Physical activity and disabilities

Background: Physical activity (PA) promotes positive physical and mental health. Despite the benefits, people with intellectual and developmental disabilities (IDD) engage in low levels of PA due to systemic barriers such as cost, transportation, accessibility, and awareness of the need. Emerging evidence suggests that Special Olympics (SO) is a promising setting to achieve the health benefits of PA and fitness for people with IDD. Purpose: The purpose of this paper is to describe the development and implementation of a longitudinal health study to gain a better understanding of the impact of SO participation on health status, fitness, and PA levels of athletes with IDD. Methods: SO is collaborating with four SO state Programs in the US to implement a prospective cohort study to understand the health status of adult SO athletes. In late spring 2024, each SO Program will recruit 30 SO athletes for study participation. Enrolled athletes will complete in-person biometric and fitness assessments. SO athletes will receive wearable devices to track PA metrics (step count, heart rate, sleep, and sedentary behavior). Ecological momentary assessment will collect daily PA and SO participation data. Results and Conclusions: Given the barriers that exist for people with IDD to engage in appropriate levels of PA, this study will provide insight into the health status of SO athletes, associations between health status and SO participation, and the feasibility of data collection methodologies and validation of outcome measures. Preliminary data will be included if accepted. Practical implications: People with IDD lack access to opportunities that promote PA and fitness. This study will demonstrate the benefits of SO participation and best practices for the collection of PA and fitness data for people with IDD. Funding: This work is funded through a cooperative agreement between SO and the Centers for Disease Control and Prevention (CDC).

Background In Thailand, 2 million people have disabilities. Mobility disabilities affect up to 50% of disabled people, often due to various causes leading to amputations. Amputees face challenges in maintaining regular physical activity, especially in resource-limited environments where prosthetic technologies may differ if compared with the US. Nevertheless, there is a lack of information on physical activity among Thai amputees. Purpose To compare physical activity in able-bodies and prosthesis users in Thailand and the United States Methods This study was approved by the Siriraj Ethical Review Board study number 324/256 and study number 2017-37 in St. Mary’s University. A total of 42 participants were recruited, including 14 able-bodies in Thailand, 14 prosthesis users in Thailand, and 14 prosthesis users in the US. For seven days, each participant wore the Actigraph GT9X to monitor their physical activity and completed 2MWT. Result All analysis of statistics has been performed by using SPSS. The Kruskal Wallis test with a significance level of 0.05 was used to compare between groups to investigate the difference in terms of 2MWT and PALs. No significant difference in step total, moderate-intensity activity, and MVPA. There is a significant difference shown in the intensity of activities in sedentary, light activity levels, METs, and walking speed. Conclusion Able-bodied is more probable than prosthesis users to reach a significant walking speed. However, both groups of Thailand spend more time in sedentary lifestyles. In contrast, Americans spend more time engaging in light-intensity activities because of their vibrant national environment. As a result, METs rates for prosthesis users in the US are higher than those for users in Thailand. This is a result of Americans being more active than Thais, who primarily spend their time sitting and resting. Funding This research project was supported by the Faculty of Medicine Siriraj Hospital,Grant Number R016232005

Background: Fitness challenges are a promising approach to increasing physical activity among population groups. Special Olympics (SO), a global organization providing sports training and competition for individuals with intellectual disabilities (ID), uses fitness challenges to engage people with ID in physical activity. Only 9% of people with ID meet the WHO Physical Activity Guidelines (Dairo, 2016). Research supports that more people with ID use smartphone applications and technology (Ptomey et al., 2015). However, a dearth of literature exists to evaluate the implementation of fitness challenges for people with ID using mobile technology. Program Delivery Components: A 20-week step challenge was delivered leading up to the 2022 USA Games competition. Participants were challenged to achieve 1,000,000 steps. Behavior-change tools included self-monitoring via a wearable device, tracking with the SO FitNow app, performance-based rewards, reinforcement, health education, and leaderboard comparison. Athletes were trained as challenge leaders to motivate and educate teammates in forming healthy habits throughout the challenge. Evaluation: Planning documents and SO FitNow app account information were analyzed to examine reach and dose. Satisfaction and context were examined via post-challenge surveys of athletes and SO Programs. Conclusions: 2,230 individuals from 55 SO Programs from the US and the Caribbean participated, including 1,440 athletes with ID. Among athletes who connected a wearable device, 58.2% maintained participation to week 20. Survey results indicated that 65% reported improved health, 81% were more active due to the challenge, and 89% would participate in another challenge. Despite various training modalities, 24% of athletes reported they “always” needed help using the app. Practical implications: While SO athletes’ limited understanding of technology was a barrier, athletes who participated were satisfied and adhered to the 20-week challenge. This demonstrates that fitness challenges may increase physical activity among people with ID. Funding: Supported by CDC grant #NU27D-D000021 and Golisano Foundation.

Context and Objectives: Levels of physical activity (PA) and sedentary behavior (SB), as well as the barriers and facilitators to PA among people with disabilities (PWD), are poorly understood, particularly for those living at home, reducing the relevance of potential interventions. Hence, the National Observatory of Physical Activity and Sedentary Behavior and the National Federation of Regional Health Observatories have collaborated to assess the levels of PA and SB among PWD and to identify the barriers and facilitators to PA. Methods: Using around fifteen indicators, all French departments were grouped into five homogeneous classes. In each class, the most statistically representative department was selected to participate in the study. 656 PWD (any type of disability) aged 20 to 59 completed a self-administered questionnaire. An adapted questionnaire for caregivers of intellectually disabled individuals who couldn’t respond to the questionnaire was also provided. Univariate and multiple correspondence analyses were conducted. Results: 34% reported no engagement in any form of PA. 18% were engaged in federated sports, and 52% were independently active outside structured settings. Pain and fatigue (34%), lack of information about sports facilities or offerings tailored to their disability (25%), and distant practice locations (24%) were the main identified barriers. 51% didn’t identify any facilitators to their PA. Gender, age, type of disability, and period of disability acquisition impacted practices, barriers, and facilitators. Conclusions: PWD living at home are predominantly inactive. These findings necessitate vigilance and adaptation of offerings and accessibility to activities, considering various specificities. Practical Implications: A second phase of the project has been initiated in 2024 to complement these data through individual interviews and to explore the representations of PWD on these topics concerning their life experiences. Funding: Ministry of Sports and Olympic and Paralympic Games / French Paralympic and Sports Committee / National Sports Agency

Background: Disabled people are more likely than non-disabled people to be physically inactive, placing them at increased risk of ill-health. Many disabled people want to be more physically active yet feel there is inadequate support to do so. Disabled people face many barriers to physical activity, over and above those experienced by the non-disabled population. However, evidence on the tangible actions that would support disabled people to be active is limited. Purpose: The aims of this study were to explore the barriers and facilitators to physical activity for disabled people and to identify the key actions that would best support their participation. Methods: Twenty-one disabled people (62% >45 years, 48% male) from across the United Kingdom were purposively sampled to participate in a focus group. Six focus groups were undertaken online using a semi-structured guide, with transcripts thematically analysed. Results: Thirteen themes were identified across four levels of the ecological model – interpersonal, institutional, community, and policy. Priority actions for stakeholders include mandatory training on how to support disabled people, improvements to the accessibility of facilities and equipment, improved frequency of public transport to activity centres, reduced cost of activities, and actions to improve societal attitudes towards disabled people. Conclusions: Urgent action is needed to support disabled people to be physically active. Policymakers, non-government organisations (NGOs), and practitioners have a vital role in creating environments and opportunities to ensure equitable access to physical activity for disabled people. Practical implications: This research highlights tangle actions that can be taken by a range of stakeholders to support disabled people to be physically active. Funding: This research was supported by funding from the University of East Anglia Faculty of Medicine and Health Studentship awarded to the lead author.

Background: Co-production is a promising approach to investigate the needs of people with disabilities in the context of physical activity. Besides guidelines on co-production in research, the primary focus of empirical findings so far has been on the perspectives of principal investigators, but not on people with disabilities and their perspectives. Purpose: To examine the perspectives of people with multiple disabilities on a co-production approach on physical activity. Methods: Six adults with intellectual and physical disability participated actively as co-researchers in a study on physical activity and health among people with intellectual disabilities (target population). To mutually define key aspects of the study (e.g., research questions, appropriate methods), six workshops were held with the co-researchers on the concepts of physical activity, important definitions, available guidelines, and aspects of measurement. Those workshops lead to the selection of tandem interviews with the target population. Co-researchers were then asked about their experiences in this co-production process using semi-structured guided interviews focusing on personal relevance of physical activity, their experience in co-researching and the collaboration in general. Results: Co-researchers reported increases in knowledge on physical activity and health and mentioned critical points for the improvement of co-production. Especially the easy-to-read definitions of physical activity, sport and exercise as well as the associated practical examples were favoured by the co-researchers. Conclusions: The perspectives of people with multiple disabilities on co-production in the field of physical activity research are important and, in addition, the group can benefit from actively participating in research. Practical Implications: The findings could be helpful to empower people with disabilities and is valuable in research to better align studies with the needs and perspectives of the target population. Funding: Ludwig Boltzmann Gesellschaft