Appropriate physical activity engagement promotes a host of psychosocial benefits. These benefits are especially valuable for individuals with disabilities because they have high rates of overweight and obesity. Additionally, because people with disabilities often have associated secondary conditions (e.g., pressure sores, diabetes) physical activity is particularly important as a mechanism to prevent or attenuate secondary conditions. Unfortunately, most individuals with disabilities are sedentary or get limited physical activity. Low levels of physical activity among people with disabilities have been documented in North America, Europe, Asia, and Africa. Minimal physical activity is evident irrespective of age, gender, the setting (physical education vs. leisure), disability type (spinal cord injury vs. visual impairment), or assessment method (pedometers vs. self-report). Older females with severe disabilities from low socioeconomic-status groups are most at risk for low physical activity engagement. In this entry, the various psychosocial benefits of physical activity are highlighted, followed by a discussion of the barriers to physical activity.
Increases in strength and endurance typically contribute to enhanced perceptions of competence. Mastery experiences and social influences both serve to contribute to enhanced competence perceptions. Competence benefits have been derived from activities as varied as lifestyle leisure activity, martial arts, youth sport, fitness training, and horseback riding. Most people also derive social benefits such as self-esteem enhancement stemming from being physically active with friends. Children in adapted sport programs find that they can more easily be themselves. Participation in physical activity also leads to increased social integration and reduces feelings of loneliness and isolation.
However, being physically active does not automatically confer social benefits upon participants. For example, it is not unusual for children to be excluded from physical education classes, ignored when sport teams are selected, and teased at recess, for looking different. Adults with disabilities (e.g., spina bifida) participating in inclusive recreation programs report both positive and negative reactions and experiences. In one study, participants with disabilities reported having difficulty ascertaining whether able-bodied participants disliked them or were simply ambivalent toward them. Other times, adult participants perceived that able-bodied exercisers treated them like children. Despite these reports, physical activity involvement helps minimize the negative influence of a disability on self-perceptions. A participant in one study reported that she felt “normal” when being physically active. Other individuals with disabilities have experienced less stigmatization which they attributed to their physical activity involvement. Researchers have also found that able-bodied people tend to evaluate people with physical disabilities more positively if they perceive them as being physically active. Two other benefits expressed by people with disabilities are greater feelings of independence from being physically active, and more opportunities to travel away from home on a sport team.
In addition to competence and social benefits, engaging in physical activity is simply enjoyable, and such experiences are valuable for quality-of life reasons. In addition to the momentary value of increased positive affect, physical activity can also help in mood management when individuals do not have good days. For example, individuals with spinal cord injury (SCI) reported increased positive affect and decreased negative affect after exercising irrespective of whether participants had positive or negative life events that day. There is also preliminary evidence that individuals with neurotic tendencies benefit the most from the mood enhancing benefits of physical activity. In a recent study, virtually half the respondents noted enhanced emotional functioning that they viewed as stemming from their physical activity involvement. Many male adults with SCI have also experienced reduced stress, depression, pain, increased life satisfaction, and subjective well-being as a result of exercise. In brief, much research has supported physical activity as an important vehicle for quality-of-life enhancement by reducing negative emotional states and increasing positive affective states.
A growing body of research has also documented the relational benefits experienced by families who are physically active. Researchers examining family recreation and leisure experiences show that such involvement enhances family quality of life. A small body of research pertained to the family as a unit and to how physical activity experiences impact children, siblings, and parents. Adolescent participants were asked to describe how their adaptive skiing or horseback riding experiences influenced the quality of their family life. Virtually 70% agreed or strongly agreed that their experiences in these two activities enhanced their family life. Additionally, almost 80% of the participants agreed, or strongly agreed, that skiing or riding with family members contributed to the meaning of the activity. This finding has also been supported by scientists who have found that parents, particularly mothers, in families that have children with disabilities often engaged in activities like bike riding with their children in order to enhance family relationships.
Unique experiences, such as outdoor skill training programs and outdoor adventure trips including both parents and children with disabilities, are promising. Parents, for instance, have reported that their experience helped them overcome or eliminate constraints to being physically active. Both qualitative and quantitative results indicated that parents believed the experience enhanced family interactions, and promoted greater cohesion. Swedish families involved in orienteering, golf, and archery found that their children believed their participation helped the family experience “a feeling of togetherness.” In brief, physical activity–oriented experiences are vehicles that enhance the psychosocial functioning of families.
Parents also benefit from their children’s involvement in physical activities. Fifteen families with children with disabilities, who participated in adapted baseball, found parents derived mutual support from each. In particular, the shared social reality nature of the support was particularly meaningful. In summary, physical activity engagement results in a plethora of benefits to participants although sometimes participants report negative experiences. Individuals participating with or supporting the physical activity experiences of people with disabilities can detract from or enhance the physical activity experience.
The benefits of being physically active are often difficult to obtain because of a multitude of barriers to physical activity. Individual based barriers include disability type. For instance, leg amputees cannot of course run or walk, although they can use crutches and wheels. Pain or discomfort is also a major barrier to being physically active. People with cerebral palsy (CP) and SCI list pain as frequently interrupting and preventing physical activity engagement. The physical discomfort of exercise is also viewed as a barrier by some individuals. In addition to pain, people with disabilities also note that fatigue, a lack of energy, disease, injury, and poor health prevent them from being physically active.
Not knowing where exercise facilities are located or how to start and develop an exercise program also inhibits physical activity. A lack of time for physical activity is also reported by adults because of work and family responsibilities. Limited financial resources reduce or prevent travelling to exercise clubs, buying exercise equipment for the home, or purchasing exercise club memberships. A fear of developing tight muscles and joints from exercising has also been reported. Finally, inner city residents are often afraid to leave their homes for fear of crime or fear of falling.
Barriers that are more social in nature are also common. For instance, most children need their parents to transport, pay for, and facilitate their physical activity involvement. At the same time, parents are often fearful that their children might get teased by their peers for looking different. Parents also fear for their children’s physical health if they engage in sports viewed as dangerous by their parents (e.g., basketball for a blind child). Parents, in turn, criticize community recreation personnel for not knowing enough about adapted sport programming principles and various disability conditions. Physical education teachers are also seen as lacking appropriate training in disability conditions and adapted physical education. Physical education teachers themselves confirm this view by indicating that they often lack adequate professional preparation in their teacher education programs. It is not unusual for physical education to be replaced by therapy or mobility training or canceled because of blanket medical excuses from doctors. Caregivers of adults with CP have asserted that they did not believe an exercise program was of value for their residents, and about a third of them believed exercise would not help their client’s CP. Some caregivers even believed, contrary to research, that exercise would worsen CP.
In addition to individual and social barriers, the environment can also hamper physical activity engagement. For instance, children with disabilities often note that there are very few places to be active and rarely are facilities conveniently located. As children get older, their limited physical activity opportunities tend to diminish. Opportunities can also be illusionary, as wheelchair basketball league officials sometimes ban motorized wheelchairs and swimming pools are viewed as too cold by some swimmers with disabilities. Built environmental barriers, such as a lack of a curb cut or crosswalks without auditory signals, can prevent individuals with disabilities from crossing the street. Ramps that are ostensibly designed to facilitate access are often built too steep and cannot be used.
Barriers are also subtle. For example, although wheelchairs help people with disabilities to move, many individuals with SCI view their wheelchair as the number one barrier to physical activity. In one study, participants rated their wheelchairs as bigger barriers to physical activity than their disability. Most medical personnel and clinicians have only limited training in prescribing wheelchairs, which might explain why some individuals with SCI find manual wheelchairs uncomfortable, too wide and heavy, and therefore hard to move.
Researchers such as James Rimmer, Barth Riley, Edward Wang, Amy Rauworth, and Janine Jurkowski have examined the accessibility of health clubs and found that many (over 50%) clubs do not have curb cuts for easy access or clear paths to lockers. Most weight rooms do not have enough room for exercisers to move their wheelchairs around the exercise floor. Inadequately lighted biking and running paths and wooded walking trails with exposed tree roots can be barriers to individuals with vision loss.
In summary, physical activities ranging from formal exercise and sport opportunities to recreation and leisure lifestyle activities can all provide a wide ranging set of psychosocial benefits to participants. However, many physical activity barriers organized across individual, social, and environmental categories limit how physically active people with disabilities are, and thus, the benefits they accrue.
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