Promoting Physical Activity in Wheelchair users

Published: 08/11/2021

This blog post explains why physical activity promotion is important for wheelchair users and a healthcare professional's considerations for its promotion.

Physical Activity guidelines and Financial cost of physical inactivity

The Chief Medical Officer guidelines for disabled adults recommends 150 minutes of moderate-intensity activity or 75 minutes of vigorous-intensity activity each week. This population should also participate in resistance training at least twice a week (Department of Health & Social Care, 2019)

However, individuals with disabilities are twice as likely to be physically inactive than able-bodied adults (Public Health England, 2019). From 2015 to 2016 adults aged 40 to 60 years old in England with disabilities were 16.7% more physically inactive than able-bodied adults of the same age (Public Health England, 2017). Physical inactivity cost CCG £455 million from 2013 to 2014 and in 2019 it cost the UK £7.4 billion. This cost is expected to rise due to a trend of increasing physical inactivity. 

Adults with disabilities have higher rates of deleterious conditions (e.g. obesity and diabetes) which can be ameliorated or prevented by physical activity. When compared to individuals without disabilities, these individuals have a 66% higher rate of obesity and minority women are at the greatest risk (Martin, 2013)

Barriers and facilitators to physical activity

Adult multiple sclerosis wheelchair users reported that the accessibility of the environment to their mobility devices and their dependence on others for transport acts as barriers to physical activity. Factors that these individuals felt would enable them to be physically active were the following. 

Extrinsic factors: 

• Wheelchair accessible venues
• Support from others
• Positive feedback provided by others
• Promotion by healthcare providers
• Enjoyable programme to follow. 

Intrinsic factors:

• Increased self-awareness of improvement and the positive impact of this on their functioning
• Feeling physical activity helped them to ‘take control' of their condition
• Goal setting to improve motivation (Learmonth et al, 2015).

Benefits of physical activity for wheelchair users

Physical activity has a range of psychological benefits: 

• Enhanced self-perception
• Increased self-esteem
• Self-efficacy
• Improved mood
• Reduced stress, depression and pain. 

Research has found that participating in physical activity provides social networks that particularly benefit female attendants. Physical activity also improves muscle function in injury-prone muscle groups, which would reduce pain and thus reduce stress (Martin, 2013).

Charities and useful websites or resources

Sportability provides accessible sports activities for individuals with paralysis (aimed at people with spinal cord injury, stroke or multiple sclerosis). 

Parasport has home workouts and activities near me to help individuals find an accessible activity near them.

References

Department of Health & Social Care (2019) UK Chief Medical Officers’ Physical Activity Guidelines. [pdf]. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chief-medical-officers-physical-activity-guidelines.pdf (Accessed: 9 June 2021).

Learmonth, Y.C., Rice, I.M., Ostler, T., Rice, L.A. and Motl, R.W. (2015) ‘Perspectives on Physical Activity Among People with Multiple Sclerosis Who Are Wheelchair Users: Informing the Design of Future Interventions’, International Journal of MS Care, 17 pp.109-119.

Martin, J.F. (2013) ‘Benefits and barriers to physical activity for individuals with disabilities: a social-relational model of disability perspective’, Disability Rehabilitation, 35(24), pp.2030-2037. 

Public Health England (2016) Physical inactivity: economic costs to NHS clinical commissioning groups.  [pdf] London: Public Health England. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/524234/Physical_inactivity_costs_to_CCGs.pdf (Accessed: 9 June 2021).

Public Health England (2017) Research and analysis: Physical inactivity levels in adults aged 40 to 60 in England 2015 to 2016. Available at: https://www.gov.uk/government/publications/physical-inactivity-levels-in-adults-aged-40-to-60-in-england/physical-inactivity-levels-in-adults-aged-40-to-60-in-england-2015-to-2016 (Accessed: 9 August 2021).

Public Health England (2019) Guidance: Physical Activity: applying All Our Health. Available at: https://www.gov.uk/government/publications/physical-activity-applying-all-our-health/physical-activity-applying-all-our-health (Accessed: 9 August 2021).