|dc.description.abstract||Introduction: Physical activity (PA) participation is promoted and encouraged for all of the population. Despite this, persons with disability, and especially those with severe disability, are less physically active than the able-bodied population, with consequent impact on their overall health and well-being. Reasons for this may be due to the severity of impairment and the presence of multiple impairments. However, it may also be a consequence of expectations about participating in PA, from self and others, combined with environmental barriers in accessing PA opportunities which may be especially pertinent when the individual lives in residential care. This study aimed to investigate and evaluate the processes required to implement PA for individuals with severe neurological disability who live in a residential service.
Method: This study used a qualitative case study design made up of a series of five individual cases (three men, two women) who lived in one residential care facility. Each case involved planning and where possible, implementation of an individualised mode of PA for the participant over a six week time-frame. Data was collected via notes of observations, notes from reflections and discussions with the supervisory team and with an advisory team, as well as semi-structured interviews with participants at six and 12 weeks. The case series was analysed and synthesised inductively for common themes to reveal processes that hindered or promoted participation in PA, and to discover what the experience meant for the study’s participants.
Results: All five participants completed the intervention. Four participants were successful in achieving participation in PA. Participants identified physical, social, or emotional benefits to being physically active. Analysis revealed three broad themes: 1) There’s more than one road to Rome, 2) Benefits and barriers, and 3) The ripple effect. The themes identified that the approach to PA participation needs to be individually adapted but that a simplicity of approach proved to be the most sustainable, that individuals with disabling conditions are interested in being physically active for its worth towards their health and well-being, and that ideas and interest in PA participation can spread throughout a residential service where individuals live together and interact on a daily basis with staff of the service.
Conclusion: This study found that it is possible to achieve individualised PA for people with severe neurological disability, when they are provided with support to facilitate the process. The three main themes identified suggest that being physically active is important to people with severe disability and therefore health care providers have a responsibility to seek ways of engaging their clients in more PA. Health care professionals will need to be creative and learn to problem-solve in order to do this, however, once this process is started the ‘ripple effect’ might result in widening awareness and action regarding the PA of persons with severe disability. This study informs individuals with disabilities and their support persons, health care professionals who work with individuals as well as people who provide PA opportunities or funders of health care for individuals with disabling conditions that necessitate residential care, about ways for their clients to achieve health and well-being via PA for their clients and the benefits they may receive from it.||