The Role of Self-Efficacy in Physical Activity Participation for Persons with Disabilities
Dixon-Ibarra, Alicia, Driver, Simon, Palaestra
As part of a healthy lifestyle, physical activity is important for everyone, including persons with disabilities. Researchers have demonstrated that regular physical activity improves health for persons with disabilities. The benefits include improved cardiovascular and muscle fitness, improved mental health, and increased ability to do tasks of daily living such as dressing, eating, ambulating, toileting, and hygiene. Sufficient evidence is available to recommend that individuals with disabilities should participate regularly in physical activity (U.S. Department of Health and Human Services, 2008). For people to experience the health benefits associated with physical activity, the Centers for Disease Control and Prevention (2009) have developed recommended guidelines. According to these guidelines, adults should participate in at least 150 minutes of moderate or 75 minutes of vigorous cardiovascular physical activity with 2 days of muscular strength exercises per week. The guidelines should be followed as closely as possible. However, adults with disabilities who are not able to meet the guidelines should engage in regular physical activity according to their abilities and should avoid inactivity.
Despite the reported health benefits, many persons with disabilities are not participating in regular physical activity, even though these individuals could benefit the most (Anderson & Heyne, 2010; Kroll, Kehn, Ho, & Groah, 2007; Motl, McAuley, & Snook, 2005; Stanish, Temple, & Frey, 2006). According to Anderson and Heyne (2010), physical activity, although important for physical health, also provides "amplified" benefits for persons with disabilities, including emotional and psychological benefits, social benefits, and community and societal benefits. Overall, persons with disabilities have both amplified negative consequences from physical inactivity and amplified benefits for pursuing physical activity (Anderson & Heyne, 2010).
Each identified population in this review has low levels of physical activity. For instance, Stanish et al. (2006) conducted a literature review and concluded that less than one third of the population with intellectual disabilities engages in sufficient physical activity to receive any health benefits. Temple's (2010) review further described that physical activity studies for persons with intellectual disabilities may overestimate the true picture of activity in this population because physical activity has been examined on a small scale, without examining individuals with more severe intellectual disability and excluding persons with comorbid, associated, or secondary conditions. Persons with physical disabilities, especially persons with spinal cord injuries, are also physically inactive to the extreme that their health is negatively impacted (Kroll et al., 2007). In fact, persons with spinal cord injuries are ranked at the lowest end of the fitness and physical activity spectrum. Again, despite the benefits of physical activity, persons with multiple sclerosis are also relatively inactive compared to persons without disability or disease. A meta-analysis conducted by Motl et al. (2005) yielded a mean effect size of -0.60 from 13 studies (n = 2,360), showing that persons with multiple sclerosis are significantly less active compared to the general population and have higher amounts of sedentary activity.
One factor that influences physical activity participation is self-efficacy. In a literature review of physical activity determinants for the general population, self-efficacy was one of the strongest correlates of physical activity in almost every study that included it (Sallis & Owen, 1999). As it will be further identified in this review, self-efficacy is a critical determinant of physical activity for persons with disabilities, based on social, environmental, and disability-specific symptoms and barriers that provide sources of efficacy for these populations. …