Biomedical Engineering Reference
In-Depth Information
In children, participation in PA is considered to have a positive impact on childhood
health (Ekelund et al. 2004; Metcalf et al. 2004) and have beneficial effects on their future
health status (Strong et al. 2005) by promoting lifetime PA participation (Huang et al. 2009).
On the other hand, physical inactivity has been implicated in the increasing epidemic of
overweight and obesity (Wang and Lobstein 2006; WHO 2010) and metabolic morbidi-
ties among children and adolescents (Strong et al. 2005). The multidimensional benefits of
regular participation in PA by children and adolescents impacts the areas of health, social-
ization, discipline, and physical fitness (Sallis and Patrick 1994; Martens 1996). Evidence-
based data indicate strong favorable effects on musculoskeletal and cardiovascular health
(Strong et al. 2005). The benefits of PA among children are universal such that they encom-
pass those with chronic diseases and disabilities as well (Murphy and Carbone 2008;
Huang et al. 2009).
19.2.1 Adapted Physical Activity
Adapted physical activity (APA) programs deal with specific populations and have evolved
from being integrated in rehabilitation interventions into services that support persons
of all ages who need adaptation in PA participation in any kind of setting (Hutzler and
Sherrill 2007). It has been considered as one of the most viable service delivery systems
for persons with disabilities (Sherrill 2004), but the clientele may also include those who
are obese, aged, or very young. Essentially, APA is directed toward making participation
in physical activities possible for everyone. Although APA programs have been initially
focused on facilitating better physical function, they have also been recognized as effec-
tive enablers of improved well being, enhanced self-worth, and a sense of empowerment
(Pensgaard and Sorensen 2002; Winnick 2005). As a field of study and practice, APA has
also evolved into a multi-, inter-, or cross-disciplinary movement, which reflects the varied
stakeholders who are concerned with the goal of universal promotion of PA (Sherrill 2004).
Extensive research in PA has led to convincing evidence supporting the importance of
being physically active in terms of health and well-being, and challenges have shifted toward
the dissemination of evidence-based interventions (Rabin et al. 2006). However, the current
status of research in APA is relatively less definitive and has been focused on establishing
epidemiologic data (Sharav and Bowman 1992; Bandini et al. 2005; Foley et al. 2008) and
clarifying measurement issues (Horvat et al. 1993; Fernhall and Unnithan 2002; Mackey et
al. 2009; Capio et al. 2010). Factors related to APA participation by different groups have also
been examined to gain an improved understanding and promote the removal of barriers to
active involvement in PA (Law et al. 2006; Warms et al. 2007; Sit et al. 2009). Cross-sectional
descriptive studies have suggested that APA programs lead to multidimensional benefits
for individuals with disabilities (Bjornson et al. 2008; Groff et al. 2009). More recently, a
growing number of intervention studies have also manifested indicators of positive effects
of APA programs for specific participant groups (Driver and Ede 2009; Daniel et al. 2010).
19.2.2 Types of APA Programs
Physical activity has been defined as any body movement produced by the forces of skel-
etal muscles resulting in increased energy expenditure above the resting level (Bouchard
and Shephard 1994). This definition is broad enough for types of PA to include active trans-
port (e.g., walking and cycling), housework, recreational games and activities, dance, and
deliberate sport or exercise (Cavill et al. 2006). As such, APA programs have been varied
not only in terms of population groups, but in terms of types of PA as well. Although this
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