10.1016/j.dhjo.2021.101227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The built environment needs to be designed so that all people can participate in the activities they want and need to do. Yet, accessibility is difficult to put into practice, and accessibility issues tend to be overlooked in the building and planning processes. OBJECTIVES The aim of this scoping review was to summarize the research front in the area of accessibility to public buildings. Specific aims were to identify knowledge gaps, to identify access activities in relation to environmental features and to link to predominant activities in terms of the International Classification of Functioning, Disability and Health (ICF). METHODS A literature search was performed in PubMed, PsycINFO, Inspec, Embase and Cochrane databases. Articles in English based on original empirical studies investigating accessibility of public buildings for adults aged ≥18 years with functional limitations were considered. RESULTS Of the 40 articles included, ten involved study participants, while 30 only examined buildings using instruments to assess accessibility. In addition, the psychometric properties were only tested for a few of them. All articles concerned mobility and several visual limitations, while few addressed cognitive or hearing limitations. Ten main access activities were identified, from using parking/drop-off area to exiting building. CONCLUSIONS By using the ICF and theoretically relating the accessibility problems to activities, the results revealed that there are large knowledge gaps about accessibility to public buildings for older people and people with functional limitations and that there is a need for more methodological considerations in this area of research.
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Affiliation(s)
- G Carlsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - B Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - S M Schmidt
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - L Norin
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
| | - E Ronchi
- Department of Fire Safety Engineering, Lund University, Sweden.
| | - G Gefenaite
- Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
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19
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Obrusnikova I, Cavalier AR, Suminski RR, Blair AE, Firkin CJ, Steinbrecher AM. A Resistance Training Intervention for Adults With Intellectual Disability in the Community: A Pilot Randomized Clinical Trial. Adapt Phys Activ Q 2021; 38:546-568. [PMID: 34010810 DOI: 10.1123/apaq.2020-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 11/18/2022] Open
Abstract
Adults with an intellectual disability have significantly lower levels of fitness compared with the general population. This study examined the effects of a 13-week theoretically guided, community-based, multicomponent resistance training intervention, resistance training for empowerment, on muscular strength and independent functional performance in 24 adults with an intellectual disability, aged 18-44 years. Twelve participants were randomly allocated to an experimental group and 12 to an active control group. An analysis of covariance revealed that the experimental group had significantly greater increases (p < .05) on the chest press and leg press one-repetition maximum tests and the 6-min walk test from the baseline to postintervention compared with the control group. The experimental group correctly and independently performed a significantly greater number of steps of resistance training exercise tasks than the control group. Marginal significance and large effect sizes were found for the prone plank test and the stair climb test. The resistance training for empowerment was effective in promoting muscular strength and independent functional performance among adults with an intellectual disability.
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20
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Nikolajsen H, Richardson EV, Sandal LF, Juul-Kristensen B, Troelsen J. Fitness for all: how do non-disabled people respond to inclusive fitness centres? BMC Sports Sci Med Rehabil 2021; 13:81. [PMID: 34330328 PMCID: PMC8325230 DOI: 10.1186/s13102-021-00303-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 07/01/2021] [Indexed: 11/17/2022]
Abstract
Background Representation of people with disabilities in fitness centres is lacking, despite initiatives to promote inclusion mainly in the UK and USA. Success creating these inclusive spaces is mixed and few were crafted taking into account attitudes and biases of non-disabled co-members. Inclusive fitness centres have not gained much attention in Denmark, and the campaign ‘Fitness for All - fitness for people with physical disabilities’ was initiated. The aim of this study was shaped by two key questions; 1) what is the ideal fitness space from the perception of non-disabled fitness users? and 2) how might their dis/ableist attitudes negate inclusion in three future pilot inclusive fitness centres across Denmark? Method Three focus groups involving 5–7 (total n = 18) adult non-disabled participants were conducted. Aged ranged between 19 and 75 years, both men and women were involved, with fitness centre experiences ranging from 0 to 20+ years. Interviews were transcribed and analysed using Malterud’s four-step method of systematic text condensation. Results Of most importance was a pleasant atmosphere which should make them feel welcome and comfortable. Good social relations within the space were also highly valued. Participants welcomed people with physical disabilities but predicted many challenges with an inclusive fitness centre and expressed unconscious ableist attitudes. Conclusion The current study adds essential knowledge regarding how non-disabled people perceive the ideal inclusive fitness centre. A welcoming and inviting atmosphere is essential whereas social skills, ableism, ignorance, and preconceptions are important barriers that may hinder inclusion of participants with disabilities in inclusive fitness centres. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00303-2.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark. .,Department of Physiotherapy, Institute of Health Studies, University College South Denmark, Esbjerg-Haderslev, Denmark.
| | | | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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21
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Nikolajsen H, Sandal LF, Juhl CB, Troelsen J, Juul-Kristensen B. Barriers to, and Facilitators of, Exercising in Fitness Centres among Adults with and without Physical Disabilities: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147341. [PMID: 34299792 PMCID: PMC8304633 DOI: 10.3390/ijerph18147341] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/05/2021] [Accepted: 07/07/2021] [Indexed: 12/15/2022]
Abstract
Fitness centres are an obvious arena for performing physical activity for the general population but representation of adults with physical disabilities (AwPD) is lacking. To increase possibilities for AwPD to exercise in fitness centres together with adults without physical disabilities (AwoPD), the aim of this study was to identify, synthesise, and compare barriers to, and facilitators of, exercising in fitness centres for each group. A scoping review was conducted and data extraction of the barriers and facilitators was performed independently by two researchers on six categories of contextual factors based on the framework of Di Blasi: (1) The fitness centre setting; (2) The fitness centre user characteristics; (3) The fitness instructor/staff characteristics; (4) The fitness centre user–instructor/management relationship; and (5) The fitness/exercise characteristics. An extra category, (6) Other relationships, was added. The PRISMA Extension for Scoping Reviews was used for reporting. Of the 102 included papers, only 26 (25%) of the papers were on AwPD, which focused mainly on physical barriers (category 1: inaccessible settings). In contrast, the remaining 76 papers involving AwoPD focused primarily on facilitators (category 2: motivational factors and exercising effects). In categories 3–6, the two groups had similar results, as both groups preferred skilled instructors, a welcoming and comfortable fitness centre environment, an ability to exercise at their preferred type and level, and good social connections. Since most data were based on AwoPD, more studies on actual experiences from AwPD are needed, to reveal the facilitators/motivational factors for fitness centre use.
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Affiliation(s)
- Helene Nikolajsen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy, Institute of Health Studies, University College South Denmark, 6705 Esbjerg Ø, Denmark
- Correspondence:
| | - Louise Fleng Sandal
- Research Unit for Physical Activity and Health in Work Life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Carsten Bogh Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, 2900 Hellerup, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark;
| | - Birgit Juul-Kristensen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark; (C.B.J.); (B.J.-K.)
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22
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Obrusnikova I, Cavalier AR, Novak HM, Blair-McKinsey AE, Suminski RR. Effects of a Community-Based Familiarization Intervention on Independent Performance of Resistance-Training Exercise Tasks by Adults With Intellectual Disability. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2021; 59:239-255. [PMID: 34030178 DOI: 10.1352/1934-9556-59.3.239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/05/2020] [Indexed: 06/12/2023]
Abstract
Adults with intellectual disability (ID) have significantly lower levels of fitness compared to the general population. The study examined the effects of a multicomponent familiarization intervention, consisting of a visual activity schedule and a video-enhanced system of least-to-most prompting, both displayed via an iPad, on the acquisition of resistance-training exercise tasks by adults with ID, aged 18-44 years, in a community fitness center. Twelve participants were randomly allocated to an experimental group (EG) and 12 to an active control group (CG). ANOVA revealed EG correctly and independently performed a significantly greater number of steps of four resistance-training exercise tasks compared with CG, relative to preintervention levels (p < .01). The intervention was effective in promoting functional performance of resistance-training exercise tasks among adults with ID.
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Affiliation(s)
- Iva Obrusnikova
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Albert R Cavalier
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Haley M Novak
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Ashleigh E Blair-McKinsey
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
| | - Rick R Suminski
- Iva Obrusnikova, Albert R. Cavalier, Haley M. Novak, Ashleigh E. Blair-McKinsey, and Rick R. Suminski, University of Delaware
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23
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Elshahat S, Treanor C, Donnelly M. Factors influencing physical activity participation among people living with or beyond cancer: a systematic scoping review. Int J Behav Nutr Phys Act 2021; 18:50. [PMID: 33823832 PMCID: PMC8025326 DOI: 10.1186/s12966-021-01116-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND It has been posited that physical activity (PA) has the potential to improve health outcomes and the health-related quality of life of people living with or beyond cancer. Despite the well-documented health benefits of PA, there is a low level of PA among cancer patients. A systematic scoping review was conducted to investigate attitudes, perceptions, preferences and barriers vs. facilitators to cancer patients' PA participation. METHODS A systematic search was performed across four automated databases (PubMed, Embase, PsycINFO and Medline) in keeping with the PRISMA guideline. All cancer types were included, and any age/gender groups were eligible. Both qualitative and quantitative studies were included. The Health Belief Model provided a conceptual framework for the conduct of the scoping review as well as guiding thinking to inform evidence-based interventions. RESULTS Ninety-eight articles were included in this review. Nearly half of the studies focused on mixed cancer sites; breast cancer was the most commonly examined cancer type (19%). Post-treatment was the most commonly investigated stage (33%), followed by studies of mixed stages of the cancer trajectory (27%), the acute treatment stage (23%) and pre-treatment stage (1%). Patient treatment stage was not reported in 16% of studies. Cancer patients reported positive attitudes to PA and recognized its benefits for health and wellbeing. Cancer-related side effects (e.g. fatigue) were a leading physiological barrier to PA participation, whereas effective symptom management techniques/tools acted as a powerful facilitator. Psychosocial barriers included low motivation and kinesiophobia, and perceived health benefits and social support/guidance by healthcare providers were significant facilitators. Inaccessible fitness facilities hindered cancer patients' PA engagement though the availability of tailored amenities appeared to be a strong facilitator. PA preferences varied in terms of type, place, time, company and source of information and pointed to the need for individualized PA programs. CONCLUSIONS There is a need for further research to identify barriers and facilitators to PA that are faced by patients with particular cancer types. Recommended PA promoting-strategies involve including exercise science professionals in healthcare teams and ensuring that fitness facilities are accessible.
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Affiliation(s)
- Sarah Elshahat
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Charlene Treanor
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK
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24
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Obrusnikova I, Cavalier AR, Blair-McKinsey AE. Certified personal trainers' beliefs about providing personal training for adults with intellectual disability in a community fitness facility. Disabil Health J 2021; 14:101100. [PMID: 33840616 DOI: 10.1016/j.dhjo.2021.101100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Numerous barriers limit the participation of adults with intellectual disability (ID) in community fitness facilities (CFFs). Lack of disability-related certification requirements for personal trainers (PTs) highlights the need to revise certification standards and develop training modules that prepare PTs to provide individualized training for individuals with ID. Therefore, insight from PTs is needed. OBJECTIVE The Reasoned Action Approach was used to explore PTs' salient behavioral, normative, and control beliefs about providing personal training for a hypothetical adult with ID in a CFF. METHODS A convenience sample of 32 certified PTs (a 37% response rate) currently employed at three YMCAs in the United States completed two online questionnaires, both assessed for content validity. Data were analyzed using directed content analysis. RESULTS Of the 334 total responses, 45% reflected behavioral, 17% normative, and 38% control beliefs. The overarching behavioral theme was that this experience would help PTs provide more individualized training for their clients. The frequently reported approving referents were "employer," "family," and "everyone around me." Two disapproving referents were elicited. Participants reported 12 facilitating (e.g., availability of adapted equipment/tools) and 11 inhibiting (e.g., lack of time, training, private space) factors of providing personal training for adults with ID in a CFF. CONCLUSIONS While PTs generally reported positive advantages and social influence of providing personal training for adults with ID, they were also aware of many factors that probably would inhibit their training of adults with ID in CFFs. The elicited beliefs have value when designing professional development curricula for PTs.
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Affiliation(s)
- Iva Obrusnikova
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE, 19713, USA.
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Different Relationships Between Steps and Movements and Healthy Biomarkers in People With and Without Disability. J Phys Act Health 2021; 18:495-506. [PMID: 33668013 DOI: 10.1123/jpah.2019-0639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 12/14/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity benefits have been extensively studied. However, the public health guidelines seem unclear about the relationships between steps and movements with healthy biomarkers for people with (PWD) and without disabilities (PWOD), respectively. While public health guidelines illustrate types of exercise (eg, running, swimming), it is equally important to provide data-driven recommended amounts of daily steps or movements to achieve health biomarkers and further promote a physically active lifestyle. METHODS Data from the National Health and Nutrition Examination Survey 2003-2006 were used. The authors conducted sensitivity, specificity, and receiver-operating-characteristic curve analyses regarding cut points from ActiGraph 7164 of daily steps and movements for health biomarkers (eg, body mass index, cholesterol) in PWD (2178 participants) and PWOD (4414 participants). The authors also examined the dose relationships of steps, movements, and healthy biomarkers in each group. RESULTS The authors found significant differences in the cut points of daily steps and movement for health biomarkers in PWD and PWOD. For daily steps, cut points of PWD were ranged from 3222 to 8311 (area under the receiver-operating-characteristic curve [AUC] range = 0.52-0.93) significantly lower than PWOD's daily steps (range = 5455-14,272; AUC = 0.58-0.87). For daily movement, cut points of PWD were ranged from 115,451 to 430,324 (AUC = 0.53-0.91) significantly lower than the PWOD's daily movements (range = 215,288-282,307; AUC = 0.60-0.88). The authors found strong but different dose relationships of many biomarkers in each group. CONCLUSIONS PWD need fewer daily steps or movement counts to achieve health biomarkers than PWOD. The authors provided data-driven, condition-specific recommendations on promoting a physically active lifestyle.
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Bonnell K, Michalovic E, Koch J, Pagé V, Ramsay J, Gainforth HL, Lamontagne ME, Sweet SN. Physical activity for individuals living with a physical disability in Quebec: Issues and opportunities of access. Disabil Health J 2021; 14:101089. [PMID: 33722579 DOI: 10.1016/j.dhjo.2021.101089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/05/2021] [Accepted: 02/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Individuals living with a physical disability have reported difficulty in meeting their healthy living and leisure needs which could be a result of poor accessibility. OBJECTIVE This qualitative study aimed to understand the relative accessibility of physical activity from the perspective of individuals living with a physical disability in Quebec, Canada. METHODS Twenty semi-structured interviews were conducted with current, past, non-members, and staff members of an adapted physical activity program. A qualitative approach with an inductive thematic analysis was used to interpret the data. RESULTS We identified five overarching themes focusing on participants' experiences related to access: (i) physical activity opportunities; (ii) social interactions; (iii) relationships; (iv) infrastructure; (v) policies and public services. Participants highlighted that access to physical activity programming is shaped by a complex interaction of these overarching themes and their sub-themes. CONCLUSIONS Access to physical activity opportunities for individuals living with a physical disability cannot be understood in isolation from the broader public policies, infrastructure, social interactions, and relationships that shape their experiences. Policy makers and other health and recreational professionals must consider these broader factors when recommending or creating physical activity opportunities for individuals with physical disabilities.
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Affiliation(s)
- K Bonnell
- Department of Kinesiology and Physical Education, McGill University, H2W 1S4, Canada.
| | - E Michalovic
- Department of Kinesiology and Physical Education, McGill University, H2W 1S4, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, H2H 2N8, Canada
| | - J Koch
- Department of Kinesiology and Physical Education, McGill University, H2W 1S4, Canada
| | - V Pagé
- Viomax Adapted Fitness Center, H2H 1L6, Canada
| | - J Ramsay
- Viomax Adapted Fitness Center, H2H 1L6, Canada
| | - H L Gainforth
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, V1V 1V7, Canada
| | - M-E Lamontagne
- Département de réadaptation, Université Laval, G1V 0A6, Canada; Centre interdisciplinaire de recherche en réadaptation et en intégration sociale, G1M 2S8, Canada
| | - S N Sweet
- Department of Kinesiology and Physical Education, McGill University, H2W 1S4, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, H2H 2N8, Canada
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Understanding urban accessibility: A community-engaged pilot study of entrance features. Soc Sci Med 2021; 273:113775. [PMID: 33621754 DOI: 10.1016/j.socscimed.2021.113775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/18/2020] [Accepted: 02/09/2021] [Indexed: 11/22/2022]
Abstract
The accessibility of the built environment is an equity issue. Accessibility standards for buildings exist, but often apply to new buildings or major renovations. This renders historic neighborhoods inaccessible. Accessibility standards and related assessments rarely consider the experiences and priorities of people who experience disability. Partnered with local government and an accessibility advisory committee, we conducted a pilot study of urban accessibility in Edmonton Edmon, Alberta, Canada. We measured four indicators of entranceway accessibility along a popular, central commercial corridor and mapped the data with building age using QGIS. We found significant accessibility barriers.
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Physical Activity Barriers in Danish Manual Wheelchair Users: A Cross-sectional Study. Arch Phys Med Rehabil 2020; 102:687-693. [PMID: 33091383 DOI: 10.1016/j.apmr.2020.09.384] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 09/10/2020] [Accepted: 09/20/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To identify physical activity barrier prevalence and severity among manual wheelchair users (MWCUs) and test whether barrier impact is associated with self-reported physical activity level (PAL). DESIGN Cross-sectional survey. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) was translated from English to Danish and administered online. The BPAQ-MI includes barriers within 4 domains and 8 subdomains and queries if an item hindered physical activity participation in the last 3 months (yes/no). If "yes," participants graded barrier severity from very small (1) to very big (5). Barrier impact scores were summed within and across domains. SETTING General community. PARTICIPANTS Danish MWCUs (N=181; 52.5% female, mean age, 48±14y.). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES PAL was rated from not active (1) to extremely active (10). Individual barrier prevalence (frequency, %) and severity (median [interquartile range]) was computed. Unadjusted (Spearman rank correlations, domains, subdomains) and adjusted (multivariate linear regression, subdomains) associations between PAL and barrier impact were computed. RESULTS The 5 most prevalent barriers were reported by ≥49.6% of participants (2 intrapersonal and 3 community). The 5 most severe barriers all had a median of 5 (1 organizational and 4 community). Unadjusted analysis showed that PAL was inversely associated with total intrapersonal (r=-0.487, P<.01) and overall (r=-0.241, P<.01) impact and the intrapersonal "health" (r=-0.477, P<.01) and "beliefs/attitudes"(r=-0.307, P<.01) subdomains. Adjustment for shared variance revealed only the "health" subdomain impact score was independently associated with PAL (P<.001). CONCLUSIONS Intrapersonal barriers were highly prevalent. Health-related barriers were inversely related to PAL. When organizational and community barriers were present, they were rated as particularly severe. These results provide novel information that can guide the design of future interventions aiming to increase MWCUs PALs.
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Lee HL, Kim JY, Kim JB. Development and application of PyeongChang 2018 Winter Olympic and Paralympic Games Accessibility Manual. Disabil Rehabil Assist Technol 2020; 16:391-397. [PMID: 32419539 DOI: 10.1080/17483107.2020.1738564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION In this study, the process of development, application, and evaluation of the PyeongChang Organising Committee for the 2018 Olympic and Paralympic Winter Games(POCOG) Accessibility Manual was introduced and the basic data for accessing venues and ways to improve accessible sporting event management were suggested. METHODS Analysing and comparing the IPC Guide and Korean accessibility laws with eight advisory meetings were held to develop "POCOG Accessibility Manual". To verify the Manual standards, accessibility assessment of the Paralympic Test-event, Olympic and Paralympic Games was conducted. RESULTS POCOG Accessibility Manual was developed based on the best practice of accessibility standards and feedback from various experts. Throughout the three-step verifications, many findings have resulted in the final recommendations for the improvements in the operation of the Olympic and Paralympic Games accessibility. CONCLUSIONS The study provided fundamental data to develop an inclusive game operation manual for future international sports competitions, and it could ultimately serve as a cornerstone for integration and inclusion through sports.Implications for RehabilitationEnsuring accessibility can secure equal opportunities to participate and enjoy the events for everyone in mega-sporting events including persons with disabilities.However, the current Korean construction law does not adequately address the accessibility requirements for the Paralympic Games. Therefore, the study of the development of the 2018 Pyeongchang Accessibility Manual based on IPC guidelines was important.In this study, the 2018 Pyeongchang Accessibility Manual was applied and evaluated according to the planning stage of the 2017 Paralympic test-events, PyeongChang 2018 Winter Olympic and paralympic Games.The result derived from our study will provide a strategy to ensure the accessibility for persons with disabilities to countries hosting future sports events.
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Affiliation(s)
- Hye Lim Lee
- Department of Policy Support, Korea Disabled People's Development Institute, Seoul, South Korea
| | - Ji Young Kim
- Department of Policy Research, Korea Disabled People's Development Institute, Seoul, South Korea
| | - Jong Bae Kim
- Department of Occupational Therapy School of Health Science, College of Health Science, Yonsei University, Wonju, South Korea
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Yoon TH, Mun YK, Lee JS, Min SK, Jee YS. Analysis for reliability and validity of gross motor function and health fitness tests for children with developmental disabilities. J Exerc Rehabil 2019; 15:667-675. [PMID: 31723555 PMCID: PMC6834701 DOI: 10.12965/jer.1938492.246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 09/18/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the reliability and validity of gross motor function and health fitness assessment tests for children with developmental disabilities. All 35 participants who took part in this study on a voluntary basis were male children (age, 10.31±1.25 years). All selected tests for gross motor function and health fitness assessments were used in previous studies to measure basic physical health and motor abilities, which include strength (grip strength test), muscular endurance (modified sit-ups test), flexibility (sit and reach test), and cardiopulmonary endurance (15-m shuttle run test). Reliability was analyzed using intraclass correlation coefficients in the pretest-posttest and Bland-Altman graphs study. Pearson correlation was used to analyze convergent validity and analysis of variance was used to analyze variations among age groups. Lastly, a correlation analysis was conducted between the tests in gross motor function and health fitness assessments. This study indicates that gross motor function and health fitness assessments have obtained adequate reliability parameters and are able to determine differences in children from 9 to 12 years of age. The tests performed were simple to use, safe, and suitable for children with developmental disabilities.
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Affiliation(s)
- Tae-Hyun Yoon
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, Korea.,Research Institute of Disabled Children, I-Gong-Gan, Angyang, Korea
| | - You-Kyung Mun
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, Korea
| | - Jong-Sun Lee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, Korea
| | - Su-Kyung Min
- Department of Physical Education, Chungbuk National University, Chungju, Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, Korea
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Stuart M, Dromerick AW, Macko R, Benvenuti F, Beamer B, Sorkin J, Chard S, Weinrich M. Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States. Neurorehabil Neural Repair 2019; 33:668-680. [PMID: 31296113 DOI: 10.1177/1545968319862562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background. As stroke survival improves, there is an increasing need for effective, low-cost programs to reduce deconditioning and improve mobility. Objective. To conduct a phase II trial examining whether the community-based Italian Adaptive Physical Activity exercise program for stroke survivors (APA-Stroke) is safe, effective, and feasible in the United States. Methods. In this single-blind, randomized controlled trial, 76 stroke survivors with mild to moderate hemiparesis >6 months were randomized to either APA-Stroke (N = 43) or Sittercise (N = 33). APA-Stroke is a progressive group exercise regimen tailored to hemiparesis that includes walking, strength, and balance training. Sittercise, a seated, nonprogressive aerobic upper body general exercise program, served as the control. Both interventions were 1 hour, 3 times weekly, in 5 community locations, supervised by exercise instructors. Results. A total of 76 participants aged 63.9 ± 1.2 years, mean months poststroke 61.8 ± 9.3, were included. There were no serious adverse events; completion rates were 58% for APA-Stroke, 70% for Sittercise. APA-Stroke participants improved significantly in walking speed. Sample size was inadequate to demonstrate significant between-group differences. Financial and logistical feasibility of the program has been demonstrated. Ongoing APA classes have been offered to >200 participants in county Senior Centers since study completion. Conclusion. APA-Stroke shows great promise as a low-cost, feasible intervention. It significantly increased walking speed. Safety and feasibility in the US context are demonstrated. A pivotal clinical trial is required to determine whether APA-Stroke should be considered standard of care.
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Affiliation(s)
- Mary Stuart
- 1 University of Maryland Baltimore County, Baltimore, MD, USA.,2 VA Health System, Baltimore, MD, USA.,3 University of Maryland, Baltimore, MD, USA
| | - Alexander W Dromerick
- 4 Georgetown University, Washington, DC, USA.,5 VA Health System, Washington, DC, USA.,6 Medstar National Rehabilitation Hospital, Washington, DC, USA
| | - Richard Macko
- 2 VA Health System, Baltimore, MD, USA.,3 University of Maryland, Baltimore, MD, USA
| | | | - Brock Beamer
- 2 VA Health System, Baltimore, MD, USA.,3 University of Maryland, Baltimore, MD, USA
| | | | - Sarah Chard
- 1 University of Maryland Baltimore County, Baltimore, MD, USA
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