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Health Outcomes of Physical Activity Interventions in Adults With Down Syndrome: A Systematic Review

Brantley K. Ballenger, Emma E. Schultz, Melody Dale, Bo Fernhall, Robert W. Motl, and Stamatis Agiovlasitis

This systematic review examined whether physical activity interventions improve health outcomes in adults with Down syndrome (DS). We searched PubMed, APA PsycInfo, SPORTDiscus, APA PsycARTICLES, and Psychology and Behavioral Sciences Collection using keywords related to DS and physical activity. We included 35 studies published in English since January 1, 1990. Modes of exercise training programs included aerobic exercise, strength training, combined aerobic and strength training, aquatic, sport and gaming, and aerobic and strength exercise interventions combined with health education. The evidence base indicates that aerobic and strength exercise training improve physical fitness variables including maximal oxygen uptake, maximal heart rate, upper and lower body strength, body weight, and body fat percentage. Sport and gaming interventions improve functional mobility, work task performance, and sport skill performance. We concluded that adults with DS can accrue health benefits from properly designed physical activity and exercise interventions.

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Development and Pilot Testing of the Disability Awareness Training and Education Program Among Community-Based Group Fitness Instructors

Brynn Adamson, Mina Woo, Toni Liechty, Chung-Yi Chiu, Nic Wyatt, Cailey Cranny, and Laura Rice

Lack of disability awareness of fitness professionals is a well-established barrier to exercise participation among people with disabilities that is likely related to the lack of disability awareness training for group fitness instructors. The purposes of this study were to develop, implement, and evaluate a disability awareness training for group fitness instructors. A 90-min video training and resource manual were developed. We recruited 10 group fitness instructors from one recreation center to participate. Participants completed baseline, posttraining, and 2-month follow-up testing on survey-based outcomes including disability attitudes, confidence in exercise adaptations, and training satisfaction. Participants’ confidence to adapt fitness classes was significantly improved; however, disability attitudes were high in the pretest and not significantly different posttraining. Semistructured interviews were conducted posttraining and revealed three themes: Formal disability training is needed, Managing inclusive class dynamics, and Training suggestions and satisfaction. This training demonstrated a feasible intervention for increasing disability awareness among community-based group fitness instructors.

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“It Shaped My Future in Ways I Wasn’t Prepared for—in the Best Way Possible”: Alumni Volunteers’ Experiences in an Adapted Sports and Recreation Program

Meredith Wekesser, Guilherme H. Costa, Piotr J. Pasik, and Karl Erickson

Adapted sport participation can have many positive benefits for adults with disabilities. However, one barrier to implementing successful adapted sport programs is lack of knowledgeable volunteers who understand accessibility and disability. In fact, little is known about volunteers’ experiences in adapted sport programs. The purpose of this study was to retrospectively examine experiences of able-bodied volunteers in an adapted sport program. A sample of 105 able-bodied volunteers (M age = 24.28 ± 1.93) completed an online qualitative survey to share their experiences. Data were analyzed using qualitative thematic analysis, and seven main themes were identified. Results showed that despite differences in initial motives for volunteering, involvement in an adapted sport program was transformative and, for some, life changing. Able-bodied volunteers experienced a wide range of benefits including deeper understanding and awareness of disability and inclusion in sport. Practical recommendations are provided for volunteer-based adapted sport program leaders.

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Coach and Athlete Perspectives on Talent Transfer in Paralympic Sport

Nima Dehghansai, Alia Mazhar, and Joseph Baker

Research pertaining to the experiences and motives of Paralympic athletes who transfer between sports is scant. This study aimed to address this gap through semistructured interviews with Canadian Paralympic coaches (n = 35) and athletes (n = 12). Three higher-order themes of “alternative to retirement,” “career extension,” and “compatibility” were identified. The subthemes of “psychobehavioral” and “physical and physiological” (from the higher-order theme of alternative to retirement) captured reasons leading to transfer, which are similar to reasons athletes may consider retirement. The subthemes of career extension—“better opportunities” and “beneficial outcomes”—shed light on factors that contributed to the withdrawal of negative experiences and reinforcement of positive outcomes associated with transferring sports. Last, compatibility had three subthemes of “resources,” “sport-specific,” and “communication,” which encapsulated factors athletes should consider prior to their transfer. In conclusion, the participants highlighted the importance of transparent and effective communication between athletes and sports to align and establish realistic expectations for everyone involved.

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Expert Views on Evidence-Based Classification for Goalball: A Delphi Study

Anna M. Martin, Donghyun Ryu, Robin C. Jackson, and David L. Mann

Para sport classification aims to minimize the impact of impairments on the outcome of competition. The International Paralympic Committee requires classification systems to be evidence based and sport specific, yet the sport of goalball uses a structure that is not supported by evidence demonstrating its legitimacy for competition. This study aimed to establish expert opinions on how a sport-specific system of classification should be structured in the sport of goalball. Using a three-round Delphi survey, 30 international experts expressed their views across topics linked to goalball classification. Participants were divided as to whether the current system fulfills the aim to minimize the impact of impairment on competition. Most felt that less impairment should be required to compete but that the one-class structure should remain. Experts identified measures of visual function that should be considered and 15 core components of individual goalball performance. Findings constitute a crucial first step toward evidence-based classification in goalball.

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Volume 40 (2023): Issue 1 (Jan 2023)

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2022 Para Report Card on Physical Activity of Israeli Children and Adolescents With Disabilities

Yeshayahu Hutzler, Riki Tesler, Avinoam Gilad, Kwok Ng, and Sharon Barak

Children and adolescents with disabilities (CAWD) represent 11% of Israeli children and adolescents. The 10 core indicators of the Global Matrix on Para Report Cards of physical activity (PA) of CAWD were used to create the 2022 Israeli Para Report Card. A panel of four experts reviewed resources and synthesized evidence of PA behaviors and policies for CAWD in Israel, converted the data to grades, and charted subcategories of language, sex, and disability across population. Data sources were surveys, reports, and memberships in sport federations and clubs. Among CAWD, levels of participation in daily PA were poor (<20%; Grade F), and participation of CAWD in sports was even lower (<10%; Grade F). A lack of environmental infrastructure may explain the low levels of participation. Females, Arabic speakers, and physiological CAWD need particular attention. Establishing governmental policies and interventions is required to increase overall PA and participation in sports among CAWD.

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Evaluation of Physical Activity Indicators for French Children and Adolescents With Disabilities: National Para Report Card and SWOT Analysis

Salomé Aubert, Charlotte Verdot, Gilles Thöni, and Jérémy Vanhelst

The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France.

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Results From South Korean 2022 Para Report Card on Physical Activity for Children and Adolescents With Disabilities

Jeongmin Lee, Kitaek Oh, Jihee Min, Seon-Young Goo, Eun-Young Lee, Kyoung June Yi, Jinmoo Heo, Joon-Sung Lee, Dong-il Kim, Wonsang Shin, Kwon-il Kim, Yeonsoo Kim, and Justin Y. Jeon

South Korea has developed its first Para Report Card on physical activity (PA) for children and adolescents with disabilities. Five national surveillance databases were used to evaluate PA indicators based on the benchmarks and grading rubric provided by Active Healthy Kids Global Alliance. Report card evaluation committees were invited to grade and assess the results using strengths, weaknesses, opportunities, and threats analysis. Five indicators (overall PA, D+; organized sports and PA, D−; active transportation, D−; physical fitness, D+; and government, A+) and one additional indicator (sleep, C−) were assigned a letter grade. The other five indicators were graded as incomplete. The Para Report Card revealed a significant gap between the behavioral-indicator grades (D− to D+) and the policy-indicator grade (A+), suggesting that government strategies and investment have not yet been translated into behavioral PA among children and adolescents with disabilities.

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Expert Appraisal of the 2022 Canadian Para Report Card on Physical Activity for Children and Adolescents With Disabilities

Kelly P. Arbour-Nicitopoulos, Nicholas Kuzik, Leigh M. Vanderloo, Kathleen A. Martin Ginis, Maeghan E. James, Rebecca L. Bassett-Gunter, Daniela Ruttle, Pinder DaSilva, Katerina Disimino, Christine Cameron, Mike Arthur, Keiko Shikako, and Amy E. Latimer-Cheung

This report provides an expert appraisal of the Canadian Para Report Card on physical activity (PA) for children and adolescents with disabilities. Thirteen indicators were graded by a panel of researchers, representatives from disability and PA organizations, and parents of children and adolescents with disabilities using benchmarks of the Global Matrix 4.0 and previous Canadian PA Report Cards. Facilitated panel discussions were used to appraise the available evidence based on data gaps, opportunities, and recommendations. The available data sources included four nationally generalizable or representative data sets. Grades were assigned to 8/13 indicators and ranged from B+ to F. Data gaps in measurement and national surveillance systems were identified. Ableism was an issue identified within some of the reporting benchmarks. The absence of PA from existing accessibility legislation in Canada was a policy gap of concern. Recommendations related to research, surveillance, and policy are provided to enhance PA among children and adolescents with disabilities in Canada.