Social functioning and self-esteem in young people with disabilities participating in adapted competitive sport

Exploring Direct and Indirect Associations of Exercise and Sport Participation with Employment among Individuals with Disabilities: A Scoping Review

Purpose Exercise and sports have many positive benefits for persons with or without a disability. Despite this, the contribution of exercise and sport participation to employment is less documented. The purpose of this scoping review was to provide insight into the direct and indirect associations of exercise and sport participation with employment among persons with disabilities. Methods Six databases were searched (MEDLINE, Embase, Scopus, PsychINFO, CINAHL, and HealthStar) from their inception date to March 20, 2020. Peer-reviewed English and French articles were included if at least one outcome measure on employment or work-related outcomes as a result of participation in, or benefits of exercise and sport participation was the focus of the study. Results The research identified 2796 hits. Of which, 23 published between 1992 and 2019 met eligibility criteria. Seven studies identified a direct association between exercise and sport participation with employment and full-time positions. Sixteen studies reported on improved health/work-related outcomes such as occupational performance (i.e., self-care, functional independence), physical fitness (i.e., upper extremity strength, endurance) and psychological well-being (i.e., self-efficacy). Conclusions This scoping review highlights that exercise and sport participation have associations with employment and work-related outcomes. Benefits of exercise and sports may be considered to a greater extent, than in the past, in programs that facilitate employment for persons with disabilities. Additional research using longitudinal design should be conducted to further understand the strength of these associations and evaluate whether exercise and sport participation should be incorporated more intensely in vocational programs.

Gender Equity in Disability Sport: A Rapid Scoping Review

Aim: A scoping review was conducted to map the literature related to gender equity in disability sport. Design: Six databases relevant to the sport sciences were searched, yielding an initial 1,543 records; after two phases of screening and data extraction, 61 records were selected for synthesis. Descriptive statistics were generated on information related to the record contexts, approaches, and results. Qualitative descriptive analyses were used to group data inductively into themes in line with addressing the research question. Results: Most records examined the experiences, participation, and representation of adults in elite contexts. Insights across records pointed to gender inequities in participation and experience, often influenced by the intersection of ableist and masculinity notions. Limited research also pointed to strategies that can contribute to advancing gender equity. Conclusions: Implications were discussed to advance understandings of disability sport and enhance participation across levels (e.g., coaching, athletic) and contexts (e.g., elite/Paralympic, recreational).

Improvements in Tennis Skills in Adults With Developmental and Intellectual Disabilities Following an 8-Week Adapted Tennis Program

This study quantified changes in tennis skills and dose of practice in adults with developmental and intellectual disabilities following an 8-week adapted tennis program. Twenty-seven adults with disabilities (mean age 24.7) participated in an 8-week adapted tennis program (1-hour, twice a week). Participants’ racquets were equipped with sensors that measured the number of shots during the program (dose). Pre- and post-test tennis skill assessments (process scores) were conducted for the forehand and backhand. All participants showed significant improvements in forehand and backhand process scores. Level of function, but not age or disability type, was associated with forehand and backhand process scores. The number of forehand shots performed during the adapted tennis program did not change across the program. The number of forehand shots was associated with age and disability type, but not level of function. The number of backhand shots (dose) was not associated with age, disability, or level of function. The number of forehand or backhand shots (dose) was not associated with changes in forehand or backhand process scores, respectively. This study provides evidence of the efficacy of this adapted tennis program to develop fundamental tennis skills in novice players with developmental and intellectual disabilities.

Associations of sport participation with self-perception, exercise self-efficacy and quality of life among children and adolescents with a physical disability or chronic disease-a cross-sectional study

Background

Little evidence is available about how sports participation influences psychosocial health and quality of life in children and adolescents with a disability or chronic disease. Therefore, the aim of the current study is to assess the association of sports participation with psychosocial health and with quality of life, among children and adolescents with a disability.

Methods

In a cross-sectional study, 195 children and adolescents with physical disabilities or chronic diseases (11% cardiovascular, 5% pulmonary, 8% metabolic, 8% musculoskeletal/orthopaedic, 52% neuromuscular and 9% immunological diseases and 1% with cancer), aged 10–19 years, completed questionnaires to assess sports participation, health-related quality of life (DCGM-37), self-perceptions and global self-worth (SPPC or SPPA) and exercise self-efficacy.

Results

Regression analyses showed that those who reported to participate in sports at least twice a week had more beneficial scores on the various indicators compared to their peers who did not participate in sport or less than twice a week. Those participating in sports scored better on all scales of the DCGM-37 scale, on the scales for feelings of athletic competence and children but not adolescents participating in sports reported greater social acceptance. Finally, we found a strong association between sport participation and exercise self-efficacy.

Conclusions

This study provides the first indications that participating in sports is beneficial for psychosocial health among children and adolescents with a disability. However, more insight is needed in the direction of the relationships.

Sport and male sexuality

The relationships between sport and sexuality in males are of great social and clinical interest, because of sports and motor activities that highly promote social and sexual relationships. Even if few literature exist, two main questions should be taken into account: whether and how physical exercise and sport positively or negatively influence sexual health and behavior and/or whether and how sexual behavior may affect a sub-sequent sport performance. Physical exercise and sport per se can influence, positively or negatively, the hypothalamic-pituitary-testicular axis function and, consequently, the individual's reproductive and/or sexual health. This depends on individual factors such as genetic and epigenetic ones and on different variables involved in the practice of sport activities (type of sport, intensity and duration of training, doping and drug use and abuse, nutrition, supplements, psychological stress, allostatic load, etc.). If well conducted, motor and sport activities could have beneficial effects on sexual health in males. Among different lifestyle changes, influencing sexual health, regular physical activity is fundamental to antagonize the onset of erectile dysfunction (ED). However, competitive sport can lead both reproductive and/or sexual tract damages and dysfunctions, transient (genital pain, hypoesthesia of the genitalia, hypogonadism, DE, altered sexual drive, etc.) or permanent (hypogonadism, DE, etc.), by acting directly (traumas of the external genitalia, saddle-related disorders in cyclists, etc.) or indirectly (exercise-related hypogonadism, drug abuse, doping, stress, etc.). Sexual activities shortly performed before a sport competition could differently influence sport performance. Due to the few existing data, it is advisable to avoid an absolute pre-competition sexual abstinence.

Performance-Focussed Sport – An Avenue to Gold-Medal Clinical Outcomes for People with Neurological Impairments?

This paper investigates the premise that long-term engagement in performance-focussed sports training may lead to significantly enhanced clinical outcomes for people with neurological impairments (NI). The minimum volume of moderate-intensity activity recommended for good health is 450 MET.minutes/week, although evidence from the general population indicates that outcomes may be enhanced by completing up to five times this volume (2250 MET.minutes/week) at vigorous (rather than moderate) intensity. Most studies evaluating physical activity interventions for people with NI deliver low volumes (<450 MET.minutes/week), which may explain why evidence for some clinical outcomes is weak. Athletes (with or without NI) who aim to achieve high-level sports performance undertake an increasingly large volume of vigorous intensity physical activity over several seasons. Evidence that people with NI may enhance clinical outcomes through performance-focussed sports training includes: evidence from studies investigating the benefits of high-intensity and/or high volume clinical exercise; scientific evidence from elite/high-level athletes; and anecdotal evidence from Paralympic athlete testimonials. Additionally, sports participants with NI may also accrue an important array of psychosocial benefits, including higher rates of employment, and higher satisfaction with life and social integration. Rigorous, prospective, longitudinal clinical monitoring of people with NI undertaking performance-focussed sports training are required to evaluate its clinical utility.

Pilot evaluation of physical and psychological effects of a physical trek programme including a dog sledding expedition in children and teenagers with cancer

AIM OF THE STUDY

To evaluate the feasibility and to measure the effects of a six-week-long adapted physical activity programme (APAP), including 5 days of intense dog sledding, on the physical and psychological health of children and adolescents treated for cancer.

METHODS

Eleven children and teenagers (4 girls, 7 boys; mean age 14.3 ± 2.9 years) participated in this monocentric pilot programme of adapted physical activities from February 2013 to March 2013. Seven were still on treatment. The programme lasted 6 weeks. A series of physical tests and psychological questionnaires were carried out before and after the programme.

RESULTS

All children and teenagers completed the full programme. An improvement in all physical and psychological parameters was observed. Statistically significant differences were observed for global self-esteem (6.2 ± 2.1 to 7.7 ± 1.8; p = 0.02), perceived sport competence (5.3 ± 3.2 to 7.4 ± 2; p = 0.02) and perceived physical strength (5.6 ± 2.5 to 7.1 ± 1.8; p = 0.001). Regarding physical tests, the physical training led to statistically significant improvement for sit-ups (13.8 ± 2.6 to 21.75 ± 5.4; p = 0.01), muscle tone (76 ± 23.7 to 100 ± 22.9; p = 0.01), and resting heart rate (96.1 ± 3.2 to 91.6 ± 4.5; p = 0.03).

CONCLUSION

This programme is feasible in children and adolescents even during their oncologic treatment. During the 6-week programme, children and adolescents improved their physical and psychological health, and the putative benefits of the APAP are discussed. A larger randomised trial started in 2014.

Sexual Health of Polish Athletes with Disabilities

The purpose of this study was to determine sexual functioning of Polish athletes with disabilities (including paralympians). The study encompassed 218 people with physical disabilities, aged between 18 and 45 (149 men and 69 women). The entire research population was divided into three groups: Polish paralympians (n = 45), athletes with disabilities (n = 126) and non-athletes with disabilities (n = 47). The quality of sexual life of Polish paralympians was measured by using the Polish version of Female Sexual Function Index and International Index of Erectile Function. Clinically significant erectile dysfunctions were most often diagnosed in non-athletes (83.33%) with 50% result of severe erectile dysfunctions, followed by athletes and paralympians with comparable results of 56.98% and 54.17% respectively (p = 0.00388). Statistically significant clinical sexual dysfunctions concerned lubrication, orgasm as well as pain domains, and prevailed among female non-athletes (68.42%, 68.42% and 57.89%). Practising sports at the highest level has a favourable effect on the sexuality of men and women with physical disabilities. Men with physical disabilities manifest more sexual disorders than women, an aspect which should be considered by health-care professionals working with people with disabilities.

Sexuality of Disabled Athletes Depending on the Form of Locomotion

The main purpose of this study was to determine sexuality of disabled athletes depending on the form of locomotion. The study included 170 disabled athletes, aged between 18 and 45. The entire population was divided into 3 research groups depending on the form of locomotion: moving on wheelchairs (n=52), on crutches (n=29) and unaided (n=89). The research tool was a questionnaire voluntarily and anonymously completed by the respondents of the research groups. The questionnaire was composed of a general part concerning the socio-demographic conditions, medical history, health problems, a part dedicated to physical disability as well as the Polish version of the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI) evaluating sexual life. STATISTICA 10.0 for Windows was used in the statistical analysis. Subjects moving on crutches were significantly older than ones moving on wheelchairs and unaided (34.41 ±11.00 vs. 30.49 ±10.44 and 27.99 ±10.51 years, respectively) (p=0.018). Clinically significant erectile dysfunctions were most often diagnosed in athletes moving on wheelchairs (70.27%), followed by athletes moving on crutches and moving unaided (60% and 35.42%, respectively; p=0.048). Clinical sexual dysfunctions were diagnosed on a similar level among all female athletes. It was concluded that the form of locomotion may determine sexuality of disabled men. Males on wheelchair revealed the worst sexual functioning. Female athletes moving on wheelchairs, on crutches and moving unaided were comparable in the aspect of their sexual life.

Longitudinal relationship between wheelchair exercise capacity and life satisfaction in patients with spinal cord injury: A cohort study in the Netherlands

OBJECTIVE

To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge.

DESIGN

Prospective cohort study.

SUBJECTS

Persons with spinal cord injury, aged 18-65 years, and wheelchair dependent at least for long distances.

METHOD

Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary.

RESULTS

Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02 to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049). Conclusion High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients.