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Challenges and tips concerning sports and physical activity for people with disabilities or chronic conditions

Regular exercise contributes to good health and improves quality of life. Physical activity also positively affects people’s social lives, from social participation to general well-being. These positive effects of physical activity apply to everyone: young and old, healthy people and those with a chronic condition or physical or mental disabilities. What’s more, for people with disabilities physical activity is not simply a way to relax, but it can also contribute to safeguarding (or even improving) functionality and therefore autonomy.

However, for people with disabilities or chronic conditions, regular participation in physical activity is not always accessible and participation rates are up to three times less than for people without disabilities. They may for instance experience difficulty finding a suitable sports or physical activity programme in their immediate surroundings, mostly due to deficits in staff training.

Below, we provide an overview of the challenges people with disabilities or chronic conditions may face when it comes to sports and physical activity. We then offer some tips for promoting physical activity and sports.

People with disabilities or chronic conditions often face the following challenges:

  • Difficulties in finding a suitable programme
  • Lack of suitably trained coaches and volunteers
  • Transport to sports and exercise facilities may be difficult, especially if one cannot drive there themselves
  • Financial obstacles that make it difficult to purchase sports and exercise equipment or pay membership fees
  • Unclear or limited reimbursement regulations for sports equipment and transport
  • Negative experiences with coaches or teammates who do not sufficiently take their disability into account or forget about it
  • Not feeling welcome due to an unwelcoming attitude on the part of some sports and exercise providers
A: People with a physical disability (motor skills)

People with a physical disability (motor skills) may face challenges when it comes to sports and physical activity that are partly specific to their condition. They may also experience other challenges not specific to their condition but related to the context in which sports and physical activities take place.

In addition to general challenges, people with impaired motor skills may face the following specific challenges:

  • Functioning difficulties related to muscle and/or joint impairments
  • May fatigue easily and require frequent short breaks
  • May experience pain, in general and while exercising however, physical activity can alleviate pain
  • Limited access to facilities, including issues such as stairs, too small toilets, narrow doors, no lift
  • Limited access to easily enter and exit a swimming pool
  • May require assistance when changing or using the toilet
  • Often experience difficulties taking part in team sports, especially competitive activities
B: People with a sensory Impairment

People with a visual impairment may have difficulty taking part in a regular sports programme, and often have to seek out specific sports programmes or buddy programmes. In addition to general challenges, they may face the following specific challenges:

  • Need for a buddy to help them engage in sports or physical activity
  • Sports and game materials must be easy to find, palpable, and/or audible
  • Need support with orientation, of the facilities and the activities
  • Guidance required in setting up and regulating fitness equipment
  • Difficulties in engaging in social contact after sports
  • Difficulties in reaching a sports accommodation if it is located outside the city

People with a hearing impairment can in principle engage in any form of sports and physical activity. In addition to general challenges, they may face the following specific challenges:

  • Communication during coaching or team games
  • Interaction with the referee
  • Feeling excluded among hearing team members, also after sports
C: People with an intellectual disability (cognitive)

Many people with an intellectual disability require support from their social environment (parents, family, support staff to engage in sports or physical activity. The level of support required will depend on their cognitive ability and independence. In addition to general challenges, they may face the following specific challenges:

  • Often require a high level of social support to participate in physical activities ranging from transport to self-care to one-on-one support during activities.
  • Parents and support staff may underestimate the person’s physical abilities
  • Assistance required for transport to a sports facility

Their social support may fail to understand or recognise the importance and value of sports and physical activity

  • Potential lack of experience with sports because of fewer opportunities to explore physical activities when growing up
  • May need some time to transition or adjust to a new environment or unfamiliar aspects of sports or physical activity
  • Exercise is not always included in the policy of care and residential facilities and programmes.
D: People with a chronic health condition

An increasing number of adults experience chronic conditions, and insufficient physical activity is one of the four primary risk factors. For many chronic health conditions, regular exercise is a safe way to reduce symptom severity. However, motivation for sedentary groups to exercise on a regular basis will require a targeted behaviour change strategy in comparison to people used to regular sports and physical activity.

In addition to general challenges, people with a chronic health condition may experience the following specific challenges:

  • Low motivation to exercise which can be supported by a ‘decisional balance’ activity
  • Limited knowledge of the positive effects and advantages of exercise, or exercising more
  • Concerns that exercise might exacerbate symptoms when in fact, when done carefully, it can improve symptoms
  • Health and mobility difficulties and fear of falling down or creating new injuries
  • Limited experience of physical exercise
  • Pain and fatigue due to the chronic condition
  • Insufficient training of school teachers to address students’ symptoms or health conditions, like asthma, during PE lessons

General and specific tips for promoting sports and physical activity

Below are general and specific tips for promoting sports and physical activity: tips for sport and exercise providers, for athletes, for caretakers and coaches, and for policy makers and educators.

  • Create an up-to-date and easily accessible overview of sports and exercise programmes
  • Make sure people know where to go for advice and coaching
  • If possible, create sports and exercise programmes close to where people live and customise the programmes on offer (level and type of activity) for specific groups
  • Organise sports and physical activity programmes at regional level; collaborate across municipal borders
  • Advise sports and exercise providers on developing suitable programmes and embedding these programmes and athletes with disabilities within organisations
  • Help people understand what sports and physical activities they can engage in
  • Make parents and caretakers aware of the importance of sports and physical activity
  • Advise people personally on their choice of sports or physical activity, and make sure your advice matches the person’s motivation
  • Make people aware of and responsible for their sports/exercising behaviour
  • Give people simple tips to include physical activity in everyday life
  • Assist and coach people the first time they visit a sports or exercise facility
  • Involve sports and exercise providers and other athletes in solving potential bottlenecks and barriers
  • Initiate and organise collaboration between social/welfare and sports organisations to better match supply and demand
  • Organise a powerful multidisciplinary network surrounding individuals with a disability or chronic condition or create a single point of contact (for example a sports coach) to link individuals’ wishes to available sports or exercise programmes
  • Work with professional, competent coaches and instructors who can create a safe sports and exercise environment and make athletes feel at home
  • As a coach or instructor, make sure you know the participants’ names and understand their condition, and make sure your coaching is attuned to their needs
  • As a coach or instructor, make contact with participants, make sure they can hear you, see you, and understand your explanations or instructions
  • As a coach or trainer, don’t use too many words, but instead show by example
  • As a coach or trainer, create positive and avoid negative experiences
  • Give constructive and specific feedback during sports and physical activity
  • Engage sport buddies to assist participants in sports and physical activity
  • When in a team, use a buddy (or a sign language interpreter)
  • Create a convivial atmosphere and a social sports and exercise network
  • Integrate physical activity in care institutions’ policy and in the work of their staff
  • Develop a knowledge portal with instruction videos for buddies and athletes
  • Organise joint sports and exercise activities for people with and without disabilities or chronic conditions to improve visibility and acceptance of athletes with disabilities and promote interpersonal helpfulness
  • Facilitate sport educational programmes, and make sure that these programmes have information about sports and physical activity for people with disabilities or a chronic condition
  • Make sure medicine educational programmes and other caretaker educational programmes devote structural attention to the health benefits of physical activity, in particular for people with a visual or motor skills impairment and people with a chronic condition
  • Make sure there is a sufficient number of adjusted, accessible sports accommodations where people with physical disabilities can engage in sports and physical activity
  • Develop or improve transport options (for example by carpooling or volunteers)
  • Create a clear, broadly available reimbursement regulation to compensate transport costs and costs of special sports aid resources (like sports wheelchairs or sports protheses)
  • Together, celebrate the successes and share the experiences of disabled athletes, their coaches and caretakers