Fitness facilities have potential to serve as places of 'health enhancement' for many underserved populations, particularly among people with physical/mobility disabilities where walking outdoors to meet recommendations for regular physical activity is not an option due to mobility or safety issues. To examine the accessibility and usability of fitness facilities across the U.S. from a broader framework of physical and program access. A convenience sample of 227 fitness facilities in 10 states were assessed by trained evaluators using the Accessibility Instrument Measuring Fitness and Recreation Environments (AIMFREE) tool. Non-parametric tests were performed to determine whether AIMFREE section scores were different by geographic region (urban, suburban), business type (nonprofit, for-profit), facility affiliation (fitness center/health club, park district/community center, hospital/rehabilitation facility, university/college), and facility construction date (pre/post passage of the Americans with Disabilities Act, ADA). Raw scores were converted to scaled scores with higher scores indicating better accessibility based on a criterion-referenced approach. Section scale scores (11/13) were low (<70) with differences found across facility affiliation. While facilities built after passage of the ADA had higher accessibility scores compared to pre-ADA facilities, only programs and water fountains had scaled scores ≥70 regardless of facility construction date. There exists a strong and urgent need to encourage owners and operators of fitness facilities to reach a higher level of accessibility. Until then, many people with physical/mobility disabilities will continue to have limited access to programs, equipment, and services offered at these facilities.

People with neuromuscular disabilities have high rates of sedentary behavior predisposing them to severe deconditioning and significant health risk. We describe this as disability-associated low energy expenditure deconditioning syndrome and propose new approaches for promoting light-to-moderate intensity physical activity in people with disabilities.

Adults with intellectual disabilities (ID) are more likely to lead sedentary lifestyles and have low levels of physical activity (LLPA). The present study investigated the prevalence of reported LLPA and time spent watching TV in adults with ID and identified the associated factors for these behaviors. The proxy informants of 1618 adults with ID completed the surveys regarding their health behaviors. Multiple logistic regressions were employed for LLPA and multiple linear regressions for time spent watching TV. About 60% of adults with ID had LLPA and average time spent watching TV was 3.4 h a day. Some characteristics and health and function variables were identified as associated factors. While engaging in community activities and involvement in Special Olympics were inversely associated with LLPA, they were not associated with time spent watching TV. Attending day/educational programs or being employed were associated with spending less time watching TV. Findings highlight differential factors associated with LLPA versus TV-watching behavior in adults with ID. Hence, a key strategy aimed at increasing physical activity includes promoting participation in social and community activities, while targeted activities for reducing sedentary behavior might focus on providing day programs or employment opportunities for adults with ID.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet