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It is well known that IDEA (the Individuals With Disabilities Education Act) is overdue for reauthorization and, borrowing from Block and colleagues, it is important to consider what evidence we have to support adapted physical activity as a field in the United States beyond this federal mandate. We believe that these questions have gained further importance in the current geopolitical climate in the United States. With that, we use this editorial to reflect on the evidence and direction of our field, with the hope of sparking dialogue and encouraging others to think about the future of adapted physical activity. In this editorial, we discuss the importance of adapted physical activity as it relates to health and physical activity and school-based physical education, as well as philosophical/moral arguments for the field. We conclude the editorial by inviting others to join the conversation about other unique aspects of importance to the field of adapted physical activity in the United States.
This article explores the tensions between adaptation and normalization in adapted physical activity (APA) for young autistic people in specialized institutions. Based on participant observations of APA sessions and interviews with educators conducted in two specialized medicosocial settings in southern France, the study examines how participation is negotiated in practice. It highlights how strict behavioral rules and time constraints can hinder participation and lead to disengagement or so-called "challenging behaviors." Drawing on crip theory and the neurodiversity paradigm, the analysis reveals how normative expectations shape inclusive practices, sometimes reinforcing ableist assumptions. The authors argue that current APA models often misalign with the embodied experiences and rhythms of autistic youth. However, some practices-such as breaks, individualized adaptations, and attention to individual tempos-can foster engagement and well-being. The study calls for a critical rethinking of APA inclusion strategies, advocating for approaches that center on enjoyment and the recognition of diverse ways of being rather than on behavioral compliance or normalization.
People with moderate to profound disability experience participate in low levels of physical activity (PA), negatively impacting their overall health and well-being. This project aimed to adapt our best practice model for PA promotion among people with disability for use by community Allied Health Professionals (AHPs) to increase PA participation among clients with moderate to profound disabilities. Four people with lived experience of moderate to profound disability and 12 AHPs participated in eight co-design workshops. All workshops were audio recorded and analyzed using a rapid data analysis approach utilizing inductive content analysis. Through the co-design process, several modifications were made to support its implementation with people with moderate to profound disability. Key modifications included (a) greater flexibility with the duration of program and session delivery, (b) a focus on social networks to support PA participation post program, (c) more support for AHPs to effectively implement behavior change strategies, and (d) broader goals beyond leisure-time PA goals. Application of the co-design process resulted in the development of a PA promotion program that can be delivered by community AHPs, tailored to the needs of people with moderate to profound disability. Recommendations are provided to support the implementation of the program within the community.
The purpose of this study was to examine the subjective feelings of belonging for blind and visually impaired women when participating in exercise, physical activity, and/or sport. To do this, an experiential qualitative research approach was used. Ten blind or visually impaired women age 27-45 years served as participants and completed two one-on-one audio-recorded semistructured interviews. A reflexive thematic analysis approach was used to analyze the interview data, from which three themes were constructed: (a) "When you get there, and people welcome you": Feeling welcomed to join spaces, (b) "Feeling like I can contribute and I'm valuable": Feeling accepted within those spaces, and (c) "Having the opportunity...": Building community that extends beyond spaces. Participants described instances of belonging in physical activity spaces where they were welcomed, felt accepted and valued, and were able to develop long-lasting friendships.
One role of adapted physical educators is connecting with parents of children with disabilities to enhance service delivery. However, parents experience a disconnect with teachers. Much of the literature has focused on parent perspectives, but equally important is understanding the perspectives of teachers. Therefore, the purpose of this study was to explore the perceptions of adapted physical education (APE) teachers toward parents of children with disabilities. Through semistructured interviews of 11 participants, four themes were extracted: (a) importance and benefits of parent involvement, (b) communicating with parents as a key facilitator to developing relationships, (c) teacher characteristics that facilitate developing parent relationships, and (d) perceived barriers to developing parent relationships. In addition to experiencing parental lack of value for and prioritizing APE, many APE teachers also experienced challenges such as feeling marginalized. Having resilience and communicating through visuals were important factors to create relationships with parents.
Understanding the psychological mechanism underlying physical activity (PA) participation in individuals with physical disabilities is crucial. In the current study, a conceptual model derived from extant literature was utilized to examine how perceived barriers, attitude, subjective norm, and self-efficacy are associated with intention and action of PA for people with disabilities. We recruited 371 adults (male = 215; female = 154; unidentified = 1; Mage = 53.20 ± 11.52 yr) with various physical disabilities. Structural equation modeling indicated that subjective norm, attitude, personal efficacy, environmental efficacy, and intention were positively associated with health actions, whereas internal, interpersonal, and environmental barriers showed negative associations. Internal and interpersonal barriers showed associations with lower motivation through self-efficacy and subjective norm, while environmental barriers were associated with diminished volitional processes through environmental efficacy. PA participation among individuals with disabilities appears to be shaped by different types of barriers and social cognitive variables across various stages of behavioral engagement. Limitations, practical implications, and future directions are also discussed.
Little is known about physical activity (PA) participation in people with advanced multiple sclerosis (MS). The purpose of this study was to (a) characterize self-reported PA levels and (b) explore how PA levels might differ based on sociodemographic (e.g., gender) and clinical (e.g., MS clinical course) characteristics in people with advanced MS. We used a cross-sectional online survey design with 101 participants. PA was measured using the Physical Activity Scale for Individuals With Physical Disabilities. The mean score on the scale was 4.5 (SD = 5.9) metabolic equivalent hours per day. There was a significant difference in scores based on employment, population density, living situation, disability, and assistive-device type (all p < .05). PA levels were higher in those who were employed, lived alone, required bilateral support for mobility, and were manual wheelchair users (all p < .05). This study highlights low PA levels in people with advanced MS and potential variables that might impact PA in this MS subgroup.
Physical activity (PA) benefits autistic1 individuals, yet barriers including limited support from PA professionals hinder PA engagement. Guided by the theory of planned behavior and the diffusion of innovations theory, this study used a quasi-experimental one-group pretest-posttest design to investigate the effectiveness and practicality of an e-learning program in changing PA professionals' intention and confidence to support autistic individuals in PA. PA professionals (N = 49) completed the Strong Minds Through Active Bodies e-learning program, as well as pre- and postevaluations. Results showed significant improvements in all theory of planned behavior constructs and positive feedback on the module's practicality. Tailored e-learning can enhance PA professionals' understanding and confidence in meeting the unique needs and preferences of autistic individuals in PA. Further research is warranted to understand how e-learning may be leveraged as a tool to foster more inclusive programs, ultimately encouraging greater participation by creating accessible and engaging PA environments that are supportive and conducive to active engagement for autistic individuals.
This study offers novel and significant insights to advance understanding, practice, and policy regarding physical activity (PA) across the lifespan among individuals with Type 1 diabetes in the United Kingdom. Utilizing both medicalized and sociocultural lenses, we aimed to (a) examine the PA experiences of people with Type 1 diabetes and (b) explore the meanings of PA across the life course. The qualitative testimonies of a 311 participants aged 3-75 were analyzed using reflexive thematic analysis across age-based case studies. We identified why PA becomes meaningful at particular life stages and how experiences are shaped by intersections of technology use, social attitudes, health care transitions, body image, and identity. Participants of all ages described navigating stigma, institutional misunderstanding, and internalized ableism, often heightened with age. We conclude that the Type 1 diabetes community remains underserved by current approaches and call for targeted policy, practitioner training, and lifespan-oriented research that fosters inclusive and empowering PA opportunities.
Despite the established benefits of physical activity, adults with disabilities experience significant disparities in participation. Exercise professionals are uniquely positioned to play a role in bridging this gap, making an understanding of their experiences critical. This qualitative study explored the perceived barriers and facilitators for Qualified Exercise Professionals in Italy when delivering programs for adults with disabilities. Semistructured interviews were conducted with 22 experienced Qualified Exercise Professionals and analyzed using reflexive thematic analysis. Findings revealed three interconnected challenges: systemic constraints, including prohibitive costs and inaccessible facilities; a profound gap between theoretical education and practical demands, fuelling a fear of causing harm; and the unrecognized emotional labor of client advocacy. The therapeutic alliance emerged as the single most important facilitator. These results underscore an urgent need for educational reform, incorporating mandatory practical placements to build professional confidence, and for policy changes to dismantle the structural barriers that inhibit participation.
The aim of this study was to determine the relationships between physical activity (PA) and fitness and mental health in persons with spinal cord injury (PwSCI) living with chronic pain. This cross-sectional baseline data analysis included n = 43 people PwSCI ≥ 18 years reporting chronic pain. We administered the Satisfaction with Life Scale, EuroQol anxiety/depression, ICEpop CAPability Measure for Adults (ICECAP-A) enjoyment and pleasure and achievement and progress, Spinal Cord Injury Quality of Life Satisfaction with Social Roles and Activities scale, Leisure-Time PA Questionnaire for PwSCI, the 36-Item Short-Form Health Survey, and an arm-crank fitness test. Hierarchical multiple regressions, controlling for age, gender, injury level, fatigue, and pain, revealed that moderate to vigorous PA and fitness explained variance in enjoyment and pleasure (ΔR2 = .133, R2 = .344, p = .002), anxiety/depression (ΔR2 = .125, R2 = .258, p = .023), Satisfaction with Life Scale (ΔR2 = .036, R2 = .240, p = .030), achievement and progress (ΔR2 = .084, R2 = .260, p = .020), and Satisfaction with Social Roles and Activities (ΔR2 = .074, R2 = .444, p = .005). Future studies should test whether interventions that increase PA and fitness improve mental health in PwSCI living with chronic pain.
This systematic review synthesizes quantitative evidence on school factors associated with physical activity (PA) participation in children and adolescents with disabilities (CAD). A comprehensive search was conducted in four databases, and studies were included if they quantitatively measured PA levels and examined school factors associated with PA participation among CAD. Methodological quality was assessed, and a semiquantitative synthesis was performed. Twenty-four studies with good to excellent methodological quality were included. Five primary and 21 secondary school factors linked to PA engagement in CAD were identified: school time structure, school PA characteristics, school physical environment, school social environment, and school organizational factors. Among these, four factors of the school time structure (i.e., physical education time, recess time, lunch time, and before- and/or after-school time) showed the most consistent positive associations with PA. This review highlights the critical role of structured school time for school-based PA promotion in CAD.
Spinal cord injury (SCI) can alter physiological responses to acute physical activity (PA), which may influence perceptions and reporting of PA intensity. We examined correlations between physiological and perceptual self-report measures of daily PA in individuals with SCI. Participants completed an assessment of peak aerobic-exercise capacity to determine individualized mild-, moderate-, and vigorous-intensity PA oxygen-uptake (V˙O2) cut points, wore a portable system that measured V˙O2, and completed the Physical Activity Recall Assessment for people with SCI. Time engaged in combined moderate to vigorous PA recorded by portable monitoring and self-report were significantly correlated (r = .659, p = .027). There were no associations between metabolic monitoring and equivalent self-report outcomes within individual PA-intensity levels. These findings highlight challenges people with SCI may have differentiating the intensity of PA, which may be related to the way self-report measures describe sensations associated with each intensity. Whether these findings are specific to SCI-related psychophysiology remains unclear.
Physical activity (PA) has significant health benefits for people with disabilities (PWD). The Centers for Disease Control and Prevention recommends a minimum amount of PA, yet PWD face barriers to meeting them. Guided by the leisure constraints model, previous research has identified constraints and facilitators affecting PA participation but has not considered that PWD may have different experiences based on their PA levels. This study examined the constraint and facilitator profiles of PWD across three different levels of PA participation, focusing on PWD enrolled in adaptive sport or PA programs. Multinomial regression was used to analyze 690 online survey responses distributed by Move United. The results highlighted that, among three constraint levels, intrapersonal constraints were more critical for meeting PA recommendations than interpersonal and structural constraints. This suggests heterogeneous constraint and facilitator profiles of PWD, highlighting tailored services to accommodate their activity levels and needs.
Previous studies have reported that adults with Down syndrome (DS) may perform less physical activity (PA) and more sedentary behavior (SB) than adults without DS (non-DS). We investigated differences in PA and SB profiles between DS and non-DS when utilizing newly developed population-specific activity-intensity cut points. Ninety adults (DS: 40; non-DS: 50) had PA and SB measured by accelerometry. Data were scored with cut points for DS and non-DS. Results from 2 × 2 (Condition × Sex) analysis of covariance indicated adults with DS had less sedentary but more moderate to vigorous PA (MVPA) time, more ≥1-min but less ≥10-, ≥30-, and ≥ 60-min sedentary bouts, and shorter ≥1- and ≥10-min sedentary bouts than non-DS. DS also had more ≥10-min MVPA bouts but shorter ≥10- and ≥20-min MVPA bouts than non-DS. DS performed more MVPA and less SB than non-DS when scoring data with population-specific cut points.
Regular participation in physical activity (PA) has been linked to improved health and well-being outcomes. People with disability, however, are faced with many barriers and often require support to participate. This scoping review aimed to understand how the support needs of people with disability wanting to participate in PA are assessed. A scoping review was conducted as per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) extension for Scoping Reviews, which involved the review of four databases. A total of 35 papers met the inclusion criteria for this review, which identified 11 standardized assessment tools. All tools measured support needs within a general health and participation assessment and included items relevant to PA. No tools were found specific to PA participation. This review suggests that a PA-specific assessment tool would be valuable in measuring the support needs of people with disability with a focus on participation-based outcomes.
Physical activity is vital for health, yet individuals with visual impairments face barriers in conventional fitness settings. This study aimed to understand the perceptions and lived experiences of exercisers with visual impairments (EVI) who participated in an adapted group exercise program (AGEP) and to identify the perceived barriers and facilitators to exercise participation among EVI in both AGEP and non-AGEP settings. Thematic analysis of focus-group interviews with nine EVI identified four themes; therein, participants described meaningful facilitators in AGEP (i.e., accessible instruction, accessible support, and socialization). However, they also reported barriers in both non-AGEP (i.e., inaccessible instruction, activity exclusion) and AGEP (i.e., untrained support staff) settings. These findings underscore the need for collaborative efforts between EVI and program staff to create supportive physical activity environments in both AGEP and non-AGEP settings. Future research could seek to explore this coproduction process to foster greater inclusivity for EVI.
Although research has shown the benefit of physical activity (PA) on executive functions (EFs) in typically developing populations, the efficacy of such interventions among individuals with Down syndrome (DS) is less understood. Therefore, the aim of the review was to systematically examine the empirical literature on the influence of PA interventions on EF in individuals with DS. The search strategy identified 10 eligible articles, which were systematically reviewed following PRISMA guidelines. Relevant data (i.e., study characteristics and major findings) were charted, and risk of bias was assessed. Study findings indicate some positive effects of PA on the EF of individuals with DS, namely, inhibition and cognitive shifting. However, risk-of-bias assessment uncovered critical methodological issues that make results difficult to interpret. Taken together, results suggest that while PA interventions may be beneficial, more high-quality intervention studies are needed to further elucidate the potential impact on the EF of individuals with DS.
Physical literacy (PL) is increasingly being implemented as a means for holistic development for children and youth. Despite this, children experiencing disabilities and their families continue to face barriers that impede participation in physical activities and subsequent PL development. To empower families to actively engage in their PL development, this study sought to provide an accessible, home- and play-based, parent-facilitated intervention, namely, PLayTubs. The purpose was to explore parents' subjective understanding, involvement, and attitudes toward facilitating physical activity opportunities contributing to PL development through this intervention. Four parents with a child (<12 years old) diagnosed with a developmental impairment participated in a 10-week PLayTub experience. Data were collected via semistructured interviews with parents and their children. Making use of an interpretive description methodology and an ecological-dynamics conceptual framework, this study resulted in three themes: (a) a catalyst for autonomy, (b) more than just movement, and (c) an accessible alternative. Parents found that PLayTubs fostered autonomous participation and individual agency, enhanced connections and togetherness, and allowed for the creation of meaningful experiences with physical activity. These positive insights demonstrate the benefit of home-based interventions for this population and highlight the need for larger studies in the future.
This qualitative study explored the experiences of coaches and physical education teachers, collectively referred to as physical activity (PA) professionals, when coaching individuals with intellectual disability (ID) and/or autism. Furthermore, this study explored the educational resources utilized by PA professionals and their needs in terms of increasing knowledge and skills. Semistructured interviews were conducted with 16 PA professionals active across various contexts (segregation, integration, and inclusion). The interviews were analyzed using reflexive thematic analysis. Coaching individuals with ID and/or autism involves considering multiple factors including their physical abilities and behavioral characteristics, the expectations of parents/caregivers, and coach competence. PA professionals experienced complexities of coaching individuals with ID and/or autism and challenges at interpersonal, sport-specific, and environmental/policy levels expressing a need for more tailored education, hands-on experience with the population, and peer support. These findings can guide the development of tailor-made educational tools for coaches to enhance sport participation for individuals with ID and/or autism.