Practical implications and future research
In this section, we present some practical strategies to enhance the participation of people with VI in exercise, sports, and other forms of physical activity. Although there is some empirical evidence supporting the implementation of the strategies proposed here, future research is necessary to test their level of effectiveness in changing the lifestyles of people with VI.
One possible solution that can be provided by national or local governments, or even non-governmental organizations (NGOs), is the creation of community transportation that facilitates people with some sensorial or motor difficulties to get to sports facilities or public green spaces. Several studies (Jaarsma et al., 2014; Phoenix, Griffin, &. Smith, 2015) verified that the difficulty in access to public transport is one of the main barriers for sports participation pointed by people with VI. By providing a closer and more personalized service for this population, authorities are creating real opportunities for sports participation for all.
System of peers
Another barrier frequently pointed by persons with VI is the lack of peers for sports participation (Jaarsma et al., 2014). In this regard, Jaarsma et al. (2014) suggested that a system of peers could be planned for increasing participation in activities such as walking, fitness, and recreational cycling. For example, walking and hiking clubs could be organized in a way that some of its sighted members receive a brief training on guiding persons with VI, facilitating their inclusion in the activities. Besides, this could also lead to higher confidence of people with VI to walk independently daily. Jaarsma et al. (2014) also pointed out that a possible solution for including people with VI in cycling clubs is the use of tandem cycling, which pairs cyclists with and without Vis. The benefits of these type of activities, where people with disabilities act side-by-side with people with VI, are not only limited to physical activity behavior but are also relevant at the level of social integration and participation (Anna Malwina & Krzysztof, 2015). The use of adult peer mentors as a strategy for helping inactive adults to become physically active is being currently studied among the general population (O'Regan et al., 2019) and should be extended to include people with VI.
Exercise programs at specialized institutions
Many persons with VI engage at some point in their lives with institutions that provide specialized assistance (e.g., education, rehabilitation, and/or orientation &. mobility programs). This puts these institutions in a privileged position to introduce supervised exercise programs and to educate people with VI in improving their daily physical activity habits since they, in most cases, have all the technical and human assistance needed for these programs to succeed. These programs could also tackle a number of barriers pointed by people with VI (Jaarsma et al., 2014; Marmeleira et al., 2018; Phoenix et al., 2015). Thus, since people already commute to the institutions, no extra transport is needed to get to a sports facility, and, importantly, people with VI can have access to supervised exercise with their peers at institutions they already know well. As such programs could also be designed around exercise classes, the social component could also act as a factor for maintaining people participating regularly (Jaarsma et al., 2014). These exercise programs should also focus on developing the autonomy of persons with VI while teaching through these programs a set of safe physical exercises and practices that people could replicate at home after they finish the main program provided by the institution.
Home-based and technology guides
Mobile exercise applications (apps) have also been demonstrated to be a successful strategy in the general population to increase leisure time exercise activity (Litman et al., 2015) and to improve exercise motivation, especially thought gamification techniques (Kari et al., 2016). These apps are extremely convenient because they help users to exercise at home. This seems particularly convenient for people with VI since transportation is one of the main barriers to exercise participation (Jaarsma et al., 2014). Nowadays, users can find thousands of exercise apps in the main mobile app stores, with video and/or illustrations and audio instructions to guide users throughout the exercise sessions. Unfortunately, most of them rely mostly on visual cues and offer insufficient audio instructions for people with VI. One possible solution, that should be tested in future research, is the development of an audio-based and home-based exercise program, with detailed instruction tailored for people with VI. This program could also be developed through a mobile app or as a simple system of direct audio file exchange, through email or even instant messaging.
Walkability and technology
Walking could be an inexpensive and effective way to improve daily physical activity and to stimulate significant health benefits (Bravata et al., 2007; Morris & Hardman, 1997). Walking has been reported as the most common form of exercise from people with VI (Jaarsma et al., 2014), and some strategies to improve walking behavior have been tested. Ackley-Holbrook, Kang, and Morgan (2016) developed an 8-week physical activity intervention called “Walk for Health" where adults with VI using pedometers were challenged to progressively increase their daily number of steps by 1,000 steps/day every two weeks. The results showed that participants had a 78% increase in step activity at the end of the 8-week pedometer-based intervention. Although the use of pedometers could be an effective strategy to increase physical activity and improve participants’ health (e.g., Bravata et al., 2007), one should consider that nowadays, almost everyone can have an accelerometer in his/her pocket due to the proliferation of smartphones. The smartphones’ accelerometer can also act as an effective step counter (Akerberg, Soderlund, & Linden, 2016; Douma, Verheul, & Buffart, 2018), and a number of studies have concluded that smart-phone-based interventions are also well succeeded on improving people’s daily physical activity (Glynn et al., 2014; Kirwan, Duncan, Vandelanotte, &. Mummery, 2012). Since people with VI have widely adopted smartphones (WebAIM, 2019), we are convinced that future research should investigate their use as a strategy to promote physical activity in this population. To address the navigation difficulties of outdoor walking faced by people with VI, some possible strategies should also be considered, such as the use of smartphone turn-by-turn navigation audio assistants for online maps (Ahmetovic et al., 2016; Matard et al., 2017) that rely on Global Positioning System (GPS) sensors and/or Bluetooth beacons, and the use of tactile maps (Giraud, Brock, Mace, &. Jouffrais, 2017; Gual, Puyuelo, Lloveras, & Merino, 2012).