Adaptive Outdoor Physical Activities for Adults with Mobility Disability: A Scoping Review

Objective(s): To identify barriers and facilitators to participation in adaptive outdoor physical activity (PA) and identify suggestions for adaptive outdoor PA design.

Data Sources: The research team selected suitable search terms, including subject headings, for different databases and used keywords with truncations. A search strategy incorporating the following concepts: (1) Individuals with mobility disability (mobility limitation), (2) Exercise (recreation or physical activity or outdoor physical activity), (3) Adaptive equipment (or sports equipment), (4) Community participation (or social participation). These specific search strategies were developed based on the Population, Concept, and Context framework. Databases: Medline (Ovid), Embase (OVID), CINAHL (EBSCO), and PsycINFO (EBSCO)—were searched without limiting the publication date to September 2023.

Study Selection: The study selection process involved four steps: identifying relevant literature, screening studies based on inclusion and exclusion criteria using titles and abstracts, assessing the eligibility of remaining studies based on complete papers, and including relevant studies during data extraction. Potential duplicates were automatically removed using Covidence software after searching all databases. During screening, eligibility, and inclusion, two researchers independently evaluated studies and documented reasons for exclusion and reached a consensus by third researcher.

Data Extraction: Qualitative study data were extracted by reading and re-reading content, extracting quotes, and noting themes. Quantitative study data were entered into an Excel sheet for descriptive analysis. The first author used thematic synthesis to code qualitative data into broader categories aligned with the Social-Ecological Model (SEM). This process was validated through discussions with co-authors.

Data Synthesis: Thirty-seven factors related to barriers and facilitators of outdoor adaptive P were extracted from a review of 19 studies spanning the years 2002 to 2023. These factors were classified into four levels of the Social-Ecological Model (SEM): intrapersonal, social-environmental, physical-environmental, and policy-related. Additionally, the study identified eleven design recommendations categorized according to the seven principles of Universal Design (UD). The research highlighted gaps in the identified barriers, facilitators, and design suggestions across the studies, particularly in the areas of social and environmental aspects, such as program delivery innovation and logistical considerations.

Conclusions: This study revealed gaps in understanding the facilitators and barriers of outdoor adaptive physical activity (PA) and in the development of interventions to address them. Future research should prioritize strategies that involve individuals with mobility disabilities in designing interventions to better understand their specific needs and preferences.

Author(s) Disclosures: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.