Increasing Physical Activity for

Individuals with Disabilities

I Can Do It, You Can Do It!

The University of Alabama at Birmingham
 Objectives
• Discuss the need to promote physical activity with individuals
with disabilities
• Identify common barriers and facilitators for physical activity
in individuals with disabilities
• State national guidelines for physical activity and exercise
• Assess barriers and facilitators to physical activity with a
client
• Assess a client’s current and potential behavior with regard
to physical activity
• Select client‐centered interventions based on assessment to
promote physical activity
• Modify and adapt various physical activities to best match
client ability
 Outline
• Epidemiology
• Determinants of health
• Federal guidelines
• Assessment
• Intervention
• (Dis)ability
• Adaptation
• Modification
• Examples
 Epidemiology
• Individuals with disabilities represent 18.7% (about
56.7 million people) of the U.S. population1
• Individuals with disabilities experience significant
health disparities2:
• Disproportionately obese
• More likely to be in poor overall health
• Less likely to receive preventive health services
• More likely to engage in unhealthy behaviors such as smoking
• Less likely to meet the national physical activity guidelines
• Yet, individuals with disabilities can benefit from
physical activity just as much as someone who is
typically functioning
 Epidemiology
Disability and Physical Activity
• Inactivity was more prevalent among adults with
any disability than adults without disability (47.1%
vs. 26.1%)
• Inactive adults with disabilities were 50% more likely
to report one or more chronic diseases than those
that were physically active
• Only 44% of adults with disabilities were told by a
health professional to increase their physical activity
level in the past 12 months
 Affecting Factors
• Economic stability
• Education
• Health and healthcare
• Neighborhood and built environment
• Social and community context
 Guidelines For Structured Exercise
• Children and Adolescents, ≥ 60 minutes daily
• Aerobic
• Muscle strengthening
• Bone strengthening
• Adults, ≥ 150 minutes weekly of moderate intensity
or 75 minutes of vigorous intensity
• Aerobic
• Muscle strengthening
• Bone strengthening
• US guidelines
 Benefits of Structured Exercise
• Reduces risk of many adverse health outcomes
• Some is better than none
• In general, the benefit is linear – the more frequent,
intense, and/or the longer the duration, the greater
the benefit
• Benefits far outweigh any risks
• Health benefits occur for individuals with disabilities
 National Guidelines For Individuals
With Disabilities
• 150 minutes a week of moderate‐intensity or 75
minutes a week of vigorous‐intensity aerobic activity, or
an equivalent combination
• Muscle‐strengthening activities of moderate or high
intensity that involve all major muscle groups on 2 or
more days a week
• For those unable to meet these guidelines, engage in
regular physical activity and avoid inactivity as much as
possible
 Beyond the Guidelines
• Assume a person meets the guidelines of 2.5 hours
per week: assuming the person sleeps for 8 hours a
day, what about the other 110 waking hours that
make up the remainder of the week?

All Activity Matters!

 Assessment of Physical Activity
• International Physical Activity Questionnaire

• YMCA Physical Activity Test

• Observation
 Assessment of Beliefs Regarding
Physical Activity
• Ask client about barriers to activities
• Use a 10 point scale (or 10cm line) to rate:
• Importance of physical activity
• Self efficacy (confidence) toward physical activity
• Readiness to participate
• Client‐centered (don’t assume)
• May need to ask caregivers or other key people
 Physical Activity Interventions
• Should be driven by assessment results
• Usually best to address beliefs first
• Be mindful of barriers, but build on strengths and facilitators
• Something is better than nothing (starting small is
okay)
• Provide choice (a menu of activities)
• Positive reinforcement throughout
• Reassess often
• Use information from governmental websites for
ideas
 Ideas To Increase Physical Activity

http://www.cdc.gov/physicalactivity/index.html

Http://www.cdc.gov/features/physical‐activity‐
disabilities/index.html

http://www.cdc.gov/ncbddd/disabilityandhealth/index.
html

http://www.fitness.gov/be‐active/useful‐resources/
 What Are Your Beliefs About
The Ability of Individuals With
Disabilities to Be Physically
Active?

Rio Paralympic Games, September 7th through the 18th

Television schedule
 What is an Adaptation?
• Changing the way a task or skill is performed
• Used to promote success
• Allow mentee to perform task/skill in a way that
aligns with each his or her abilities
• Allow mentee to perform skills or activities which are
challenging, yet will promote success and self‐‐esteem
 What is a Modification?
• Making a task easier or more
difficult
• But keeping the skill or
performance the same
• Individualized to meet the
needs of the mentee
• Promote success, yet provide
challenge as appropriate
 How to Determine Adaptation or
Modification
Adaptation Modification
Changing technique Changing equipment or
or rules of the game adjusting environment
 Strategies For Promoting Success
● Using a larger object and
a wider implement for
striking practice
● Decreasing size of the
playing field (e.g., ½ court
basketball
● Low compression tennis
balls
● Using varying sizes,
shapes, colors
Power Soccer
Wheelchair Basketball
Volleyball
 TREE Mnemonic
● Focus on abilities rather than disabilities
● Determine mentee’s present level of performance
(PLP)
● Would the mentee’s PLP benefit from a change in:
T – Technique of the skill
R – Rules of the game
E – Equipment
E – Environment
Application to Activities
● Throwing and Catching
● Jump Rope
● Aquatics

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 Activity ‐ Throwing and Catching
Adaptation Modification

Assistive catching devices, such as Velcro Use larger balls for catching; smaller balls
and other tools for throwing
Passing or rolling ball off lap instead of Use lighter balls, balloons, bean bags,
throwing smaller balls
Using the mouth, head, or any other body Use brighter balls for individuals with
part to throw or catch visual impairments
Knowing it is okay to drop some cues if Increase or decrease the throwing
appropriate distance
Allowing the mentee to throw functionally Practice the motion of throwing without a
that best works for him or her, even if it is ball
not the mature pattern (underhand vs.
overhand; toss over shoulder vs. arm back
to full extension)
 Activity ‐ Jump Rope
Adaptation Modification

Rope on the floor – jump over rope or line Use a beaded rope that makes noise when
it hits the ground
Wheelchair users – roll back and forth Hold both ends of rope in one hand; swing
over the line rope while jumping up and down
Wall squats while others are jumping rope Hold onto the wall or person while others
turn the rope
 Activity ‐ Aquatics
Adaptation
Practice arm strokes outside of water
Utilizing a frog kick instead of free style
kick during front crawl
Walk in the water moving arms in a
circular motion
Swimming on the steps (removing
flotation requirement)
Modification
Life jackets or aqua jogger belts; pool
bouts or noodles for flotation support
Shallow water
Decreasing or increasing swimming
distance
Mentor supporting behind head forcing
mentee to look back (chin up) during back
float. Object on belly
Promote Success for Your Mentee!
 Resources
• National Center on Health, Physical Activity Disability:
www.nchpad.org

• Lakeshore Foundation: www.lakeshore.org

• Palaestra – Adapted Sport, Physical Education, and

Recreational Therapy: www.palaestra.com

• Inclusive Fitness Coalition: www.incit.org