Physical Activity, Motivation and People with Disabilities
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Motivating individuals with disabilities to be physically active
Increasing the number of individuals with disabilities who are
physically active is a public health priority [United States Department
of Health and Human Services (USDHHS), 2001]. The purpose of this
presentation is to report motivational strategies aimed toward physical
activity participation. The benefits of exercise/physical activity
for certain disability types will be presented as a reminder of
the importance of an active lifestyle. Physical activity concerns
will also be reported in order to introduce certain considerations
when trying to identify ways to increase motivation.
General benefits of physical activity
Both physiological and psychological benefits can be obtained
from regular physical activity involvement.
Regular exercise (i.e., 3 or more days per week for 20 or
more minutes) can increase health-related physical fitness such
as cardiovascular endurance (CVE), muscle strength and endurance,
Weight control, prevention of obesity and other health-related
conditions such as cardiovascular diseases, diabetes, colon
cancer, hypertension, osteoporosis, and arthritis can all be
reduced by physical activity.
Psychological benefits such as decreased anxiety and depression
may also be realized with positive improvements in emotions,
self-esteem, and self-confidence.
Physical activity benefits for people with physical disabilities
Physical activity can contribute to self-control, psychological
empowerment, physical strength, and personal freedom for women
with several disabilities such as spinal cord injury, post-polio,
spina bifida, dwarfism, type I diabetes, breast cancer, AIDS,
and heart disease (Guthrie, 1999).
Within the same populace, physical activity has been utilized
to optimize body-mind functioning and reconstruct self-identity
based on personal rather than societal standards.
Subgroups of women based on ethnic backgrounds with the aforementioned
disabilities participated in organized sports and adopted a
political perspective through exercise. Specifically, their
purpose was to challenge gender role, sexual, racial, and disabilities
stereotypes indicating that successful sport participation is
not only the province of high functioning heterosexual European-Americans.
The group of minority populations emphasized self-enhancement
and fulfillment through participation in organized sports.
Adolescent swimmers with physical disabilities can experience
high self-esteem (self-worth) and strong athletic identity.
On the contrary, social physique anxiety (perceived negative
evaluations of one's body from others) has been shown to be
low to moderate and highly related to self-esteem and athletic
identity (Martin, 1999).
Perceived competence within and outside sport settings to
attain specific tasks and goals, social integration (social
skill development), goal setting behaviors, and persistence
in sports have been identified to increase among male, college
students with physical and sensory disabilities (Blinde &
Physical activity benefits for people with developmental disorders
Regular physical activity can improve cardiovascular and respiratory
functioning among individuals with intellectual disabilities
(ID). It can also increase muscle strength and endurance, energy
levels, vocational functioning, and decrease anxiety (Chanias,
Reid, & Hoover, 1992; Eichstaedt & Lavay, 1992).
Participation in exercise programs of moderate intensity has
revealed increased time on-task and attention to task relevant
information leading to successful responses for adolescents
with autism (Rosenthal-Malek & Mitchell, 1997).
Physical activity can also diminish and control inappropriate
behaviors related to autism and intellectual disabilities such
as stereotypic behaviors (Elliot, Dobbin, Rose, & Soper,
Physical activity benefits for people with depression
An 8-week running program with intensity varied between 70%
and 85% of maximal heart rate was found to decrease depression
and increase psychological well-being among individuals who
experienced a major depressive episode (Bosscher, 1993).
Objective changes in physical measures (e.g., improvement
of flexibility and body composition) after an ongoing exercise
program can increase self-perceptions such as physical self-efficacy,
physical competence, physical acceptance, and eventually self-esteem.
Increased self-esteem in turn can elevate mood (Sonstroem &
Morgan, 1989; Van De Vliet, Van Coppenolle, & Knapen, 1999).
Physical activity concerns
Beyond the positive gains of physical activity, scholars and practitioners
in the field of adapted physical activity/education have taken into
consideration the potential negative implications of physical activity
for certain populations.
In the western European-American society, media advertisements,
Hollywood movies, fashion shows and magazines relate fitness
to thinness for women. Thinness in turn is linked to sexual
and physical attractiveness, success, power, and status (Kilbourne,
1994). Such messages may render vulnerable individuals to eating
disorders such as anorexia nervosa (Sherwood & Nenmark-Sztainer,
2001). For individuals with anorexia or bulimia nervosa, excessive
exercise may be a way to remain slender, but not necessarily
healthy (Kilbourne, 1994).
Excessive exercise to restore a distorted body image can result
in very negative complications (e.g., injuries, dehydration).
Vigorous exercise, which lasts for many hours, may not contribute
to enjoyment and fun. On the contrary, motivation and joy can,
in fact, decrease. In addition, aerobic exercise may not result
in well-sculpted muscles of certain body parts. Therefore, increases
in body weight and lack of well-sculpted muscles on certain
body parts may lead to dissatisfaction and frustration given
that the role of exercise is viewed superficially (e.g., lose
weight and look thinner). Dissatisfaction may, in turn, lead
to withdrawal from exercise and sports (Polivy & McFarlane,
The negative consequences of the western culture messages
may have affected individuals from different ethnic groups.
Eating disorders are not a "province" of only heterosexual European-Americans.
Acculturation of different ethnic and religious groups such
as African-Americans and Jewish may evoke the negative implications
of the thinness over idealization of the western society. For
example, an African-American, a white Jewish, or a homosexual
woman may adopt a slender body ideal and engage in maladaptive
behaviors such as dieting and excessive exercise in order to
better fit into the western society and avoid further discrimination
An analogous phenomenon has evolved recently among individuals
with muscle dysmorphia (Goodale, Watkins, & Cardinal, 2001).
Muscle dysmorphia is the reverse phenomenon of anorexia nervosa.
There is a perceived dissatisfaction with body shape and size
as in anorexia nervosa. However, those with muscle dysmorphia
think that they are too thin and frail; although their body
shape and size may be "normal" or even "super-normal". This
person is preoccupied with their muscularity and engages in
unhealthy behaviors such as excessive weight training and misuse
of anabolic steroids in order to increase their muscle size
(Pope, Gruber, Choi, Olivardia, & Phillips, 1997). Preoccupation
with exercise can lead to social alienation and isolation (Lantz,
Rhea, & Mayhew, 2001).
Muscle dysmorphia has been identified among European (Austrian
and French) and American college students who can exhibit obsession
with exercising at the gym (Pope et al., 2000).
Goodale, Watkins, and Cardinal (2001) did not find significant
differences in muscle dysmorphia symptomatology between men
and women. This suggests that women also can be preoccupied
with their muscle development.
According to the above statements, scholars and practitioners
who work with people with disabilities should emphasize the
importance of physical activity for health and not for body
size (Goodale et al., 2001). Distorted body sizes and shapes
based on unrealistic societal standards should be challenged.
Media campaigns should encourage healthy lifestyles rather than
maladaptive and potentially dangerous behaviors (Goodale et
Accordingly, policy makers should reinforce proper health
and physical activity education starting in kindergarten; exclusion
or objection to advertisements and products that promote unhealthy
images should be emphasized as well (Kilbourne, 1994). The United
Kingdom government has already taken action to boycott unrealistic
body ideals that may be adopted by individuals vulnerable to
Although the importance of exercise/physical activity as well as
healthy exercise behaviors are very well documented, only 23% of
individuals with disabilities engage in regular physical activity,
which is characterized by at least 20 minutes of exercise on 3 or
more days per week (USDHHS, 2000). One reason for that might be
low motivation to participate in regular physical activity. Low
motivation may not be a personal choice, but rather an undesirable
outcome of negative affect and self-perceptions due to societal
and cultural constraints and discrimination. In order to increase
motivation toward physical activity participation certain strategies
will be proposed:
Encouragement to participate in leisure-type activities that
promote successful experiences to increase self-confidence and
motivation to further participation.
Encouragement to set individual and specific goals to accomplish
in certain time limits (Cole, Leonard, Hammond, & Fridinger,
Information about benefits and risks of physical activity,
stress management techniques, goals setting, problem solving
strategies, reevaluation of benefits and costs of physical activity,
social support, self-talk, and relapse prevention can be very
beneficial in enhancing motivation (Sallis, et al., 1999).
Barriers, preferences, and constraints identification toward
physical activity should be communicated with physical activity
promoters in order to organize activities that cover individual
Another important area is the plan of local events in order
to promote health-related behaviors. Such activities may include
a walking event to the local zoo or aquarium encouraging family
members to take action. Hosting weekend events in the community
(e.g., basketball or volleyball games), outdoor dancing lessons
or power-walking seminars, as well as indoor or worksite events
can increase opportunities for and motivation toward physical
activity participation. Through these events, physical activity
can become more enjoyable and available to everyone.
In a similar vein, the increasing percentages of young people
who are overweight led to the development of certain recommendations
for the promotion of age-appropriate, meaningful, and enjoyable
physical activities among youth (Cardinal, Engels, & Zhu,
1998; CDC, 2001). Certain strategies have been identified such
as barriers identification, education of parents and guardians
as physical activity promoters for their children, and quality
physical education incorporating both extracurricular and recreational
exercise programs have been recommended (Cardinal, Engels, &
In addition, accessibility and equal opportunities to recreational
and organized athletic programs, well trained coaches and recreation
program staff, design considerations such as the development
and use of close-to-home bicycle and walking paths, sidewalks,
and community facilities may encourage and promote physical
activity participation (Wright, Paterson, & Cardinal, 2000).
Challenging tasks that reinforce active involvement and equal
opportunities should be offered. Participants in physical activity
programs should have some control in decision making. Individual
effort should be recognized encouraging self-evaluation and
allowing time for improvement (Epstein, 1988).
Positive attitudes toward teaching individuals with disabilities
can increase motivation toward physical activity participation.
Such positive attitudes can be derived from appropriate training
of the adapted physical activity specialists (Conatser, et al.
2000; Folsom-Meek et al. 1999). Appropriate training in the
area of adapted physical education should not only be the responsibility
of adapted physical educators but also of all physical educators.
Physical activity experiences should offer fun, enjoyment,
and excitement, by diminishing anxiety, embarrassment, and discrimination.
In conclusion, the importance of health-related lifestyles should
be fostered by specialists in the adapted physical education/activity
field. Strategies to heighten awareness about the health benefits
of physical activity by increasing choices and thus motivation toward
physical activity participation should be of priority. Equal opportunities
and discrimination elimination should be fostered in order to understand
and recognize the needs and culture of individuals with disabilities
increasing their quality of life.
Support for this Web cast is provided by the National
Institute for Disability and Rehabilitation Research (NIDRR)
as part of its initiative to promote greater use of disability research
findings by consumers, their families, service providers, and other
non-researcher stakeholders. Specific NIDRR project support
comes from RIIL
(Research Information for Independent Living), RRTC
on Managed Health Care & Disability, and RTC
on Health & Wellness. NIDRR is part of the U.S. Department
of Education, and no endorsement of the opinions expressed as part
of this Web cast by the Department should be inferred.