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de Campos LFCC, Fica N, Fernandéz M, Dos Santos LGTF, Gamonales JM, Winckler C, Pena LG, Muñoz F, Pleticosic Y, Rocha CL, de Victo ER, Del Val Martín P, Ferrari G. The barriers perceived by Chilean athletes with disability at different social ecological levels. Sci Rep 2025; 15:18960. [PMID: 40442237 PMCID: PMC12122878 DOI: 10.1038/s41598-025-04211-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 05/26/2025] [Indexed: 06/02/2025] Open
Abstract
People with disabilities face various barriers that hinder or prevent access to physical activity, impacting their quality of health and life. This study aimed to examine the barriers to physical activity experienced by Chilean athletes with disability. The sample consisted of 35 Chilean athletes with disability. The participants answered the Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) to assess perceptions of social ecological subdivided into four levels. Sex, the type of sport practice, the region where live, the type of disability, and the physical disability were considered. The organizational level was the main barrier according to the ecological level, with the lack of adaptation of outdoor spaces and the lack of information or inclusive advertising in the sports center being the main barriers identified. An effect of the type of disability on the social ecological barriers was observed, with differences between the non-wheelchair user and wheelchair user groups. The organizational and community context were the main perceived barriers. Thus, it is considered relevant to generate actions for specific interventions in order to promote the practice of physical activity and reduce the main barriers identified in the different contexts within the community.
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Affiliation(s)
| | - Nicolas Fica
- Faculty of Health, Santo Tomas University, Temuco, Chile
| | - Mónica Fernandéz
- Faculty technician in Physical Activity and Health, University of Católica de la Santísima Concepción, Chillán, Chile
| | | | - José M Gamonales
- Departament of Didactic of Musical, Plastic and Corporal Expression, Universidad de Extremadura, Extremadura, Spain
| | - Ciro Winckler
- Departament of Rehabilitation and Science of Movement, Federal University of Sao Paulo, São Paulo, Brazil
| | | | - Fernando Muñoz
- Departament of Kinesiology, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | - Yazmina Pleticosic
- Faculty of Education Sciences, Universidad San Sebastian, Concepción, Chile
| | - Cristian Luarte Rocha
- Faculty of Dentistry and Rehabilitation Sciences, Universidad San Sebastian, Concepción, Chile
| | - Eduardo Rossato de Victo
- Núcleo de Investigación en Ciencias del Movimiento, Universidad Arturo Prat, Iquique, Chile
- Postgrad Program in Health Sciences, Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil
| | - Pablo Del Val Martín
- Facultad de Educación y Ciencias Sociales, Observatorio Chileno de Educación Física y Deporte Escolar, Universidad Andres Bello, Santiago, Chile
| | - Gerson Ferrari
- Faculty of Health Sciences, Universidad Autónoma de Chile, Providencia, Chile.
- Physical Activity, Sports and Health Sciences School, Universidad de Santiago de Chile (USACH), Santiago, Chile.
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Silveira SL, Motl RW, Froehlich-Grobe K, Kay M. Feasibility, acceptability, and initial efficacy of a wheelchair exercise training program in persons with multiple sclerosis: study protocol for a parallel group randomized controlled trial. Disabil Rehabil Assist Technol 2024; 19:2998-3005. [PMID: 38520055 PMCID: PMC11416561 DOI: 10.1080/17483107.2024.2332322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/15/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE This study is a randomized controlled trial (RCT) that examines the feasibility, acceptability, and initial efficacy of a home-based, remotely supported and supervised exercise training program that was developed using a three-step community engaged research process for persons with multiple sclerosis (MS) who are wheelchair users. MATERIALS AND METHODS The study design is a parallel group RCT (NCT05888727). We aim to enroll 24 wheelchair users with MS who will be randomly assigned using REDCap randomization module into exercise training or attention/contact wellness control conditions. The conditions will be delivered remotely over 16 weeks and supported using online, one-onone behavioral coaching. The feasibility outcomes of interest include recruitment and retention rates, and safety outcomes collected throughout the study period. The acceptability outcomes include participant satisfaction and perceptions measured using formative surveys and interviews following the 16-week period. Efficacy outcomes include metabolic health, MS symptoms, and exercise behavior measured before and after the 16-week period. The data analysis will follow intent-to-treat principles using 2 group by 2 time mixed factor ANOVA with estimation of Cohen's d values as effect sizes. CONCLUSIONS The results will guide future research targeting health outcomes using exercise training among wheelchair users with MS who have largely been absent from health promotion research.
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Affiliation(s)
- Stephanie L. Silveira
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1155 Union Circle #310769, Denton, TX 76203, USA
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W Taylor St, Chicago, IL 60612, USA
| | | | - Mitch Kay
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1155 Union Circle #310769, Denton, TX 76203, USA
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Eisenberg Y, Hofstra A, Twardzik E. Quantifying active travel among people with disabilities in the US. Disabil Health J 2024; 17:101615. [PMID: 38565481 PMCID: PMC11194152 DOI: 10.1016/j.dhjo.2024.101615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND People with disabilities have higher rates of physical inactivity than people without. Active travel (e.g., walking/wheeling to nearby destinations or transit) is a recommended approach to increasing total physical activity (PA) but limited research has examined active travel among people with disabilities. OBJECTIVE To describe active travel among a nationally representative sample of people with disabilities, analyze variation between sub-groups, and examine factors associated with active travel. METHODS Using the 2017 National Household Travel Survey, our cross-sectional analysis summarized counts and duration of walking/wheeling trips for people with four different types of disabilities. We examined which factors were associated with doing any active travel and the duration of active travel, using zero inflated negative binomial regression models. RESULTS Our analysis identified that 14.55% of people with disabilities took a mean of 2.56 (95%CI = 2.42-2.69) walking/wheeling trips per day. Compared to non-active travelers, a higher proportion of active travelers were low-income, lived alone, had no-vehicle, and were Black or Hispanic. For active travelers, daily walking minutes, on average, were 46.41 (95%CI = 40.25-52.57) among people who used ambulatory devices, 41.55 (95%CI = 24.61-58.49) among people who were blind/low-vision, 39.93 (95%CI = 35.41-44.45) among people who used no device, and 29.58 (95%CI = 23.53-35.64) among people who used chair devices. Our analysis identified individual, household, and community factors associated with the likelihood and duration of walking/wheeling for travel and variation across disability types. CONCLUSIONS Understanding the multiple identities of active travelers with disabilities can inform walking/wheeling intervention strategies. Infrastructure improvements that support less reliance on automobiles could increase active travel among people with disabilities.
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Affiliation(s)
- Yochai Eisenberg
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States.
| | - Amy Hofstra
- Department of Disability and Human Development, University of Illinois- Chicago, Chicago, IL, 1640 Roosevelt Road, Chicago, 60608, United States; College of Urban Planning and Public Affairs, University of Illinois-Chicago, Chicago, IL, 412 S. Peoria St., Chicago, 60607, United States.
| | - Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
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van der Slikke R, de Leeuw AW, de Rooij A, Berger M. The Push Forward in Rehabilitation: Validation of a Machine Learning Method for Detection of Wheelchair Propulsion Type. SENSORS (BASEL, SWITZERLAND) 2024; 24:657. [PMID: 38276350 PMCID: PMC10821488 DOI: 10.3390/s24020657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
Within rehabilitation, there is a great need for a simple method to monitor wheelchair use, especially whether it is active or passive. For this purpose, an existing measurement technique was extended with a method for detecting self- or attendant-pushed wheelchair propulsion. The aim of this study was to validate this new detection method by comparison with manual annotation of wheelchair use. Twenty-four amputation and stroke patients completed a semi-structured course of active and passive wheelchair use. Based on a machine learning approach, a method was developed that detected the type of movement. The machine learning method was trained based on the data of a single-wheel sensor as well as a setup using an additional sensor on the frame. The method showed high accuracy (F1 = 0.886, frame and wheel sensor) even if only a single wheel sensor was used (F1 = 0.827). The developed and validated measurement method is ideally suited to easily determine wheelchair use and the corresponding activity level of patients in rehabilitation.
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Affiliation(s)
- Rienk van der Slikke
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
- Department of BioMechanical Engineering, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Arie-Willem de Leeuw
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
| | - Aleid de Rooij
- Department of Innovation, Quality and Research, Basalt Revalidatie, 2545 AA The Hague, The Netherlands;
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), 2333 ZA Leiden, The Netherlands
| | - Monique Berger
- Faculty of Health, Nutrition & Sport, The Hague University of Applied Sciences, 2521 EN The Hague, The Netherlands; (A.-W.d.L.); (M.B.)
- Department of Innovation, Quality and Research, Basalt Revalidatie, 2545 AA The Hague, The Netherlands;
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Soleymani H, Jeng B, Abdelmessih B, Cowan R, Motl RW. Accuracy and Precision of Actigraphy and SMARTwheels for Measuring Push Counts Across a Series of Wheelchair Propulsion Trials in Non-disabled Young Adults. INTERNATIONAL JOURNAL OF MEDICAL STUDENTS 2023. [DOI: 10.5195/ijms.2023.1950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Background: There has been a growing interest in “Lifestyle Physical Activity” (LPA) among wheelchair users. LPA can be quantified via “pushes” as an outcome metric. This study examined the accuracy and precision of research-grade devices for counting pushes across a series of wheelchair propulsion trials.
Methods: Eleven non-disabled, young adults completed 19, 1-minute wheelchair propulsion trials at self-selected speeds with a wheelchair equipped with a SMARTwheel (SW) device while being video recorded. Participants also wore 2 ActiGraph accelerometers, one on the wrist and one on the upper arm. Video footage enabled manual counting of the number of pushes (gold standard). Total pushes were averaged across 16 workloads (3 trials of repeated workloads were excluded) for each device and compared to manually counted pushes.
Results: Compared to manually counted pushes, SW demonstrated the greatest accuracy (mean difference [MD] compared to video of 2.3 pushes [4.5% error]) and precision (standard deviation of the mean difference [SDMD]) compared to video of 4 pushes, (Coefficient of Variation [CV] =.04), followed by the upper arm-worn accelerometer (MD of 4.4 pushes [10.4% error] and SDMD of 10, [CV= .06]) and the wrist-worn accelerometer (MD of 12.6 pushes [27.8% error] and SDMD of 13 [CV=.15]).
Conclusions: SW demonstrated greater accuracy and precision than ActiGraph accelerometers placed on the upper arm and wrist. The accelerometer placed on the upper arm was more accurate and precise than the accelerometer placed on the wrist. Future investigations should be conducted to identify the source(s) of inaccuracy among wearable push counters.
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