Perceived barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities

Abstract

Objective: To explore the main barriers to and facilitators of physical activity in young adults with childhood-onset physical disabilities. Design: Qualitative study using focus groups. Participants: Sixteen persons (12 men and 4 women) aged 22.4 (standard deviation 3.4) years, of whom 50% were wheelchair-dependent, participated in the study. Eight were diagnosed with myelomeningocele, 4 with cerebral palsy, 2 with acquired brain injury and 2 with rheumatoid arthritis. Methods: Three focus group sessions of 1.5 h were conducted using a semi-structured question route to assess perceived barriers to and facilitators of physical activity. Tape recordings were transcribed verbatim and content analysed. According to the Physical Activity for People with a Physical Disability model, barriers and facilitators were subdivided into personal factors and environmental factors. Results: Participants reported several barriers related to attitude and motivation. In addition, lack of energy, existing injury or fear of developing injuries or complications, limited physical activity facilities, and lack of information and knowledge, appeared to be barriers to physical activity. Fun and social contacts were mentioned as facilitators of engaging in physical activity, as well as improved health and fitness. Conclusion: Young adults with childhood-onset physical disabilities perceived various personal and environmental factors as barriers to or facilitators of physical activity. These should be taken into account when developing interventions to promote physical activity in this population. into adulthood (1-3). As a consequence, healthcare is shifting from disability prevention towards health promotion, in order to prevent secondary conditions and to ensure a healthy adult life (4). Secondary conditions affecting people with physical disabilities include osteoporosis, decreased balance, reduced muscle strength and endurance, reduced aerobic fitness, increased spasticity, overweight, hypertension and depression. With increasing age, lifestyle-related diseases, such as diabetes mellitus and cardiovascular diseases, may also be of concern. Encouraging physical activity (PA) is important for health promotion, and is assumed to have positive effects on secondary conditions, and on functional independence, social integration, and life satisfaction (5, 6).Previous studies in adolescents and young adults with MMC and CP showed low levels of PA and low aerobic fitness, compared with able-bodied people of the same age (7-9). In order to develop programmes to promote PA in people with childhood-onset physical disabilities, it is important to understand the factors that determine PA behaviour in this population (10, 11). To describe factors associated with PA in people with a physical disability, van der Ploeg et al. (12) proposed the Physical Activity for People with a Disability (PAD) model (Fig. 1). The model uses the International Classification of Functioning, Disability and Health (ICF) as its starting point. The ICF model describes th...

Perceived exercise benefits and barriers among power wheelchair soccer players

“…Our cohort also reported personal benefit factors such as "I enjoy exercise" and "Exercise improves my mental health." These perceived benefits are consistent with motivation and attitude factors reported for persons with [26,36] and without [37] physical disabilities.…”

“…Inconsistent with the primarily attitudinal influences reported for many persons with physical disabilities [26,33,36], power wheelchair soccer players with CP perceived several physical outcome benefits, including improvement of muscle tone and cardiovascular functioning (Figure 3). However, persons with MD reported social interaction as the primary benefit of exercise.…”

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“…As individuals with CP age and become less active, they may also be at greater risk of lifestyle-related diseases, such as diabetes mellitus or obesity. Encouraging physical activity (PA) is important for health promotion, and may have beneficial effects on secondary conditions and on functional independence, social integration, and well being (Buffart et al 2009). …”