Indonesian Version of the Physical Activity Scale: Development and Validation for Individuals with Physical Disabilities

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.

ObjectiveTo translate the Physical Activity Scale for Individuals with Physical Disabilities into Mandarin according to Brislin guidelines and to examine its reliability and validity.DesignCross-sectional study.SettingsTwo rehabilitation centers in China.ParticipantsA convenience sample of 208 adults with spinal cord injury.Main MeasuresA total of 208 participants completed the Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities at the first measurement. One week later, 122 of them completed both the scale and the International Physical Activity Questionnaire Short Form. Construct validity, criterion-related validity, internal consistency, test-retest reliability, goodness of fit of items, and differential item functioning were evaluated in this study.ResultsFactor analysis found a four-factor structure, including household activities, moderate to vigorous intensity activities, mild activities, and work-related activities. The Cronbach's α coefficient of the Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities was 0.795. A significant correlation was found between Physical Activity Scale for Individuals with Physical Disabilities and International Physical Activity Questionnaire Short Form (r = 0.842, p＜0.05). The test-retest intraclass correlation coefficient was 0.814 (P < 0.001). Three rounds of Rasch analyses were conducted in this study. The results indicated that the Rasch model for the questionnaire had a good fit.ConclusionThe Chinese version of the Physical Activity Scale for Individuals with Physical Disabilities is a reliable and valid scale for assessing physical activity among individuals with spinal cord injury in China.

Physical activity levels of adults with various physical disabilities.

Background and purpose Physical activity is a key determinant of health, yet children with intellectual disabilities (ID) consistently exhibit lower participation levels due to intersecting biomedical, socioeconomic, and environmental barriers. In developing countries such as Indonesia, disparities in disability severity, family income, and residential context further limit access to inclusive physical activity opportunities. However, empirical evidence examining the combined influence of these factors remains limited. The present study investigates the underlying determinants of physical activity (PA) among children with intellectual disabilities (ID) in Indonesia, emphasizing a holistic analytical approach. Material and methods The research adopted a cross-sectional approach and included 80 children with intellectual disabilities (ID) aged 7–18 years, purposively recruited from Special Schools (SS) across East Java Province, Indonesia. Data were collected using the Indonesian version of the Physical Activity Questionnaire (IPAQ-D), consisting of eight items completed by students with assistance from parents and teachers. Data analysis involved Spearman’s rank correlation to assess associations between ordinal variables and physical activity, and the Kruskal–Wallis test to compare physical activity levels across geographical areas using IBM SPSS Statistics version 26. Results Spearman’s rank correlation analysis revealed a significant negative association between IPAQ-D scores and disability severity (r = −0.259, p = 0.020), while a significant positive association was observed between IPAQ-D scores and parental income (r = 0.270, p = 0.015). The Kruskal–Wallis test demonstrated a significant difference in PAQ scores across geographical areas (H(2) = 8.737, p = 0.013). Conclusions These findings demonstrate significant urban–rural disparities in physical activity participation among children with intellectual disabilities in Indonesia, reflecting structural inequities in access to services and supportive environments. Geographical context, beyond individual and socioeconomic factors, plays a critical role in shaping physical activity opportunities. Geographically tailored, low-resource, school- and community-based interventions integrated within educational and primary healthcare settings are needed to reduce regional inequalities and promote more equitable physical activity participation.

The aim of the study is to investigate the association between patient self-efficacy, impression of exercise education, and physical activity among stroke survivors. We hypothesized that low self-efficacy and/or poor impressions of exercise education after stroke would be associated with reduced exercise participation. This is a cross-sectional investigation of patients' poststroke with physical activity as the primary outcome variable. Physical activity was measured with the Physical Activity Scale for Individuals with Physical Disabilities. Self-efficacy was measured with the Self-Efficacy for Exercise questionnaire. Impression of exercise education measured by the Exercise Impression Questionnaire. There was a low but significant correlation between Self-Efficacy for Exercise questionnaire and Physical Activity Scale for Individuals with Physical Disabilities ( r (66) = 0.272, P = 0.012). There was an insignificant correlation between Exercise Impression Questionnaire and Physical Activity Scale for Individuals with Physical Disabilities ( r (66) = 0.174, P = 0.078). There was a low but significant correlation between age and Physical Activity Scale for Individuals with Physical Disabilities ( r (66) = -0.269, P = 0.013). There was no correlation between sex and Physical Activity Scale for Individuals with Physical Disabilities ( r (66) = 0.051, P = 0.339). Age, sex, Exercise Impression Questionnaire, and Self-Efficacy for Exercise questionnaire predict 17.1% of Physical Activity Scale for Individuals with Physical Disabilities variance ( R2 = 0.171). Self-efficacy was the strongest predictor of physical activity participation. There was a lack of association between the impressions of exercise education and physical activity. Addressing patient confidence to complete exercise has the potential to improve exercise participation in patients after stroke.

Purpose: The lower participation of persons with disabilities (PWD) in physical activity is not only related to health problems, but also to barriers such as the physical and social environment, personal beliefs, and motivation (Úbeda-Colomer et al., 2019). Although sports infrastructure has recently become increasingly adapted to the needs of PWD, the opportunities for PWD to participate in sports are still limited. The aim of the study was to identify and evaluate the main barriers to participation in physical activity by PWD. Methods: The study involved 54 working age (18–65 years old) persons with physical disabilities whose working capacity was not less than 25 percent. The data collection was done by using: 1) Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) (Washburn et al., 2002) and 2) Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) (Úbeda-Colomer et al., 2019). Results: 92.6% of the subjects had very low physical activity (PA). Women spend more time on light housework than men (U = 214.5; p = 0.009). At the interpersonal level, the inactivity of friends and family were the main barriers. Women lack support from sports centre staff ((χ² = 3) 13.671; p = 0.003) and adapted transport ((χ² = 3) 10.587; p = 0.014) more than men. There was no difference between genders in PA and the association between barriers, and an inverse correlation between PA and social connectedness was found in the total sample (p &lt; 0.05). Conclusions: Physical activity of PWD is very low, only 7.4 percent of subjects participating in the study were physically active. The subjects pointed out these barriers to PA: fatigue, motivation, inadequate facilities, lack of sports programmes, inadequate sidewalks/streets. Analysis of the study data showed that as physical activity increases, dependence on others decreases. No significant differences in physical activity and barriers to participation in physical activity have been identified in terms of gender, except: women spend more time on light housework, women lack the help of sports centre employees, women lack accessible transportation to go to the sports centre. Keywords: Physical disability, exercise, participation

The benefits of physical activity participation are greater for children with physical disabilities compared with able-bodied children because these children have the potential to gain not only the same health benefits of participation as their able-bodied peers but also specific benefits related to their condition. Research in this area is particularly limited, however theoretically physical activity participation may intervene in a cycle of disuse which often leads to de-conditioning, secondary health complications and further decreases in physical function for children with physical disabilities. Despite these potential benefits, children with physical disabilities have low levels of physical activity participation and perform less physical activity than their able-bodied peers. To improve these participation levels the factors that influence participation need to be understood. Study Number 1 in this thesis investigated the factors that influence the physical activity participation of children with physical disabilities. A pilot study determined that the best method for gathering the data was through the use of semi-structured interviews. Therefore, 14 children (ranging in age from 8 to 16 years of age) with physical disabilities, including spina bifida, cerebral palsy and acquired brain injury, were interviewed to examine factors influencing physical activity participation, from the child’s perspective. The interviews were tape recorded, later transcribed verbatim and analysed by identifying core themes which recurred frequently in the data and linked the data together. This qualitative analysis resulted in the identification of nine factors. The most noteworthy of these factors were: availability of skilled and knowledgeable leaders; school practices that influence physical activity participation; peer acceptance or rejection, and; desire to be physically active and/or attitude towards physical activity. It was concluded that the identified factors could positively inform the development of future strategies or interventions to increase the physical activity participation of children with physical disabilities. Study Number 2 in this thesis, used the results of Study Number 1 as a guide for developing an effective short-term intervention program for a specific group of children with physical disabilities. As mentioned earlier, research in the area of the outcomes of physical activity participation for children with physical disabilities is limited. Therefore, the provision of evidence for the benefits of physical activity participation for this group coupled with the results of Study Number 1 may enable appropriate bodies to act upon the need to increase physical activity participation for children with physical disabilities. Consequently, the aim of Study Number 2 was to determine a disability-specific benefit of physical activity participation, improved physical functional ability, for children with physical disabilities. Study Number 2 was a prospective nonrandomised control study where the intervention was an 8 week progressive resistance training program instructed by an Exercise Physiologist. Subjects (manual wheelchair users with spina bifida, aged from 10 to 17 years of age) chose to be either in the Intervention Group (IG; n = 8, who participated in the twice weekly individualised program) or in the Usual Care Group (UCG; n = 9). Parameters of upper body muscular strength and physical functional ability (measured by three wheelchair propulsion tests and the mobility domain of the Pediatric Evaluation of Disability Inventory {PEDI}) were measured prior to the commencement of the intervention period and following the completion of the intervention period. The changes in the measurement parameters pre-test and post-test, within and between groups were calculated, and paired t-tests were performed, to determine the outcome of the intervention. Significant increases in upper body strength of up to 75.6% (p < 0.00005) for the IG compared with the UCG following the intervention were found. However, the results of the physical functional tests were not as conclusive. There was no change in the mobility domain of the PEDI following the intervention however, a significant improvement in the time to complete one of the wheelchair propulsion tests by the IG was found. It was concluded that further research into the strain of wheelchair propulsion during various activities of daily living and other aspects of physical function of children with physical disabilities following a physical activity intervention is needed. In summary, this thesis established a list of factors that influence physical activity participation of children with physical disabilities that can inform future intervention strategies to improve physical activity participation levels of this group. Additionally, this thesis confirmed previous evidence for increasing the strength of children with physical disabilities through participation in a progressive resistance training program. And finally, this thesis demonstrated a clear trend for improving physical functional ability by participation in resistance training and provided new methodological ideas for the application of a future successful intervention to clearly define the ability of progressive resistance training to increase physical functional ability in children with physical disabilities.

Background: Subjective well-being is vital for individuals with physical and intellectual disabilities to possess because it affects their future life development. Adolescents with physical disabilities are one of the groups considered to have low levels of Subjective Well Being. Materials and Methods: A cross-sectional study was conducted among 139 female adolescents with disability in Indonesia. The data were collected by directly interviewing the students based on the questionnaire guide and reviewing the participant information through secondary data. The data collection instruments cover the socio-demographic data questionnaire and Satisfaction with Life Scale. Results: The majority of the female adolescent with disability satisfy with their life (70.5%). Their satisfaction was associated with their family type and their age (p &lt; 0.05), but not associated with age, parent occupation and their grade (p &gt; 0.05). Conclusion: Students from nuclear family seems to have better support to the disabled adolescent, so that they have better lafe satisfaction compared to their peer living in an extended family.

Purpose To translate the “Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)” into Turkish, to make a cultural adaptation, and to examine the psychometric properties including validity and reliability. Methods During the translation period cross-cultural adaptation design proposed by guideline was used. Patients completed the Turkish version of the PASIPD and it was applied again a week later. To determine the reliability and internal consistency, Cronbach’s alpha coefficient was calculated. Test–retest reliability was determined by using intraclass correlation coefficient (ICC) and Pearson’s correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing PASIPD with Functional Independent Measurement (FIM), Nottingham Health Profile (NHP), and Craig Handicap Assessment and Reporting Technique Short (CHART-SF), and criterion validity was examined by comparing PASIPD with Manual wheelchair propulsion tests scores. Results Cronbach’s alpha coefficient was 0.725. The ICC coefficient for the test–retest reliability was 0.851. PASIPD was explained by three factors. The ratio of explaining the total variance of these 3 factors was determined as 51.66%. FIM (r = 0.307, p = 0.040) and CHART-SF were moderately positively correlated with PASIPD total score. The correlation between the total score of PASIPD and NHP was r = −0.443 (p = 0.002). 20 Meters Propulsion (r = −0.404, p = 0.005) and Slalom Tests (r = −0.305, p = 0.037) were highly negative and 6 min Push Propulsion (r = 0.456, p = 0.001) were moderately positive with PASIPD total score. Conclusion The Turkish version of the PASIPD is a valid and reliable scale in patients with spinal cord injury. IMPLICATIONS FOR REHABILITATION The Turkish and cross-culturally adapted version of PASIPD is a useful physical activity scale to evaluate the physical activity level of SCI. The Turkish version of the PASIPD is a valid and reliable scale and can be used in Turkish patients with SCI. PASIPD can be used to compare physical activity levels between disability types and groups with and without disabilities. PASIPD can be used to evaluate the effectiveness of attempts to increase physical activity in patients with SCI.

Background and objectivesThis study examined the associations between quality of life (QoL) and physical activity (PA), self-perceived health and fitness, and sociodemographic characteristics among individuals with physical disabilities (IWPDs) in Saudi Arabia.Materials and methodsA total of 230 IWPDs aged 18 years and older participated in the study, comprising 133 males (57.8%) and 97 females (42.2%). QoL was assessed using the World Health Organization Quality of Life–Disabilities module, while PA levels were measured using the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities. Structural equation modeling was used to examine the relationships of overall PA and its specific domains—household, recreational, vocational, and home-repair activities—with overall QoL and its subdomains.ResultsSelf-perceived health and fitness were identified as the strongest correlates of both overall and domain-specific QoL. Education and income were positively associated with multiple QoL components—participants with higher education levels reported significantly greater Discrimination (β = 0.141), Autonomy (β = 0.236), and Inclusion/Participation (β = 0.29) but lower social relationships (β = −0.336). While total PA was not significantly associated with overall QoL, specific PA domains showed nuanced effects; For example, household activities were positively associated with the psychological domain (β = 0.25), social relationships (β = 0.542), environmental domain (β = 0.149), and autonomy-related domain (β = 0.531), but were negatively associated with physical health (β = −0.336) and inclusion/participation (β = −0.399). In contrast, home repair activities exhibited the opposite pattern. Sex differences were also observed, with men reporting lower QoL than women across several domains.ConclusionsThese findings underscore the relevance of health, education, employment, and psychosocial factors for QoL among IWPDs and provide insights that may inform future research as well as evidence-based health and disability policy planning in Saudi Arabia.

Introduction: Physical activity can play a critical and effective role in the health and self-esteem of the general population. However, the research on the association between participation in physical activity and self-esteem in those with physical disabilities in non-Western countries, especially Saudi Arabia is limited. Objective: To analyze self-esteem levels among those with physical disabilities in Saudi Arabia, and examine the relationship between participation in physical activity and self-esteem among those with physical disabilities in Saudi Arabia. Methods: A participant sample (N = 292) consisting of Saudi Arabian individuals with physical disabilities (male n = 201; female n = 91) aged 18-59 years (M = 36.08 years; SD = 10.64) was recruited to participate in this study. Levels of self-esteem were measured using the Arabic version of the Rosenberg Self-Esteem Scale (RSES). Results: Statistical analysis illustrated that the participants’ overall self-esteem was moderate (M = 3.14; SD = 0.56). A stepwise multiple linear regression demonstrated that participating in physical activity (measured by days per week) was the only predictor of the total RSES scale (ß = −0.304; p = &lt;0.001). Conclusions: The findings suggest that participation in physical activity is a statistically significant predictor of self-esteem levels in those with physical disabilities in Saudi Arabia. Therefore, it is essential to increase awareness of the importance of participation in physical activity among people with physical disabilities. Level of evidence II; Therapeutic Studies - Investigation of Treatment Results.

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

Background/Aims Physical activity levels after stroke can be influenced by a variety of factors. However, the specific determinants that most significantly affect physical activity in this population remain unclear. The aim of the present study was to determine the physical activity level of patients who have had a stroke and examine the factors affecting this. Methods A total of 78 individuals who had experienced a stroke were included. The physical activity levels of participants were determined using the Physical Activity Scale for Individuals with Physical Disabilities. Participants' perceived benefits of, and barriers to, exercise were determined using the Exercise Benefits/Barriers Scale, balance levels were determined using the Berg Balance Scale; fear of falling was determined using the Falls Efficacy Scale International; levels of fatigue were evaluated using the Fatigue Severity Scale; the degree of depression was evaluated using the Beck Depression Inventory; and sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Results In the correlation analysis, a moderate negative relationship was detected between Physical Activity Scale for Individuals with Physical Disabilities and Falls Efficacy Scale International scores (r=0.515, P=0.001). A weak positive relationship was observed between the participants' Physical Activity Scale for Individuals with Physical Disabilities and Berg Balance Scale scores (r=0.283, P=0.006). A weak negative relationship was found between Physical Activity Scale for Individuals with Physical Disabilities score and age, body mass index, Exercise Benefits/Barriers Scale, Fatigue Severity Scale and Pittsburgh Sleep Quality Index scores (r=−0.210, P=0.032; r=−0.286, P=0.006, r=−0.334, P=0.001, r=−0.328, P=0.002, r=−0.330, P=0.002 respectively). Multiple linear regression analysis was used to determine the factors affecting Physical Activity Scale for Individuals with Physical Disabilities scores. It was determined that among the independent variables included in the model, the Falls Efficacy Scale International scores (t=−2.322, P&lt;0.05) and sleep quality (t=−2.128, P&lt;0.05) significantly affected physical activity levels. Conclusions The results found that the physical activity levels of stroke patients were low. Fear of falling, sleep quality, level of education, body mass index, perceived benefits of and barriers to exercise, balance and fatigue affected physical activity levels. When these factors are taken into consideration in interventions to increase physical activity levels, treatment success will increase. Implications for practice Understanding the factors that influence physical activity levels after stroke is crucial for designing effective rehabilitation strategies. Integrating these factors into rehabilitation planning may enhance recovery outcomes, prevent secondary complications and improve overall quality of life.

Validation of the Physical Activity Scale for Individuals With Physical Disabilities

Physical activity (PA) has numerous health benefits for individuals with physical disabilities (IWPD). However, it is common for activity levels to fall below the suggested limits. This study aimed to evaluate the prevalence, pattern, and levels of PA among IWPD in Saudi Arabia. It also investigated the effects of individuals' type of disability, mobility assistive devices, and demographic features on PA levels. Data were collected from 238 participants, mostly male (62.2%), aged 39.76 ± 12.19 years. Among them, 19.3% had spinal conditions, 14.7% had progressive muscular dystrophy, 15.1% had multiple sclerosis, 17.6% had cerebral palsy, 16.4% had poliomyelitis, and 16.8% had limb or foot amputations. The participants were assessed using the Arabic version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-AR). The results showed that 62.6% (64.9% of males and 58.9% of females) met the minimum PA guidelines specified by the WHO. The average PASIPD-AR score was 10.33 ± 10.67 MET-hours/day, indicating lower PA levels, and 8.4% of individuals did not participate in any form of PA. Significant discrepancies were detected in disability type and mobility assistive device use after age adjustment. Marital status, education, and occupation greatly affected PA components. Greater attention should be paid to promoting an active lifestyle among IWPD in Saudi Arabia.