Physical activity for people with a disability: a conceptual model.

The promotion of a physically active lifestyle has become an important issue in health policy in first-world countries. A physically active lifestyle is accompanied by several fitness and health benefits. Individuals with a disability can particularly benefit from an active lifestyle: not only does it reduce the risk for secondary health problems, but all levels of functioning can be influenced positively. The objective of this article is to propose a conceptual model that describes the relationships between physical activity behaviour, its determinants and functioning of people with a disability. The literature was systematically searched for articles considering physical activity and disability, and models relating both topics were looked for in particular. No models were found relating physical activity behaviour, its determinants and functioning in people with a disability. Consequently, a new model, the Physical Activity for people with a Disability (PAD) model, was constructed based on existing models of disability and models of determinants of physical activity behaviour. The starting point was the new WHO Model of Functioning and Disability, part of the International Classification of Functioning, Disability and Health (ICF), which describes the multidimensional aspects of functioning and disability. Physical activity behaviour and its determinants were integrated into the ICF model. The factors determining physical activity were based mainly on those used in the Attitude, Social influence and self-Efficacy (ASE) model. The proposed model can be used as a theoretical framework for future interventions and research on physical activity promotion in the population of people with a disability. The model currently forms the theoretical basis for a large physical activity promotion trial in ten Dutch rehabilitation centres.