Low
levels of physical activity
Determinants
of physical activity
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Women with disabilities have very low rates of physical activity, which may be an important
contributor to overweight in this population.
According to the U.S. Department of
Health and Human Services, people with disabilities and chronic illness are
less likely than those without disabilities to report regular moderate physical
activity (27.2% vs. 34.4%) or regular vigorous activity (9.6% vs. 14.2%). The
few studies that have been conducted on the physical activity patterns of women
with disabilities also suggest that they are not engaging in physically active
lifestyles.
In one study, researchers reported
that out of a sample of 50 African-American women with mobility impairments:
·
92%
indicated that they did not participate in any type of leisure-time physical
activity;
·
10%
indicated they exercised regularly three or more times weekly;
·
2%
stated that they participated in outdoor unstructured physical activity, such
as gardening;
·
almost
82% of the women said that they would like to start an exercise program.
In
another study of 165 women with physical disabilities:
·
72%
reported decreasing levels of participation in physical activity over the past
10 years;
·
almost
60% reported that they “never or rarely” participated in leisure-time physical
activity that increased their breathing and heart rate;
·
over
half of the women reported never participating in physically active household
activities (71%) or in physical activities like standing (58%), walking (55%),
lifting (91%), or exercise (55%).
Other researchers have reported
lower scores on physical activity participation in a cohort of women with
multiple sclerosis compared to a normative sample of women without
disabilities.
Barriers to participation in
physical activity include knowledge, skills, attitudes, values, beliefs, social
support for participation, time, money, and accessibility issues.
In
general, barriers to participation in physical activity can be conceptualized
as being intrapersonal, interpersonal, or structural. Existing
research on barriers or constraints to physical activity for women with
disabilities suggest that all three categories of constraints impede the
ability of these women to routinely engage in physical activity.
1.
Intrapersonal constraints include attitudes, values, or beliefs
which a person holds that hinder involvement in physical activities. Examples include negative
attitudes or beliefs about the value of physical activity, low expectations
about one’s ability to participate, or lack of interest or knowledge. Intrapersonal constraints identified by women
with disabilities that limit their involvement in physical activities include
fatigue and pain, the disability itself, lack of knowledge about where
to find a program, and limited access to knowledge about their capabilities for
activity. Researchers conducting a study of women with multiple sclerosis
reported that these women generally lacked the knowledge and skills needed to
exercise safely. Lack of behavioral capability and knowledge about how to
exercise may be a particular concern for certain subgroups of women with
disabilities. For example, some women with severe mobility impairments may not
know how to exercise in their wheelchairs, and women with conditions such as
multiple sclerosis may exacerbate their symptoms if they do not know how to
exercise properly.
2.
Interpersonal constraints can be categorized as
those that arise from interactions with others (e.g., family, friends,
co-workers). An example of an interpersonal constraint is lack of social
support for participation in physical activity. Data from qualitative interviews with women with mobility
impairments identified social support as a factor that influenced the values
and attitudes women with physical disabilities have about physical
activities. Likewise, women with
physical disabilities surveyed in another study identified social support,
specifically lack of companionship, as a major barrier to being physically
active.
3.
Structural constraints consist of barriers that arise
as a result of external conditions in the environment (e.g., lack of
opportunities). Examples of structural
constraints include lack of time, money, or accessibility issues. Women with
physical disabilities in one survey identified
structural constraints that inhibited their involvement in physical activity.
These included lack of money and concern about crime. Additionally, 50 women
with physical disabilities in another study identified structural barriers
related to transportation and costs. A
sample of 215 women with various disabilities in another investigation reported
similar structural barriers, including problems with architectural access,
access to available and affordable transportation, access to knowledgeable
professionals regarding equipment and programs, and feeling safe in their
community activity.
Despite these barriers, women with
disabilities report interest in participating in physical activity. In a sample
of African-American women with mobility impairments, almost 82% said that they
would like to start an exercise program. In another survey of 165 women with
physical disabilities, many of the participants also indicated that they would
like to make lifestyle changes regarding their exercise (42%) and leisure and
recreation (48%) activities.
Studies have not yet investigated whether the long-term benefits of physical
activity, such as reduced risk for cardiovascular disease, osteoporosis, and
obesity, can be obtained by women with disabilities.
While research has recently begun to
investigate the health benefits of physical activity among people with disabilities,
few studies have specifically focused on women with disabilities. No studies
have yet investigated whether the long-term benefits of physical activity, such
as reduced risk for cardiovascular disease, osteoporosis, and obesity that
occur among persons without disabilities, also apply to persons with
disabilities. However, the available data do suggest these benefits would
extend to people with disabilities.
Additionally, numerous studies have
established that people with disabilities have the same physiological response
to physical activity as the general population. In a review of the published
physical activity research conducted with people with disabilities, researchers
reported that the data clearly demonstrated physical activity generated
significant physiological changes among people with arthritis, neuromuscular
diseases, spinal cord injury, respiratory diseases, and stroke. These and more
recent studies reveal that the health benefits of physical activity include
improved muscle strength of the exercised extremities, improved aerobic
capacity, decreased walking times, extended time to fatigue onset, reduced
joint swelling, pain, and stiffness, decreased serum cholesterol levels,
improved pulmonary function among those with respiratory diseases, and
decreases in levels of depression.
The benefits of physical activity
may be even greater for people with disabilities than for the general
population due to increases in endurance and strength that may improve
function. Additionally, people with disabilities who participate in physical
activity may reduce their risk for developing additional health conditions.
Since women with disabilities have low rates of physical
activity, it is important to identify determinants,
or factors, that predict exercise maintenance for this population. To date,
only one study has investigated determinants of physical activity among people
with disabilities (Kinne, Patrick, & Maher, 1999).
Determinants
of physical activity are factors that distinguish individuals who are more
physically active. Three general categories of determinants have been
identified as relevant for the adoption and maintenance of physical activity.
These determinant categories encompass the physical and social environment,
personal attributes, and aspects of the physical activity itself, such as
exercise intensity and enjoyment of activity.
To date, only one study has
investigated determinants of physical activity among people with disabilities.
This study examin
Due to the current lack of evidence
regarding determinants of physical activity among people with disabilities in
general, and women with disabilities in particular, it is important to identify
factors that predict exercise maintenance in these subgroups.
Much more research is needed to investigate methods to promote physical activity effectively
among women with disabilities.
While
numerous studies have demonstrated that people with disabilities show
significant physiological improvements due to physical activity, little
research has investigated how to promote physical activity effectively among
this population. Even fewer studies have targeted women with disabilities.
Two studies have focused on home-based
exercise programs for people with disabilities, while other researchers have
investigated center-based studies of physical activity for people with
disabilities using community centers or other locations where accessible
fitness equipment is available. These studies include interventions to promote
walking programs among women with fibromyalgia, home-based strength training
for people with various disabilities, exercise classes for people with
arthritis and other disabilities, and walking and water aerobics for people
with arthritis. While the results of these studies are promising, there have
been mixed results in participant retention and adherence to fitness programs.
While the usefulness of alternate forms of moderate physical
activity, such as T'ai Chi, has not been explored specifically for women with
disabilities, some preliminary evidence of their usefulness for person with
disabilities has been documented in mixed gender research.
In
terms of physical activity,
Some preliminary evidence of T'ai Chi's
usefulness for person with disabilities has been documented in mixed gender
research. The use of T’ai Chi has been investigated with hip replacement
patients, individuals with rheumatoid arthritis, older adults with
osteoarthritis, people with multiple sclerosis, and as part of a rehabilitation
program for clients with severe head injury. Collectively, these studies
provide preliminary support for further research examining the usefulness of
T'ai Chi as a form of moderate physical activity in persons with disabilities.
Less research exists regarding the use
of yoga as a form of physical activity for persons with disabilities. Most of the research done in this area has
focused on the use of yoga in individuals with back pain, chronic pain,
osteoarthritis, or rheumatoid arthritis. These studies primarily focused on
yoga's utility in decreasing the experience of pain in these populations,
although researchers have reported increases in hand grip for persons with
rheumatoid arthritis and increases in finger range of motion following yoga
training.
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