Participation of people living with disabilities in physical activity: a global perspective

Thriving Through Adaptation: Adaptive Sports after Spinal Cord Injury

This article focuses on identifying how health care providers can support a person with spinal cord injury to pursue and maintain involvement in adaptive sports. Benefits and barriers of sport participation, equipment considerations, and recommendations on how to determine sport appropriateness for a person with spinal cord injury will be provided. The authors emphasize through appropriate medical management and consideration of level of disability, functional performance, psychological readiness, and individual preference, a health care provider can play a valuable role in connecting individuals with spinal cord injury to adaptive sports and recreation.

Community Integration of Disability: A Bibliometric and Knowledge-Map Analysis

Background

Community integration (CI) is the ultimate goal of rehabilitation for individuals with disabilities. It plays a significant role in restoring their social functioning and facilitating their reintegration into community and family life. However, no studies have utilized bibliometric methods to explore community integration.

Objective

To conduct a review about community integration of disabilities and to clarify the knowledge, hotspots, and trends through the bibliometric method.

Methods

Studies on community integration from 1990 to 2023 were retrieved from the Web of Science Core Collection (WOSCC). CiteSpace 6.2.R4 and Microsoft Office Excel 2019 were applied. The CiteSpace node types involved in this study include keyword, reference, cited author, cited Journal, and the dual-map overlay of journals. CiteSpace presented the keyword cluster map, keywords timeline view map, keywords bursts map, and overlay map of journals. Microsoft Office Excel 2019 was used to present the trend of annual publications and draw up related tables and figures.

Results

A total of 2239 hits were included. The number of publications related to community integration is increasing gradually. The three most frequent keywords is Brain Injury (571, 13%), Individuals (488, 11%), Quality of Life (434, 10%). Keyword cluster map and timeline map with eight clusters were obtained, and the current strongest citation burst keywords are social participation, substance use, experiences, interventions, and Afghanistan. Willer is the author with the most citations. McColl has the largest centrality in the first ten cited authors. The most cited reference is published by the World Health Organization (WHO). Archives of Physical Medicine and Rehabilitation is the journal with the highest co-citation frequency. The overlay map of journals presented four distinct paths: the journals in "psychology education, health" and "neurology, sports, ophthalmology" often cite journals in "health, nursing, medicine" and "psychology, education, social".

Conclusion

Community integration for individuals with disabilities is gradually becoming a hot topic. Research on community integration related to traumatic brain injury (TBI), stroke, children, and spinal cord injuries is current focus of community integration. Future research should explore the experiences and feelings of different groups of disabilities regarding community integration and develop more effective interventions for their community integration. Community integration is complex, and future research on community integration for individuals with disabilities needs to be explored more specifically.

Enhancing adapted physical activity training for community organizations: co-construction and evaluation of training modules

Community-based physical activity programmes benefit persons with disabilities. However, there is a lack of evidence-based tools to support kinesiologists' training in such programmes. This study aimed to co-create and evaluate physical activity training modules for community-based adapted physical activity (APA) programmes. In Phase 1, a working group (n = 8) consisting of staff, kinesiologists from two community-based APA programmes, and researchers met over four online meetings to discuss needs, co-create training modules, and assess usability. In Phase 2, a pre-post quasi-experimental design evaluated changes in capability, opportunity, and motivation of kinesiologists (n = 14) after completing the training modules, which included standardized mock client assessments and participant ratings of module feasibility. Means and standard deviations were computed for feasibility, followed by paired-samples t-tests, along with Hedge's correction effect size. Mock client sessions underwent coding and reliability assessment. The working group meetings generated two main themes: training in (i) motivational interviewing and behaviour change techniques and (ii) optimizing APA prescription. Nine online training modules were created. In Phase 2, medium to large effects of training modules were observed in capability (Hedge's g = 0.67-1.19) for 8/9 modules, opportunity (Hedge's g = 0.77-1.38) for 9/9 modules, and motivation (Hedge's g = 0.58-1.03) for 6/9 modules. In mock client assessments, over 78% of participants appropriately used five behaviour change techniques and, on average, participants demonstrated good use of motivational interviewing strategies. The findings indicate that training kinesiologists was feasible and has the potential to enhance community-based physical activity programmes for persons with disabilities.

Fostering the Physical-Literacy Development of Individuals Experiencing Disability Through the Use of PLayTubs: A Pilot Study

Physical literacy (PL) is increasingly being implemented as a means for holistic development for children and youth. Despite this, children experiencing disabilities and their families continue to face barriers that impede participation in physical activities and subsequent PL development. To empower families to actively engage in their PL development, this study sought to provide an accessible, home- and play-based, parent-facilitated intervention, namely, PLayTubs. The purpose was to explore parents' subjective understanding, involvement, and attitudes toward facilitating physical activity opportunities contributing to PL development through this intervention. Four parents with a child (<12 years old) diagnosed with a developmental impairment participated in a 10-week PLayTub experience. Data were collected via semistructured interviews with parents and their children. Making use of an interpretive description methodology and an ecological-dynamics conceptual framework, this study resulted in three themes: (a) a catalyst for autonomy, (b) more than just movement, and (c) an accessible alternative. Parents found that PLayTubs fostered autonomous participation and individual agency, enhanced connections and togetherness, and allowed for the creation of meaningful experiences with physical activity. These positive insights demonstrate the benefit of home-based interventions for this population and highlight the need for larger studies in the future.

Factors influencing sport development among women with disabilities: a case study of a visually impaired Spanish Paralympic woman

Introduction

Women with disabilities may experience particular difficulties in starting and developing in sport, also in the Paralympic context. Although a great deal of research has been conducted with high-performance athletes, relatively few studies have focused on athletes with disabilities, especially Paralympic women using person-first approaches. Thus, the main objective of this study is to understand, through the experience and opinion of a Paralympian female athlete, how these athletes reach their full potential, identifying the elements and initiatives that can influence (whether positively or negatively) their sporting trajectory and developmental milestones.

Methodology

This study analyzes the case of a quadruple Paralympic medalist in blind Judo, who has competed in Paralympic Games from Athens 2004 to Paris 2024. Information was gathered from a semi-structured interview, a book chapter she had written, and her participation in a forum.

Results

The athlete differentiated between two key stages in the sports career of people with disabilities: (1) the beginning of sports practice; and (2) development processes and the search for future Paralympic athletes. Women with disabilities face particular difficulties in accessing sport, with foundations for people with disabilities and coaches playing a fundamental role. It is crucial to give visibility and have sports references in these areas, highlighting initiatives such as Paralympic School Days and inclusive competitions. There are conditioning factors in the identification and development of talent, such as the rules and the nature of each Paralympic sport, and the level of inclusion that the athletes have experienced in their environment.

Conclusions

This case study presents the perceptions of a female athlete with regard to the beginnings and development of sport in the Paralympic framework, underlining the need to promote actions that help and encourage the development and participation of women with disabilities in sport.

Industry perspectives on the implementation of social support for young adults with disability in community gyms: a qualitative study

PURPOSE

Social support is a known facilitator of exercise for people with disability. A qualitative approach was used to understand current social support practices in community gyms for young adults with disability.

METHODS

Embedded within a larger project "Getting Young adult Moving - Supporting Participation and Access to Recreation Centres" (GYM-SPARC), semi-structured interviews were completed with 25 gym staff, representing 29 community gym facilities across Victoria, Australia. Data were analysed using inductive thematic analysis.

RESULTS

Social support types and availability varied across community gyms. Social support practices included orientation, supervision, specialist input, logistical support, motivation, peer support and social activities. These were provided as "standard" supports available to all members, "inclusion" supports specific to people with disabilities, or "external" supports provided by external services but operating within the gym facility. Two themes described how social supports were implemented: (i) stages of participation - "getting in the door, getting started and ongoing participation," and (ii) influencing factors - "people, partnerships and policy."

CONCLUSION

Social support practices are seldom implemented by community gyms to facilitate young adults with disability to "get in the door." Improving partnerships between gyms, rehabilitation, health and disability services may support the transition into community gym exercise.IMPLICATIONS FOR REHABILITATIONUnderstanding current social support practices enables rehabilitation clinicians and the recreation sector to identify gaps and opportunities to promote gym participation for young adults with disability.Social supports for young adults with a disability are implemented variably across participation phases and driven by people, partnership, and policy factors.Currently, a gap exists in the provision of social support to facilitate young adults with disability "getting in the door" of community gyms.An opportunity exists for rehabilitation clinicians (such as physiotherapists) and community gyms to collaborate and facilitate the transition into community-based gym exercise for young adults with disability.

School-based factors influencing physical activity participation in children and adolescents with disabilities: A qualitative systematic review and meta-synthesis

BACKGROUND

Children and adolescents with disabilities (CAD) frequently encounter barriers to participation in physical activity (PA). Schools play a vital role in promoting PA, making it crucial to understand the school-based factors influencing CAD's PA participation.

OBJECTIVE

This qualitative systematic review and meta-synthesis aims to identify and elucidate the school-based factors influencing PA engagement among this population.

METHODS

A comprehensive search across six databases-Web of Science, PsycINFO, Scopus, SPORTDiscus, and Embase, CNKI-was conducted in August 2023, and subsequently updated in April 2024. English or Chinese peer-reviewed journal articles that contained substantial qualitative data regarding school-based factors affecting PA in CAD were included. The methodological quality of included studies was evaluated utilizing the Critical Appraisal Skills Program Qualitative Checklist. Qualitative data were analyzed through thematic synthesis.

RESULTS

A total of 16 studies (12 qualitative studies and 4 mixed-methods studies) were included, all of which were of moderate to high quality. Thematic synthesis identified four major themes: (a) physical environment (provision of facilities, specialized and adapted equipment, space for activities); (b) social environment (peers, school leaders, teachers and other school staff); (c) opportunities for PA (physical education, classroom movement integration, extra-curricular activities); and (d) characteristics of PA (adaption of rules and task difficulty, competition components, diversified activities, fun).

CONCLUSIONS

This review reveals the complex interplay of different school-based factors affecting PA participation among CAD. The findings provide valuable insights for educators, policymakers, and health professionals to enhance PA participation in this population.

Results From the First Para Report Card on Physical Activity for Children and Adolescents With Disabilities in Chile

BACKGROUND

Global initiatives have been put in place to attain a thorough understanding of worldwide variations in physical activity (PA) among children and adolescents. Yet, there is limited knowledge about PA-related indicators, specifically for children and adolescents with disabilities (CAWD). To bridge this data gap, the Global Matrix of Para Report Cards (PRCs) of CAWD initiative was established to address the scarcity of information on PA for this population globally. The purpose of this manuscript is to summarize the results of Chile's First PRC on PA for CAWD.

METHODS

Chile's PRC included 10 core PA indicators common to the Global Matrix of PRCs. Evidence from scientific articles, reports, and databases available or released from 2018 to January 2022 was included for each indicator. A scientific committee collected and analyzed the data, assigning letter grades (A-F) based on benchmarks.

RESULTS

The grades assigned were as follows: Overall PA, D-; Organized Sports and Physical Activity Participation, C-; Active Play, INCOMPLETE; Active Transportation, D-; Sedentary Behavior, F; Physical Fitness, INCOMPLETE; Family and Peers, D+; School, C+; Community and Environment, D+; Government, B-.

CONCLUSIONS

Chile scored low in most indicators. Although some efforts have been made in the last decade in terms of policies, these have not been reflected in PA and related behaviors in CAWD. The results underscore that maintaining the current situation is inadequate for addressing the widespread problem of physical inactivity among CAWD in Chile, emphasizing the urgency for substantial changes and a comprehensive approach to effectively combat this crisis.

Extended Reality Gaming for Exercise and Mindfulness Throughout Pediatric Cancer Rehabilitation: Protocol for a Randomized Controlled Trial

BACKGROUND

Pediatric patients with cancer have limited options to self-manage their health while they are undergoing treatments in the hospital and after they are discharged to their homes. Extended reality (ER) using head-mounted displays has emerged as an immersive method of improving pain and mental health and promoting health-enhancing physical activity among a variety of clinical groups, but there is currently no established protocol for improving both physical and mental health in pediatric cancer rehabilitation.

OBJECTIVE

This phase I, pilot, feasibility randomized controlled trial aims to investigate the potential effects of a 14-week ER program on physical activity participation and indicators of health among pediatric patients with cancer who undergo bone marrow transplantation. An ancillary aim is to evaluate the feasibility of the program through participant engagement.

METHODS

This study includes a 2-arm parallel group design with a 1-group crossover (the control group will start the intervention after a waiting period). Overall, 16 pediatric patients with cancer undergoing rehabilitation (aged ≥8 years) at a children's hospital will be randomly allocated into one of two groups: (1) an immediate start group that undergoes an ER program in the hospital until discharge and then for 8 weeks at home (total duration of approximately 14 weeks), and (2) a waitlist control group that undergoes usual care in the hospital and for 8 weeks at home, before receiving the 8-week home ER program. The program will include active video gaming with rhythmic music exercises as well as mindfulness-based practices using a high-quality app. Home-based programming will include behavioral coaching calls. Physical activity will be measured daily through step counts using a tri-axial accelerometer. Health outcomes will be measured across time and include global health, measured by the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health Scale Short Form 7+2, and lung function, measured by a forced expiratory volume using a peak flow meter. Feasibility will be evaluated through participant engagement metrics, such as enrollment, dropout, adverse events, and attendance rates. Descriptive statistics will be obtained for all study variables. Outcomes will be modeled using mixed modeling procedures, and changes in means will be estimated with CIs.

RESULTS

The study was funded in February 2024. Recruitment procedures started on June 27, 2024. All data are anticipated to be collected by February 2026. Full trial results are anticipated to be analyzed and submitted for publication by March 2026. The study's anticipated end date is March 31, 2026.

CONCLUSIONS

This trial tests an accessible remote program for improving both physical and mental health among pediatric patients with cancer. The knowledge obtained from this study will inform the development of a larger trial.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06298357; https://clinicaltrials.gov/study/NCT06298357.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/64879.

Long-term trajectories of physical activity behavior in adults with physical disabilities and/or chronic diseases following rehabilitation: the prospective cohort study ReSpAct 2.0

PURPOSE

This study aimed to identify trajectories of physical activity behavior from discharge up to 6-8 years after rehabilitation among adults with physical disabilities and/or chronic diseases, and to determine modifiable determinants associated with trajectory membership.

MATERIAL AND METHODS

390 Adults with physical disabilities and/or chronic diseases participated in the Rehabilitation, Sports and Active lifestyle (ReSpAct) 2.0 study with measurements at 3-6 weeks before discharge (T0), and 14 (T1), 33 (T2), and 52 weeks (T3), and 6-8 years (T4) after discharge from rehabilitation. Physical activity behavior and its determinants were assessed using questionnaires. Latent class growth modeling was used to identify trajectories of physical activity behavior. Associations between determinants at T0 and trajectory membership were analyzed using logistic regression analyses.

RESULTS

Three trajectories of physical activity behavior were identified: a moderately active (n = 297; baseline total physical activity: 1370 (770:2070) min/week), highly active (n = 71; baseline total physical activity: 2950 (1945:3475) min/week), and increasingly active (n = 22; baseline total physical activity: 1755 (461:2415) min/week) trajectory. Barriers regarding physical activity (OR = 0.71, 95%CI 0.53-0.95) and perceived fatigue (OR = 0.75, 95%CI 0.57-0.98) were significantly associated with trajectory membership in univariable models, corrected for age and sex.

CONCLUSIONS

Targeting barriers regarding physical activity and perceived fatigue early in rehabilitation seem crucial for membership of a trajectory resulting in a more favorable development of physical activity behavior after rehabilitation.

The current physical activity in persons with disability in Qatar: a cross-sectional study

Purpose

The primary objective of this study was to measure and quantify the current level of physical activity among persons with disability in Qatar. The secondary objective was to assess and analyze the duration of sedentary behavior among individuals with disability in Qatar.

Methods

This was a cross-sectional epidemiological study of persons with disability living in Qatar. The study period was from October 2020 to December 2021.

Results

96 persons with disabilities participated in this study. They included individuals with amputations, spinal cord injuries, cerebral palsy, and other developmental impairments. Of the respondents, 56% were male and 64% were Qataris. Of the respondents, 61.5%said that they felt psychologically and emotionally better when engaging in physical activity, and this difference was statistically significant. 71% of all those who reported feeling physically good after sport, 65% said that they enjoyed the social aspects of sports. This corroborates the beneficial effects of exercise, sports, and physical activity in persons with all types of disabilities.

Conclusion

There was a definite impact on the emotional and physical well-being of those who participated in the physical activities. There was less participation in team activities and two-thirds preferred to exercise alone. However, their numbers were not statistically significant because of low enrollment in the study.

Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study

AIM

To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity.

METHOD

We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions. Free-text responses were then analysed thematically, creating items categorized according to the family of participation-related constructs (fPRC). In round 2, participants rated the perceived importance of these items using a 5-point Likert scale. The top 10 priorities were constructed from the highest-ranked items.

RESULTS

One hundred and sixteen participants (mean age = 14 years 7 months, range = 13-17 years; 66 males; 58 with cerebral palsy; 43 wheelchair users) completed round 1; 108 items were included in round 2. Fifty-eight items were rated as either 'important' or 'really important' by 70% of participants. The top 10 priorities were rated as important or really important by 82% to 94% of participants with a mean Likert score of 4.40 (range = 4.25-4.63). Seven of the top 10 priorities were related to the environmental context of the fPRC. The other three were related to involvement and the related concept of preference.

INTERPRETATION

The priorities identified will help inform future physical activity interventions for adolescents with a physical disability.

Current Trends in Virtual Exercise Interventions Among People With Disabilities: A Scoping Review

Objective

To analyze existing literature on virtual exercise interventions delivered to people with disabilities to assess effectiveness, efficiency, usability, satisfaction, and feasibility, and describe current trends that aimed to improve health outcomes among people with disabilities.

Data Sources

CINAHL, MEDLINE, and PsycINFO were searched.

Study Selection

Articles were included if they were (1) incorporated a virtual exercise intervention including people with physical disabilities and mobility limitations aged 18 years and older and (2) published between the years of 2009-August 14, 2024 with free access to full-text, peer-reviewed papers; and (3) published in English. Exclusion criteria: (1) unrelated to disability; (2) non-peer-reviewed articles; (3) protocol or review papers; (4) study focused on virtual exercise through perspective other than that of the participant; (5) study's primary objectives were not related to physical functioning and/or rehabilitation; and (6) study used only qualitative methods.

Data Extraction

A single search was conducted from January 2023 and ceased on August 14, 2023. Duplicate records were pulled from the article search within each database; article abstracts were assessed; and finally, full-text articles were retained upon meeting inclusion criteria. The primary researcher conducted the initial search, while 2 independent reviewers, J.R. and J.W., assisted with and confirmed article extraction.

Data Synthesis

Thirty-seven articles were included. Trends were explained by recapitulating statistically significant results per study among each disability group and virtual exercise delivery mode, exercise type, and intervention synchronicity.

Conclusions

More facilitators, satisfaction, usability, and perceived benefits were reported when compared to reported barriers among people with physical disabilities and mobility limitations who participated in virtual exercise interventions.

Bibliometric Analysis of Studies on The Rehabilitation of Disabled Athletes Through Visual Mapping

CONTEXT

The rehabilitation of disabled athletes is a critical area of research aimed at improving athletes' performance and well-being. This bibliometric analysis examines scientific studies related to the rehabilitation of disabled athletes, focusing on trends, authors, publications and interdisciplinary collaborations.

OBJECTIVE

This study seeks to provide quantitative and qualitative insights into the trends, interdisciplinary collaborations, and significant contributions in the rehabilitation of disabled athletes.

DESIGN

Bibliometric analysis of 660 scientific publications related to the rehabilitation of disabled athletes, from 1975 to 2023.

SETTING

The analysis reveals that research in this field is multidisciplinary, encompassing sports, medicine, rehabilitation and education. Studies focused on disabled athletes and their rehabilitation.

INTERVENTION

Rehabilitation plays a vital role in disabled athletes' lives, aiding in injury recovery and enhancing overall health and performance.

RESULTS

The United States leads in research output. Collaborative networks among authors are evident, indicating joint research efforts. Identification of research trends, prominent authors  Bartosz Molik and Natalia Morgulec-Adamowicz), collaborative networks and common keywords (e.g., adaptive sports, disability, rehabilitation). Keywords such as adaptive sports, disability and rehabilitation are frequently mentioned, reflecting the focus of research.

CONCLUSIONS

The rehabilitation of disabled athletes is a growing field with significant contributions from researchers worldwide. Collaborative efforts and interdisciplinary approaches are essential for advancing knowledge and improving the lives of disabled athletes.

Adolescents' Daily Lives (ADL) project: an intensive longitudinal design study protocol examining the associations between physical literacy, movement behaviours, emotion regulation and mental health

INTRODUCTION

Adolescence represents a critical developmental period, with changes in emotional regulation capacities influencing physical and mental health. With less than 6% of Canadian youth currently meeting the 24-hour movement guidelines for physical activity, sleep and sedentary behaviour, there is an urgent need to understand the potential association between movement behaviours, physical literacy, emotional regulation and mental health during adolescence. Additionally, there is a need to better understand these associations among equity-deserving groups. We developed the Adolescents' Daily Lives (ADL) project to identify how, when, under what contexts and to whom to promote healthy engagement in movement behaviours to optimise youth mental health.

METHODS AND ANALYSIS

For the ADL project, we will employ a 14-day intensive longitudinal design to investigate the associations between physical literacy, movement behaviours, emotion regulation and mental health among a diverse sample of 120 adolescents (ages 13-17 years) living in the Greater Victoria Area, British Columbia, Canada. A comprehensive baseline survey and movement competence test, assessing physical and mental well-being, 24-hour movement behaviours (ie, physical activity, sleep and sedentary behaviours) and physical literacy, will be accompanied by daily diary surveys and accelerometer-based movement tracking (ie, Fitbit Inspire 3) to assess daily fluctuations in movement behaviour, emotional regulation and mood. Multivariate analyses, including multilevel modelling, multilevel structural equation modelling and Bayesian hierarchical continuous-time SEM, will be used to model the repeated measures data and understand the simultaneous variations in daily movement behaviours, emotion regulation and mental health.

ETHICS AND DISSEMINATION

The ADL project received ethical approval from the University of Victoria Behavioural Research Ethics Board (protocol #22-0262). Study participation is voluntary, and data collection will be anonymised to protect participant privacy and confidentiality. Research findings will be shared through academic publications and conference proceedings. Through knowledge mobilisation resources, cocreated with the youth community advisory board, relevant findings will be shared directly with the wider community of adolescents.

Aerobic fitness in children with cerebral palsy compared to typically developing peers: A systematic review and meta-analysis

BACKGROUND

In the public health domain, aerobic fitness is an important predictor of both health and disease.

OBJECTIVE

To determine aerobic fitness in children with cerebral palsy (CP) compared to typically developing (TD) peers measured with a maximal exercise test.

METHODS

A systematic literature search was conducted in PubMed (MEDLINE), PsycArticles, PsycInfo, CINAHL, and SPORTDiscus (EBSCO). Original studies that reported findings on aerobic fitness expressed as peak oxygen uptake (VO2peak) during a maximal exercise test measured with a gas analysis system, in children with CP, aged 18 years or younger, were included. VO2peak values were pooled, using the generic inverse variance method, for type of maximal exercise test, Gross Motor Function Classification System (GMFCS) level, distribution of CP, and sex.

RESULTS

Thirty-six studies with a total of 510 children with CP (GMFCS I-IV) and 173 TD peers were included. VO2peak was measured using cycle ergometer test (n = 16), treadmill exercise test (n = 13), arm crank ergometer test (n = 6), shuttle run test (n = 3), and shuttle ride test (n = 1). The overall pooled VO2peak in children with CP was 32.84 mL/kg/min (SE 1.28) and 45.02 mL/kg/min (SE 1.32) in TD peers, with a difference between CP and TD of -12.17 mL/kg/min (95% CI: -16.70, -7.64). Subgroup analyses revealed that aerobic fitness was most compromised in children at higher GMFCS levels and boys with CP.

CONCLUSION

Aerobic fitness is severely compromised in children with CP. Promoting a healthy lifestyle and increasing participation in physical activities for young people with CP is recommended. The study protocol was prospectively registered in the PROSPERO registry with reference number CRD42021292879.

Transforming research systems for meaningful engagement: a reflexive thematic analysis of spinal cord injury researchers' barriers and facilitators to using the integrated knowledge translation guiding principles

PURPOSE

To develop an in-depth understanding of spinal cord injury (SCI) researchers' barriers and facilitators to deciding to use 1) a partnered approach to research and, 2) systematically developed principles for guiding Integrated Knowledge Translation (IKT) in spinal cord injury research (IKT Guiding Principles).

METHODS

Qualitative interview study with North American SCI researchers who were interested in using a partnered research approach. The research was conducted using an IKT approach, and interview data were analyzed using reflexive thematic analysis.

RESULTS

Thirteen SCI researchers whose research focused on prevention, clinical, rehabilitation, and/or community SCI research were interviewed. Three themes were co-constructed with partners: 1) the principles are necessary but not sufficient for the implementation of a partnered approach to research; 2) relational capacity building is needed; and 3) institutional transformation is needed to value, resource, and support meaningful engagement.

CONCLUSIONS

Supporting change that enables SCI researchers to adopt and implement the IKT Guiding Principles will require transformation at the individual (theme 1), relational (theme 2), and institutional levels (theme 3). Findings provide clear, practical, and tangible actions to promote change that can support meaningful engagement in the SCI Research System.

Effect of adaptive sports on quality of life in individuals with disabilities who use wheelchairs: a mixed-methods systematic review

PURPOSE

Adaptive sports participation has been shown to improve quality of life (QoL) in individual with disabilities. However, inconsistent results in various domains of QoL exist in the literature. The objective of this mixed-methods systematic review is to identify and synthesize evidence from quantitative and qualitative studies on the effect of adaptive sports on QoL in individuals with disabilities who use wheelchairs for mobility.

METHODS

A systematic literature review of quantitative, qualitative, and mixed-methods research on the effect of adaptive sports on QoL was conducted on five databases (Scopus, Web of Science, PsycINFO, Medline, and PubMed). Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool.

RESULTS

This review identified 4 key findings from 41 studies, including 31 quantitative and 10 qualitative studies. First, individuals with disabilities using wheelchairs for mobility who actively engaged in adaptive sports tend to report higher QoL scores compared with those who were inactive or did not participate. Second, the relationship between the duration of regular participation in adaptive sports and QoL scores exhibited inconsistent results. Third, a multi-component adaptive sports program demonstrates the potential to further improve QoL scores. Last, qualitative investigations reveal that participation in adaptive sports positively influences various domains of well-being in wheelchair users, including encompassing physical and emotional well-being, interpersonal relationships, material well-being, personal development, self-determination, and social inclusion.

CONCLUSION

This review provides a comprehensive relationship between adaptive sports participation and QoL of wheelchair users. This study identifies the value of multi-component interventions and demonstrates the diverse positive influences of adaptive sports on well-being.

Assessing teachers' beliefs and practices regarding vocational rehabilitation services for individuals with intellectual disabilities

This study investigates UAE teachers' beliefs and practices regarding vocational rehabilitation (VR) services for individuals with intellectual disabilities. The study used a descriptive survey methodology with a 30-item Likert scale questionnaire. The sample size consisted of 121 VR teachers in the Emirate of Abu Dhabi. The data was analyzed using Fisher's exact test and the Chi-square test. Male teachers (P<0.0063) and diploma in special education holders (P<0.0272) were significantly good at career counseling, while female teachers and bachelor's in education degree holders were good at vocational training (P<0.0039 and P<0.0001, respectively) and placement (P<0.0006 and P<0.001). Educators with 1-5 and 6-10 years of experience had more positive beliefs and practices than their more experienced counterparts in terms of VR services. VR instructors have an important role in improving the results and opportunities for people with intellectual disabilities, and their empowerment and professional development should be endorsed.

Comparisons and associations of psychological factors and the number of painful sites in wheelchair basketball athletes with and without shoulder pain: A cross-sectional case-control study

OBJECTIVE

To compare psychological factors and the number of painful sites between wheelchair basketball athletes (WBA) with and without shoulder pain and examine their associations with shoulder pain.

DESIGN

A cross-sectional, case-control study.

METHODS

Forty-three WBA participated. Shoulder pain was assessed with the Wheelchair User's Shoulder Pain Index (WUSPI), pain catastrophizing with the Pain Catastrophizing Scale (PCS), kinesiophobia by the Tampa Kinesiophobia Scale (TKS), self-efficacy with the General Self-Efficacy Scale (GSES), and the number of painful sites using the Nordic Musculoskeletal Questionnaire. Disability and sport-related data were collected. Spearman's correlation coefficients were calculated. Mann-Whitney U and independent samples t-tests were used for between-group comparisons.

RESULTS

Athletes with shoulder pain (n = 21) had an increased number of painful sites (P < .050) and higher PCS (P = .003). The WUSPI exhibited moderate associations with the number of painful sites during the last year (rho = .581) and past seven days (rho = .602), and PCS (rho = .470), and a weak association with the TKS (rho = .333)(P < .050). The number of painful sites with disability exhibited moderate associations with PCS (rho = .427) and GSES (rho = -.473)(P < .050). WBA classification levels showed moderate associations with the WUSPI (rho = -.400) and the number of painful sites during the last year (rho = -.437), and a weak association with the number of painful sites during past seven days (rho = -.315)(P < .050). The PCS showed weak associations with the number of painful sites during the last year (rho = .365) and the past seven days (rho = .398)(P < .050).

CONCLUSIONS

Results suggest considering WBA classes, pain catastrophizing, self-efficacy and multisite pain in the pain management of WBA.

Qualitative evaluation of factors influencing adherence to virtual exercise programs for people with physical disabilities

Virtual community-based programming for people with disabilities has become a popular method for advocating for health promotion, specifically exercise, for people with disabilities (PWD). Using theoretical frameworks to better understand the perspective of PWD who participate in virtual exercise programs allows strategies of implementation following completion of virtual exercise programs. The objective of this study was to examine the effect adherence had on perceptions, experiences, and post-program exercise maintenance in participants with disabilities. Eight qualitative interviews were conducted in highly adherent participants using the Social Cognitive Theory (SCT). Interviews were recorded on Zoom, transcribed using Microsoft 365, and analyzed using NVivo software. Data were analyzed by the primary author and an independent coder to increase rigor and reduce bias. Thirty-five unique codes were generated from transcribed interviews. Member-checking was employed to increase internal validity; 100% of participants agreed with the findings. Results demonstrate an overall positive experience in the virtual exercise program, noting specific facilitators (i.e., knowledgeable instructor, program provided equipment, etc.) and barriers (i.e., limited physical space at home to exercise, other participant's attitudes, etc.) of participating. Impressionably, 100% of participants maintained exercise following their time within the virtual exercise program.

Effects of different training methods in tele-exercise on acute performance decrement in adults with disability and wheelchair users

PURPOSE

Wheelchair users and people with disabilities have limited access to physical exercise due to various factors, including medical follow-up and training facilities. Although tele-exercise guided by experts has become a viable option, there is limited knowledge about the acute performance decrement (APD) resulting from remote training methods. The current cross-sectional study aimed to: (1) assess the APD of muscle resistance strength after three synchronous tele-exercise training methods in wheelchair users and (2) compare the training loads associated with each training method.

MATERIALS AND METHODS

Eighteen male and female wheelchair users who participated in tele-exercise strength practices were recruited. The participants performed a maximum resistance strength test by synchronous tele-assessment (push-up test, PUT) at baseline and immediately after three training methods: high-intensity interval training (HIIT), moderate-intensity continuous training (MICT) and sprint interval training (SIT). The primary outcome was the APD, which was measured by the percentage decrease in the number of repetitions of the PUT immediately after the training methods.

RESULTS

APD was observed for all three training methods, with no significant differences between them (-34.8%, -29.9% and -38.0% for MICT, SIT and HII, respectively), and presented a non-significant correlation with the training loads. HIIT had a significantly higher training load than MICT and SIT.

CONCLUSIONS

APD occurred in all training sessions, but did not correlate with training load, indicating that it is not an appropriate metric for comparison. Findings provide insight into APD response and highlight the need to consider multiple metrics when comparing training protocols.

Relegated to the Sidelines: A Qualitative Inquiry of Gatekeepers' Perspectives and Values of Physical Education for Disabled Children

Several institutional aspects within the U.S. public school system impede the delivery of adapted physical education (APE) services to disabled children, including a lack of understanding and prioritization of these services by the special education team and a lack of qualified APE professionals to deliver these services. Thus, we conducted a qualitative inquiry grounded in a critical-ableism perspective to explore special education gatekeepers' experiences and perspectives of APE. Gatekeepers included parents, physical educators, and school administrators. Using a reflexive thematic analysis, we developed four interrelated themes: (a) disregard, negative, and charity mindsets toward disability; (b) systemic challenges in valuing and prioritizing APE; (c) presence as inclusion: (un)intentional marginalization in physical education; and (d) physical education for my child was a nightmare. These findings illustrate the complexities around the provision of physical education and APE to disabled children.

Piloting the effectiveness of the Workout on Wheels Internet Intervention (WOWii) program among individuals with mobility disabilities

BACKGROUND

Doing any amount of moderate-to-vigorous physical activity yields health benefits. Individuals with mobility disabilities are among the least physically active Americans and limited evidence indicates effective strategies to promote physical activity among this group.

OBJECTIVE

Examine whether a 16-week virtual intervention program (Workout on Wheels internet intervention, WOWii) increases exercise engagement among mobility impaired individuals.

METHODS

Participants recruited through community organizations that provide services to individuals with disabilities. The WOWii program is comprised of 3 core components: 16 weeks of virtual intervention delivery and access to the WOWii website; staff and peer support; an exercise package that included an activity tracker and heart rate monitor, pedal exerciser, and therabands.

RESULTS

Ten people enrolled. Participants demonstrated good program engagement, attending an average of 14.1 ± 2.1 of the 16 virtual meetings and completing an average of 10.6 ± 5.6 weekly activities. Exercise data revealed that participants increased their time spent in aerobic exercise from an average of two days a week performing 32 ± 22 min during week one to an average of five days a week doing 127 ± 143 min in the final WOWii week. Only half continued to exercise over the two months once WOWii virtual meetings ended.

CONCLUSION

WOWii program delivery successfully promoted increased exercise participation for people with mobility disabilities over the 16 intervention weeks. Future studies should investigate approaches to promote exercise maintenance beyond program delivery.

"Now We Can Speak": Wheelchair Sport Participation in Areas of Armed Conflict

This study sought to understand the lived experiences of wheelchair basketball athletes from low- and middle-income countries of recent or current armed conflict and the meaning that they ascribed to their participation. Wheelchair basketball athletes (N = 108) from eight national teams participated in semistructured focus-group interviews. Study data were analyzed thematically using an interpretive descriptive approach. Three themes were developed: "I can do anything I want; not only basketball," self-concept changes through sport participation; "Now they see me as a respectable person," societal belonging through sport; and "I have motivated other disabled people," influence on nonparticipating disabled persons. The findings indicated that participation in wheelchair sports may help disabled persons see themselves as capable individuals on the court and in aspects of daily living, perhaps even peer role models for other disabled persons in their communities and countries.

Physical activity and sedentary behavior among ambulatory children with cerebral palsy using accelerometer: a cross-sectional study

Background and objective

Physical activity (PA) is paramount for childhood development and growth. However, children diagnosed with Cerebral Palsy (CP) were often considered sedentary, and their physical inactivity was associated with adverse health conditions and complications. Therefore, this study aimed to objectively describe and compare the PA levels and SB levels of children with and without CP of the same age group. It also studied the factors correlating with PA, SB, and step count per day in children with CP.

Subjects and methods

A cross-sectional study using a wrist-worn accelerometer was conducted. PA and SB were measured over seven consecutive days.

Results

Eighty-five children aged 6-12 years, consisting of 41 children with CP and 44 TD children, participated in this study with a mean age of 9.18 ± 1.95 and 8.45 ± 1.78 years, respectively. According to the gross functional measures, 53.6% of children with CP were classified as first classification. A significant amount of time was spent in SB and Light PA (LPA) by children with CP compared to TD children, and no significant differences were observed in moderate PA (MPA) or step count. Gender mainly affected MPA as girls spent more time in MPA than boys. The age, height, and weight of children with CP correlate significantly with SB. As children's age, height, and weight increase, SB increases. Additionally, children with higher weights have lower step counts per day.

Conclusion

This study showed that children with CP spend more time in LPA and SB than typically developed children. Therefore, concerted efforts are needed to encourage physical activity and reduce the sedentary lifestyle, to take into account the gender and anthropometric measures of children to enhance the quality of life among children with CP, and to consider gender and anthropometric measures of the children.

Psychological Well-Being of Young Athletes with Physical Disabilities: A Systematic Review

Currently, young people with disabilities practice less sport than people without disabilities, which is a risk to their health and affects their well-being. The aim of this research was to identify the specific dimensions and tools used to measure psychological well-being (PWB) in young athletes with physical disabilities and to analyze the influence of sport. A systematic review was conducted using PUBMED/MEDLINE, Web of Science, Scopus, and Sportdiscus databases, and the search was completed without limitation to any specific year, including results up to and including 29 May, 2023. A total of 2112 articles were obtained in the initial search. Eligibility criteria were: (i) athletes with a physical disability, (ii) performing adapted and non-adapted physical activity and/or sport, (iii) the study aimed to analyse well-being, and (iv) outcomes of psychological well-being variables were identified. Exclusion criteria were (i) people with injury or transient difficulty, (ii) rehabilitative physical activity, and (iii) the results did not show any psychological well-being variables or mentions. This review identified that the most used dimension was mastery of the environment, together with the autonomy. All studies showed a positive correlation between sport practice and psychological well-being. Five measurement tools were identified knowing the state of psychological well-being of young athletes with disabilities is essential to promote successful participation in sports activities.

Potential Impact of Physical Activity on Measures of Well-Being and Quality of Life in People with Rare Diseases: A Nationwide Cross-Sectional Study in Italy

BACKGROUND

Rare diseases constitute a heterogeneous group of approximately 7000-8000 conditions, distinguished by their low prevalence. Collectively, they present a significant global health challenge, affecting millions of people worldwide. It is estimated that rare diseases affect approximately 10% of the global population, which places a significant burden on individuals, families, and society. It is, therefore, important to consider strategies to improve the overall well-being and quality of life of individuals with rare diseases. One potential avenue for exploration is the incorporation of physical activity (PA). The scope of this study was to ascertain whether PA has a positive impact on measures of well-being and to determine its potential to enhance the quality of life of these individuals.

METHODS

The data were collected via an online survey. The one-way ANOVA test for multiple groups and multivariate Poisson models were employed to identify the significant predictors of the outcomes of interest.

RESULTS

The protective effects of PA become evident with a minimum of six hours of activity per week. Our data confirm that the weekly hours devoted to PA can serve as a significant protective factor for QoL. The study also provided some insights into the motivations behind patients' engagement in PA. These included improving QoL and physical well-being, as well as the desire to interact socially, with the goal of meeting friends or making new acquaintances. Finally, for adults and older adults, engaging in PA can also be a way to control weight.

CONCLUSIONS

It is becoming increasingly clear that individuals with rare diseases stand to benefit greatly from PA, so it is only sensible to educate them on the advantages of an active lifestyle.

Digital motor intervention effects on physical activity performance of individuals with developmental disabilities: a systematic review

PURPOSE

Post-pandemic, use of digital technologies (e.g., mobile app, Zoom, virtual reality, and videogaming) to promote physical activity (PA) in populations with intellectual and developmental disabilities (IDD) has increased. The efficacy of various digital technologies in promoting PA in individuals with IDD varies. We conducted a systematic review to examine current literature findings on the efficacy of digital PA interventions on PA outcomes in individuals with IDD.

METHODS

Articles published between 1900 and 2024 that examined effects of technology-based PA interventions on PA levels/fitness of individuals with IDD using experimental or quasi-experimental study designs were included. Sixteen articles were retrieved from four health databases PubMed (914), PsycInfo (1201), SCOPUS (1910), and CINAHL (948).

RESULTS

Findings based on 604 participants (Autism: 383; Down Syndrome: 106; Developmental Disability: 83, Developmental Coordination Disorder: 37) provide the most support for exergaming/digital PA intervention benefits for populations with ID, Down Syndrome, and Autism; however, there was limited support for its use in those without ID (e.g., DCD).

CONCLUSION

Digital technology is an effective tool to promote improvements in PA/fitness, motor, cardiovascular performance in individuals with ID. Future studies need to build on this evidence to support the use of PA outcomes in individuals with different IDD diagnoses.

Using mixed methods and partnership to develop a program evaluation toolkit for organizations that provide physical activity programs for persons with disabilities

BACKGROUND

The purpose of this paper is to report on the process for developing an online RE-AIM evaluation toolkit in partnership with organizations that provide physical activity programming for persons with disabilities.

METHODS

A community-university partnership was established and guided by an integrated knowledge translation approach. The four-step development process included: (1) identify, review, and select knowledge (literature review and two rounds of Delphi consensus-building), (2) adapt knowledge to local context (rating feasibility of outcomes and integration into online platform), (3) assess barriers and facilitators (think-aloud interviews), and (4) select, tailor, implement (collaborative dissemination plan).

RESULTS

Step 1: Fifteen RE-AIM papers relevant to community programming were identified during the literature review. Two rounds of Delphi refined indicators for the toolkit related to reach, effectiveness, adoption, implementation, and maintenance. Step 2: At least one measure was linked with each indicator. Ten research and community partners participated in assessing the feasibility of measures, resulting in a total of 85 measures. Step 3: Interviews resulted in several recommendations for the online platform and toolkit. Step 4: Project partners developed a dissemination plan, including an information package, webinars, and publications.

DISCUSSION

This project demonstrates that community and university partners can collaborate to develop a useful, evidence-informed evaluation resource for both audiences. We identified several strategies for partnership when creating a toolkit, including using a set of expectations, engaging research users from the outset, using consensus methods, recruiting users through networks, and mentorship of trainees. The toolkit can be found at et.cdpp.ca. Next steps include disseminating (e.g., through webinars, conferences) and evaluating the toolkit to improve its use for diverse contexts (e.g., universal PA programming).

Disability-related disparities in health outcomes among newly diagnosed diabetic patients: A retrospective cohort

BACKGROUND

A distinct gap in the literature persists regarding the health outcome of individuals with Type 2 diabetes who also have disabilities. This study aimed to investigate potential disparities in events occurrence among diabetes patients across various disability stages.

METHODS

We conducted a retrospective cohort study on patients newly diagnosed with diabetes in 2013 and 2014, aged ≥ 18 years, and followed them until December 2021, using data from the Korean National Health Insurance database. All-cause mortality and hospitalization for diabetes mellitus and cardio-cerebrovascular diseases (CVD) was assessed.

RESULTS

The study included 26,085 patients, encompassing individuals without disabilities and those with physical, visual, hearing and speech, intellectual and developmental, and mental disabilities. After adjustment, individuals with disabilities had a higher risk of all-cause death (adjusted hazard ratio [aHR]: 1.25, 95% CI: 1.07-1.48) compared to those without disabilities. In particular, severe disabilities and hearing and speech disabilities showed significantly higher risks of all-cause death (aHR: 1.40, 95% CI: 1.06-1.85 and aHR: 1.58, 95% CI: 1.17-2.15, respectively), with marginal significance for mild disabilities (aHR: 1.20, 95% CI: 0.99-1.45) and mental disorders (aHR: 1.92, 95% CI: 0.98-3.73). Patients with disabilities also had significantly increased risks of CVD-related first admissions (aHR: 1.30, 95% CI: 1.07-1.56) and diabetes-related first admissions (aHR: 1.31, 95% CI: 1.20-1.43) compared to those without disabilities.

CONCLUSIONS

This study underscores the urgent need for public health policies to prioritize individuals with disabilities and diabetes, addressing the disparities in health outcome.

Physical activity experiences of community-dwelling older adults with physical disabilities: a scoping review of qualitative research

PURPOSE

The aim of this review was to synthesise qualitative literature on physical activity experiences of community-dwelling older adults with physical disabilities.

METHODS

We conducted a scoping review of peer-reviewed, qualitative studies on physical activity with community-dwelling older adults with physical disabilities. We analysed eligible studies identified through electronic database searches (CINAHL Complete, MEDLINE, SPORTDiscus) and manual searches undertaken up to June 2023.

RESULTS

Twenty-eight articles with 306 participants were included. As regard the experience of physical activity, although physical activity could elicit pleasure and enjoyment, many reported that physical activity sometimes produced pain. Various outcomes of physical activity were reported, with several physical, psychological, social, and lifestyle benefits prominent. Analyses of barriers and facilitators demonstrated how intrapersonal, interpersonal, environmental, and systems and programme factors influenced physical activity participation among older adults with physical disabilities.

DISCUSSION

Our findings contribute to literature on physical activity in older adults with physical disabilities by synthesising qualitative research on physical activity experiences, outcomes, barriers, and facilitators in this population. Findings demonstrate the need for knowledgeable and supportive healthcare and exercise professionals, environments that support physical activity, and activities that promote pleasure and social connections.Implications for RehabilitationPhysical activity is perceived to have wide-ranging benefits for community-dwelling older adults with physical disabilities.Various intrapersonal, interpersonal, environmental, and systems and programme barriers constrain physical activity in physically disabled people.Knowledgeable and supportive healthcare and exercise professionals, accessible environments, and activities that promote pleasure and social connections could enhance engagement in physical activity.

Biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation: A systematic review of qualitative research

BACKGROUND

People with disability living in supported accommodation experience ongoing health disparities. Physical activity and dietary quality are factors that may minimise the risk of chronic disease, however this population may experience a range of biopsychosocial barriers to physical activity and healthy eating.

OBJECTIVE

The aim of this review was to synthesise the biopsychosocial determinants of physical activity and healthy eating for people with disability living in supported accommodation, as reported by existing qualitative research.

METHODS

A systematic review of qualitative evidence was conducted according to the JBI's methodological guidance. In September 2023, five academic databases were searched for relevant literature published since database inception. A secondary analysis of the results of included studies was guided by the International Framework for Functioning, Disability, and Health (ICF), using the ICF Linking Rules.

RESULTS

A total of 31 articles were included. The analysis identified 154 determinants of physical activity and 112 determinants of healthy eating. Determinants were most prominently representative of environmental factors that captured the health promoting role and attitudes of staff, alongside the influence of the organisational context.

CONCLUSION

This review provided evidence for the complex interactions between body functions and structures, activities and participation, personal factors, and the environment that influence physical activity and healthy eating within supported accommodation. Although there is a limited body of evidence to guide practice, the findings highlight the multifactorial nature of interventions that can be utilised by direct care professionals and adapted to the individual needs and interests of people with disability.

The Influence of Blind Tennis on Subjective Inclusion Experiences-An Ableism-Critical Analysis

In this paper, we analyze the subjective inclusion experiences of visually impaired (VI) adult tennis players from an ableism-critical perspective. The primary focus of this research is the inclusive potential of blind tennis from the perspective of VI individuals. Episodic interviews were conducted to capture subjective perspectives. A qualitative text analysis revealed that the interviewees were confronted with multiple ability assumptions by sighted people in their everyday lives. Deficit notions on the performance of VI people included sports, work, and general activities. Participation in blind tennis helped the interviewees build a "competent identity" and acquire various skills useful for their everyday lives as participation in blind tennis was a pathway for competence in sports. Further research is needed to identify exclusion experiences from the perspective of disabled people to recognize the potential of different sports in reducing barriers to participation.

Digital platforms to facilitate physical activities for people with physical or sensory disabilities: A scoping review

BACKGROUND

People with disabilities (PWD) commonly experience difficulties in accessing their environments, which can lead to restricted participation in outdoor leisure-time physical activity. Participating in outdoor leisure-time physical activity (OLTPA) provides health and social benefits to PWD and benefits to the communities in which they live.

OBJECTIVE

The aim of the study was to identify features existing in digital platforms that facilitate access to OLTPA for PWD.

METHODS

A scoping review was conducted in four library databases and in Google advance search to identify relevant scientific and grey literature, and websites. Each step of the review was independently conducted by two co-authors who confirmed consensus of results. Descriptive data analyses were performed.

RESULTS

Seven scientific studies and ten websites were included in the scoping review. Seven presented mobile apps, nine presented a website and one presented an online database. Sources reported five main obstacles to using digital platforms that support access to physical activities (e.g., lack of digital literacy, technical issues, unintuitive design), and 10 facilitators (e.g., possibility to personalize your online space, accessibility features of the navigation). Among these sources, a trend emerged in the most important factors and features to consider for the visuals and navigation of the platforms.

CONCLUSION

The features of digital platforms that facilitate access to OLTPA include intuitive design compliant with accessibility guidelines and supported by navigation tools, personalization of the online space, and features for social interactions.

Prevalence of meeting 24-hour movement guidelines and its associations with health indicators in people with disabilities: A systematic review and meta-analysis

BACKGROUND

Meeting the 24-h movement guidelines (i.e., physical activity, sedentary behavior, sleep) could generate health benefits to people with disabilities. However, no systematic reviews or meta-analyses have examined the prevalence of meeting these guidelines and associations with health indicators in this group.

OBJECTIVE

This systematic review and meta-analysis aimed to examine the prevalence of meeting the 24-h movement guidelines and associations with health indicators among people with disabilities.

METHODS

Six electronic databases were searched for studies published in English from inception to May 31, 2023. Meta-analyses with the random-effects model were used to determine the prevalence of meeting the 24-h movement guidelines. Qualitative syntheses were employed to describe the associations between meeting the guidelines and health indicators.

RESULTS

Twenty-four studies comprising 77510 participants (41.6% females) with disabilities aged 6-65 years from eight countries were identified. Overall, 6.97% of the participants with disabilities met all 24-h movement guidelines, and 16.65% met none of the guidelines. Significant age (P = 0.006) and disability type (P = 0.001) differences were found in meeting all guidelines. Participants with disabilities who met all guidelines reported better psychosocial health indicators (9/9 studies) than those met none or only one of the guidelines. There was limited evidence or research for other health indicators.

CONCLUSION

There is some evidence showing that the prevalence of meeting all 24-h movement guidelines in people with disabilities is low. Meanwhile, there is preliminary evidence suggesting that meeting all guidelines is associated with better psychosocial health than meeting none of the guidelines.

Exploring needs and requirements for a prototype device measuring physical activity in pediatric physical therapy: A qualitative study

AIMS

To analyze needs and requirements of Pediatric Physical Therapists (PPTs), parents, children and adolescents with and without developmental disabilities in the future use of an activity monitor prototype (AM-p) in everyday clinical practice.

METHODS

Qualitative exploratory study with a thematic analysis approach, based on Braun and Clarke's six steps. Codes derived from the analysis and central themes were collated, based on Fleuren et al.'s groupings of determinants.

RESULTS

We interviewed 25 PPTs, 12 parents, and 12 children and adolescents. Within four groupings of determinants, we found nine themes: 1) development of information materials; 2) application: output visualization and ease of use; 3) design; 4) relevance and acceptance; 5) shared decision-making; 6) compatibility in daily living; 7) finances, 8) time, and 9) legislation and regulations.

CONCLUSIONS

End-users have similar basic needs, with individual fine-tuning to be addressed during further development of the AM-p. A child-friendly design, information material, and an easy-to-use application to read and interpret results, need to be developed. Efficient training for PPTs is important for the use of the AM-p and analysis of results. Communication between PPTs and children as well as parents enhances shared decision-making. We recommend involving diverse end-users to enable maximum customization of the AM-p.

Comparison of motion sensor and heart rate monitor for assessment of physical activity intensity in stroke outpatient rehabilitation sessions: an observational study

OBJECTIVE

To compare the estimation of time spent on 4 categories of physical activity intensity (sedentary behaviour, light physical activity, moderate physical activity, and vigorous physical activity) between a motion sensor and a heart rate monitor during a stroke outpatient rehabilitation session.

DESIGN

A multicentre cross-sectional observational study.

SUBJECTS/PATIENTS

Participants with stroke (> 6 months) undergoing outpatient rehabilitation sessions.

METHODS

Participants wore the SenseWear Armband motion sensor and the Polar H10 heart rate monitor during 2 rehabilitation sessions. The times estimated by each device were compared using a generalized linear mixed model and post-hoc tests.

RESULTS

Ninety-nine participants from 29 clinics were recruited and data from 146 sessions were included in the analysis. The estimated times depended on the devices and the physical activity intensity category (F = 135, p < 0.05). The motion sensor estimated more time spent in sedentary behaviour and less time spent in moderate physical activity and vigorous physical activity than the heart rate monitor.

CONCLUSION

The motion sensor and heart rate monitor provide different estimates of physical activity intensity during stroke rehabilitation. Further research is needed to establish the most appropriate device for each physical activity category.

Examining variation in the relationship between disability and physical activity across Australian local government areas

Understanding the relationship between disability and physical activity and whether it differs across local government jurisdictions may aid in the development of placed-based approaches to reducing disability-related inequalities in physical activity. The objectives of this study were to examine the association between disability and physical activity and assess whether this association varied between Australian Local Government Areas. The sample included 13,315 participants aged 18-64 years from the Household Income and Labour Dynamics Australia Survey, 2017. Participants self-reported disability and physical activity. Linear mixed-effects models estimated the association between disability and physical activity. People with disability reported less physical activity per week. We did not find evidence that this association varied across LGAs. Our findings do not add evidence towards local government-based approaches in Australia to reducing physical activity inequalities between people with and without a disability.

Appraising the Physical Activity Levels of Saudis with Physical Disabilities: Effects of Disability Type, Mobility Assistive Devices, and Demographic Factors

Physical activity (PA) has numerous health benefits for individuals with physical disabilities (IWPD). However, it is common for activity levels to fall below the suggested limits. This study aimed to evaluate the prevalence, pattern, and levels of PA among IWPD in Saudi Arabia. It also investigated the effects of individuals' type of disability, mobility assistive devices, and demographic features on PA levels. Data were collected from 238 participants, mostly male (62.2%), aged 39.76 ± 12.19 years. Among them, 19.3% had spinal conditions, 14.7% had progressive muscular dystrophy, 15.1% had multiple sclerosis, 17.6% had cerebral palsy, 16.4% had poliomyelitis, and 16.8% had limb or foot amputations. The participants were assessed using the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-AR). The results showed that 62.6% (64.9% of males and 58.9% of females) met the minimum PA guidelines specified by the WHO. The average PASIPD-AR score was 10.33 ± 10.67 MET-hours/day, indicating lower PA levels, and 8.4% of individuals did not participate in any form of PA. Significant discrepancies were detected in disability type and mobility assistive device use after age adjustment. Marital status, education, and occupation greatly affected PA components. Greater attention should be paid to promoting an active lifestyle among IWPD in Saudi Arabia.

Empowerment and social inclusion through Para sports: a qualitative study on women with physical impairments in Saudi Arabia

Background

Participation in sports represents a potent means of empowerment and social inclusion. Nevertheless, women with physical impairments encounter specific challenges in accessing Para sports. The main aim of this study is to present the experiential participation and achievements in sports of women with physical impairments in Saudi Arabia.

Methods

Twenty women athletes with physical impairments who engaged in competitive Para sports in Saudi Arabia were interviewed. Interpretive phenomenological analysis was employed to extract themes elucidating the experiences of women athletes with physical impairments in Para sports.

Results

Four dimensions were identified: (i) Exploring participation in sports; (ii) The positive impact of participation in sports; (iii) obstacles in participation in sport; and (iv) hopes and aspirations to improve participation in Para sports.

Conclusion

In Saudi Arabia, participation in Para sports functions as a powerful tool for empowering and socially integrating women with physical impairments. However, these women encounter challenges in accessing sports. Achieving empowerment in Para sports necessitates the establishment of an inclusive ecosystem that celebrates diversity and equality. Collaborative efforts from governments, sports organizations, communities, and individuals are indispensable in creating an environment where women with impairments can flourish in sports.

Preliminary translation of 'Reducing Disability in Alzheimer's Disease' among individuals with intellectual disabilities and caregiver dyads

BACKGROUND

The Reducing Disability in Alzheimer's Disease in Kansas City (RDAD-KC) intervention has been shown to improve the health of individuals with dementia and caregiver dyads. This manuscript reports the results of implementing the RDAD among individuals with intellectual disabilities and caregiver dyads.

METHODS

Nine community agencies deployed the 12-week intervention. We assessed changes in individuals with intellectual disabilities' behavioural symptom related severity and physical activity, and caregivers' behavioural symptom-related distress, unmet needs, and caregiver strain.

RESULTS

Forty-four dyads enrolled, and 23 (~60 years, 48% female) completed ≥75% of the intervention. We observed decreases in behavioural symptom related severity (p = .07) and increases in physical activity (p = .20) among individuals with intellectual disabilities. We also observed decreases in behavioural symptom related distress (p = .14), unmet needs (p = .50), and caregiver strain (p = .50) among caregivers.

CONCLUSIONS

The RDAD-KC intervention showed promising, although statistically non-significant, benefits among individuals with intellectual disabilities and their caregivers.

Comparison of Participation in Strength Activity Among People With and Without Disabilities: 2013-2017 Behavioral Risk Factor Surveillance System

BACKGROUND

The current physical activity guidelines recommend engagement in strength activities at least 2 days per week. Currently, there is a lack of literature examining strength activities among people with disabilities. The purpose of this study is to estimate and compare the prevalence of engagement in strength activities and adherence to strength activity guidelines among adults with and without disabilities in the United States.

METHODS

A total of 1,005,644 adults (18-80 y old) with and without disabilities from the 2013 to 2017 Behavioral Risk Factor Surveillance System were included in this secondary data analysis. Descriptive analyses were performed to describe the prevalence of strength activity behaviors of adults with and without disabilities. Logistic and Poisson regression models were performed to evaluate the relative contribution of disability status on strength activity behaviors.

RESULTS

A higher proportion of participants without disabilities (46.42%, 95% CI, 46.18-46.65) reported engaging in strength activities compared with participants with disabilities (30.68%, 95% CI, 30.29-31.08; P < .01). Participants with disabilities were less likely to engage in strength activities (odds ratio = 0.51, 95% CI, 0.50-0.52; adjusted odds ratio = 0.75, 95% CI, 0.73-0.77) and meet strength activity guidelines (odds ratio = 0.56, 95% CI, 0.54-0.57; adjusted odds ratio = 0.75, 95% CI, 0.73-0.77) than participants without disabilities.

CONCLUSION

Experiencing a disability is associated with lower engagement in strength activities; thus, it is important to identify effective and efficient approaches to promoting strength activities among people with disabilities.

Impact of a Service-Learning Program Using Soccer Training on the Emotional and Behavioral Problems of Children with Developmental Disabilities

Children with developmental disabilities may develop emotional and behavioral problems that arise from difficulties in social interaction, and therefore, a process of providing and testing intervention activities for emotional and behavioral issues in the early stages of development is required. This study evaluated the effects of a 12-week service-learning exercise program on children with developmental disabilities, contrasting it with a control group not engaged in specific physical activities. The participants included 18 children with developmental disabilities who participated in the service-learning exercise program (SLG) and 18 children with developmental disabilities (Non-SLG) who did not participate. The Korean Behavior Assessment System for Children-2 was used to evaluate children's emotional and behavioral problems. A two-way repeated-measures ANOVA was conducted to verify the interaction effect between the group and period according to program participation. The results showed the positive internalization of problem behaviors in the emotional domain (F = 4.291, p = 0.011), attention deficit/hyperactivity (F = 4.761, p = 0.012), and personal adjustment (F = 4.116, p = 0.023) in the SLG group. These results suggest that participation in a service-learning exercise program positively affected emotional and behavioral problems in children with developmental disabilities. This could provide a basis for future research on service-learning exercise programs for children with developmental disabilities.

Physical activity of children and adolescents with disabilities in Poland - First Para Report Card

Background

This study provides a comprehensive evaluation of the Polish Para Report Card, which assesses various aspects of physical activity (PA) and related indicators among Polish children and adolescents with disabilities. This area has been under-researched, especially in the Polish context.

Methods

The research methodology included systematic literature searches from 2014 to 2022, utilizing databases such as PubMed, EBSCO, and Google Scholar. This was complemented by outreach to governmental institutions for additional reports and data. The search strategy was aligned with the Global Matrix methodology and aimed at evaluating ten distinct indicators: Overall PA, Organized Sport and PA, Active Play, Active Transportation, Sedentary Behavior, Family and Peers, School, Community and Environment, Government.

Results

Grades were assigned to three of ten indicators. The Overall PA, Sedentary Behavior, and Government indicators each received a D-grade.

Conclusions

The study reveals the need for an extensive system to monitor PA among Polish children and adolescents with disabilities, and the development of effective strategies to enhance PA in this group. Children with disabilities in Poland are under-researched in the area of PA compared to their their counterparts without disabilities.

Physical Activity Levels, Correlates, and All-Cause Mortality Risk in People Living With Different Health Conditions

BACKGROUND

To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality.

METHODS

We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity Questionnaire, and mortality data were obtained from the Dutch death register.

RESULTS

People with a reported health condition were less likely to meet physical activity guidelines than people without a reported health condition (odds ratios ranging from 0.55 to 0.89). Higher body mass index and sitting time, and lower self-rated health, physical functioning, and education levels were associated with lower odds of meeting physical activity guidelines across most health conditions. Finally, we found a protective association between physical activity and all-cause mortality in both people living with and without different health conditions.

CONCLUSION

People living with different health conditions are generally less physically active compared with people living without a health condition. Both people living with and without self-reported health conditions share a number of key factors associated with physical activity levels. We also observed the expected protective association between physical activity and all-cause mortality.

Autonomy, Resilience and Life Satisfaction among Badminton Paralympians

Background

People with disabilities are marginalised in mainstream culture and they also experience increased restrictions in a variety of areas, such as sport. The barriers they encounter may adversely affect their life satisfaction, especially if they have a low perceived sense of autonomy and resilience. The purpose of this study was to investigate the relationship between autonomy, resilience and life satisfaction in para-badminton athletes and the mediating role of resilience in the relationship between autonomy and life satisfaction.

Methods

Data were collected from 137 para-badminton athletes (male: 65.0% and female: 35.0%). Self-reported measures were used to assess the participants' autonomy, resilience and life satisfaction levels.

Results

A structural equation model analysis was performed; the model had sufficient fit indices (comparative fit index [CFI] = 0.94, root mean square error of approximation [RMSEA] = 0.06, standardised root mean square residual [SRMR] = 0.07). The findings showed that autonomy had a significant effect on resilience (β = 0.32, P = 0.001). Further, resilience had a significant effect on life satisfaction (β = 0.19, P = 0.011) and significantly mediated the effect of autonomy on life satisfaction (β = 021, P = 0.033).

Conclusion

This study revealed that autonomy fosters resilience among athletes, in turn allowing them to achieve greater life satisfaction. Therefore, society and sport communities should actively seek ways to improve the autonomy and resilience levels of athletes with disabilities.

The International Classification of Functioning Disability and Health Framework (ICF): a new approach to enhance sport and physical activity participation among people with disabilities in Scotland

This research provides a pilot study of the International Classification of Functioning Disability and Health Framework (ICF) involving persons with disabilities (PWD) with and without lived experience of sport participation in Scotland. National surveys in Scotland provide limited information on the nature of individual disability restricting the understanding of the relationship between disability and sport and physical activity participation. The ICF is a framework that aims to describe and classify functioning and thus can be used as a tool to provide a more detailed description of impairment for PWDs beyond their clinical condition. This knowledge has the potential to enhance the development of policies to increase the participation levels in this group. The ICF has also been used to inform the current IPC classification system at a competitive and elite level. As part of a larger study, 450 participants aged between 12 and 70 years completed an online questionnaire examining attitudes to, and participation in, sport and physical activity as well as completing the structural and functional components of the ICF. Subsequently, 18 people participated in focus groups aged between 13 and 61 years. The focus groups examined four meta-theme areas: physical, social, psychological, and sport-specific factors. The results confirm that the ICF provided a more detailed indicator of the key impairments that could have an impact on sport and physical activity participation. There was a clear lack of awareness of the links between the ICF and the classification system for competitive parasport. We concluded that a modified ICF-based assessment tool, incorporating social and environmental factors, has the potential to predict the likelihood of participation and offers a more comprehensive picture of both individual and national disability characteristics. This allows for the development of targeted policies and strategies to assist those with a disability to participate in sport. The overall framework presents a shift in thinking, in policy terms, for those in public health and in sport governance and delivery. The significance of this work is especially concerned with public health and wellbeing and sport development policy as pathways from recreational sport user to elite athlete parasport classification and performance.

The co-development and evaluation of an e-learning course on spinal cord injury physical activity counselling: a randomized controlled trial

BACKGROUND

Health, fitness and lifestyle professionals can play important roles in promoting physical activity in groups at risk of developing an inactive lifestyle, such as people with spinal cord injury (SCI). Tailored counselling is a promising tool to promote and improve physical activity levels. To support professionals to effectively have a conversation about physical activity with clients with SCI, evidence-based training and resources are needed. This project aimed to (1) co-develop an e-learning course on best practices for SCI physical activity counselling and, (2) examine the effectiveness and usability of this course.

METHODS

Guided by the technology-enhanced learning (TEL) evaluation framework, we used a systematic, multistep approach to co-develop and evaluate an e-learning course. The development process was informed by input and feedback from a diverse group of end-users and experts (n > 160) via online surveys and (think-aloud) interviews. A randomized controlled trial was used to compare learning outcomes (post-knowledge and self-efficacy) between participants who completed the course (intervention group) and the wait-listed control group. Usability, learning experiences, and satisfaction were assessed among all participants.

RESULTS

Forty-one participants (21 intervention-group; 20 control-group) with various backgrounds (e.g., lifestyle counsellors, physiotherapists, occupational therapists, recreation therapists, fitness trainers) enrolled in the randomized controlled trial. After completing the course, participants in the intervention group showed significantly improved knowledge on the best practices for SCI physical activity counselling and higher self-efficacy for using these best practices in conversations with clients with SCI compared to the control group (p <.001). Participants reported above average usability scores, positive learning experiences, and high levels of satisfaction when completing the course.

CONCLUSION

We used a systematic, multi-step, theory-informed approach to co-develop and evaluate an evidence-based e-learning course on SCI physical activity counselling to support professionals to promote physical activity in their daily practices. The overall positive findings demonstrate that the e-learning course is feasible and ready for further implementation in various health and community settings. Implementation of the e-learning course can help professionals improve the physical activity support they provide to their clients, and subsequently increase physical activity participation in people with SCI.