Benefits for the Psychological and Social Functioning 4. 1.

Author: Michele Lepori, Alessandro Munarini, Silvia Noci, Paolo Zarzana

Keywords: well being; physical activity; muscular fitness; self-esteem; self-confidence; social relationship

Introduction

There are many publications in the field of motor sciences and the promotion of health; many studies have been carried out to state both the value and the importance of motor activity, physical activity and sports on the psychophysical well-being of any individual.

WHO guidelines (2010) provide recommendations on Physical Activity specific for each age group (following) and concepts and technical terminologies.

5–17 years

For children and young people physical activity includes play, games, sports, transportation, recreation, physical education or planned exercise, in the context of family, school, and community activities. Physical activity benefits include cardiorespiratory and muscular fitness, bone health, cardiovascular and metabolic health biomarkers and reduced symptoms of anxiety and depression.

18–64 years old

For adults of this age group, physical activity includes recreational or leisure-time physical activity, transportation (e.g. walking or cycling), occupational (i.e. work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities in order to improve cardiorespiratory and muscular fitness, bone health and to reduce the risk of Non-Communicable diseases NCD’s (e.g. Parkinson’s disease, stroke, and cancer) and depression.

Adults aged 18–64 years should aim to do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week, or at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity.

65 years old and above

For adults of this age group, physical activity includes recreational or leisure-time physical activity, transportation (e.g. walking or cycling), occupational (if the person is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities in order to improve cardiorespiratory and muscular fitness, bone and functional health, and reduce the risk of NCD’s, depression and cognitive decline.

In 2008 the U.S. Department Health and Human Services published the Physical Activity Guidelines for Americans - Be Active, Healthy, and Happy! (www.health.gov/paguidelines) that provide achievable steps for youth, adults and seniors, as well as people with special conditions to live healthier and longer lives.

Key Guidelines for Adults with Disabilities

  • Adults with disabilities, who are able to, should get at least 150 minutes a week of moderate-intensity, or 75 minutes a week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.
  • Adults with disabilities, who are able to, should also do muscle-strengthening activities of moderate or high intensity that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits.
  • When adults with disabilities are not able to meet the Guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity.
  • Adults with disabilities should consult their health-care provider about the amounts and types of physical activity that are appropriate for their abilities (ODPHP, 2008).

In addition, it is important to note that sport has an important social role, not only does it help to improve the physical and psychological recovery, but it also helps to develop social relationships regardless of the age, the social origin or the physical difficulties. It is a source of important values such as team spirit, solidarity, tolerance and fair play, contributing to personal development and fulfilment.

Sport is an important means of social integration by which the person increases social interactions which subedequently improve self-esteem.

Benefits for the Psychological and Social Functioning

Sports activity, in general, assumes, of course, a role of “privileged context” within which to foster relationships and to counter the risk of isolation, which weighs heavily on certain categories of citizens, such as, for example, people with disabilities.

The UN Convention on the Rights of Persons with Disabilities suggests a set of rights, including:

  1. to encourage and promote the widest possible participation of persons with disabilities in mainstream sports activities at all levels;
  2. ensure that they have access to places that host sports activities
  3. to ensure that minors with disabilities can participate, on an equal basis with other minors, in recreational activities, leisure and sport, including the activities provided for by the school system.

As the Ministry of Health confirms, sporting activity produces, a beneficial effect on the physical and mental health.

It is well known that the benefits of sport are undeniable. Those who play sports live longer because they protect their health better example prevents muscle and bone decline. The calming action of sports activity should not be forgotten. Doing sports allows you to disconnect from everyday problems and recharge yourself. Sport makes it possible to become not only stronger physically but also mentally, giving greater motivation to achieve increased self-esteem, confidence and optimism.

All these considerations can thus safely be transported to the world of sports for persons with a disability; we always tend to think of disabled people as sick, steady, immobile people, but if we look at them engaged in sports we find them to be tenacious, determined and concentrated people. This is because practising a sport and trying to reach a goal creates important motivations. Through the sporting activity the disabled person has the possibility to improve in different aspects, in particular on the psychological, social and educational level increasing their autonomy, encouraging commitment during training and respect for opponents, teaching courage, promoting loyalty; encouraging socialization, integration, thus overcoming fears, prejudices and isolation. We must therefore always put the person at the centre of our project. Sport has some peculiarities that we must always be able to exploit: managing emotions, collaborating with others, feeling part of a team, respecting the rules and learning to accept their limits, not without trying to go further. All these benefits affect all people, disabled or not (Munarini A., CSI referente nazionale attività disabili CSI).

Motivation

One of the most influential internal barriers addressed in the literature is the attitudes and motivations of people with a disability, particularly self-consciousness and low levels of confidence. This lack of confidence and self-esteem has been reported to manifest itself in the following ways:

  • Feeling different from the majority of the population.
  • Feeling unable to fit in at a sporting facility.
  • Self-consciousness or lack of confidence in asking for help and assistance in a sporting environment.
  • A fear of failure on the part of the person with the disability can present another type of internal barrier, particularly in the case of people who have newly acquired their disability and with low self-esteem.

Motivation is essential for physical activity in the general population and among individuals with disabilities. Self-determination theory (SDT) divides motivation into 2 components. Controlled motivation is derived from external sources, such as physicians, trainers or media, while autonomous motivation is derived from oneself across 3 basic psychological needs: autonomy, relatedness and competence. Recent research has shown the importance of autonomous motivation for adherence to physical activity, and that it is associated with increased activity in people with physical disabilities (Saebu M. et al.; 2013). It is also noteworthy that maintenance of behaviours over time requires autonomous motivation for that behaviour. Conversely, controlled motivation is unrelated to long-term adherences and is less malleable (Bean J. Et al., 2007). Autonomous motivation is closely associated with motivation for a change in behaviour, and is a person’s confidence in the ability to perform new activities. This notion is often termed “self-efficacy” and is defined by Bandura (Bean J. Et al., 2007) as the perceived capability of a person to perform a specific action required to achieve a concrete goal. Self-efficacy has been shown to be a strong predictor of physical activity in individuals with disabilities (Hutzler Y. Et al.; 2007). In addition, the degree of impairment is closely related to physical activity in individuals with disabilities. However, it is challenging to reach a common assessment of impairment across different diseases and disabilities. Pain and fatigue are associated with disability, but may play a unique role for motivation in physical activity. Adapted Physical Activity (APA)-based rehabilitation includes physical activities adapted to the specific needs of each individual with a disability. The goal is to enhance the subject’s autonomy, motivation and ability to engage in physical activities, and ultimately increase physical activity over time. Although this type of rehabilitation is beneficial with respect to pain and functioning, we have less knowledge about its influence on motivation and physical activity levels over time (van Middelkoop M. et al. ; 2011).

Self-Esteem

Practising sport helps to develop and enhance the potential and autonomy of the disabled person in respect of the evolutionary process: through motor sports activities aimed at the well-being of the disabled person, it contributes to the increase of specific skills to be carried out by increasing the opportunities for social integration, using it as a tool for growth and enhancement of personal skills (Noci S., CSI National technical commission for disabled people).

Individuals with disabilities who participate in sports have higher self-esteem, better body images and higher rates of academic success; are more confident and more likely to graduate from high school and enrolling in college. Furthermore, sport is where skills like teamwork, goal-setting, the pursuit of excellence in performance and other achievement-oriented behaviours necessary for success in the workplace are developed (Richman, E. L.; 2000).

An adapted physical activity helps to achieve a good autonomy in the game and changing room environment, to develop a gradual transition from not knowing one’s body to the elaboration of the body schema; to find a balance between mind and body; to reach a personal balance, to improve co-ordinative and conditional skills, to develop laterality, to better perceive one’s own body through the elaboration of motor and perceptual experiences (Noci S., CSI commissione tecnica Nazionale disabili)

Emotional Well-Being

Sports Reduce Stress and Depression

Those who practice sport prevent bone and muscle decline, protect their health, recharge by detaching their mind from everyday problems and focusing on movement. The sporting motion produces endorphins, substances that stimulate the body to react positively to situations of anxiety and stress. The movement not only enhances the physical, but also strengthens the mind, increasing self-esteem, optimism and self-confidence. On the sporting level, the technical knowledge of the sports disciplines is acquired, the respect of the rules and the collaboration are encouraged, communication is encouraged. On the psychological level we work on the containment of emotions and on increasing the capacity for self-control. (Noci S., CSI National technical commission for disabled people).

When you are physically active, your mind is distracted from daily stressors. This can help avoid getting bogged down by negative thoughts. Exercise reduces the levels of stress hormones in your body. At the same time, it stimulates production of endorphins. These are natural mood lifters that can help keep stress and depression at bay. Endorphins may even leave you feeling more relaxed and optimistic after a hard workout on the field. Experts agree that more quality research is needed to determine the relationship between sports and depression.

Attention

Regular physical activity helps keep your key mental skills sharp as you age. This includes sharp thinking, learning, and using good judgement. Research has shown that doing a mix of aerobic and muscle strengthening activities is especially helpful. Thanks to the sporting performance a return is achieved in terms of improving the strength of determination, vital energy and passion in everyone.

Social encounters and Social Skills

The relationship with the sports opponent or with the teammate, stimulates interaction with the other, promotes socialization and social integration, offering valuable help to the prevention of isolation and overcoming fears and false judgements (Noci S., CSI National technical commission for disabled people). If the physical benefits are evident and known, perhaps the psychological benefits of sport, are less experienced, and are a secondary and not very visible aspect.

Sport, on the other hand, produces decidedly positive and important effects on a psychological level. Physical activity allows the athlete with a disability to gain greater confidence in the things they do, helping to restore confidence in their potential.

In addition, the athlete is able to test their skills and abilities, their possibilities and limits, thus acquiring a greater awareness of them.

Sports practice is very important, because it allows individuals to be inserted or reinserted in a healthy and suitable social context. By coming into contact with the outside world, an athlete with a disability discovers a healthy collaboration, one that goes beyond personal benefits, and savours the joy of human relationships. Within the sports world the interactions that are established are, in fact, multiple and of different types; for example, you get in touch with the coach, with the teammates, in the case of team sports, and with opponents.

These connections allow individuals to experience a wide range of feelings and emotions, to manage any relationship conflicts and to learn how to adapt relationships dependent on who they are interacting with. In the interpersonal relationships to the subject, goals and a specific role are recognized, thus enhancing the process of building his personal identity (Zarzana P., CSI National trainer and CSI formatori nazionali, Italian National amputee football team coach).

The power of sport as a transformative tool is of particular importance for women as women with disabilities often experience double discrimination on the basis of their gender and disability. It is reported that 93% of women with disabilities are not involved in sport and women comprise only one-third of athletes with disabilities in international competitions. By providing women with disabilities the opportunity to compete and demonstrate their physical ability, sport can help to reduce gender stereotypes and negative perceptions associated with women with disabilities.

Moreover, by improving the inclusion and well-being of persons with disabilities, sport can also help to advance the Millennium Development Goals (MDGs). For example, sports-based opportunities can help achieve the goal of universal primary education (MDG2) by reducing stigma preventing children with disabilities from attending school; promote gender equality (MDG3) by empowering women and girls with disabilities to acquire health information, skills, social networks, and leadership experience; and lead to increased employment and lower levels of poverty and hunger (MDG1) by helping to reduce stigma and increase self-confidence.

The UN Convention on the Rights of Persons with Disabilities is the first legally binding international instrument to address the rights of persons with disabilities and sport. Article 30 of the Convention addresses both mainstream and disability-specific sport and stipulates that “States Parties shall take appropriate measures to encourage and promote the participation, to the fullest extent possible, of persons with disabilities in mainstream sporting activities at all levels”. It also calls upon Governments, States party to the Convention, to ensure that persons with disabilities have access to sport and recreational venues — as spectators and as active participants. This also requires that children with disabilities be included in physical education within the school system “to the fullest extent possible” and enjoy equal access to “play, recreation and leisure and sporting activities” (Convention on the Rights of Persons with Disabilities Article 30); (General Assembly Resolution: Sport as a means to promote education, health, development and peace A/RES/69/6); (International Disability in Sport Working 2018).

Case studies

Background Although the promotion of social inclusion through sports has received increased attention with other disadvantaged groups, this is not the case for children and adults with intellectual disability who experience marked social isolation. The study evaluated the outcomes from one sports programme with particular reference to the processes that were perceived to enhance social inclusion.

Method The Youth Unified Sports programme of Special Olympics combines players with intellectual disabilities (called athletes) and those without intellectual disabilities (called partners) of similar skill level in the same sports teams for training and competition. Alongside the development of sporting skills, the programme offers athletes a platform to socialise with peers and to take part in the life of their community. Unified football and basketball teams from five countries – Germany, Hungary, Poland, Serbia and Ukraine – participated. Individual and group interviews were held with athletes, partners, coaches, parents and community leaders: totalling around 40 participants per country.

Results Qualitative data analysis identified four thematic processes that were perceived by participants across all countries and the two sports to facilitate social inclusion of athletes. These were: (World Health Organization 2010 “Global Recommendations on Physical Activity for Health”) the personal development of athletes and partners; (Richman, E. L., & Shaffer, D. R.; 2000) the creation of inclusive and equal bonds; (Saebu M.; 2013) the promotion of positive perceptions of athletes; and (Bean JF, 2007) building alliances within local communities.

Conclusions Unified Sports does provide a vehicle for promoting the social inclusion of people with intellectual disabilities that is theoretically credible in terms of social capital scholarship and which contains lessons for advancing social inclusion in other contexts. Nonetheless, certain limitations are identified that require further consideration to enhance athletes’ social inclusion in the wider community

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