Skip to main content

Advertisement

Log in

Physical Activity for People with a Disability

A Conceptual Model

  • Leading Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

The promotion of a physically active lifestyle has become an important issue in health policy in first-world countries. A physically active lifestyle is accompanied by several fitness and health benefits. Individuals with a disability can particularly benefit from an active lifestyle: not only does it reduce the risk for secondary health problems, but all levels of functioning can be influenced positively.

The objective of this article is to propose a conceptual model that describes the relationships between physical activity behaviour, its determinants and functioning of people with a disability. The literature was systematically searched for articles considering physical activity and disability, and models relating both topics were looked for in particular. No models were found relating physical activity behaviour, its determinants and functioning in people with a disability. Consequently, a new model, the Physical Activity for people with a Disability (PAD) model, was constructed based on existing models of disability and models of determinants of physical activity behaviour. The starting point was the new WHO Model of Functioning and Disability, part of the International Classification of Functioning, Disability and Health (ICF), which describes the multidimensional aspects of functioning and disability. Physical activity behaviour and its determinants were integrated into the ICF model. The factors determining physical activity were based mainly on those used in the Attitude, Social influence and self-Efficacy (ASE) model. The proposed model can be used as a theoretical framework for future interventions and research on physical activity promotion in the population of people with a disability. The model currently forms the theoretical basis for a large physical activity promotion trial in ten Dutch rehabilitation centres.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Fig. 2
Table II
Fig. 3

Similar content being viewed by others

References

  1. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995 Feb; 273(5): 402–7

    Article  PubMed  CAS  Google Scholar 

  2. Committee of Ministers. Recommendation no. R17 of the Committee of Ministers to the Member States on the significance of sport for society. Strasbourg: Council of Europe (CDDS), 1995; 58: 8–10

    Google Scholar 

  3. US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers of Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996

    Google Scholar 

  4. Vuori I, Fentem P. Health, position paper. In: Vuori I, Fentem P, Svoboda B, et al., editors. The significance of sport for society. Strasburg: Council of Europe Press, 1995: 11–90

    Google Scholar 

  5. WHO/FIMS committee on physical activity for health. Statement: exercise for health. Bull World Health Organ 1995; 73(2): 135–6

    Google Scholar 

  6. Powell KE, Blair SN. The public health burdens of sedentary living habits: theoretical but realistic estimates. Med Sci Sports Exerc 1994 Jul; 26(7): 851–6

    PubMed  CAS  Google Scholar 

  7. Calfas KJ, Long BJ, Sallis JF, et al. A controlled trial of physician counseling to promote the adoption of physical activity. Prev Med 1996 May–Jun; 25(3): 225–33

    Article  PubMed  CAS  Google Scholar 

  8. Kohl III HW, Dunn AL, Marcus BH, et al. A randomized trial of physical activity interventions: design and baseline data from project active. Med Sci Sports Exerc 1998 Feb; 30(2): 275–83

    Article  PubMed  Google Scholar 

  9. Long BJ, Calfas KJ, Wooten W, et al. A multisite field test of the acceptability of physical activity counseling in primary care: project PACE. Am J Prev Med 1996 Mar–Apr; 12(2): 73–81

    PubMed  CAS  Google Scholar 

  10. Sallis JF, Calfas KJ, Nichols JF, et al. Evaluation of a university course to promote physical activity: project GRAD. Res Q Exerc Sport 1999 Mar; 70(1): 1–10

    PubMed  CAS  Google Scholar 

  11. Stevens M, Bult P, de Greef MH, et al. Groningen Active Living Model (GALM): stimulating physical activity in sedentary older adults. Prev Med 1999 Oct; 29(4): 267–76

    Article  PubMed  CAS  Google Scholar 

  12. Cooper RA, Quatrano LA, Axelson PW, et al. Research on physical activity and health among people with disabilities: a consensus statement. J Rehabil Res Dev 1999 Apr; 36(2): 142–54

    PubMed  CAS  Google Scholar 

  13. Durstine JL, Painter P, Franklin BA, et al. Physical activity for the chronically ill and disabled. Sports Med 2000 Sep; 30(3): 207–19

    Article  PubMed  CAS  Google Scholar 

  14. Heath GW, Fentem PH. Physical activity among persons with disabilities: a public health perspective. Exerc Sport Sci Rev 1997; 25: 195–234

    Article  PubMed  CAS  Google Scholar 

  15. Rimmer JH, Braddock D, Pitetti KH. Research on physical activity and disability: an emerging national priority. Med Sci Sports Exerc 1996 Nov; 28(11): 1366–72

    Article  PubMed  CAS  Google Scholar 

  16. Rimmer JH. Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions. Phys Ther 1999 May; 79(5): 495–502

    PubMed  CAS  Google Scholar 

  17. Shephard RJ. Benefits of sport and physical activity for the disabled: implications for the individual and for society. Scand J Rehabil Med 1991; 23(2): 51–9

    PubMed  CAS  Google Scholar 

  18. Frontera WR, Dawson DM, Slovik DM. Exercise in rehabilitation medicine. Champaign (IL): Human Kinetics, 1999

    Google Scholar 

  19. McNeil JM. Americans with disabilities: 1991–1992. In: US Bureau of the Census. Current population reports. Washington, DC: US Government Printing Office, 1993

    Google Scholar 

  20. Kaye HS, La Plante MP, Carlson D, et al. Trends in disability rates in the United States, 1970–1994. Disability statistics abstract, no. 17. Washington, DC: US Department of Education, National Institute on Disability and Rehabilitation Research, 1996

    Google Scholar 

  21. La Plante M, Carlson D. Disability in the United States: prevalence and causes, 1992. Disability statistics report, no. 7. Washington, DC: US Department of Education, National Institute of Disability and Rehabilitation Research, 1996

    Google Scholar 

  22. Americans with Disabilities Act of 1990. Public law 336 of the 101st congress, enacted 1990 Jul 26

  23. World Health Organization. International classification of functioning, disability and health. Geneva: World Health Organization, 2001

    Google Scholar 

  24. US Department of Health and Human Services. Healthy People 2010: understanding and improving health. 2nd ed. Washington, DC: US Government Printing Office, 2000 Nov

    Google Scholar 

  25. Nagi SZ. Some conceptual issues in disability and rehabilitation. In: Sussman MB, editor. Sociology and rehabilitation. Columbus (OH): Ohio State University Press, 1965: 100–13

    Google Scholar 

  26. World Health Organization. International classification of impairments, disabilities and handicaps: a manual of classification relating to the consequences of disease. Geneva: World Health Organization, 1980

    Google Scholar 

  27. Abberley P. The concept of oppression and the development of a social theory of disability. Disabil Handicap Soc 1987; 2(1): 5–19

    Article  Google Scholar 

  28. Brandt EN, Pope AM. Enabling America: assessing the role of rehabilitation science and engineering. Washington, DC: National Academy Press, 1997

    Google Scholar 

  29. Johnson RJ, Wolinsky FD. The structure of health status among older adults: disease, disability, functional limitation, and perceived health. J Health Soc Behav 1993 Jun; 34: 105–21

    Article  PubMed  CAS  Google Scholar 

  30. National Center for Medical Rehabilitation Research. Research plan for the National Center for Medical Rehabilitation Research. Washington, DC: National Institute of Health, 1993

    Google Scholar 

  31. Pope AM, Tarlov AR. Disability in America: toward a national agenda for prevention. Washington, DC: National Academy Press, 1991

    Google Scholar 

  32. Suchman EA. A model for research and evaluation on rehabilitation. In: Sussman M, editor. Sociology and rehabilitation. Washington, DC: American Sociological Association, 1965: 52–70

    Google Scholar 

  33. Verbrugge LM, Jette AM. The disablement process. Soc Sci Med 1994 Jan; 38(1): 1–14

    Article  PubMed  CAS  Google Scholar 

  34. Wan TT. Correlates and consequences of severe disabilities. J Occup Med 1974 Apr; 16(4): 234–44

    PubMed  CAS  Google Scholar 

  35. Peters DJ. Disablement observed, addressed, and experienced: integrating subjective experience into disablement models. Disabil Rehabil 1996 Dec; 18: 593–603

    Article  PubMed  CAS  Google Scholar 

  36. Talo S, Rytokoski U, Puukka P, et al. An empirical investigation of the ‘Biopsychosocial Disease Consequence model’: psychological impairment, disability and handicap in chronic pain patients. Disabil Rehabil 1995 Aug–Sep; 17(6): 281–92

    Article  PubMed  CAS  Google Scholar 

  37. Post MW, de Witte LP, Schrijvers AJ. Quality of life and the ICIDH: towards an integrated conceptual model for rehabilitation outcomes research. Clin Rehabil 1999 Feb; 13(1): 5–15

    Article  PubMed  CAS  Google Scholar 

  38. Altman BM. Disability definitions, models, classification schemes, and applications. In: Albrecht GL, Seelman KD, Bury M, editors. Handbook of disability studies. Thousand Oaks (CA): Sage, 2001: 97–122

    Chapter  Google Scholar 

  39. Gray DB, Hendershot GE. The ICIDH-2: developments for a new era of outcomes research. Arch Phys Med Rehabil 2000 Dec; 81 (12 Suppl. 2): S10–4

    Article  PubMed  CAS  Google Scholar 

  40. Halbertsma J, Heerkens YF, Hirs WM, et al. Towards a new ICIDH. Disabil Rehabil 2000 Feb; 22(3): 144–56

    Article  PubMed  CAS  Google Scholar 

  41. World Health Organization. International statistical classification of diseases and related health problems. 10th rev. Geneva: World Health Organization, 1992–1994

    Google Scholar 

  42. Dishman RK, Sallis JF. Determinants and interventions for physical activity and exercise. In: Bouchard C, Shephard RJ, Stephens T, editors. Physical activity, fitness, and health: international proceedings and consensus statement. Champaign (IL): Human Kinetics, 1994: 214–38

    Google Scholar 

  43. Humpel N, Owen N, Leslie E. Environmental factors associated with adults’ participation in physical activity: a review. Am J Prev Med 2002 Apr; 22(3): 188–99

    Article  PubMed  Google Scholar 

  44. King AC, Blair SN, Bild DE, et al. Determinants of physical activity and interventions in adults. Med Sci Sports Exerc 1992 Jun; 24 (6 Suppl.): S221–36

    PubMed  CAS  Google Scholar 

  45. Sallis JF, Owen N. Physical activity and behavioral medicine. Thousand Oaks (CA): Sage, 1999

    Google Scholar 

  46. Buckworth J. Exercise determinants and interventions. Int J Sport Psychol 2000; 31: 305–20

    Google Scholar 

  47. Buckworth J, Dishman RK. Determinants of physical activity: research to application. In: Rippe JM, editor. Lifestyle medicine. Boston (MA): Blackwell Science Inc., 1999: 1016–27

    Google Scholar 

  48. Baker EA, Brennan LK, Brownson R, et al. Measuring the determinants of physical activity in the community: current and future directions. Res Q Exerc Sport 2000 Jun; 71(2): 146–58

    Google Scholar 

  49. Seefeldt V, Malina RM, Clark MA. Factors affecting levels of physical activity in adults. Sports Med 2002; 32(3): 143–68

    Article  PubMed  Google Scholar 

  50. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs (NJ): Prentice-Hall, 1986

    Google Scholar 

  51. Rosenstock IM. Historical origins of the health believe model. Health Educ Monogr 1974; 2: 1–9

    Google Scholar 

  52. Ajzen I. From intentions to action: a theory of planned behavior. In: Kuhl J, Beckmann J, editors. Action-control: from cognition to behavior. Heidelberg: Springer, 1985: 11–39

    Google Scholar 

  53. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983 Jun; 51(3): 390–5

    Article  PubMed  CAS  Google Scholar 

  54. De Vries H, Dijkstra M, Kuhlman P. Self-efficacy: the third factor besides attitude and subjective norm as a predictor of behavioural intentions. Health Educ Res 1988; 3: 273–82

    Article  Google Scholar 

  55. De Vries H. Determinanten van gedrag. In: Damoiseaux V, van der Molen HT, Kok GJ, editors. Gezondheidsvoorlichting en gedragsverandering. Assen: Van Gorcum, 1993: 109–32

    Google Scholar 

  56. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977 Mar; 84(2): 191–215

    Article  PubMed  CAS  Google Scholar 

  57. Marcus BH, Selby VC, Niaura RS, et al. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport 1992 Mar; 63(1): 60–6

    PubMed  CAS  Google Scholar 

  58. Rimmer JH, Rubin SS, Braddock D. Barriers to exercise in African American women with physical disabilities. Arch Phys Med Rehabil 2000 Feb; 81(2): 182–8

    PubMed  CAS  Google Scholar 

  59. Finch C, Owen N, Price R. Current injury or disability as a barrier to being more physically active. Med Sci Sports Exerc 2001 May; 33(5): 778–82

    PubMed  CAS  Google Scholar 

  60. Kinne S, Patrick DL, Maher EJ. Correlates of exercise maintenance among people with mobility impairments. Disabil Rehabil 1999 Jan; 21(1): 15–22

    Article  PubMed  CAS  Google Scholar 

  61. Van der Ploeg HP, Streppel KRM, Van der Beek AJ, et al. A study evaluating physical activity promotion in people with disabilities [abstract]. Int J Behav Med 2002; 9Suppl. 1: 282

    Google Scholar 

Download references

Acknowledgements

The authors were funded by the Netherlands Organisation for Health Research and Development (ZonMw) and The Netherlands Sports Organisation for People with a Disability (NebasNsg). The authors have no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Willem van Mechelen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van der Ploeg, H.P., van der Beek, A.J., van der Woude, L.H.V. et al. Physical Activity for People with a Disability. Sports Med 34, 639–649 (2004). https://doi.org/10.2165/00007256-200434100-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200434100-00002

Keywords

Navigation