The Effects of Sport Participation for Adults With Physical or Intellectual Disability: A Scoping Review.

BACKGROUND: Adults with physical or intellectual disability are less active than those without disability. OBJECTIVE: To review literature regarding sport participation in adults with physical or intellectual disability. Specifically, to examine characteristics of available studies including participants, interventions, outcomes, and impact. METHODS: A scoping review was completed. Searches of 6 databases and a trial registry plus citation tracking were undertaken. Two independent reviewers screened items for eligibility and extracted data about the studies, participants, interventions, and outcomes. A single reviewer extracted data to quantify impacts of sport participation, classified as favorable, insignificant, or unfavorable. RESULTS: 164 studies involving 11,642 participants were included. Most studies (128/164) used a cross-sectional design. Most participants were men (81%) with physical disability (135/164), and spinal cord injury was the most prevalent underlying health condition (54%). Most studies evaluated a mix of sports (83/164) in a disability-specific context (159/164), with basketball or wheelchair basketball being the most common individual sport (28/164). Physical impairment was the most frequently reported outcome domain (85/334 results). Sports participation impact was classified as 55% favorable, 42% insignificant, and 3% unfavorable. CONCLUSIONS: There were many favorable and few unfavorable outcomes for participation in sport for adults with physical or intellectual disability. More research is needed to address the evidence gaps of gender, health condition, and type of sport, and to use more rigorous research designs to evaluate the effects of sport participation. While new evidence is generated, we suggest adults with physical or intellectual disability be encouraged to engage in sport. REGISTRATION: PROSPERO registration number CRD42018104379.

Effects of sport or physical recreation for adults with physical or intellectual disabilities: a systematic review with meta-analysis.

OBJECTIVES: To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Six databases searched from inception to May 2022. ELIGIBILITY CRITERIA: Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control. RESULTS: Seventy-four trials (n=2954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n=469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n=801) with low certainty evidence and balance (Berg Balance Scale, range 0-56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n=906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n=468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n=486). CONCLUSION: Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity. PROSPERO REGISTRATION NUMBER: CRD42018104379.

Aspiring physicians program: description and characterization of the support processes for an undergraduate pathway program to medicine.

Latinx physician rates are lower than non-Latinx white physicians. Many pathway programs to careers in medicine have been established for underrepresented students, yet few focus on premedical college education or undergraduate pathway programs, which marks a critical junction in the commitment to and preparation for application to medical school. Moreover, little is known about the program components which prepare and support learners. Framed by Swail's Model for Persistence and Achievement, we characterize how a given program's components impact support and growth for participating students. Using the process step of the Context, Input, Process, and Product evaluation model, we conducted focus groups at the end of the program, with four cohorts of student participants between 2019 and 2022. Focus groups identified strengths and limitations in content and delivery to improve program effectiveness and plan for the future of a program. We used thematic analysis, following an inductive approach, to analyze data from transcribed focus groups. A total of 66 of 81 (81.5%) students participated in focus groups. Students described that supportive program components include long-term mentorship and advising that builds trust, academic preparation for medical school, early exposure to clinical career exploration, tools to articulate students' personal narrative, methods to recognize and address challenging situations in the professional environment, community leadership development, and leveraging health policy and advocacy to empower students to create systems change within communities. Our findings affirm and provide a needed account of program components known to be contributors to student success in undergraduate pathway programs. Our evaluation also characterizes additional supportive processes not discussed elsewhere. Our findings contribute to knowledge about development and implementation of undergraduate pathway programs and the components by which these programs create opportunities for success among underrepresented students aspiring to careers in medicine.