Are we really moving people to move? A systematic review of physical activity intervention effectiveness in persons with physical disability


Purpose: Among samples of persons with physical disabilities, the overall and relative effectiveness of theory-based, physical activity (PA)-enhancing intervention strategies is unknown. The purpose of this systematic review was to evaluate the empirical evidence and use of theory in interventions and their effects on PA behaviour in persons with physical disability. Methods: Medline, Embase, PsychINFO, and AMED databases were searched for randomized controlled trials that tested the effects of a PA intervention in persons with physical disability (spinal cord injury, multiple sclerosis, cerebral palsy, osteoarthritis, stroke, fibromyalgia, amputees, and Parkinson's Disease). A total of 22 articles met the inclusion criteria. Data were extracted regarding participant demographics, theories and interventions employed, and effects on PA behaviour were synthesized. Results: The majority of interventions were classified as behavioural (n=18) and/or informational (n=15). Social interventions (n=13) were always delivered in conjunction with the former intervention types. No studies evaluated the impact of environmental interventions. More than half of the articles (n=14) explicitly used a theory to guide intervention development. Less than one third of interventions demonstrated significant improvements in PA behaviour from control, all of which were guided by theory (n=6). Conclusion: The literature examining the effects of PA interventions in persons with physical disability is limited. Future research should use theory to guide intervention development and carefully consider which behaviour change strategies are most likely to bring forth the greatest impact on PA behaviour.