Recruitment is one of the biggest challenges that I have noticed regarding physical activity programs for people with disabilities. I experienced this first hand several years ago, when I was developing adaptive sports and exercise programs for students with disabilities at Kent State University. I remember I was very excited for the opportunity to provide such programs to students with disabilities, and also to have have students try activities that they did not think they could do, or that they knew existed.

With the help of the fitness coordinator and student disability services, I was able to set up a variety of adaptive programs - chair aerobics, yoga, aquatics, archery, rock climbing, skiing and an introduction to wheelchair basketball. I assumed that once these activities were available, students would be lining up to join. The truth was, hardly any of the students voluntarily signed up for any of the programs, and the rest had to be encouraged.

Some students are simply not interested in these types of activities, but others, I believe, just had a lack of knowledge - not knowing these programs exist, and not knowing that they can participate in sports and exercise activities even if they do have a physical disability. Also, sports and exercise are generally introduced early to children. But due to the competitive nature of sports, children with disabilities often don't get to reap the benefits of physical activity at all, or are exposed to them much later in their lives.

Temple University in Philadelphia, PA has one of the most creative programming ideas that I've come across. It's called the Workout Buddy Program, and is one of many available from their Adaptive Recreation Department. The goal of the Workout Buddy Program is to provide an opportunity for students with disabilities to experience various sports and exercise activities. Students with disabilities who want to participate are partnered up with a fellow student/volunteer, and they participate together in whatever activity they choose - tandem walking/jogging, handcycling, aquatics, weight traning, cardiovascular conditioning, etc.

Since many individuals with disabilities are not aware of adaptive sports/recreation programs, there needs to be introductory programs that expose young individuals with disabilities to various physical activities. This group also needs to learn about how exercise and sports can benefit them physically and emotionally, and understand that participating in physical activity improves their health and wellbeing. Universities and colleges in particular should be providing such programs for their students since the setting is ideal for fostering new experiences and self-growth.

What other ways can colleges and universities encourage students with disabilities to join sports, exercise, or recreation programs? Also, should there be more focus on attitudinal change from the nondisabled student population?

One of my favorite things to do during the summertime when I was in grade school was going to the pool at my community's recreation center. It was convenient because I lived in town and it was a place where I could socialize with friends.

Looking back almost 20 years later, I realize the importance of the recreation center for me and rest of the community. I grew up in a family where I was encouraged and pushed to be active, regardless of my physical disability. Today, children are less physically active, and instead, playing video games and watching TV. As someone who loves various physical activities, I understand the positive impact physical activity has on an individual's physical and mental well-being. I think this is especially true for children with disabilities. One of the biggest issues is the availability of community physical activity programs for children with disabilities.

With the high obesity rate among Americans - even higher in people with disabilities - communities have the responsibility to provide fitness or physical activity programs for people of all abilities. Today, it's amazing to find so many adaptive sports and recreational opportunities available to people with disabilities, while twenty years ago many of these opportunities were non-existent.

Many of these adaptive sport and physical activity programs are run by non-profit organizations, and now park districts are providing programs. However, it's still not enough. Local communities should be collaborating with school districts to provide programs. Disabilities in general are more "visible" and recognizable in mainstream society now. And, people with disabilities who are living in every community have the right to have fitness/physical activity programs be available to them - just like individuals without disabilities.

Besides the availability of community fitness/physical activity programs, there lies another issue - getting the word out to people. One of the complaints among parents and people with disabilities is that they are unaware these kinds of programs exist. One of the reasons why so many individuals with disabilities do not participate in physical activity is because they don't realize they can, and that it's available. Agency outreach activity needs to be expanded.

In order to get people with disabilities to participate in fitness/physical activity programs they need to be available in communities. This would eliminate people having to search for programs, and accessing them would be easy. One challenge that seems to occur is engaging people with disabilities. I believe that the solution starts in communities, and in collaboration with school districts.

In addition, providing inclusive programs, as well as programs for young children, is a great start. By exposing children to fitness/physical activity programs at an early age, they will continue the behavior as they get older, and receive the health benefits from it. The key is to have programs be available and accessible - the community is a perfect place to start!

What are other ways communities can engage people with disabilities to be physically active?

"If you always put limits on everything you do, physical or anything else, it will spread into your work and into your life. There are no limits. There are only plateaus, and you must not stay there, you must go beyond them." - Bruce Lee

As important as it is for health and fitness professionals to know what limitations an individual may have in terms of creating appropriate activities, especially for safety and medical considerations, it's also important to consider what that individual CAN do, and what they can do in context with their environment. The social model of disability has taught us that systemic barriers, negative attitudes and exclusion by society (whether purposely or not) are the main contributing factors in disabling people, not the disability itself.

The International Classification of Functioning, Disability, and Health, or ICF, is a comprehensive framework used by the World Health Organization (WHO) for describing and measuring health and disability at both the individual and population levels. This framework is used to assess the relationship among an individual's function, activities, and participation while also considering these in the context of the environmental and personal factors that influence an individual's overall health. 

The ICF puts the idea of 'health' and 'disability' in a new light and recognizes that any person can experience peaks and valleys in health, and therefore any person is prone to experiencing some kind of disability. It shifts the focus from what caused a disability to the impact that it has on the person. In addition, ICF considers the social aspects of disability and does not see disability as a medical condition. By including these contextual factors, the ICF helps us to assess the impact of the environment on the person's functioning, and therefore possibly assess potential "limitations" a bit differently.

The health domain and health-related domain contained in the ICF are described fromt he perspective of the body, the individual, and society in two basic categories: (1) Body Functions and Structures (system level); and (2) Activities and Participation (person level and person-environment interaction). The ICF can be used as a tool in exercise physiology to conduct a needs assessment or as an outcome evaluation. It allows the fitness professional to identify the barriers and facilitators that affect the health of the client with the disability and then find or create modifications for the specific individual in order to facilitate participation in an activity. The ICF emphasizes function, NOT the health condition, and categorizes the situation, NOT the person. Here is an example.

Do you see the ICF as having application in your field?

Reference: http://www.who.int/classifications/icf/en