Pushing forward: Understanding physical activity in adults with medical complexity.

Area of Science:

• Health Sciences
• Disability Studies
• Rehabilitation Medicine

Background:

• Adults with severe and profound intellectual disabilities (SPIDs) often have complex healthcare needs and mobility impairments (MIs).
• Understanding physical activity (PA) experiences for adults with SPIDs and MIs post-pediatric care is limited.
• This study examines PA experiences from the perspective of clinicians working with this population.

Purpose of the Study:

• To explore the facilitators and barriers to physical activity (PA) engagement in adults with severe and profound intellectual disabilities (SPIDs) and mobility impairments (MIs).
• To understand the role of clinicians in promoting PA for adults with SPIDs and MIs.
• To identify factors influencing PA across different levels of the socio-ecological model (SEM).

Main Methods:

• Semi-structured interviews were conducted with eight clinicians.
• Interview data was analyzed thematically, organized by the 5-level socio-ecological model (SEM).
• Clinician-identified barriers and facilitators to PA were documented.

Main Results:

• Key facilitators included individualized PA preferences, accessible environments, and strong social support.
• Major barriers involved inaccessibility (transportation, buildings), lack of education on PA needs/opportunities, and clinician reimbursement issues.
• The importance of clinician advocacy and improved home and community-based services (HCBS) was highlighted.

Conclusions:

• Addressing SEM-level factors is crucial for improving PA access and health outcomes for adults with SPIDs and MIs.
• Clinicians are vital in assessing, educating, and promoting PA opportunities for this population.
• Enhanced support and policy changes are needed to foster inclusive PA environments.