Physical Activity, Sport and Recreation for Young People with Physical Disabilities

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Physical Activity

What is Physical Activity and How Much is Enough For My Child?

Did you know that Physical Activity (P.A) is any movement made by your body that uses energy? (WHO, 2016). So, thinking about what P.A is, how much would you think is actually enough..?
I’ll give you some help! ;)

Your child, as well as any other child should be doing at least one hour of medium to hard P.A daily. (WHO, 2016). These types of activities will increase your childs’ breathing and heart rate, which will warm up their body in preparation for further activities. Your child may also work up a sweat on hot days with this level of intensity.

The more difficult activities may leave your child feeling out of breath during the activity - don’t worry, this in completely normal! An example of hard physical activities could be dancing, swimming or skateboarding, or other activities that your child would do on a daily basis, for example, walking or cycling. You should try to get your child to do some of these activities two or three times a week, to improve their aerobic capacity, cardiovascular health, bone health, muscle strength and their flexibility. (NICE GUIDELINES 2016).

These guidelines are set out for both children living with and without disabilities, and those with medical conditions, provided suitable adaptations and modifications are put in place for each child based on their exercise capacity and any other special health/risk issues they may have. If your child has a disability, they should engage in regular physical activity based on their own abilities and should always avoid inactivity.

If you are concerned about the amount and type of physical activity that would be suitable for your childs abilities click <a href="https://health.gov/paguidelines/pdf/paguide.pdf">here</a>, or if you are still unsure, you can get further information from your local G.P or a physiotherapist. Your G.P and also Physiotherapists will play a major role in promoting P.A options for you and your child with a disability.Would you believe that people with disabilities were 82% more likely to engage in P.A if a doctor or physiotherapist recommended it, ‘Centres for Disease Control and Prevention’ (2016).

In Summary

• It is most important your child participates in an appropriate amount and type of P.A to suit their ability.
• Your child should begin slowly, based on their ability and current level of fitness, e.g. begin with 10 minutes of regular activity if your child has been inactive for some time, gradually increase the amount of time, followed by increasing the intensity of the activity
• Include aerobic activities to increase your childs’ breathing and heart rate
• Familiarise yourself with adaptations and modifications for your child, and be comfortable making alterations where necessary
• Always avoid your child being inactive, any P.A is better than none!

More Benefits of Physical Activity!

Now, just incase we haven’t convinced you just yet to sign your child up (or yourself!) to some sort of P.A, here's a few more reasons why you should get those running shoes on, and get your body moving…!

<a href="http://www.who.int/topics/physical_activity/en/">http://www.who.int/topics/physical_activity/en/</a>

• It boosts confidence and self-esteem, and makes you feel good and happy in yourself
• It helps to control weight - (so you wont feel as guilty for having that extra donut!)
• Improves gross and motor skill development, e.g. assists with writing (REF EMCK)
• Improves their ability to be competent in school and in P.A (REF EMCK)
• Increases their adjustment towards their feelings and emotions (REF EMCK)
• Improves muscular and cardiorespiratory fitness
• Improves bone and functional health
• Reduces the risk of falls and fractures
• Physically active wheelchair users tend to go to hospital less than those wheelchair users who don’t do P.A.
• Wheelchair athletes who do P.A have fewer pressure sores and kidney complications than wheelchair users who don’t do P.A
• P.A also has a lessening effect on challenging behaviour (Moon et al, 1982; Nishiyama et al, 1986; Lancioni et al, 1994 and 1998; Washburn et al, 2002; Nary et al, 2000 cited by Boland, 2005).
• P.A is important in maintaining fitness for daily living, reducing functional limitations, helps with independent living and preventing, delaying and reducing chronic illnesses and secondary conditions (Fentem, 1994).

What If My Child Has Cerebral Palsy?

You may want to consider the following if your child has cerebral palsy:

Children with cerebral palsy are said to participate in lower levels of P.A than any other child, and they are beginning to show an increase in mobility problems as a result of this decreased P.A level. 2,3,4,5 Some of the things you might also want to remember if this is the case with your child, they are more likely to be less fit than others, more likely to have issues with their mobility down the line, and reduced muscle tone. However, not to worry, this can all be prevented by participating in regular activity weekly, rather sooner than later to avoid this inactivity creeping further into their teenage years!6
“Physical activity stimulation program for children with cerebral palsy did not improve physical activity: a randomised trial “Leontien Van Wely, Astrid CJ Balemans, Jules G Becher, Annet J Dallmeijer (REFERENCES 2,3,4,5 & 6 USED)

What Can Happen If My Child Doesn't Exercise?

Now take a look at some of the more serious health risks associated with inactivity, would make you think eh?

• Not having enough P.A is 1 of the 10 leading risk factors for death across the world and is on the rise in many countries, adding to the burden of NCDs (noncommunicable diseases, i.e cardiovascular disease, cancer and diabetes) and affecting general health worldwide.
• People with disabilities are three times more likely to have the above complications than those without disabilities, but thankfully aerobic P.A can help reduce the impact of these complications. http://www.cdc.gov/ncbddd/disabilityandhealth/pa.html
• People who are less active have a 20% to 30% increased risk of death compared to people who meet the above P.A recommendations.
• Inactivity can also lead to an increase in needing others, a decrease in socialising with friends and becoming more tired, feeling low or upset, putting on weight and an increase in pressure sores.
• Physical inactivity increases the risk of coronary heart and cerebrovascular diseases, type 2 diabetes mellitus, hypertension, stroke, several cancers (e.g. lung, prostate, breast, colon, others), osteoporosis/fractures, depression and dementia, among others.

Interested In Some Random Facts About Inactivity?

• Globally, 1 in 4 adults is not active enough.
• More than 80% of the world's adult population doesn’t do enough physical activity.
• Policies to address insufficient physical activity are operational in only 56% of WHO Member States.
• WHO Member States have agreed to reduce insufficient physical activity by 10% by 2025.
• Globally, 81% of adolescents aged 11-17 years were insufficiently physically active in 2010.
• Adolescent girls were less active than adolescent boys, with 84% vs. 78% not meeting WHO recommendations.
• Globally, around 23% of adults aged 18 and over were not active enough in 2010 (men 20% and women 27%).
• In high-income countries, 26% of men and 35% of women didn’t do enough physical activity, as compared to 12% of men and 24% of women in low-income countries.
• The drop in P.A is partly due to inaction during leisure time and sedentary behaviour on the job and at home.
• Likewise, an increase in the use of "passive" modes of transportation also contributes to insufficient physical activity.

How Much Exercise Do Parents and Grandparents Need?

So, after becoming aware of the importance of P.A and the effects of not being active enough, would this cause you to think about your own P.A levels? If so...here is some more information for parents and grandparents who want to spend time being physically active with their children and grandchildren!

Parents and Grandparents Aged 18-64 Years

• Adults aged 18-64 should do at least 150 minutes of medium intensity, and at least 75 minutes of hard P.A throughout the week, or a combination of medium and hard activities.
• If you want to go that extra mile, adults should increase their medium intensity P.A to 300 minutes per week, or equivalent.
• Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week.
  

Parents and Grandparents Aged 65 Years and Above

• Do at least 150 minutes of medium intensity P.A or at least 75 minutes of hard P.A throughout the week, or an equivalent combination of medium and hard activities.
• Again, to go that extra mile, you should increase medium intensity P.A to 300 minutes per week, or equivalent.
• If you consider yourself to have poor mobility, you should still perform P.A to improve your balance and prevent falls, 3 or more days per week.
• Muscle-strengthening activities should be done involving major muscle groups, 2 or more days a week.
• The intensity of different forms of P.A varies between people. In order for P.A to benefit your cardiorespiratory health, all activities should be performed in bouts of at least 10 minutes duration.
  
  

Barriers and Facilitators to Exercise - What Stops Me and What Helps Me

So, you’re now aware of the importance and benefits of your child’s involvement in PA. It’s understood however things aren’t always easy and you may encounter a number of barriers when trying to engage your child in PA. Here are some you may come across...

Barriers

These are things that get in the way....

Physical Barriers

• Limitations of your child’s body may make participation in PA more difficult. This may include restricted range of motion at joints, reduced flexibilty and agility, along with reduced strength and endurance. Additionally your child may have difficulties with balance and coordination resulting in fear of falling while attempting to be physically active (Conchar et al. 2014). Each of these deficiencies may unfortunately demotivate your child to participate in PA.
• Pain and fatigue may also limit your child from being active. This can result from; wearing their assistive devices e.g. orthosis, from training, or from sitting for long periods (Conchar et al. 2014).
• Requiring more time to get outdoors during break times at school as a result of handling orthoses may come as an inconvenience to your child and inhibit them from using this time to be physically active with their peers (Lauruschkus et al. 2014).
• Physical strength and skill developed by your child may unfortunately be lost as a result of interruptions in training during recovery period after surgery (Conchar et al. 2014).
• As your child gets older, the gap in physical strength and agility increases between able bodied children and disabled athletes. With this, the skill gap also widens and sports become more competitive; potentially making it more difficult for your child to continue participating in mainstream activities (Conchar et al. 2014).

Psychosocial And Emotional Barriers

• Embarrassment, vulnerability, disappointment and shame at appearing physically incapable are just some of the uncomfortable emotions your child may experience . These may lead to reduced confidence and self-esteem, along with frustration at taking longer to acquire a skill than their peers of typical development, resulting in avoidance of participation (Conchar et al. 2014).
• Social barriers including negative attitudes from parents, staff and peers can inhibit your child’s interest in PA (Jones, 2003). This may come in the form of teasing from other children, along with and/or lack of trained instructors/teachers skilled to adapt activities to suit your child and therefore often fearful to involve them in PA activities at school/clubs (Shields and Sinnot 2012) ....
• This can result in your child feeling singled out, isolated and forming the opinion of not being good enough; all of which make it more difficult to persevere at PA (Lauruschkus et al. 2014).
  
  
  

Recent Related Research (from <a href="http://www.ncbi.nlm.nih.gov/pubmed/">Pubmed</a>)

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References

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