The 2014 Commonwealth Games have been praised for integrating the para-sports programme into the main schedule and including the medals in the tally of each nation. The London Olympics in 2012 told a similar story of success, with the president of the International Paralympic Committee, Sir Philip Craven describing it as “the greatest Paralympic Games ever”.
But, the impact of the Olympics for promoting para-sport participation has since been questioned, which is concerning for the health of people with disabilities. It is important that more is done to encourage the broader uptake of sport and promotion of physical activity for people with disabilities.
The 2012 Paralympic legacy
The record crowds and unprecedented media coverage of the 2012 Paralympic Games positively transformed the way people with impairments were viewed by the public. As a result, UK Sport increased funding for Paralympics GB through to Rio 2016 and transport operators have worked to improve accessibility in the transport system.
The English Federation of Disability Sport, thanks to a £2m investment from Sport England, has also been working tirelessly to increase the number of disabled people participating in sport. They found eight out of ten disabled people considered taking part in more sport or exercise following London 2012.
While these early signs were encouraging, a Sport and Recreation Alliance Survey raised questions over the impact of the Paralympic legacy. This was particularly regarding its effectiveness at translating Paralympic success into sport participation at a grassroots level. Nine out of ten clubs reported no change in the number of disabled people joining their club. Almost the same number (86%) noticed no change in the number of enquiries they received from disabled people wanting to take part.
A recent survey has also questioned the physical education provision for children with disabilities in mainstream schools. This not only limits the potential to develop future Paralympian prospects but more importantly future active generations.
What the guidelines say
For the past ten years at least, the UK Chief Medical Officer’s Report has made the same statement regarding the lack of evidence to inform policy on the recommended levels of physical activity for disabled people:
A good understanding of the health and functional benefits derived from physical activity by persons with disabilities is still limited due to a lack of research.
It has been suggested that individuals with disabilities should strive to meet the American College of Sports Medicine physical activity guidelines of 150 minutes of moderate intensity physical activity per week. There is a degree of uncertainty as to whether these able-bodied guidelines are realistically achievable.
This is mainly due to altered physical function in individuals with a disability and the numerous challenges that they face when trying to be more physically active. There is also a distinct lack of evidence as to whether individuals with a disability even accrue the same health benefits from meeting these guidelines.
The World Health Organisation has addressed physical inactivity as a global public health concern. Figures from the Centers for Disease Control and Prevention in the US suggest that adults with a disability who do not perform any physical activity are 50% more likely than their active peers to report at least one chronic disease (cancer, diabetes, stroke or heart disease).
Worryingly the same report states that one in two disabled adults gets no aerobic physical activity. By getting volunteers to transition from high to low levels of physical activity over a 14 day period, researchers have associated reduced physical activity with impaired metabolic function. Even as little as three days of reduced physical activity can negatively affect the body’s ability to regulate blood sugar levels.
The reduced level of physical activity in people with disabilities is a result of numerous psychosocial and environmental barriers to exercise. These include reduced self-esteem, a lack of accessible facilities, unaffordable equipment, fear of injury and parental or medical over protection.
Secondary complications such as pressure sores, common in individuals who are wheelchair dependent, require bed rest and further compound the issue of physical inactivity.
People with disabilities should be a high priority for research support. There are now over 11m people living in the UK (750m worldwide) with long-term illness or disability. Within the Centre for DisAbility Sport and Health at the University of Bath we are interested in the benefit of physical activity on the health of individuals across a range of disabling conditions that lead to mobility impairments.
Tanni Grey-Thompson, one of the UK’s most successful Paralymic athletes, said, “The Commonwealth Games is the one event that does integration properly.” So it is important that we capitalise on this legacy. In light of the negative consequences that being sedentary can have on health and well-being, it is crucial that efforts are made to help people with a disability overcome the barriers to engage in physical activity. Developing achievable physical activity guidelines that can enhance people’s lives is one place to start.