Barreiras ambientais à atividade física entre pessoas com deficiência motora na Indonésia
DOI:
https://doi.org/10.47197/retos.v72.116559Palavras-chave:
inclusão de pessoas com deficiência, modelo de ecologia da saúde, deficiências de mobilidade, barreiras à atividade física, barreiras estruturaisResumo
Introdução: Considerando as evidências globais de profundas disparidades nas atividades físicas que afetam as pessoas com deficiência de mobilidade, as investigações contextuais em casos de baixa gravidade, como a Indonésia, são extremamente limitadas.
Objectivo: De um modo geral, este estudo identifica as principais barreiras à participação em actividades físicas nesta população utilizando o modelo da Ecologia da Saúde, analisando especificamente a comparação de variáveis do tipo de deficiência com base na mobilidade, sexo, educação e outras barreiras.
Metodologia: Aplicando o Modelo da Ecologia da Saúde, este estudo transversal identificou as principais barreiras à participação em 75 participantes com deficiência de mobilidade em cinco províncias de Java, utilizando o instrumento BPAQ-MI (SPSS v25; estatística descritiva, AFE, Spearman, regressão logística).
Resultados: A inacessibilidade às infraestruturas/transportes foi a barreira dominante (83%), reduzindo significativamente a probabilidade de participação (OR = 0,11, p = 0,01). O apoio familiar aumentou a participação (r = 0,301, p = 0,001), ultrapassando as limitações intrapessoais (61%) e interpessoais (57%). Discussão: Embora as barreiras estruturais e gerais estejam alinhadas com os padrões globais, a centralidade da familiaridade (OR = 2,3) contrasta com os modelos de sociedade individual que influenciam a influência dos pais.
Conclusões: Este estudo identifica as barreiras estruturais como o principal impedimento à atividade física na Indonésia com deficiências de mobilidade, ultrapassando os fatores intrapessoais e interpessoais, o que revela deficiências sistémicas nos sistemas inclusivos de deficiência. Por conseguinte, é imperativo transformar a infraestrutura acessível, as políticas inclusivas e as regras parentais; pesquisas futuras requerem desenhos de métodos mistos, coortes multirregionais e análises longitudinais para analisar os determinantes socioculturais e a eficácia das intervenções.
Referências
Ascondo, J., Martín-López, A., Iturricastillo, A., Granados, C., Garate, I., Romaratezabala, E., Martínez-Aldama, I., Romero, S., & Yanci, J. (2023). Analysis of the Barriers and Motives for Practicing Physical Activity and Sport for People with a Disability: Differences According to Gender and Type of Disability. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021320
Ashadi, K., Setijono, H., Wiriawan, O., Wijono, W., Wibowo, S., Andriana, L. M., Sidik, R. M., Utami, T. S., Hafidz, A., Purnomo, M., Jatmiko, T., Kusuma, D. A., Wulandari, F. Y., Fajar, M. K., Widohard-hono, R., Daulay, D. A. A., & Zolkafi, M. A. A. (2024). Comparison of barriers to physical activity to levels of physical activity and psychological well-being based on the demographic environ-ment in the vision impairment disability group. Retos, 59, 1158–1167. https://doi.org/10.47197/retos.v59.108122
Bailie, J., Fortune, N., Plunkett, K., Gordon, J., & Llewellyn, G. (2023). A call to action for more disabil-ity-inclusive health policy and systems research. BMJ Global Health, 8, 11561. https://doi.org/10.1136/bmjgh-2022-011561
Barreno, M., Sisa, I., Cecilia, M., García, Y., Shen, H., Villar, M., Kovalskys, I., Fisberg, M., Gomez, G., Rigotti, A., Cortés, L. Y., Pareja, R. G., Herrera-Cuenca, M., & Guajardo, V. (2021). Association between built environment and physical activity in Latin American countries: a multicentre cross-sectional study. BMJ Open, 11, 46271. https://doi.org/10.1136/bmjopen-2020-046271
Bethancourt, H. J., Rosenberg, D. E., Beatty, T., & Arterburn, D. (2014). Barriers to and Facilitators of Physical Activity Program Use Among Older Adults. Clinical Medicine & Research, 12(2), 10–20. https://doi.org/10.3121/cmr.2013.1171
Botagariyev, T., Mambetov, N., Aralbayev, A., Mukhanbetaliyev, A., Ispulova, R., & Akhmetov, N. (2023). Web-Based Technologies in Middle School Physical Education. Retos, 51, 172–178. https://doi.org/10.47197/retos.v51.100310
Boucher, T. Q., McIntyre, C. L., & Iarocci, G. (2023). Facilitators and Barriers to Physical Activity In-volvement as Described by Autistic Youth with Mild Intellectual Disability. Advances in Neuro-developmental Disorders, 7(4), 512–524. https://doi.org/10.1007/s41252-022-00310-5
BPS. (2020). Peraturan Kepala Pusat Statistik Nomor 120 Tahun 2020 tentang Klasifikasi Desa Perkotaan dan Perdesaan di Indonesia. Badan Pusat Statistik. https://ppid.bps.go.id/upload/doc/Perka_BPS_Nomor_120_Tahun_2020_Tentang_Klasifikasi_Desa_Perkotaan_dan_Perdesaan_di_Indonesia_Tahun_2020_1659511791.pdf
Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psy-chologist, 32(7), 513–531. https://doi.org/10.1037/0003-066X.32.7.513
Carmichael, J. H., Kalagher, K. M., Reznek, M. A., & Modi, P. (2023). Improving Accessibility in the Emergency Department for Patients with Disabilities: A Qualitative Study. Western Journal of Emergency Medicine, 24(3), 377–383. https://doi.org/10.5811/WESTJEM.58406
Dairo, Y. M., Collett, J., Dawes, H., & Oskrochi, G. R. (2016). Physical activity levels in adults with intel-lectual disabilities: A systematic review. Preventive Medicine Reports, 4, 209–219. https://doi.org/10.1016/j.pmedr.2016.06.008
Declerck, L., Stoquart, G., Lejeune, T., Vanderthommen, M., & Kaux, J. F. (2021). Barriers to develop-ment and expansion of adaptive physical activity and sports for individuals with a physical dis-ability in sports clubs and centres. Science and Sports, 36(3), 202–209. https://doi.org/10.1016/j.scispo.2020.12.002
Devarajan, R., Prabhakaran, D., & Goenka, S. (2020). Built environment for physical activity—An urban barometer, surveillance, and monitoring. Obesity Reviews, 21(1), 12938. https://doi.org/10.1111/OBR.12938
DHDS. (2020). Disability and Health Data System (DHDS). DHDS. https://www.cdc.gov/dhds/about/?CDC_AAref_Val=https://www.cdc.gov/ncbddd/disabilityandhealth/dhds/index.html
Elekanachi, R. U., Shikako, K., Snider, L., & Dahan-Oliel, N. (2023). A Portrait of the Rights of Children with Disabilities in Nigeria: A Policy Review. International Journal of Environmental Research and Public Health, 20(21), 6996. https://doi.org/10.3390/IJERPH20216996/S1
Fagher, K., Deluca, S., Derman, W., & Blauwet, C. (2022). Optimising health equity through para sport. British Journal of Sports Medicine, 57(3). https://doi.org/10.1136/bjsports-2022-106229
Garcia, L., Mendonça, G., Bertoldo Benedetti, T. R., Justino Borges, L., Amanda Streit, I., Christofoletti, M., Lopes Silva-Júnior, F., Bosquiero Papini, C., & Angélica Binotto, M. (2022). Barriers and fa-cilitators of domain-specific physical activity: a systematic review of reviews. BMC public health, 22(1), 1964. https://doi.org/10.1186/s12889-022-14385-1
Ginis, K., van der Ploeg, H. P., Foster, C., Lai, B., McBride, C. B., Ng, K., Pratt, M., Shirazipour, C. H., Smith, B., Vásquez, P. M., & Heath, G. W. (2021). Participation of people living with disabilities in physical activity: a global perspective. The Lancet, 398(10298), 443–455. https://doi.org/10.1016/S0140-6736(21)01164-8
Jacinto, M., Vitorino, A. S., Palmeira, D., Antunes, R., Ferreira, J. P., Bento, T., & Matos, R. (2021). Per-ceived barriers of physical activity participation in individuals with intellectual disability—A systematic review. Healthcare, 9(11),521. https://doi.org/10.3390/healthcare9111521
Khani, A., Bahramizadeh, M., Mardani, M. A., & Babaee, T. (2023). Validity and Reliability of the Persian Version of Barriers to Physical Activity Questionnaire for People With Mobility Impairments. Journal of Physical Activity and Health, 20(12), 1116–1124. https://doi.org/10.1123/jpah.2023-0169
Liu, X., Han, H., Li, Z., Huang, S., Zhao, Y., Xiao, Q., & Sun, J. (2025). Barriers and facilitators to participa-tion in physical activity for students with disabilities in an integrated school setting: a meta-synthesis of qualitative research evidence. Frontiers in Public Health, 13, 1496631. https://doi.org/10.3389/fpubh.2025.1496631
Luarte-Rocha, C., López-Casanova, L., Navarro-Gajardo, V., Pleticosic-Ramírez, Y., Sagredo-Aravena, R., Campos, L. F. C. C. de, & Campos-Campos, K. (2023). Awareness Programs Towards People With Disabilities in the School Context, Physical Education and Health. A Systematic Review of the Last 10 Years. Retos, 50, 1281–1288. https://doi.org/10.47197/retos.v50.99529
Ma, Y., Liu, M., Liu, Y., Liu, D., & Hou, M. (2024). Exploring Physical Activity in Children and Adoles-cents with Disabilities: A Bibliometric Review of Current Status, Guidelines, Perceived Barriers, and Facilitators and Future Directions. Healthcare, 12(9), 934. https://doi.org/10.3390/healthcare12090934
MacEachern, S., Forkert, N. D., Lemay, J. F., & Dewey, D. (2022). Physical Activity Participation and Barriers for Children and Adolescents with Disabilities. International Journal of Disability, De-velopment and Education, 69(1), 204–216. https://doi.org/10.1080/1034912X.2021.1952939
Mayo, X., Liguori, G., Iglesias-Soler, E., Copeland, R. J., Clavel San Emeterio, I., Lowe, A., Del Villar, F., & Jimenez, A. (2019). The active living gender’s gap challenge: 2013-2017 Eurobarometers phys-ical inactivity data show constant higher prevalence in women with no progress towards global reduction goals. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-8039-8
McDermott, G., Brick, N. E., Shannon, S., Fitzpatrick, B., & Taggart, L. (2022). Barriers and facilitators of physical activity in adolescents with intellectual disabilities: An analysis informed by the COM-B model. Journal of Applied Research in Intellectual Disabilities, 35(3), 800–825. https://doi.org/10.1111/jar.12985
Mckenzie, G., Willis, C. and Shields, N. (2021). Barriers and facilitators of physical activity participation for young people and adults with childhood-onset physical disability: a mixed methods system-atic review. Developmental Medicine and Child Neurology, 63(8), 914–924. https://doi.org/10.1111/dmcn.14830
Michalsen, H., Henriksen, A., Hartvigtsen, G., Olsen, M. I., Pedersen, E. R., Søndenaa, E., Jahnsen, R. B., & Anke, A. (2024). Barriers to physical activity participation for adults with intellectual disability: A cross-sectional study. Journal of Applied Research in Intellectual Disabilities, 37(4). https://doi.org/10.1111/jar.13242
Monforte, J., Úbeda-Colomer, J., Pans, M., Pérez-Samaniego, V., & Devís-Devís, J. (2021). Environmental Barriers and Facilitators to Physical Activity among University Students with Physical Disabil-ity—A Qualitative Study in Spain. International Journal of Environmental Research and Public Health, 18(2), 464. https://doi.org/10.3390/IJERPH18020464
Moro, L., Colere, J., & Lange de Souza, D. (2024). Barriers to participation in sports activities: a study with caregivers and professionals linked to the Association of Parents, Friends, and People with Disabilities of Banco do Brasil Employees (APABB). Retos, 57, 790–799. https://doi.org/10.47197/retos.v57.105799
Olasagasti-Ibargoien, J., Castañeda-Babarro, A., León-Guereño, P., & Uria-Olaizola, N. (2023). Barriers to Physical Activity for Women with Physical Disabilities: A Systematic Review. Journal of Functional Morphology and Kinesiology, 8(2),82. https://doi.org/10.3390/jfmk8020082
Prieto, J., & Paramio-Salcines, J. L. (2018). The United Nations Convention on the Rights of Persons With Disabilities and Its Effects on the Promotion of Elite Disability Sport: A Worldwide Analy-sis. The Age of Human Rights Journal, 10, 119–138. https://doi.org/10.17561/tahrj.n10.6
Sakalidis, K. E., Fadeeva, A., Hettinga, F. J., & Ling, F. C. M. (2023). The role of the social environment in inclusive sports participation-Identifying similarities and challenges in athletes with and with-out Intellectual Disabilities through coaches’ eyes: A qualitative inquiry. PLoS ONE, 18(1). https://doi.org/10.1371/journal.pone.0280379
Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An Ecological Approach to Creating Active Living Communities. Annual Review of Public Health, 27, 297–322. https://doi.org/10.1146/annurev.publhealth.27.021405.102100
Shady, K., Phillips, S., & Newman, S. (2024). Barriers and Facilitators to Healthcare Access in Adults with Intellectual and Developmental Disorders and Communication Difficulties: an Integrative Review. Review Journal of Autism and Developmental Disorders, 11(1), 39–51. https://doi.org/10.1007/s40489-022-00324-8
Smith, B., & Monforte, J. (2021). Title Disability, the Communication of Physical Activity and Sedentary Behaviour, and Ableism: A Call for Inclusive Messages Authors 5 Professor Brett Smith. British Journal of Sport Medicine, 55. https://doi.org/10.1136/bjsports-2020-103780
Suryadi, D., Komaini, A., Suganda, M. A., Rubiyatno, R., Faridah, E., Fauzan, L. A., Fauziah, E., Putra, M. E., & Ayubi, N. (2024). Sports Health in Older Age: Prevalence and Risk Factors - Systematic Review. Retos, 53, 390–399. https://doi.org/10.47197/retos.v53.102654
Sutherland, L., McGarty, A. M., Melville, C. A., & Hughes-McCormack, L. A. (2021). Correlates of physical activity in children and adolescents with intellectual disabilities: a systematic review. Journal of Intellectual Disability Research, 65(5), 405–436. https://doi.org/10.1111/jir.12811
Ucpruk. (2011). Sejarah UCPRUK – UCP Roda Untuk Kemanusiaan. UCPRUK. https://ucpruk.org/sejarah-ucp-ruk/
UN. (2015). THE 17 GOALS | Sustainable Development. UN. https://sdgs.un.org/goals
Valle Ramírez, A., Sáez-Gallego, N. M., & Abellán, J. (2022). A study about the participation in Physical Education of a student with physical disability. Retos, 44, 116–127. https://doi.org/10.47197/retos.v44i0.83500
Vasudevan, V., Rimmer, J. H., & Kviz, F. (2015a). Development of the Barriers to Physical Activity Ques-tionnaire for People with Mobility Impairments. Disability and Health Journal, 8(4), 547–556. https://doi.org/https://doi.org/10.1016/j.dhjo.2015.04.007
WHO. (2011). World Report on Disability. World Report on Disability. https://www.who.int/publications/b/online-reader/30358#settings
WHO. (2018). Assistive technology. WHO. https://www.who.int/health-topics/assistive-technology#tab=tab_3
WHO. (2022). Global Status Report on Physical Activity 2022. WHO. https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022
WHO. (2024). Kesehatan dalam Kontribusi yang Ditetapkan secara Nasional. WHO. https://iris.who.int/bitstream/handle/10665/380144/9789290229896-ind.pdf?sequence=1
Wildekamp, M., Krops, L. A., Seves, B. L., Hettinga, F. J., Houdijk, H., Dekker, R., & Hoekstra, F. (2024). Physical activity barriers among adults with physical disabilities or chronic diseases during and after rehabilitation: the ReSpAct cohort study. European Journal of Adapted Physical Activity, 17, 11–11. https://doi.org/10.5507/euj.2024.008
Yu, S., Wang, T., Zhong, T., Qian, Y., & Qi, J. (2022). Barriers and Facilitators of Physical Activity Partici-pation among Children and Adolescents with Intellectual Disabilities: A Scoping Review. Healthcare, 10(2). https://doi.org/10.3390/healthcare10020233
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Direitos de Autor (c) 2025 Kunjung Ashadi, Ima Kurrotun Ainin, Afif Rusdiawan, Laily Mita Andriana, Tri Setyo Utami, Riski Septa Jatmikanto, Fadilah Umar, Mohd Azrul Anuar Zolkafi
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