In a guest blog, Tom Nightingale of The University of Bath talks about the lack of research that is hampering our knowledge of what kind of physical activities proffer the most benefit to the disabled.
Recent findings from the multi-centre European Prospective Investigation into Cancer and Nutrition (EPIC) study found that even modest increases in activity (~ 20 minutes a day) could bring significant health benefits for inactive individuals. This adds to the expanding evidence which suggests regular activity is related to a reduced incidence of many chronic conditions in able-bodied individuals.
Whilst it is encouraging that a relatively small amount of activity can demonstrate a beneficial effect, there is a paucity of research answering this question in various disabled populations. A previous guest blog and various qualitative research studies have highlighted numerous psychosocial and environmental barriers for people with disabilities to engage in physical activity. As such, only two in ten disabled people in England are currently active and more than 70% do not participate in any sport whatsoever (English Federation of Disabled Sport report) This is concerning as figures from across the pond (Centers for Disease Control and Prevention in the US) suggest that adults with a disability who do not perform any physical activity are 50% more likely than their active peers to report at least one chronic disease (cancer, diabetes, stroke or heart disease).
At a population level, various initiatives such as ‘Being Active’ are an extremely useful resource to support behaviour change for the seven in ten disabled people wanting to increase their physical activity.
However, the question still remains what constitutes sufficient physical activity in specific disabled populations? Are the government guidelines of 150 minutes of moderate intensity physical activity per week realistically achievable, considering some of the current barriers and various functional impairments?
Also due to the pathology of various conditions, do individuals with a disability even accrue the same health benefits from meeting these guidelines?
There are now over 11 million people living in the UK with long-term illness or disability. For the past ten years at least, the UK Chief Medical Officer’s Report has made the same statement regarding the lack of evidence to inform policy on the recommended levels of physical activity for disabled people:
‘A good understanding of the health and functional benefits derived from physical activity by persons with disabilities is still limited due to a lack of research’.
Within the Centre for DisAbility Sport and Health at the University of Bath we wish to address this statement across a range of disabling conditions that lead to mobility impairments.
My current research focuses on the impact of home-based moderate-intensity arm crank exercise (4 x 45 minutes per week) on metabolic health, inflammation and fitness in individuals with a spinal cord injury (SCI).
Spinal cord injury creates a complex pathology whereby level and completeness of injury, plus other lifestyle factors can lead to increased sedentary behaviours and alterations in body composition.
A comprehensive systematic review to inform physical activity guidelines specific to this population indicated that most studies were of poor quality and focused on just physical capacity or muscular strength.
Another review (requested by the Consortium for Spinal Cord Medicine) concluded based on the inconsistent findings across studies, that the current evidence is insufficient to determine whether exercise improves metabolic health among adults with SCI.
As a result we are trying to improve our understanding of the potential mechanisms whereby physical activity may influence health in this population, by assessing the expression of key genes in a variety of biological processes.
In order to investigate this we are inviting inactive volunteers with a SCI (between the 2nd Thoracic and 5th Lumbar vertebrae) to the University of Bath on two occasions separated by a six-week exercise intervention or control period.
If you’re interested in finding out more about this research then please contact Tom Nightingale on 01225 384809 or. T.E.Nightingale@Bath.ac.uk.
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