Increasing Physical Activity for Women with Mobility Disabilities through Structured Programs

Research Questions

Can an exercise program promote increased physical activity among women with mobility impairments? Would this program promote improve psychological and physical health?

Purpose and Anticipated Benefits

This study sought to develop a program that women with disabilities could use to increase their activity levels.

Who

Katherine Froehlich Grobe, Research and Training Center on Independent Living at the University of Kansas, enrolled 93 women from the metro Kansas City, Missouri, area with various mobility impairments. With ages ranging from 21 to 58, the average age was 44.4.  Of the women, 73% were white; 26%, black; 6%, Native American; and 2%, Hispanic. Fifty-nine percent used one or more assistive devices. Forty-three percent were married; 30%, divorced; 22%, never married; and 4% separated or widowed. Most (65%) had children; 34% had their children living with them.

When

1997

Method

The six-month program funded by the Centers for Disease Control started with an all-day educational workshop encouraging participants to increase their weekly physical activity levels. Participants also were introduced to a program the researcher created to assist participants with engaging in physical activity at home or in a community location. Several components promoted increased activity: an educational workshop, individualized physical activity counseling, weekly monitoring of physical activity levels, partner pairing with a peer, and self-reward for goal attainment.

Participants were randomly assigned to an exercise group or control group on the waiting list to do the exercise program. The women kept weekly records on their activity. They also were monitored for weight, body fat, cholesterol levels, blood pressure, depression levels, sleep problems, chronic pain, bladder problems, timed performance on the fitness course and several more conditions. Grobe asked the women to use a partner, and many didn't.

Results

Twenty-five percent of the women dropped out of the program. Those who stayed put in 100 minutes of cardiovascular activity each week. In line with new exercise guidelines suggesting about 150 minutes or more in cardiovascular activities, these women actually did more than 150 minutes of activity when factoring in their strengthening and stretching activities. While activity adherence varied over the 25 weeks, participants’ activity patterns revealed they occasionally had short bouts of inactivity and then resumed activity within one to four weeks rather than stopping activity altogether.

Despite participants increased activity levels, they did not experience significant physiological and psychological changes immediately following the six-month intervention. However, qualitative data collected from phone interviews after the intervention revealed that 78% of participants felt that increasing their physical activity fostered positive changes in other life areas. Women talked about things like gaining more self-confidence, feeling more energetic, becoming more active and doing things like going back to school and visiting friends, and being prompted to think more about their health. More than one-quarter of the women reported having increased strength, 23% reported increased energy, and 23% reported increased endurance. Further, more than half of the women reported positive changes in their mental state such as having better concentration, feeling motivated, and feeling a sense of accomplishment and confidence about doing something they had not thought they could do.

Conclusion

This intervention successfully promoted increased participation in physical activity for women with disabilities over six months. Although the women did not show significant changes in weight, blood pressure, and other areas while doing more physical activity, the activity did not appear to be enough to make significant physical changes. This may have been because the program wasn't long enough, the researchers thought.

"Another reason we didn't see a larger effect on health outcomes was because so many ─ nearly everybody ─ was doing a different type of program," Grobe said. "So we really ended up comparing apples and oranges. And 75% of the women who had gone through the program told us that they did experience other improvements and things like their strength, endurance, ability to sleep better, and their ability to engage in other activities that they now had energy for."

Another plus, Grobe said was the feeling of accomplishment. "Many of the women told us, 'you guys told me I could do something I never even thought I could or should be doing, and I tried it and I could do it.' It felt great and several women stated that accomplishment fed into other areas of their life."

Participants said they found the weekly logs to be the most motivating part of the program. Many said they thought weekly feedback on their efforts would have been helpful.

Products

Grobe, K.F., & White, G.W. (2004, April). Promoting physical activity among women with mobility impairments: A randomized controlled trial to assess a home- and community-based intervention. Archives of Physical Medicine and Rehabilitation 85, 640-648

Grobe, K. F., & Nary, D.E. (2002, October 23). Webcast: Physical activity and independent living: What's the connection? Houston, TX: Independent Living Research Utilization.

Nary, D. E., Pulvers, K.M., & White, G. W. (2002). Testing a home physical activity program for persons with physical disabilities.  Presentation at DisAbility Forum of the American Public Health Association, Philadelphia, PA.

Nary, D. E.,Froehlich, K., & White, G. W. (1999). Barriers to physical activity for women with disabilities: Results of a statewide survey. Presentation at the Centers for Disease Control and Prevention's Promoting the Health & Wellness of Women with Disabilities Conference, San Antonio, TX.

Nary, D. E.,Froehlich, K.F., White, G. W., Bigelow, K., & Thompson, C. (1998). Using behavioral methods to increase physical activity levels of women with physical disabilities. Poster presented at the DisAbility Forum, American Public Health Association Annual Conference, Washington, DC.

Froehlich, K.F. & Nary, D.E. (1997). Increasing physical activity for women with disabilities.  Paper presented at the DisAbility Forum, American Public Health Association Annual Conference, Indianapolis, IN.