Physical activity of adolescents with long term illnesses or disabilities in reference to ICF personal factors

Abstract

Participation and activities are important for adolescents’ functioning and health. This is in line with the World Health Organisation’s International Classification of Functioning, Disability and Health (ICF). Main areas of functioning include physical activities (PA) and participation in organised sport clubs. To ensure adolescents with long term illnesses or disabilities (LTID) can participate fully in society, functional abilities interact with contextual environmental and personal factors. Because habits and attitudes of adolescents can carry through to adulthood, it is important to assess the personal factors in relation to activities and participation. Therefore, the aims of this study were to describe PA trends and to determine the associations between physical activity and the ICF personal factors in adolescents with LTID. Finnish data, from a national representative sample from the Health Behaviour in School-aged Children (HBSC) study, of 13 and 15 year olds in 2002 (n=3016), 2006 (n=2979), 2010 (n=3578), and 2014 (n=3250) were used in this study. With all data collections combined, 17% (n=2206, mean age=14.8 years, 55% girls) had self-reported LTID. When possible, descriptions of functional difficulties were included in analyses. All studies used the same HBSC protocol across the different data collection years with analysis of items that measured PA, sports club participation, psychological assets related to PA and educational aspirations. Descriptive statistics, mediation regression and binary logistic regression models were used to identify and report associations between PA and personal factors. Trend analysis was also performed. Younger (13 year old) boys were the most physically active and older (15 year old) girls the least. Moreover, there has been an increase from 11% to 21% of adolescents that reported daily PA from 2002 to 2014, with a twice likelihood from sports club members. Intentions for future PA was strongly associated with increased PA in both boys and girls. Furthermore, boys with high PA self-perceptions and aspirations not to general upper secondary schools were associated with daily PA. Global self-esteem was reported to be a significant mediator between perceived fitness and intentions for future PA in boys but this relationship was not found in girls. The results of this study connect with previous studies in that there are similar trends in PA in adolescents with and without LTID. It is important to take into account sports club membership when reporting amounts of physical activity of adolescents with LTID. There is almost one in six adolescents with LTID in general schools and realising this may influence the implementing of guides for inclusion in sport clubs at various levels. Finally, as PA are recommended to be part of daily routines, finding commonalities in personal factors can assist with future classifications of functioning, disability and health of adolescents with LTID.