The impact of (adapted) sports participation on health in youth with a chronic disease or physical disability

Abstract

In typically developing youngsters, participation in sports has been proven to be positively correlated to both physical and psychosocial health outcomes. In youngsters with a physical disability or chronic disease (CDPD) participation in both recreational and competitive sports is often reduced, while for this population an active lifestyle may be even more important in reaching optimal levels of physical and psychosocial health. Therefore, the aim of this research is to determine both negative and positive effects of sports on children and adolescents with CDPD. The main objective of this study was to investigate the association of (adapted) sports participation with health-related fitness, physical activity, psychosocial health, and injuries and illness among youngsters with CDPD. A secondary objective is to develop and validate an instrument to measure physical activity in ambulatory youngsters with and without motor disability. Furthermore, based on scientific evidence, recommendations were made for instruments measuring physical activities in daily life in youngsters who use a wheelchair. Youngsters with CDPD participating at least twice weekly in (adapted) organized sports performed better on all health-related outcome parameters, compared with their non-sporting peers and those who participated in sports once a week. They have a significantly higher oxygen uptake (VO2peak), they achieved a higher power on the muscle power sprint test, are faster on the 10x5 meter sprint test, have a higher hand grip strength and were able to jump further. They also appeared to have a healthier weight, a better body composition and a lower percentage of fat compared to their non-sporting peers or those who participate once a week. Sports participants who participate twice weekly in sports are more active in daily life (on average 30 minutes a day), has a higher quality of life and self-efficacy, feels more athletically competent in comparison their non-sporting peers and those who participate in sports once per week. In addition, thresholds of less than 35 ml/kg/min for VO2peak, more than 73 cm for waist circumference and -0.05 units of waist circumference standard deviation score were associated with increased arterial stiffness. Participation in sports at least two times a week does not pose a significant increased risk in the incidence of injury or illness per 1000 hours of PA in youngsters with CDPD compared to once weekly or no sports participation. Sports participants get injured mostly during their sporting activities, while non-sporting peers get injured during physical education (PE) lessons or non-organized sports and play in leisure time. The Activ8 is a valid tool measuring the type of physical (in)activity in daily life in youngsters with typical development and peers with motor disability, and can be used to monitor and evaluate interventions targeting physical activity (PA). According to current literature, two questionnaires seems promising for measuring the intensity of PA in people who use a wheelchair. For objective measurement of PA, four devices showed positive criterion validity to measure intensity of PA in wheelchair users, for measuring the type of PA two devices are suitable, showing both good evidence for criterion validity.