The importance of regular movement activities for persons with disabilities and the factors that impede their inclusion and implementation
Physical activities are defined as physical movements that are produced by skeletal musculature and require energy consumption. They include activities that are carried out during work, travel, play, housework and recreation. The World Health Organization advises 150 minutes of moderate physical activity per week (WHO, 2017). In comparison with persons performing physical activities in this range, inactive persons have a 20-30% higher risk of mortality due to various causes (WHO, 2017).
When talking about persons with disabilities, it is essential to put the individual first. Disability does not define the person and is only a medical diagnosis. According to the medical model, disability is defined as a medical and biological problem, the emphasis is on treatment compared to prevention and promotion of health. On the other hand, the social model presents disability as a uniqueness, without condemnation, and highlights deficiencies in the system and discriminatory behavior as an obstacle to the integration of people with disabilities into motor activities (Martin, 2013).
For people with disabilities, physical activity is extremely important due to the high degree of influence on chronic diseases, due to the positive effect on cognitive, emotional and social difficulties, psychological benefits in terms of improving self-image in positive experiences during exercise, stress reduction, reduction of pain, improvement of depressive symptoms, due to the social benefits - better social integration, improved communication skills, networking through communication with professionals and other participants (Jaarsma, 2014).
Despite these benefits, there are obstacles to the integration of people with disabilities into physical activities related to their age and type of disability. Obstacles can be individual - lack of knowledge about opportunities engaging in physical activity, fears, nature of deficits and pain, lack of energy. There are also social barriers, such as the lack of properly trained professionals (eg gym trainers, sports education professors with special skills in activities adapted for people with disabilities), lack of necessary equipment for adapted sports practice, underestimation of the ability of persons with disabilities by health professionals and other experts. Obstacles may also be environmental when locations for physical activities are not adapted for use by persons with disabilities. (Martin, 2013).
Professional recommendation and guidelines for facilitating physical activities
Physical activities are one of the most important factors for improving the health status of people of all ages. Therefore, the recommendations and guidelines that the general population receives from experts is very important. For example, in the US, the US Physical Activity Guidelines 2008 (2008 Physical Activity Guidelines for Americans) are applied. The guidelines contain guidance based on scientific evidence to help people aged over 6 years to improve their health by appropriate physical activity. This is even more important for people with disabilities, as they tend to have less active lifestyle. According to US data, almost half of the people with disabilities who are capable of physical activities do not even perform aerobic exercise. On the other hand, disability should not be equated with poor health, since most people with disabilities are able to engage in regular physical activities. Therefore, there are special guidelines for persons with disabilities in the USA that include the following recommendations:
- Adults with disabilities should practice at least 150 minutes of weekly moderate exercise activity or 75 minutes of more intense aerobic activity or an equivalent combination of moderate and intense motor activity. Aerobic activity should be performed in episodes of at least 10 minutes, best spread over the week.
- Adults with disabilities should also perform twice a week activities of moderate or higher intensities, which involve bigger muscle groups to increase muscular strength. These activities bring additional positive health effects.
- In case persons with disabilities are not able to adhere to these guidelines, they should be involved in physical activities according to their abilities and avoid physically inactive life.
- They should consult an expert about the quantity, type and intensity of physical activities.
- Also, children and adolescents with disabilities should adhere to specific guidelines for physical activity appropriate for their age and abilities.
It has been proven that physical activities play an important role in the maintenance of health, well-being and quality of life. They can help maintain adequate body weight, improve mental functioning, reduce the risk of premature death, heart disease, type 2 diabetes, and certain types of cancer. Physical activities are very helpful for improving day-to-day functioning and for increasing the autonomy of persons with disabilities (CDC, 2014).
The role of healthcare and other professionals who treat people with disabilities in the promotion of physical activities
Healthcare workers significantly influence the amount of physical activity persons with disabilities engage in as they are more likely to contact them than other experts. It is also more likely for people with disabilities to be more active if they are recommended by experts.
In order to appropriately encourage people with disabilities to perform physical activities, experts can follow these steps:
- Physical activities are recommended for all persons with disabilities.
- When performing physical activities, persons with disabilities follow general recommendations.
- Persons with disabilities are led and asked by experts on specific issues, such as how often they are active in the week, what is the duration of activities, what is the intensity, what activities they perform, how to incorporate more physical activities into their life, etc.
- Experts encourage persons with disabilities to talk about their obstacles and limitations when performing physical activities. Thus obtain information about the individual and his/her ability needed to prepare an appropriate program, appropriate preparation of the venue, necessary adjustments, necessary assistance from the experts and the extent of social support.
- Experts need to know the particular opportunities for physical activity of persons with disabilities and provide them with appropriate instructions and guidance for participation in various physical activities and in various organized programs (CDC, 2014).
The importance of educating professionals in the field of adapted physical activities for people with disabilities
Nowadays, the term is adapted physical activity. It refers to movement, physical activities and sports activities, with special emphasis on the interests and abilities of individuals with different limitations such as disability, health problems and age. This growing field requires the integrated treatment of people with disabilities, which includes a multidisciplinary approach and professionals from various fields (occupational therapists, physiotherapists, social workers, psychologists, coaches, sports instructors, sports education professors, etc.).
The technological development and accessibility of modern equipment makes it easier to include more and more people with disabilities not only in recreational but also in competitive sports activities. Therefore, continuous professional training is necessary as well as developing and learning new methods and approaches. Experts with appropriate knowledge and approach can encourage people with disabilities in performing physical activities, monitoring them and providing necessary support resulting in positive effects on their health and functioning.
CDC Centers for Disease Control and Prevention. Adults with Disabilities - Physical activity is for everybody. 2014 [cited 01/08/2018]. Retrieved from: https://www.cdc.gov/vitalsigns... on 20.6.2018
Jaarsma EA, Dijkstra PU, Geertzen JHB, Dekker R. Barriers to and facilitators of sports participation for people with physical disabilities: A systematic review. (2014) Scandinavian Journal of Medicine & Science in Sports, 24 (6), 871-881
Martin JJ. (2013). Benefits and barriers to physical activity for individuals with disabilities: a social-relational model of disability perspective Disability Rehabilitation. ;35(24):2030-7. doi: 10.3109/09638288.2013.802377. Epub 2013 Jun 19.
US Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans, 2008. Retrieved from https://health.gov/paguideline... on 20.6.2018
WHO. Physical Activity Fact sheet [Internet]. 2017 [cited 01/08/2018]. Retrieved from: http://www.who.int/mediacentre... on 20.6.2018
WHOa. Prevalence of insufficient physical activity [Internet]. 2017 [cited 01/08/2018]. Retrieved from: http://www.who.int/gho/ncd/ris... on 20.6.2018