INTRODUCTION

According to the World Report on Disability, approximately 15% of the global population (about 1 billion people) live with a disability, and among these, 200 million experience a severe functional limitation [1]. In Chile, data from the First National Study of People with Disabilities (ENDISC I) show a disability prevalence of 12.9%, representing roughly 2 million individuals. This prevalence is higher among female and those living in poverty [2].

The World Health Organization (WHO) defines physical activity as “any bodily movement produced by skeletal muscles that requires consuming energy” [3]. Physical activity plays a critical role in the prevention of cardiovascular disease, diabetes, and cancer; it also reduces symptoms of anxiety and depression and may help prevent up to 5 million deaths annually [3]. WHO guidelines recommend that adults (ages 18 to 64) and older adults (65 and over) engage in regular physical activity, minimize sedentary behavior, and substitute it with activity of any intensity [4].

The global prevalence of insufficient physical activity increased from 28.6% in 2010 to 31.3% in 2022, and is projected to reach 34.7% by 2030 [5]. Within Latin America, Brazil reports the highest prevalence of sedentary lifestyles, with 47% of the population participating in insufficient physical activity. This is followed by Costa Rica (46%), Argentina (41%), and Colombia (36%) [6]. In Chile, data from the 2021 National Survey of Physical Activity and Sports Habits indicate that 64.3% of adults are considered inactive, defined as engaging in physical activity fewer than 3 days per week for at least 60 minutes per session. Inactivity is more prevalent among female (69.1%) than male (59.1%) [7].

Physical inactivity constitutes a significant public health concern affecting all population groups, with individuals with disabilities facing a heightened risk of severe complications arising from inactivity [8]. However, there is a limited body of research on this topic in Latin America—a region where disability prevalence has risen due to demographic changes and increasing rates of chronic diseases [9]. Furthermore, the region displays substantial disparities in physical activity participation, especially among older adults and individuals with disabilities [10]. The results of this study have potential implications for public health policies designed to improve quality of life among people with disabilities, particularly given the limited availability of relevant data in Latin America.

The primary objective of this study was to estimate the association between disability and participation in sports or physical activity during the past month among the Chilean population. Secondary objectives included examining this association across different age groups and analyzing the reasons for not engaging in physical activity according to disability status.

METHODS

Design and Data Source

A cross-sectional analysis was performed using data from the Second National Disability Study (ENDISC II) of Chile. ENDISC II was conducted by the National Disability Service in collaboration with the National Institute of Statistics. The ENDISC II sample comprised 12 265 individuals aged 18 years or older and 5515 individuals aged 2 years to 17 years [11].

The sampling design of ENDISC II was probabilistic and biphasic, utilizing survey data collected from dwellings as part of the 2013 National Socioeconomic Characterization Survey (Encuesta de Caracterización Socioeconómica Nacional 2013). The dwelling served as the final selection unit, with 2 levels of sampling units. The first unit included all occupied private dwellings within selected blocks, chosen through random selection. The second unit involved selecting 1 respondent per household, randomly chosen using the Kish method. This survey enabled estimation of disability prevalence at national, regional, and zonal levels [11].

Data were collected through voluntary, in-person interviews using a paper-based questionnaire. Interviewers approached participants directly at each selected dwelling. Further details regarding ENDISC II methodology are available in the final report [11].

Selection Criteria

This analysis included Chilean residents aged 18 years or older. Individuals with missing data or inconsistent responses were excluded.

Variables

The dependent variable was participation in sports or physical activity within the past month, assessed by the question: “In the last month, did you practice sports or engage in physical activity outside your work schedule for 30 minutes or more?” Response options were: (1) 3 or more times per week, (2) 1 to 2 times per week, (3) fewer than 4 times per month, (4) once a month, and (5) no physical activity in the last month. For analysis, this variable was categorized into 3 groups: high participation (option 1), moderate participation (options 2, 3, and 4), and no participation (option 5).

The independent variable was disability status, measured by ENDISC II using a methodology based on the Model Disability Survey (MDS) [12]. This approach provides a functional metric ranging from 0 points to 100 points (from no difficulty to maximum difficulty) across 8 domains, following the International Classification of Functioning, Disability, and Health. Disability was classified into 3 categories: no disability, mild or moderate disability, and severe disability.

Covariates

Socio-demographic variables included sex (male, female), age group (18-29, 30-44, 45-59, ≥60), marital status (married/cohabiting, separated/divorced/widowed, single), educational level (no education, elementary, middle, high school), ethnic self-identification (yes or no), and current employment status (yes or no).

In addition, variables previously associated with physical activity were included. Chronic disease [13] was assessed for conditions such as hypertension, diabetes, arthritis, heart disease, respiratory disease, migraine, and physician-diagnosed AIDS, using the question, “Have you ever been told by a doctor (or other health professional) that you have (name of disease)?” (yes or no). Mental illness [14], specifically physician-diagnosed depression and anxiety, was similarly assessed. Participation in recreational activities [15] was determined by the question, “During the past 6 months, did you participate in or attend any of the following activities or places?” (yes or no). Personal assistance [16] was evaluated by asking, “Do you have someone to help you at home or outside your home, including family and friends, to perform the following activities?” (yes or no). Perceived discrimination was measured with the question, “In the past 12 months, have you felt discriminated against?” (yes or no) [17].

The primary reasons for not engaging in physical activity were assessed with the question, “What is the main reason for not having practiced more physical activity?” which included 11 independent response options.

Statistical Analysis

The dataset was downloaded from the ENDISC II website (https://bit.ly/endiscII) and analyzed using Stata version 18 (StataCorp., College Station, TX, USA). All estimates accounted for the complex sampling design of ENDISC II. Categorical variables were presented as frequencies and weighted percentages. Bivariate associations between covariates and participation in sports or physical activity in the past month were examined using the chi-square test. Crude and adjusted ordinal logistic regression models were used to obtain odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Variables associated with the outcome (p<0.05) in the crude model were included in the adjusted model. The variance inflation factor (VIF) was calculated to assess potential collinearity among variables in the adjusted model.

Ethics Statement

The study was reviewed and approved by the Medical School of the Universidad Científica del Sur. It was exempted from ethics committee review as it involved secondary analysis of publicly available databases or data from research previously approved by an ethics committee, in accordance with item 2 of Directorial Resolution No. 008-DGIDI-CIENTIFICA-2023.

RESULTS

A total of 12 265 individuals aged 18 years or older participated in ENDISC II. After excluding 29 individuals who did not meet the selection criteria, 12 236 participants were included in the final analysis (Supplemental Material 1).

In the univariate analysis, 20.0% of participants were identified as having a disability, with 11.7% classified as having mild or moderate disability and 8.3% as having severe disability. Among the general population, 35.3% reported engaging in sports or physical activity in the past month (21.1% at a moderate level and 14.2% at a high level) (Table 1). By contrast, only 17.2% of individuals with disabilities reported participating in sports or physical activity during the last month (10.7% at a moderate level and 6.5% at a high level).

In the bivariate analysis, the proportion of individuals not engaging in sports or physical activity increased with the severity of disability: 60.2% among those without disabilities, 79.0% among individuals with mild or moderate disabilities, and 88.2% among those with severe disabilities. These differences were statistically significant (p<0.001) (Table 2).

In the multivariate analysis, the crude model showed that individuals with mild or moderate disabilities had 2.45 times the odds of engaging in less physical activity (OR, 2.45; 95% CI, 2.05 to 2.92), while those with severe disabilities had 4.93 times the odds (OR, 4.93; 95% CI, 3.61 to 6.73) (Table 3).

In the adjusted model, which controlled for sex, age group, marital status, educational level, current employment status, chronic disease, mental illness, recreational activities, personal assistance, and perceived discrimination, individuals with mild or moderate disabilities were 54% more likely to engage in less physical activity (OR, 1.54; 95% CI, 1.27 to 1.87). Those with severe disabilities were 73% more likely to participate less in physical activity compared to individuals without disabilities (OR, 1.73; 95% CI, 1.19 to 2.52) (Table 3). The VIF in the fitted model ranged from 2 to 4, indicating no collinearity among the variables.

In the age-stratified model, the odds of reduced physical activity among individuals with disabilities were significant in the “18 years to 29 years” age group (OR, 2.28; 95% CI, 1.40 to 3.73) and in the “60 years and older” group (OR, 1.79; 95% CI, 1.35 to 2.39) (Figure 1).

Among participants who did not engage in physical activity or sports (n=8115), the primary reasons cited were “lack of time” (n=2927) and “health limitations” (n=2497). Of those reporting “lack of time,” 89.8% did not have a disability, whereas 58.3% of those who cited “health limitations” had a disability (Figure 2).

DISCUSSION

Overall, 35.5% of the general population engaged in sports or physical activity in the past month, compared to only 17.2% of individuals with disabilities. The proportions of moderate and high levels of sport or physical activity participation decreased as the severity of disability increased. Furthermore, individuals with disabilities were less likely to participate in sports or physical activities than those without disabilities. However, this association was significant specifically among young adults and older adults.

Approximately one-third (35.3%) of the population reported engaging in sports or physical activity in the past month. This result aligns with findings by Fernández-Verdejo and Suárez-Reyes [18], who analyzed data from the Chilean National Health Survey 2016-2017, which included 5564 Chileans aged 18 or older. Their study reported a sedentary lifestyle prevalence of 87.7%, using a question similar to that in ENDISC II to assess physical activity. This comparison suggests that our findings accurately reflect the current state of physical activity in Chile.

Only 17.2% of people with disabilities in Chile reported engaging in sports or physical activity in the past month. This percentage is lower than that reported by Hollis et al. [19], who studied 450 016 individuals in the United States and found that 45.2% of adults with motor disabilities engaged in aerobic activity (with 30.4% being sufficiently active and 14.7% insufficiently active), while 54.8% did not engage in any physical activity in the previous month. In a Chilean cross-sectional study of 3150 adults (ages 18 to 99) conducted during the coronavirus disease 2019 (COVID-19) pandemic (2020) as part of the Chilean National Physical Activity and Sports Habits in Populations with Disabilities Survey, only 11.9% met WHO recommendations for physical activity (≥150 min/wk), while the rest of the population was either inactive (62.6%) or performed very low levels of physical activity (22.5% <150 min/wk) [20]. This finding suggests that physical activity levels among people with disabilities in Chile have remained consistently low, even prior to the COVID-19 pandemic. While initial explanations for reduced activity levels centered on confinement and fear of infection, our analysis suggests there are additional factors contributing to low physical activity participation among individuals with disabilities in Chile.

The main finding of this study is that individuals with disabilities are less likely to participate in sports or physical activities than those without disabilities. Supporting this, a study analyzing 19 waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey among 463 females aged 18 years to 75 years reported that individuals with high levels of disability were less likely to engage in leisure activities (OR, 0.29, 95% CI, 0.13 to 0.65) and vigorous exercise (OR, 0.17, 95% CI, 0.04 to 0.75), making it one of the few studies to consider disability as an exposure variable rather than an outcome [21].

It is also important to note that the observed association between disability and physical activity may be bidirectional. Early engagement in physical activity may reduce the risk of developing a disability later in life. This is supported by longitudinal studies, such as that by Keramat et al. [22], who analyzed 14 waves (2006-2019) of the HILDA survey involving 189 515 participants, approximately 28% of whom had a disability. The study found that adults who met recommended physical activity levels (more than 3 times per week) were 17% less likely to develop a disability (OR, 0.83, 95% CI, 0.81 to 0.85) [22].

In this study, the observed association was found only among younger individuals and older adults. In this context, the 2021 National Survey of Physical Activity and Sports Habits reported a high prevalence of physical inactivity (78.5%) among adolescents aged 11 years to 17 years in Chile, one of the highest recorded for this age group [7]. Similarly, a cross-sectional study conducted in 46 low-income countries found that adults with various physical conditions—including, but not limited to, disabling conditions such as arthritis, hearing impairments, and visual impairments—especially those over 50 years of age, were less likely to meet physical activity guidelines than adults without these conditions [23]. These studies reinforce the age-specific findings observed here. Nevertheless, further research is needed to confirm these results.

People with disabilities reported that the primary reason for not engaging in sports or physical activity was that “their health does not allow it.” Many individuals with disabilities experience specific conditions—such as mobility limitations, pain, fatigue, muscle weakness, or comorbidities including cardiovascular disease, diabetes, or respiratory issues—that may restrict physical activity. Nevertheless, specialized agencies recommend physical activity tailored to specific health conditions [24]. Reducing informational barriers regarding safe and effective exercise for individuals with disabilities is essential.

The findings of this study and existing evidence support the hypothesis that individuals with disabilities participate in sports and physical activity less frequently than their non-disabled counterparts. One possible explanation is provided in a systematic review of 52 studies that investigated barriers and facilitators to sports participation among individuals with physical disabilities. This review identified personal barriers—including the disability itself, health conditions, and fatigue—and environmental barriers such as inadequate facilities, high costs, transportation challenges, and limited accessibility to sports venues [25]. Similarly, a Spanish study of individuals with various disabilities found that personal barriers were generally more significant than environmental ones, though these barriers varied by disability type. For instance, individuals with visual impairments cited environmental barriers as more limiting, whereas those with physical or intellectual disabilities identified personal barriers as more impactful. Additionally, the study found that females perceived more barriers to physical activity and sports than males [26].

The lack of physical activity among people with disabilities has significant public health implications, including higher medical expenses. Evidence suggests that regular physical activity can save an average of US$2150 in annual healthcare costs per individual [27]. Additionally, people with disabilities are more likely to be obese than those without disabilities, increasing their risk for chronic conditions such as diabetes and cancer. Although aerobic exercise can mitigate the effects of these chronic diseases, adults with disabilities typically engage in only half the recommended amount of physical activity compared to the general population [23]. Furthermore, limited or absent physical activity negatively impacts mental health; studies have demonstrated a positive correlation between physical activity and improved emotional, mental, and psychosocial well-being in individuals with intellectual disabilities [28].

The WHO has published guidelines based on cohort analyses and systematic reviews supporting physical activity for individuals with disabilities and emphasizing that the benefits far outweigh any potential risks. These guidelines recommend that individuals with disabilities engage in physical activity “when possible and when they feel able,” starting with small amounts and gradually increasing frequency, duration, and intensity [24]. Additionally, consulting a healthcare professional is advised to determine the most appropriate type and level of physical activity [29].

The low prevalence of physical activity or sports participation observed among individuals with disabilities in Chile represents a previously undescribed finding in similar studies, with significant implications for public health policies targeting this vulnerable population group.

Several limitations should be considered in light of the study design. First, recall and social desirability biases may have influenced data collection, potentially leading to overestimation of the prevalence of sports or physical activity. Second, potential confounding variables—such as socioeconomic status, place of residence, diet, social support, or knowledge about physical activity—were not included in the analysis due to their unavailability in the ENDISC II dataset. Third, the use of self-reported measures of disability may not provide the most accurate estimates; however, the ENDISC II methodology is endorsed by the WHO as producing prevalence measures close to reality. Fourth, a standardized instrument was not used to assess physical activity, so comparisons with similar studies should be made with caution. Fifth, as this analysis is based on data collected in 2015, the findings may not fully reflect the current context, particularly in the aftermath of the COVID-19 pandemic; however, to our knowledge, no comparable study has been conducted in this population before or after the pandemic. Sixth, the cross-sectional design of this study precludes the establishment of causal relationships between disability and participation in sports or physical activity, and there is a high likelihood that reverse causation could influence these results. A notable strength of this study is its representativeness of the Chilean population, as it is based on a population-wide survey.

In Chile, individuals with disabilities participate less in sports or physical activities compared to those without disabilities, but this difference is observed only among younger and older adults. Physical activity levels decline as the severity of disability increases. These findings highlight a significant public health challenge affecting this vulnerable population. To address this issue, promoting adapted and accessible physical activity for individuals with disabilities is essential to prevent health complications and improve their quality of life. Additionally, staff at sports centers should receive training in inclusive practices, adaptive techniques, and strategies to sustain user motivation. Social interaction should also be encouraged through support groups and social networks aimed at fostering physical activity among individuals with disabilities.

Supplemental Materials

Notes

Data Availability

The data supporting the findings of this study are openly accessible on the SENADIS website (https://bit.ly/endiscII).

Conflict of Interest

The authors have no conflicts of interest associated with the material presented in this paper.

Funding

None.

Acknowledgements

The authors would like to thank the authorities of Universidad Científica del Sur for their support of the EpiDIS research group. This work forms part of the theses of Renzo Gianmarco Avila-Terrones and Leslie Paulina Quiroga-Morales for their medical degrees at the Universidad Científica del Sur.

Author Contributions

Conceptualization: Avila-Terrones RG, Quiroga-Morales LP, Alarco JJ. Data curation: Alarco JJ. Formal analysis: Alarco JJ. Funding acquisition: None. Methodology: Alarco JJ. Project administration: Avila-Terrones RG, Quiroga-Morales LP, Alarco JJ. Visualization: Avila-Terrones RG, Quiroga-Morales LP. Writing – original draft: Avila-Terrones RG, Quiroga-Morales LP. Writing – review & editing: Alarco JJ.

Figure. 1.

Association between disability and participation in sport or physical activity in the last month, according to age group among Chilean residents aged 18 years or older. Adjusted for sex, age group, marital status, educational level, current employment status, chronic disease, mental illness, recreational activities, personal assistance, and perceived discrimination. aOR, adjusted odds ratio; CI, confidence interval.

Figure. 2.

Main reasons for not participating in sport or physical activity among Chilean residents aged 18 years or older according to disability status.

REFERENCES

• 1. World Health Organization. World report on disability 2011 [cited 2024 Nov 14]. Available from: https://iris.who.int/handle/10665/44575
• 2. Paolinelli C, González M. Epidemiology of disability in Chile, children and adults. Rev Med Clin Condes 2014;25(2):177-182. (Spanish). https://doi.org/10.1016/S0716-8640(14)70028-8Article
• 3. World Health Organization. Physical activity; 2024 [cited 2024 Nov 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity
• 4. World Health Organization. WHO guidelines on physical activity and sedentary behaviour; 2020 [cited 2024 Nov 14]. Available from: https://www.who.int/publications/i/item/9789240015128
• 5. Strain T, Flaxman S, Guthold R, Semenova E, Cowan M, Riley LM, et al. National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants. Lancet Glob Health 2024;12(8):e1232-e1243. https://doi.org/10.1016/S2214-109X(24)00150-5ArticlePubMedPMC
• 6. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Health 2018;6(10):e1077-e1086. https://doi.org/10.1016/S2214-109X(18)30357-7ArticlePubMed
• 7. Ministerio del Deporte. National survey of physical activity and sports habits 2021 [cited 2024 Nov 14]. Available from: https://biblioteca.digital.gob.cl/server/api/core/bitstreams/45368c3b-5fac-425c-9d95-be9269c2d151/content (Spanish)
• 8. Rimmer JH, Marques AC. Physical activity for people with disabilities. Lancet 2012;380(9838):193-195. https://doi.org/10.1016/S0140-6736(12)61028-9ArticlePubMed
• 9. Berlinski S, Duryea S, Perez-Vincent SM. Prevalence and correlates of disability in Latin America and the Caribbean: evidence from 8 national censuses. PLoS One 2021;16(10):e0258825. https://doi.org/10.1371/journal.pone.0258825ArticlePubMedPMC
• 10. Werneck AO, Barboza LL, Silva EC, Araujo RH. Sociodemographic inequalities in physical activity in Latin America: time for policies targeted at groups that need it the most. Int J Public Health 2022;67: 1605125. https://doi.org/10.3389/ijph.2022.1605125ArticlePubMedPMC
• 11. Servicio Nacional de la Discapacidad. Results book II: national disability study. 2015 [cited 2024 Nov 14]. Available from: https://www.senadis.gob.cl/descarga/i/3959 (Spanish)
• 12. Sabariego C, Fellinghauer C, Lee L, Kamenov K, Posarac A, Bickenbach J, et al. Generating comprehensive functioning and disability data worldwide: development process, data analyses strategy and reliability of the WHO and World Bank Model Disability Survey. Arch Public Health 2022;80(1):6. https://doi.org/10.1186/s13690-021-00769-zArticlePubMedPMC
• 13. Marques A, Santos T, Martins J, Matos MG, Valeiro MG. The association between physical activity and chronic diseases in European adults. Eur J Sport Sci 2018;18(1):140-149. https://doi.org/10.1080/17461391.2017.1400109ArticlePubMed
• 14. Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med 2003;36(6):698-703. https://doi.org/10.1016/s0091-7435(03)00042-2ArticlePubMed
• 15. Bowles HR, Merom D, Chey T, Smith BJ, Bauman A. Associations of type, organization, and number of recreational activities with total activity. J Phys Act Health 2007;4(4):469-480. https://doi.org/10.1123/jpah.4.4.470ArticlePubMed
• 16. Bondár RZ, di Fronso S, Bortoli L, Robazza C, Metsios GS, Bertollo M. The effects of physical activity or sport-based interventions on psychological factors in adults with intellectual disabilities: a systematic review. J Intellect Disabil Res 2020;64(2):69-92. https://doi.org/10.1111/jir.12699ArticlePubMed
• 17. Shelton RC, Puleo E, Bennett GG, McNeill LH, Goldman RE, Emmons KM. Racial discrimination and physical activity among low-income-housing residents. Am J Prev Med 2009;37(6):541-545. https://doi.org/10.1016/j.amepre.2009.07.018ArticlePubMedPMC
• 18. Fernández-Verdejo R, Suárez-Reyes M. Physical inactivity versus sedentariness: analysis of the Chilean national health survey 2016-2017. Rev Med Chil 2021;149(1):103-109. (Spanish). https://doi.org/10.4067/S0034-98872021000100103ArticlePubMed
• 19. Hollis ND, Zhang QC, Cyrus AC, Courtney-Long E, Watson K, Carroll DD. Physical activity types among US adults with mobility disability, Behavioral Risk Factor Surveillance System, 2017. Disabil Health J 2020;13(3):100888. https://doi.org/10.1016/j.dhjo.2020.100888ArticlePubMedPMC
• 20. Henríquez M, Ramirez-Campillo R, Cristi-Montero C, Reina R, Alvarez C, Ferrari G, et al. Alarming low physical activity levels in Chilean adults with disabilities during COVID-19 pandemic: a representative national survey analysis. Front Public Health 2023;11: 1090050. https://doi.org/10.3389/fpubh.2023.1090050ArticlePubMedPMC
• 21. Alyousef B, Kazemi Z, Cicuttini FM, Heritier S, Wang Y, Urquhart DM. High levels of back disability, not back pain, are associated with reduced physical activity across key activity domains. Musculoskelet Sci Pract 2023;65: 102768. https://doi.org/10.1016/j.msksp.2023.102768ArticlePubMed
• 22. Keramat SA, Alam K, Sathi NJ, Gow J, Biddle SJ, Al-Hanawi MK. Self-reported disability and its association with obesity and physical activity in Australian adults: results from a longitudinal study. SSM Popul Health 2021;14: 100765. https://doi.org/10.1016/j.ssmph.2021.100765ArticlePubMedPMC
• 23. Martin Ginis KA, van der Ploeg HP, Foster C, Lai B, McBride CB, Ng K, et al. Participation of people living with disabilities in physical activity: a global perspective. Lancet 2021;398(10298):443-455. https://doi.org/10.1016/S0140-6736(21)01164-8ArticlePubMed
• 24. Carty C, van der Ploeg HP, Biddle SJ, Bull F, Willumsen J, Lee L, et al. The first global physical activity and sedentary behavior guidelines for people living with disability. J Phys Act Health 2021;18(1):86-93. https://doi.org/10.1123/jpah.2020-0629ArticlePubMed
• 25. Jaarsma EA, Dijkstra PU, Geertzen JH, Dekker R. Barriers to and facilitators of sports participation for people with physical disabilities: a systematic review. Scand J Med Sci Sports 2014;24(6):871-881. https://doi.org/10.1111/sms.12218ArticlePubMed
• 26. Ascondo J, Martín-López A, Iturricastillo A, Granados C, Garate I, Romaratezabala E, et al. Analysis of the barriers and motives for practicing physical activity and sport for people with a disability: differences according to gender and type of disability. Int J Environ Res Public Health 2023;20(2):1320. https://doi.org/10.3390/ijerph20021320ArticlePubMedPMC
• 27. Xu X, Ozturk OD, Turk MA, McDermott SW. Physical activity and disability: an analysis on how activity might lower medical expenditures. J Phys Act Health 2018;15(8):564-571. https://doi.org/10.1123/jpah.2017-0331ArticlePubMed
• 28. Borland RL, Cameron LA, Tonge BJ, Gray KM. Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: a systematic review. J Appl Res Intellect Disabil 2022;35(2):399-420. https://doi.org/10.1111/jar.12961ArticlePubMed
• 29. Carty C, van der Ploeg HP, Biddle SJ, Bull F, Willumsen J, Lee L, et al. Response to “Commentary on: the first global physical activity and sedentary behavior guidelines for people living with disability”. J Phys Act Health 2021;18(4):350-351. https://doi.org/10.1123/jpah.2021-0137ArticlePubMed

Figure & Data

References

Citations

Citations to this article as recorded by