A survey of disabled persons about their physical activity

Background: People with physical disabilities and/or chronic diseases report lower levels of physical activity and well-being than the general population, which potentially is exacerbated through the COVID-19 pandemic. This study explored the international literature on physical activity, sedentary behavior and well-being in adults with physical disabilities and/or chronic diseases during the first wave of the pandemic. Method: In a rapid review, we included studies reporting on physical activity, sedentary behavior and/or well-being in adults with physical disabilities and/or chronic diseases. Four databases (Pubmed, CINAHL, PsycInfo, Embase) were searched for studies published until 30 September 2020. Results: We included twenty-nine studies involving eleven different types of disabilities or health conditions from twenty-one different countries. Twenty-six studies reported on physical activity, of which one reported an increase during the COVID-19 pandemic, four studies reported no difference, and twenty-one studies reported a decrease. Thirteen studies reported a decline in well-being. Only one study measured sedentary behavior, reporting an increase. Conclusion: Despite the variety in methods used, almost all studies reported negative impacts on physical activity and well-being in people with physical disabilities and/or chronic disease during the first wave of the pandemic. These findings highlight the importance of supporting this population, especially in times of crisis.

Purpose: The Physical Activity Scale for Individuals with Physical Disabilities questionnaire provides an assessment of physical activity after spinal cord injury. This study sought to adapt, with cultural competence, the English questionnaire and translate it into Bahasa Malaysia, including evaluation of content and face validity, internal consistency and test–retest reliability, and completion of a factor analysis in order to validate the Malaysian version.Materials and methods: A total of 250 participants completed the questionnaire that was distributed via email, postal mail, the internet, physically and by word of mouth. Sixty-eight respondents were re-contacted to complete the questionnaire again.Results: The adapted PASIPD demonstrated adequate internal consistency Cronbach’s α = 0.68 and acceptable test–retest reliability, intraclass correlation = 0.87. Factor analysis extracted four main dimensions for physical activity; factor 1 (heavy housework, home repair, lawn work and gardening), factor 2 (sports and recreation), factor 3 (light housework and caring for another person) and factor 4 (leisure and occupational activities) that accounted for 64% of the physical activities’ total variance.Conclusion: The Malaysian-adapted English and translated Bahasa Malaysia versions of the questionnaires intended to measure physical activity levels in individuals with spinal cord injury, demonstrated good to acceptable validity and reliability. However, some individual items revealed weak reliability measures. Further work is needed to validate the questionnaire’s criterion validity against other physical activity measures.Implications for rehabilitationThe Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire provided preliminary support for its use since it has demonstrated adequate construct validity and reliability.The Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire can quantify the physical activity level of community-dwelling individuals with spinal cord injury, whilst deriving descriptive information on their physical activities.Deploying the Physical Activity Scale for Individuals with Physical Disabilities questionnaire to a spinal cord injury population in Malaysia may provide the first data on activities of daily living in an Asian developing country.

The physical activity scale for individuals with physical disabilities: Development and evaluation

BackgroundPeople with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases.MethodsFour databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device.ResultsOne hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness.ConclusionThis scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.

BackgroundLittle is known of physical activity behaviour among adults with a disability and/or chronic disease during and up to 1 year post-rehabilitation. We aimed to explore (1) dose characteristics of...

Physical activity levels of adults with various physical disabilities.

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

Adults with physical disabilities or chronic diseases face numerous barriers to participate in physical activity (PA). There is little knowledge about how these PA barriers evolve during and after rehabilitation, and how this relates to PA behaviour. In this study, we investigated how perceived PA barriers change over time for adults with physical disabilities or chronic diseases during and after rehabilitation, and their associations with PA behaviour. A total of 1,065 individuals from the longitudinal cohort study Rehabilitation, Sports, and Active Lifestyle (ReSpAct) were examined at various time points from baseline to 52 weeks post-rehabilitation. All participants received counselling as part of a PA promotion program in Dutch rehabilitation care. Longitudinal mixed model analyses showed that the frequency of perceived PA barriers decreased significantly during the transition from rehabilitation to community-based PA. These barriers, categorized as capability, opportunity, and motivation, were also found to be longitudinally negatively associated with self-reported total PA minutes per week. This study provides new insights into the dynamic nature of PA barriers for this diverse population and demonstrates how various types of PA barriers are related to PA behaviour. These findings offer valuable considerations for optimizing PA promotion strategies during and after rehabilitation.

To describe leisure participation in adolescents with congenital heart defects (CHD) and identify factors associated with intensity of participation. Eighty adolescents with CHD were recruited (39 males, 41 females; mean age [SD] 15y 8mo [1y 8mo] range 11y 5mo-19y 11mo) of whom 78 completed the Children's Assessment of Participation and Enjoyment (CAPE) outcome measure of leisure participation. The measure has five subscales: recreational, active-physical, social, skill-based, and self-improvement. Associations between the CAPE and age, sex, and development were examined. Motor ability (Movement Assessment Battery for Children, Second Edition), cognition (Leiter International Performance Scale-Revised), behavior (Strengths and Difficulties Questionnaire), and motivation (Dimensions of Mastery Questionnaire) were assessed. Participants exhibited impaired motor (43.5%), behavioral (23.7%), and cognitive (29.9%) development. The most intense participation was in social (mean [SD] 3.3 [0.99]) and recreational (2.9 [0.80]) activity types on the CAPE. Male sex (p<0.05) and younger age were associated with greater physical activity (<15y: 1.87; ≥15y: 1.31, p<0.05). Greater engagement in social activities was related to better cognition (r=0.28, p<0.05), higher motor function (r=0.30-0.36, p<0.01), and fewer behavioral difficulties (r=-0.32 to -0.47, p<0.01). Cognitive ability (r=0.27, p<0.05), dexterity and aiming/catching (r=0.27-0.33, p<0.05), and behavior problems (r=0.38-0.49, p=0.001) were correlated with physical activity participation. Persistence in tasks, an aspect of motivation, correlated with physical (r=0.45, p<0.001) and social activity involvement (r=0.28, p<0.05). Ongoing developmental impairments in adolescents with CHD are associated with decreased active-physical and social engagement, putting them at risk of poor physical and mental health. Health promotion strategies should be considered. Adolescents with congenital heart defects (CHD) have limited engagement in active-physical leisure activities. Cognitive, motor, and behavioral impairments are associated with decreased participation in leisure in children with CHD. Female sex and older age are associated with less engagement in leisure. Mastery motivation correlates with participation, suggesting an avenue for intervention.

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.

A large percentage of adults with physical disabilities are inactive (56%). To improve this situation, more theory-based research is needed. One promising approach is offered by the Transtheoretical Model (TM). PURPOSE Assess adults with physical disabilities' physical activity behavior using each of the core constructs of TM, along with unique barriers experienced by this population segment, and determine if disability type has a moderating effect. METHODS This was a cross-sectional study whereby 411 people responded to national advertising, with 322 (78.3%) people meeting the study's eligibility criteria and returning usable surveys. On average participants were 52.5 yr. old, the majority were female (62.1%) and Caucasian (91.9%), and the majority had experienced one or more of the following disability types: post polio, multiple sclerosis, spinal cord injury, amputation, or cerebral palsy. Participants completed a demographic questionnaire and physical activity and disability specific measures of stage of change, processes of change, decisional balance, self-efficacy, and barriers. Data were analyzed using a 5 (stage of change [SOC]) × 6 (disability type) MANOVA. RESULTS Significant main effects (p < 0.01) were observed for both SOC and disability type, however the interaction was not significant (p > 0.25). Participants classified by their SOC differed on each of the TM constructs, as well as physical activity barriers. Intra-ocular observations revealed a gradient pattern of improvement from precontemplation through maintenance for all constructs. Across disability types, the behavioral processes of change, self-efficacy, and decisional balance all showed differential patterns of use. CONCLUSION These results generally support the utility of TM for understanding and describing adults with physical disabilities' physical activity behavior, though it does appear disability type may have a moderating effect. Funded by the National Institute on Disability and Rehabilitation Research, U.S. Department of Education.

Background:We aimed to explore the effect of education levels on self-rated health and physical activity (PA) and to provide basic data for developing interventions based on physical education to improve the quality of life among Koreans.Methods:The 2019 Community Health Survey data were selected through primary and secondary phylogenetic extraction. The survey was conducted among Korean adults aged ≥19 years (n=229,099), in 2019, using an electronic questionnaire. The education levels were classified into eight groups: uneducated, Seodang/Hanhak (traditional Korean school), elementary school, middle school, high school, college (2 or 3 years), university (4 years), and post-graduate or higher. In this study, the effect of participants’ education levels on self-rated health levels and PA was investigated (the PA subdimensions were: the number of days of vigorous PA, moderate-intensity PA, walking, and flexibility exercises).Results:1) Regarding self-rated health, significant differences according to education level were recorded (P<0.001), with higher education levels leading to higher averages. 2) Regarding PA, significant differences according to education level were revealed, and the number of days of vigorous PA, walking, and flexibility exercise (P<0.001) increased with higher education levels. Moreover, the university (4 years) group reported the highest average. However, the middle school group reported the highest average for the number of days of moderate-intensity PA (P<0.001), and the average number of days decreased as the education level increased after middle school.Conclusion:Education plays an important role in maintaining health, and practicing appropriate PA contributes to one’s quality of life.

To describe overall physical activity prevalence measured by the Global Physical Activity Questionnaire as well as inequalities in leisure-time physical activity among Brazilian adults (15y and older). Data from the Brazilian Survey on Medicine Access, Utilization, and Rational Use of Medicines were analyzed. The study was carried out between September 2013 and February 2014. Physical activity was measured through Global Physical Activity Questionnaire and classified according to the recommendations of the World Health Organization. Additional analysis determined the contribution of each physical activity domain to the total amount of physical activity. Inequalities in terms of sex, age, and socioeconomic position were explored. About one-third of the participants (37.1%; 95% confidence interval, 35.5-38.8) were physically inactive. Work-based activities were responsible for 75.7% of the overall physical activity. The prevalence of participants achieving physical activity guidelines considering only leisure-time activities was 17.8% (95% confidence interval, 16.7-19.2). Females and older participants were less active than their counterparts for both overall and leisure-time physical activity; socioeconomic status was positively associated to leisure-time physical activity. Major overall physical activity is attributed to work-related physical activity. Leisure-time physical activity, a key domain for public health, presents important gender and socioeconomic inequalities.

This study aimed to (a) explore the associations between psychosocial factors and physical activity behavior in people with physical disabilities and/or chronic diseases, both between and within persons over time; and (b) examine whether these associations differ for people initiating and people maintaining physical activity behavior. Data of 1,256 adults with physical disabilities and/or chronic diseases enrolled in the prospective cohort study Rehabilitation, Sports, and Active lifestyle (ReSpAct) were analyzed. Self-reported physical activity and four main psychosocial factors (i.e., self-efficacy, attitude, motivation, social support) were measured with questionnaires 3-6 weeks before discharge (T0) and 14 (T1), 33 (T2), and 52 (T3) weeks after discharge from rehabilitation. Hybrid multilevel regression models (corrected for age, sex, education level, diagnosis, counseling support) were used. Multivariable significant between-subject associations were found for self-efficacy (std β = .094; 95% CI [0.035, 0.153]) and intrinsic motivation (std β = .114; [0.036, 0.192]). Multivariable significant within-subject associations were found for identified regulation (std β = -.038; [-0.072, -0.005]) and intrinsic motivation (std β = .049; [0.016, 0.082]). Effect modification of initiating or maintaining physical activity was found for the between-subject association of attitude (p = .035). No significant associations were found for social support, amotivation, external regulation, and introjected regulation. This study is the first that explored the between- and within-subject associations between psychosocial factors and physical activity over time in a large cohort of adults with physical disabilities and/or chronic diseases. The findings indicate the importance of intrinsic motivation, identified regulation, and self-efficacy in initiating and maintaining physical activity behavior. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The health benefits of regular physical activity and the relation between physical inactivity and chronic disease morbidity and mortality are well established. Also clear is the fact that efforts to increase physical activity at the population level will require collective action by government, nongovernment, for-profit, and nonprofit entities working together at the local, state, and national levels. The US National Physical Activity Plan (NPAP), developed by the National Physical Activity Plan Alliance, of which the American Heart Association (AHA) is a member, is designed to facilitate this collective action, to help organizations from all sectors of society work together to increase physical activity in all segments of the American population. The purposes of this advisory are to summarize the data that describe the health benefits of regular physical activity and the public health burden of low levels of physical activity, to describe the NPAP and the role it will play in increasing population levels of physical activity, and to encourage readers of Circulation to join the AHA’s efforts to promote its implementation. As summarized in Table 1, there is substantial evidence supporting the benefits of regular physical activity to prevent a wide variety of disease conditions and to enhance quality of life. Interestingly, there is less of an appreciation of noncardiovascular benefits of lifestyle physical activity and structured exercise, and this is an area of great opportunity for educating the public and healthcare practitioners. View this table: Table 1. The Health Benefits of Regular Physical Activity Physical inactivity is rapidly becoming a major global concern and is the fourth leading cause of death worldwide.2,3 As noted by Kohl and colleagues, “In view of the prevalence, global reach, and health effect of physical inactivity, the issue should be appropriately described as pandemic, with far-reaching health, economic, environmental, and social consequences.”4 According …