Physical Disability and Physical Activity A Review
Physical Disability and Physical Activity A Review
Physical Disability and Physical Activity A Review
Martin Saebu*
The purpose of this article was to examine the literature on correlates and associations of physical
activity among adults (age 16-65 years) with physical disabilities. Electronic searches were
conducted to identify research articles published from 1980 to 2009. Specific inclusion criteria were
identified. The search produced 4,189 articles; however, only 57 met all specified criteria. They
represented seven different disability groups, including one cross-over category with two or more
disabilities. The International Classification of Functioning, Disability and Health developed by the
World Health Organization were used as a structural framework for organizing the results. The
results revealed a substantial core of research concerning a few disability groups, among them
spinal cord injury and multiple sclerosis. Significant correlates were identified in relation to type of
disability and functioning, but also among environmental factors (e.g. costs, accessibility, built
environment, information and social support) and personal factors (e.g. age, exercise self efficacy,
depression, and mental health). Findings are discussed relative to conducting future physical
activity research on persons with disabilities.
activity, categorized by gender, race, annual that lack of motivation, lack of energy, and
income, and education, did not include lack of interest were the most frequently cited
persons with disabilities (Rimmer et al., barriers to exercise among individuals with
1996). SCI, emphasizing that psychosocial aspects
However, 15 years later, there exists are important, too. Consequently, personal
more knowledge about this population and factors should be included, in a similar way as
also about various disability groups. In 2005, in research on able-bodied (Bauman, Sallis,
CDC reported that twice as many adults with Dzewaltowski, & Owen, 2002). Personal
a disability (25,6%) were physically inactive factors include demographic-, biological-,
during the preceding week, compared to psychological-, cognitive-, and emotional
adults without a disability (12,8%) (Centers correlates. The correlates of environmental
for Disease Control and Prevention, 2007). and personal factors were chosen based on
This was consistent with other studies from similar research among able-bodied (Bauman
the U.S. (Boslaugh & Andresen, 2006; Ellis, et al., 2002; Trost, Owen, Bauman, Sallis, &
Kosma, Cardinal, Bauer, & McCubbin, 2007; Brown, 2002).
McGuire, Strine, Okoro, Ahluwalia, & Ford, In summary, the purpose of this paper
2007; Rimmer, Rubin, & Braddock, 2000). is to provide a comprehensive review of the
There is also an increasing amount of research literature which examines (1) physical activity
connected to activity level and methods for level and (2) correlates and associations of
measuring physical activity and exercise in physical activity among adults with a
this population (Cervantes & Porretta, 2010; disability, in relation to (a) functioning (b)
Washburn, Zhu, McAuley, Frogley, & Figoni, environmental factors and (c) personal
2002). Therefore, the aim of this review was factors. Finally, (3) we will also examine the
to get an overview of the existing knowledge- studies in relation to disability type.
base about correlates and associations of
physical activity and disability. METHOD
General
Selection of variables within the ICF factors Scoping reviews are particularly
Within the factor functioning and important as an overview when a research
disability, there has been a call for research on area (such as disability and physical activity)
potential differences in activity patterns does not have uniformity in study design and
between groups of people with different measurement (Hempel, Norman, Golder,
disabilities (Rimmer et al., 1996). Research Aguiar-Ibanez, & Eastwood, 2008; Rimmer,
indicates that the severity of the disability is Chen, McCubbin, Drum, & Peterson, 2010).
negatively correlated with physical activity This type of review use specific protocols to
(Jahnsen, Villien, Aamodt, Stanghelle, & increase focus in study identification,
Holm, 2003). Consequently, information appraisal, and synthesis, thereby reducing bias
about the type and the severity of the (Petticrew & Roberts, 2006). On this basis,
disability seems important to include. the methodological approach of a scoping
Furthermore, environmental barriers seem to review was preferable.
limit participation in physical activity for
people with disabilities (Rimmer, 2005; Literature search
Rimmer, Wang, & Smith, 2008). PubMed, PsycINFO and
Consequently, information about SPORTdiscus were systematically searched
environmental factors should be included to for relevant articles. These databases were
fully understand the correlates of physical chosen because together they are generally
activity. Environmental factors include acknowledged to provide a complete
physical environment factors, social and overview of studies and articles covering
cultural correlates. In addition, Scelza, disability and physical activity/exercise, in
Kalpakjian, Zemper and Tate (2005) reported relation to sport, psychology and
rehabilitation. This is in line with previously review. Physical disability was defined as
conducted similar literature reviews (van der someone with a mobility or sensory
Ploeg et al., 2004). We specifically looked for impairment. Although important, cognitive,
studies describing the relationship between mental health and developmental disabilities
physical activity and disability. The keywords were not included in this review. The search
used in the Medline search were “exercise” included articles about persons with a
(Medical Subject Headings term – MeSH - physical disability aged 18-65 years
including both “physical activity” and (excluding children and older adults), for the
exercise) and disabled persons (MeSH term period from 1980-2009. The research before
including disabled, disability, physically 1980 was limited and mostly described the
disabled, physically challenged, physically health benefits of activity, and early
handicapped). PsycINFO was searched using experiences with physical activity and
“physical activity” or “exercise” and “disab*” disability. Further, we excluded articles
to include disability, disabled and people with concerning physical activity in school and
a disability. SPORTdiscus was searched using education, athletes with a disability, low back
the terms “physical activity”, “exercise”, pain, and fibromyalgia. Due to the scope and
“motivation” and “disab*” to include complexity of the present review, studies
disability, disabled and people with a testing theoretical models and constructs were
disability. also excluded. Keywords for the link between
physical activity and persons with a disability
Selection criteria were; determinants, associations, correlates,
English language peer-reviewed predictors, barriers, facilitators, and
primary literature that examined physical mediators. Search results are presented in
activity (or exercise) and disability among Table 1.
adults with disabilities was included in the
and less with correlates of existing physical Table 2. Percent and number of physical
activity. Rimmer et al. (2010) were for activity studies by disability, research design,
instance focusing on health outcomes (i.e., data collection method, and publication year
functional health, cardiorespiratory health,
musculoskeletal health, metabolic health Characteristic N %
including healthy weight and mental health) Disability
of clinical exercise interventions. Therefore,
Stroke 1 1,8
intervention studies were excluded in the
MS 9 15,8
present paper.
The reason for excluding studies SCI 12 21,0
involving participants aged 65 years and older CP 5 8,8
was to control for aging related factors that Parkinson 1 1,8
may attenuate the potential impact of the Heterogeneous 29 50,8
exercise interventions on younger individuals Sum 57 100,0
with disabilities. In conclusion, studies that Research design
met the following criteria were included: (1) Cross sectional 42 73,7
cross sectional studies, prospective studies; Qualitative 15 26,3
qualitative studies (2) health outcomes Sum 57 100,0
(physical activity or disability) as dependent Data collection method
variables or discussion point; and, most
Postal questionnaire 30 52,6
importantly, (3) describing correlates,
determinants, associations or mediators in Telephone-interview questionnaire 5 8,8
relation to physical activity. 57 studies were Internet-questionnaire 1 1,8
included in the final analysis (see Table 2.) In-depth interview 13 22,8
Focus-group 2 3,5
Data extraction and synthesis Combined (e.g.
For studies that met the inclusion pedom./accelerom./quest.) 6 10,5
criteria, we extracted the data for each Sum 57 100,0
individual study by type of disability, research Publication year
design, data collection method, type of 2000 - 2009 44 77,1
independent variables (environmental, 1990 - 1999 12 21,1
personal and function-related) and dependent 1980 - 1989 1 1,8
variable. Type of disability was classified Sum 57 100,0
according to the participants’ main diagnosis
described were cross-over activities (more
(1) Stroke; (2) Multiple Sclerosis; (3) Spinal
than one activity).
cord injury; (4) Cerebral palsy; (5)
Parkinson’s disease; (6) Combined diagnosis
or disability groups. The research design was
RESULTS
classified into one of the following categories:
Initial search results
(1) Cross-sectional studies and (2) Qualitative
Table 1 provides an overview of the
studies. Data collection method as listed
review process. After completing the
under the following headings: (1) Postal
literature search, 4,189 articles were
questionnaire; (2) Telephone-interview
identified. The first-level review involved 460
questionnaire; (3); Internet-questionnaire; (4)
articles related to physical activity and
In-depth interview (5) Focus-groups and (6)
exercise. A second-level review was
Combined (e.g., pedometer/accelerometer/
conducted in order to identify studies that
questionnaire). Types of exercise was also
were strictly physical activity/exercise and
extracted, but yielded only limited
disability related. Among the 460 citations,
information. Ninety percent of the activities
262 additional studies were excluded because
they focused on specific rehabilitation
interventions (e.g., gait training, functional fast wheeling (IPAQ Research Committee,
electrical stimulation, constraint-induced 2005).
movement training), athletes, elderly, lower Further, Santaigo & Coyle (2004)
back pain or fibromyalgia, and 131 studies reported leisure time physical activity
were excluded because they were; testing a participation to be 2.9 times (+ 5.12) per week
theoretical model or construct, describing the in 170 women with physical disabilities, with
research field, literature reviews or 39.4% reporting no participation at all. In a
commentaries. Another 10 studies were study among Afro-American woman with
excluded because they did not primarily focus physical disabilities (N = 50) Rimmer, Rubin,
on physical activity. As a result, a total of 57 Braddock, & Hedman (1999) revealed low
studies met the inclusion criteria and were levels of leisure time physical activity. Only
included in the final analysis. 8.2% of the sample participated in leisure-
time physical activity, and only 10% engaged
Physical activity studies sorted by disability, in some kind of aerobic exercise three or more
research design and publication year days per week for at least 15 min.
Table 2 provides the characteristics of Unstructured physical activity (e.g., work-
the 57 studies by disability, research design, related activity, housework, gardening,
data collection method, and publication year. shopping) was nearly absent.
Please note the high number of studies In a study among 4,038 adults with
including people with spinal cord injury disability, Boslaugh and Andresen (2006)
(SCI). We also noticed a significant number concluded that the majority of adults with
of studies including multiple sclerosis (MS). disability did not meet basic
However, most of the studies included several recommendations for physical activity. The
diagnostic groups (n = 29, 50.8%). Of the recommendation of the CDC and ACSM for
articles included, there was only one study moderate physical activity was used:
from the eighties, and a small amount of moderate exercise for at least 30 minutes on 5
studies from the nineties (n = 12, 21.1%). or more days per week in segments of at least
Forty-two of the studies were cross-sectional 10 minutes each was considered to be
and 15 were qualitative studies/case studies. sufficiently active. Participants were
About half of the studies in the present review classified dichotomously as meeting this
used postal questionnaires as the main data recommendation or not.
collection method (see Table 2). Among the studies on cerebral palsy
(CP), van der Slot et al. (2007) concluded that
How active are adults with a physical the levels of everyday physical activity and
disability? community participation, measured by an
In this review, studies that are activity monitor in adults with CP, were
measuring both total physical activity and comparable to levels in able-bodied. Other
leisure time physical activity are included. studies including persons with CP have
Several studies have reported activity levels, reported quite low levels of activity. Jahnsen
but only a few of them are accurate when it et al. (2003) reported that among 403 adults
comes to description of the activity level. with CP, 46% were regularly physically
Among the diagnostic cross-over studies, active, defined as a minimum of 1 hour a
Ellis et al. (2007) reported that among 223 week. In their qualitative study among 22
adults (M_age = 45.4 years, SD = 10.8) who individuals aged 35-68 years, Sandstrom,
completed a web-based survey, the average Samuelsson and Oberg (2009) demonstrated
total physical activity score was 20.5 a low activity level among the interviewed
metabolic equivalent (METS)-hours/day (SD participants.
= 16.8). This corresponds approximately to Several studies included persons with
five hours a week with extensive walking or SCI. In a group of 985 persons with SCI, just
over half (52.1 %, n = 501) of participants
engaged in no sports activities each week monitor. They calculated that the duration of
(Tasiemski, Kennedy, Gardner, & Blaikley, average dynamic activities was 49 minutes
2004). They had no measure for total physical per day in the SCI-group. This was
activity. Van den Berg-Emons et al. (2008) significantly lower than the mean duration of
reported low activity level compared to able- dynamic activities among able-bodied (143
bodied in a group (N =16) of persons with min. per day).
SCI, one year after in-patient rehabilitation.
The activity level was measured by activity-
Does the disability and the level of disability as an important correlate when
functioning count? discussing physical activity and disability. In
Table 3 provides an overview of the following we have reported some of these
correlates of physical activity and disability. studies, starting with the cross-over studies
Several studies have outlined functioning and without any specific diagnosis.
Longmuir and Bar-Or (2000) observed for physical independence, mobility, and
significant differences in habitual physical occupation were positively correlated with
activity between disability types, specific physical activity in quadriplegic persons.
diagnostic categories, and age in a study They also concluded that physical activity
among 957 youths with a disability. They also may play an important role in perceived
found significant differences in perceived physical function for persons with SCI, and
participation limitations among disability particularly for persons with quadriplegic
types. Youths with CP, muscular dystrophy, injuries.
and visual impairment had the most sedentary Furthermore, studies conducted in the
lifestyles. Gender, however, did not influence domain of multiple sclerosis (MS) also give
the results. Among a number of variables, support to level of functioning as an important
Santiago & Coyle (2004) emphasized that de- correlate. Becker and Stuifbergen (2004)
conditioning was inversely related to the reported that fatigue and grade of impairment
ability of 170 moderately mobility- impaired were significantly associated with decreased
women to participate in leisure time physical activity level in a study in 2,710 persons with
activity. Shifflett, Cator, & Megginson (1994) MS. This observation was supported by
also reported that functional health barriers in several studies which found that increased
62 persons with a disability had a negative MS and decreased function reduced the
impact on their adherence to an active activity level (Crocker, 1993; Kasser, 2009;
lifestyle. Motl, Snook, McAuley, Scott, & Gliottoni,
Twenty percent of the survey 2007; Stroud, Minahan, & Sabapathy, 2009).
respondents in a study (N = 2298) by Finch, Finally, CP represents a heterogeneous
Owen, & Price (2001) posted current injury or disability group. Not surprisingly, studies
disability as a reason for not being more have revealed associations between physical
active. There was a significant trend toward activity and type of disability and functional
more frequently mentioning current injury or level. According to Jahnsen et al.(2003), the
disability as a barrier for participation in degree of CP seems to play a main role for the
activities with increased age. High body mass activity level. This was supported by van Eck
index and current low physical activity levels et al. (2008), who found low activity levels in
were significantly related to the injury or persons with more severe CP (Gross Motor
disability barriers. This was supported by Function Classification System - GMFCS
Warms et al (2007) and Ellis et al. (2007). III/IV) than persons with GMFCS I/II.
Further, adults with disabilities (N = 117) In summary, increasing body mass
were more likely to engage in a health- index, low levels of health status, low
promoting lifestyle if less mechanical mobility level, and low physical function
assistance was required (Stuifbergen & seems to be correlated with reduced activity
Becker, 1994), assuming that less mechanical level. Further, increasing severity of MS, and
assistance also indicates higher physical severe degree of SCI or CP also demonstrate
functioning. In a study by Bodde, Seo and high correlation with reduced activity level.
Frey (2009), a national US-sample of 46,883
adults with disabilities was examined. They Environmental factors
reported that physical activity participation Focus on environmental barriers and
was significantly associated with self-rated facilitators have increased in this field over
health status. the last decade. These factors are many and
When looking at the diagnose-specific quite heterogeneous, because we are
studies, Manns & Chad (1999) found that discussing different kind of environments
among 38 participants with SCI, physical (e,g., social, natural, technical, equipment,
activity was negatively correlated with built environment, facilities, transportation
reduced physical functioning in quadriplegic etc). Among the general studies, Lockwood
and paraplegic persons. Hence, higher scores (1997) explored views and behaviors of 493
people with and without disabilities in among 206 persons with SCI suggested a role
relation to their levels of participation in of the physical environment in predicting
physical activity in settings ranging from physical activity; particularly moderate
segregated to fully inclusive. The findings intensity leisure time wheeling (Arbour &
identified that there is considerable room for Martin Ginis, 2007). In a qualitative
improvement in areas such as training, interview-study with 32 participants, Vissers
flexible programming, support services for et al. (2008) discussed the most important
inclusive settings and transport to sporting barriers to and facilitators of the level of
facilities. everyday physical activity in thirty-two
The four major environmental barriers persons with a SCI. The major environmental
reported by Rimmer et al. (2000) among fifty barriers were accessibility of stores and
African American women with physical buildings. The most frequently mentioned
disabilities were cost of the exercise program facilitators were preparation in the
(84.2%), transportation (60.5%), and not rehabilitation centre with respect to daily
knowing where to exercise (57.9%). Financial activities and social activities and stimulation
resources were also representing important to be physically active.
barriers to physical activity in the studies by When caregivers perceived greater
Becker and Stuifbergen (2004) and Scelza et benefits of exercise, adults with CP (N = 83)
al. (2005). The latter study also emphasized were likely to exercise more frequently
the importance of knowledge of where to (Heller, Ying, Rimmer, & Marks, 2002). This
exercise and access to a place to exercise is supported by Sandstrom, Samuelsson and
among 72 individuals with SCI. Ellis et al. Oberg, who committed an interview with 22
(2007) revealed that factors obstructing community-living adults (35 - 68 years) with
physical activity were disability itself and CP. They identified five different themes, and
associated symptoms, and a lack of access to among the environmental factors we mention
adequate facilities, equipment, or programs. “being integrated in daily life”, and
The factors that facilitate physical activity “supportive healthcare with competent
were access to adequate facilities, equipment, professionals” from that study. Social support
or programs, and support or assistance. was also underlined as important mediator on
Rimmer et al. (2008) administered a the pathway between physical activity and
survey to a group of 83 adults with unilateral quality of life in a sample of persons with MS
stroke (M age = 54.2 years) to explore their (Motl & McAuley, 2009).
perceived barriers to exercise. The five most Among wheelchair users, Warms et al.
common barriers ranked in order were (1) (2007), demonstrated that subjectively
cost of the program (61%), (2) lack of measured activity correlated significantly
awareness of a fitness centre in the area with healthcare providers discussing exercise,
(57%), (3) no means of transportation to a and social support for exercise. These results
fitness centre (57%), (4) no knowledge of also adhere to the results of Standal and
how to exercise (46%), and (5) no knowledge Jespersen (2008) who investigated the
of where to exercise (44%). As revealed, the learning that took place when people with
financial cost has repeatedly been emphasized disabilities interacted in a rehabilitation
in several studies as a barriers to participate in context. The results indicated that peer
physical activity (Becker & Stuifbergen, learning extends beyond skills and
2004; Scelza, Kalpakjian, Zemper, & Tate, techniques, and includes ways for the
2005; Rimmer et al., 2008; Rimmer et al., participants to make sense of their situations
2000) as wheelchair users.
Shifflett, Cator and Megginson (1994) Rolfe, Yoshida, Renwick and Bailey
also pointed out access to activities and (2009) explored how material and social
facilities as correlates of leisure time physical structures and functions, existing and
activity level in their study, while findings operating within 15 disabled women's
and MS (Plow et al., 2009). Hence, an Betzen, 1990), and especially in MS (Motl et
inaccessible environment seem to be al., 2009; Motl & McAuley, 2009). Daily
negatively correlated with physical activity in activities require additional energy for those
populations with SCI (Arbour & Martin who are severely impaired (Kemp &
Ginis, 2007). As an example, lack of paved Thompson, 2002), and may have an influence
pathways is an obstacle for wheelchair access. on the activity level . However, the results
Focus on support and assistance is also give some support to statements that
needed in some populations (eg. Lockwood, there is a connection between general,
1997), but were not among the strongest heterogeneous groups with disability and
correlates in the studies reviewed. More increasing inactivity (Boslaugh & Andresen,
emphasized was the need for information on 2006), and that having a disability, regardless
where to exercise (Buffart, Westendorp, van of type, reduces the average activity level.
den Berg-Emons, Stam, & Roebroeck, 2009; Research on the effect of body mass index on
Ravenek & Schneider, 2009), indicating that activity in this population is needed.
there is a need for more research on how to We can conclude that people with a
reach the targeted population with disability are on average less active than the
information about adapted facilities, general population, but we must be aware of
equipment and activity. the great differences in defining physical
Social support for being physically activity and ways of measuring the activity
active represents some of the strongest (Cervantes & Porretta, 2010). This makes it
correlates, and are represented across further difficult to compare results from
diagnosis and age (Ellis et al., 2007; Motl et various studies. However, using the
al., 2009; Plow et al., 2009; Standal & acknowledged definition by Caspersen,
Jespersen, 2008; Stuifbergen et al., 2000; Powell, & Christenson (1985) is quite usual,
Wahman, Biguet, & Levi, 2006; Warms et al., and probably also correct, because many
2007), including support from health persons with a disability use much energy to
professionals (Ellis et al., 2007). The solid finish daily activities. In a public health
documentation on this issue emphasizes the perspective, daily tasks and activities that
need for additional research on how to change require calorie expenditure are also important
attitudes among family, friends and peers. to measure. Low levels of physical activity
Activity planners should plan programs that are defined as less than half an hour, five days
place emphasis on modifying the social a week (2 ½ hours per week) with moderate
environment and removing attitudinal physical activity (Haskell et al., 2007).
barriers. Most of the studies are across
The level of physical activity among diagnoses, probably because of the limited
adults with a disability demonstrated some number of people within the different
differences between types and degrees of categories or diagnosis. It is challenging to
functioning and disability that could be get access to a representative sample,
expected, and indicated a positive correlation especially for low-incidence disability groups
between reduced functioning and reduced (Rimmer et al., 2010). However, it need to be
physical activity. This seems to be most clear addressed that SCI also represents a low-
in the populations with severe activity incidence disability group, but is frequently
limitations like MS (Becker & Stuifbergen, represented here. Unfortunately, there is a
2004; Crocker, 1992; Motl et al., 2007; lack of research including persons with
Stroud et al., 2009) CP (Jahnsen et al., 2003) hearing disabilities and persons with visual
and SCI (Manns & Chad, 1999). These impairment, which represent high-incidence
groups also struggle with fatigue and exertion, disability groups. Accordingly, the number of
which seems to be negatively correlated with incidents does not explain the whole picture,
physical activity in this population (Becker & so there is a need for other ways to explain
Stuifbergen, 2004; Fernandez, Pitetti, & the different representation of disability
groups. Another possible explanation may be power, it limits the generalizability of the
connected to the fact that the studies results. Whenever possible, studies should be
presented here in this review on MS and SCI designed with more homogeneous samples in
represent a few but active research terms of age, health status, and functional
environments. This may indicate that level. Consequently, we emphasize the need
scientific environment and the choice of for researchers that address specific disability
topics, as well as economical issues and groups, but are also aware of the
grants may play a role of the priority in this heterogeneity between and within disability
field. groups. The low incidence of many
Persons with stroke are only disabilities make it extremely difficult to
represented in one study in this review. This obtain adequate sample sizes when recruiting
reflects the age criterion set for ages 16-65 subjects from one setting (Rimmer et al.,
years. The incidence of stroke is much higher 2010).
after 65 years, and can probably explain why It is difficult to make comparisons
only one study is present here. The same between studies when instruments are not the
explanation may be given for Parkinson’s same or not explained well enough to make
disease, which is quite often represented in critical comparisons between them. Cervantes
studies on persons with disabilities, but the and Porretta (2010) suggest the use of a
incidence of Parkinson’s is low under 65 combination of measurement methods (i.e.,
years. multiple measures of physical activity), and
we agree that this appears to offer the best
Study limitations solution for assessing the level of physical
The search terms we used may not activity. However, until then, we may suggest
have captured all the relevant studies, or the the development and consensus in the future
number and scope of search-engines could be to use of one survey to measure physical
too limited. There is also a possibility that the activity among persons with a disability.
exclusion criteria selected were too many, or Most research material is conducted
too narrow. In addition, the review was with volunteers, and it is difficult to
limited to papers published in English with generalize the findings of the study to the
abstract and only peer-reviewed journals. As entire subgroup. In general, those who are
such, unpublished papers from proceedings responding are also those most interested in
and abstracts were excluded due to physical activity. The people who volunteer
convenience. Studies involving adults older for exercise- related research may also have a
than 65 years were not reported, which limits higher functional level. Given the complexity
the findings of age-related conditions like of identifying and recruiting individuals with
Parkinson’s disease and stroke. We also disabilities for exercise research, classifying
excluded research from education, but are subjects by function (ICF) rather than
aware of the extensive research and the disability may be an alternative approach to
significant contribution coming from this increase recruitment size and identify key
research field. health outcomes that generalize across
disability groups (Rimmer et al., 2010).
Future research Perspective
The 57 studies identified in this review There is a need to establish a stronger
were spread across seven different disability evidence base to increase our knowledge of
groups (including one category that combined correlates, determinants and associations in
two or more types of disabilities) although relation to physical activity and disability.
heterogeneous populations make it easier to The results revealed a need for common
recruit subjects (e.g., including individuals measurement methods to assess physical
with paraplegia and quadriplegia in the same activity among persons with a disability. This
study) and obtain higher levels of statistical is in line with previous research (Cervantes &
Porretta, 2010). Further, there is a need for Boslaugh, S. E. & Andresen, E. M. (2006).
research on determinants and associations in Correlates of physical activity for adults
relation to physical activity and disability with disability. Preventing Chronic Disease,
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among low incidence groups. Among the Buffart, L. M., Westendorp, T., van den Berg-
environmental factors, we emphasize the need Emons, R. J., Stam, H. J., & Roebroeck, M.
for research on informational routines and E. (2009). Perceived barriers to and
how to reach the targeted populations. The facilitators of physical activity in young
impact of gender among people with a adults with childhood-onset physical
disability seems to be an understudied issue in disabilities. Journal of Rehabilitation
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Die Absicht dieses Artikels war es, die Literatur, die sich mit den Korrelationen und
Assoziationen zwischen körperlicher Aktivität Erwachsener (im Alter zwischen 16 und 65 Jahren)
und Körperbehinderung beschäftigt, zu untersuchen. Es wurde elektronisch nach
Forschungsartikeln gesucht, die zwischen 1989 und 2009 veröffentlicht worden waren. Es wurden
dazu spezifische Einschlusskriterien identifiziert. Die Suche ergab 4.189 Artikel, wobei allerdings
nur 57 alle spezifizierten Kriterien erfüllten. Sie repräsentierten sieben verschiedene
Behinderungsgruppen, einschließlich einer Crossover-Kategorie mit zwei oder mehr
Behinderungsformen. Die von der Weltgesundheitsorganisation (WHO) entwickelte Internationale
Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) wurde als Bezugssystem
zur Strukturierung der Ergebnisse verwendet. Die Resultate deckten auf, dass es einen wesentlichen
Kern an Forschung zu einigen wenigen Behinderungsgruppen gibt, wozu Rückenmarksverletzungen
und Multiple Sklerose zählen. Signifikante Zusammenhänge konnten in Bezug auf die Form der
Behinderung und die Funktionsfähigkeit gefunden werden, aber auch zwischen Umweltfaktoren
(z.B. Kosten, Zugänglichkeit, bauliche Umwelt, Information und soziale Unterstützung) und
personalen Faktoren (z.B. Alter, Trainingsselbstwirksamkeit, Depression, mentale Gesundheit). Die
Diskussion der Untersuchungsergebnisse bezieht sich auf zukünftige Studien zu körperlicher
Aktivität mit Menschen mit Behinderungen.
L’objectif de cet article était d’établir une revue de la littérature sur les corrélats et les
associations de l’activité physique et du handicap moteur chez des personnes adultes (16-65 ans).
Une recherche électronique a été réalisée pour identifier les articles scientifiques publiés entre 1980
et 2009. Des critères de sélection spécifiques ont été choisis. La recherche a fourni au total 4 189
articles ; cependant seulement 57 ont été retenus sur la base des critères de sélection. Ces articles
représentaient 7 groupes de handicap différent, incluant une catégorie pour laquelle deux ou
plusieurs handicaps étaient compris. La classification internationale du fonctionnement, du
handicap et de la santé développée par l’Organisation Mondiale de la Santé a été utilisé afin
d’organiser les résultats. Les résultats ont démontré que la recherche scientifique était orientée vers
des handicaps spécifiques, parmi lesquels les blessés médullaires et la sclérose en plaques sont très
présents. Des corrélations significatives ont été identifiées dépendantes du type de handicap et des
facteurs environnementaux (par exemple le coût, l’accessibilité, l’environnement, l’information et
l’aide sociale) mais aussi des facteurs personnels (par exemple l’âge, l’estime de soi, la dépression,
la santé mentale). Les résultats confirment la nécessité de mener de futures recherches sur l’activité
physique au sein des personnes handicapées.
(edad, ejercicio, autoeficacia, depresión, salud mental). Los resultados se discuten en relación con la
realización de futuras investigaciones de actividad física en las personas con discapacidad.