Motivations and barriers to prosthesis users participation in physical activity, exercise and sport

Abstract

Background: The UK will host the Paralympics in 2012 and the Commonwealth Games in 2014 showcasing the talents of elite athletes and aiming to inspire the population to become involved. However, low levels of physical activity are prevalent: only 40% of men and 28% of women meet the minimum UK physical activity recommendations. The population of people with limb absence is no exception. Objectives: To determine if people with amputation are participating in physical activity and sport; whether post-amputation activity levels match pre-amputation levels; and if there are motivations and barriers to participation. Study Design: Literature review. Methods: Five reviewers systematically searched all peer reviewed and gray literature in seven bibliographic databases and the Cochrane Library. Results: Following rigorous elimination, 12 articles were finally included in the review and critically appraised. Four themes were identified: components; rehabilitation outcomes; body image; and motivations and barriers to participation. Conclusion: People with limb absence are not participating in physical activity conducive to health benefits, and only a minority participate in exercise and sports. Participation following amputation does not mirror that of pre-amputation levels, and more barriers than motivations exist to adopting or maintaining a physically active lifestyle. Clinical relevance This literature review aims to inform those involved in rehabilitation and ongoing care of those with limb absence about what motivates or precludes their participation in physical activity, exercise and sport. Such knowledge could be applied to improving health and wellbeing in this population.

Decline in Physical Activity Level in the Childhood Cancer Survivor Study Cohort

“…Multiple studies in patients with chronic heart failure, or who have experienced a cerebrovascular accident or myocardial infarction, have shown that specialized physical training programs can improve various indices of cardiovascular health (33–35), reduce fatigue (33), and improve physical function and quality-of-life (36, 37). Survivors with musculoskeletal late effects can benefit from working with specialists who have experience with prosthetics and movement retraining to facilitate physical function and improve body image (38). Thus, physical training programs may have important health benefits for survivors who develop chronic illnesses following cancer therapy.…”

Physical Activity in Adults With an Amputation as Assessed With a Self‐Reported Exercise Vital Sign

“…14,41,42 This is not unexpected due to the barriers to PA that this population faces, and is also consistent with previously published literature regarding PA in patients with an amputation. [21][22][23][24][29][30][31]36 The finding that female gender, increasing age, and disease burden correlate with decreased PA is also observed in the general population. 41 In addition, a prior study indicated that female patients are less likely to be successfully fitted with a lower-limb prosthesis than male patients, which could contribute to this disparity.…”

“…The majority of these studies find that individuals with an amputation have lower PA than recommended. [21][22][23][24][25][26] One study suggests that individuals with an above-knee amputation (AKA) have lower PA than those with a below-knee amputation (BKA). 27 Some note that individuals with a dysvascular amputation etiology have lower PA than those with a nondysvascular etiology.…”

“…29 Individuals with an amputation may face challenges to exercise such as lack of accessible equipment and facilities, skin issues on the residual limb, and changes in body image. 23 Additional educational and motivational support may be needed to help initiate PA. 30 Individuals who were active prior to amputation may need to adapt their exercise and find locations where adaptive sports and exercise are possible. 31,32 These difficulties play a role in the decreased participation in sporting events observed in previously active individuals following an amputation.…”

An investigation into the relationship between paracycling athletes and their prosthetics technology: a proposed design framework

“…There has been a reported paucity of available case studies of sports prostheses design to help inform practitioners [6]. The limited case studies have included prostheses designs for swimming [7], running [8], athletics [9], golf, fishing, baseball and cycling [10] skiing [11], triathlon [12] and snowboarding [13].…”