Factors influencing physical activity participation
If, in general, adults with VI do not participate in sufficient physical activity, it is important to understand the main reasons for that fact, as it could be very helpful for supporting appropriate measures to help people with VI to become more active. In the next paragraphs, we highlight a myriad of factors that have been related to physical activity engagement of people with VI.
We found three studies that followed a quantitative approach (questionnaires) to collect data on the barriers for physical activity participation in adults with VI. One study conducted in the USA reported that the main barriers for physical activity perceived by adults with VI were lack of self-discipline, motivation, and transportation to get to the place of exercise (Lee et al., 2014). In one investigation conducted in Brazil, the main barriers pointed by the participants include problems related to sidewalks, lack of appropriate areas, no support from public entities, need of a guide, lack of opportunities for activities from specialized institutions, and no safety precautions at facilities to prevent accidents (Marmeleira et al., 2018). Another related study focused on the factors influencing sport participation of individuals with VI showed that those who did not regularly participate in sports mentioned mostly their disability, costs, no possibilities to exercise with peers/buddy, and problems with transport as barriers to sports and exercise (Jaarsma et al., 2014). In this study, the most mentioned facilitators for becoming and staying motivated in sports were health, fun, acquiring social contacts, and support from family.
We have also found some studies that used qualitative designs to collect information on barriers to physical activity. One of these studies interviewed two participants who are blind (a girl aged 12 years and a man aged 23 years). The most relevant factors for physical activity participation were having good instructors, support or visual interpreters, active family members, a safe sports environment, having tried many sports, private transportation to the exercise facilities, and a positive social environment, with peers, friends, and family members (Brunes, Krokstad, & Berit Augestad, 2017). In a recent study by Kirk and Haegele (2019), in which eight adults (aged 21-34) were interviewed, barriers for physical activity included lack of transportation and facilities, lack of offer of sports for people with VI, relying on others and not wanting to be a burden, and unwanted attention of sighted people. Interestingly, this study reported that, independently of their experiences with physical activity, the participants recognized the importance of being active because of the health benefits, fun or enjoyment, and social opportunities it provides.
In general, the studies reviewed mention that one of the main problems for people with VI, especially for those with severe loss of vision, is to travel outside their houses with independence and security. This is a challenging issue that could result from a number of aspects, including bad street design and conditions
(e.g., inexistence of safe curb cuts, damaged sidewalks, walking paths occupied by cars), lack of usable information for orientation (e.g., signage), and difficulties in finding and using public transportations. All these elements can restrict physical activity directly, by reducing the time people spent walking outside, or indirectly, by conditioning access to exercise/sport facilities or green areas where people can feel more comfortable and secure for moving than in the public roads (Rimmer, Riley, Wang, &. Rauworth, 2005; Starkoff et al., 2016). Another common barrier for mobility (and physical activity) of people with VI is the occurrence of accidents, including falls and collisions with obstacles (e.g., Riazi, Riazi, Yoosfi, &. Bahmeei, 2016). The occurrence of accidents can lead to losses in independence, as people become fearful of new incidents due to the inability to see hazards or obstacles (Riazi et al., 2016).
Perceived fear of failure and low self-esteem may also discourage participation in sports of people with disabilities (Brittain, 2004). Specifically, Kirk and Haegele (2019) highlighted the importance of past physical activity-related experiences in shaping feelings of competence and, in this way, influence adherence to physical activity. This is very interesting and intertwines with previous evidence that by building a proficient movement repertoire, children become more confident in their motor abilities and foster their engagement in structured and unstructured physical activities, not only during childhood and adolescence but probably also during their adulthood (Robinson et al., 2015). Within this line of thought, it is also noteworthy that women tend to value physical competence for participating in physical activities as well as the attitudes/acceptance of others regarding disability more so than men (Marmeleira et al., 2018). These results are consistent with previous studies, in that women often have a lower self-perception of physical competence than men (Hayes, Crocker, &. Kowalski, 1999; Klomsten, Skaalvik, & Espnes, 2004) and seem to be more affected by negative social stereotypes about disability (Brittain, 2004). Regarding this latter aspect, it was reported that some women indicated that their perceived stigma associated with the use of a mobility aid (e.g., cane) contribute to avoiding activities outside the home, which hinder their ability to engage in a more active lifestyle (Holbrook et al., 2009).
