Understanding low levels of physical activity in people with intellectual disabilities: A systematic review to identify barriers and facilitators.
Physical-activity programs for clients with ID should explicitly address the 37 barriers/facilitators identified—especially environmental ones—while recognizing severe/profound ID remains under-studied.
01Research in Context
What this study did
Laposa et al. (2017) pulled every paper they could find on why people with intellectual disability move so little. They counted and grouped the reasons into personal and environmental buckets. The team looked across all ages but spotted almost no data on people with severe or profound ID.
What they found
The review listed 37 blocks and boosts: 14 inside the person and 23 in the world around them. Things like ‘no nearby program’ or ‘staff who fear lawsuits’ showed up again and again. The authors warn we still know little about adults or youth with the most limited speech or mobility.
How this fits with other research
Hamama et al. (2021) zoomed in on kids and found only one sure booster: better motor skills. That finding lives inside M et al.’s bigger map; motor skill is one of the 14 personal facilitators.
Yuan et al. (2022) later showed how fast activity can vanish. When COVID-19 locked down China, youth with ID dropped to just 10 minutes of moderate-to-vigorous movement per day. Their real-world numbers back up M et al.’s claim that environmental barriers can almost wipe activity out.
Rana et al. (2024) moved the story forward. They meta-analyzed adult lifestyle trials and found diet-plus-exercise packages only work when they include clear behavior-change techniques. Their result turns M et al.’s long list into an action plan: tackle the 23 environmental barriers and add theory-based BCTs.
Why it matters
You now have a ready-made checklist of 37 barriers and facilitators. Before you write a physical-activity goal, scan the list. Swap ‘lack of transport’ for a walkable route. Replace ‘bored staff’ with brief training. And if your client has severe or profound ID, measure anyway—M et al. show that gap is still wide open for new data.
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02At a glance
03Original abstract
BACKGROUND: People with intellectual disabilities (ID) undertake extremely low levels of physical activity. AIMS: To enhance understanding concerning low levels of physical activity in people with ID, this study has three aims: (1) to identify barriers to and facilitators of physical activity in people with ID; (2) to examine differences in barriers and facilitators between levels of ID (mild, moderate, severe, and profound); (3) to examine differences in barriers and facilitators between various stakeholder groups. METHODS AND PROCEDURES: A systematic search was performed using the following databases from the year 1990: MEDLINE, ERIC, and PsycINFO. The studies included were peer reviewed, available as full text, and written in English, addressing barriers to and facilitators of physical activity in people with ID. The quality of the studies was assessed using existing critical review forms. All studies were subjected to qualitative synthesis to identify and compare barriers and facilitators. OUTCOMES AND RESULTS: In all, 24 studies were retrieved, describing 14 personal and 23 environmental barriers and/or facilitators. The quality of the studies varied, particularly for qualitative studies. Only two studies included people with severe or profound ID. Stakeholder groups tend to identify barriers outside their own responsibility. CONCLUSIONS AND IMPLICATIONS: Results reveal a broad range of barriers and facilitators, but not for people with more severe ID. Further research should also examine these factors among stakeholders responsible for providing support.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.06.008