Adapted Physical Activity Quarterly, 2015, 32, 68-82 http://dx.doi.org/10.1123/apaq.2013-0110 © 2015 Human Kinetics, Inc.
Official Journal of IFAPA www.APAQ-Journal.com REVIEW
Physical Activity and School-Age Individuals With Visual Impairments: A Literature Review Justin A. Haegele and David Porretta The Ohio State University The purpose of this article was to review published research literature on physical activity for school-age individuals with visual impairments by describing study characteristics and major findings. Keyword searches were used to identify articles from electronic databases published from 1982 to June 2013. Eighteen articles met all inclusion criteria, and relevant data such as participants, visual-impairment levels, theory, measurement, and dependent variables were extracted from them. Of the 18 studies, 5 were descriptive, 6 correlational, and 7 were interventions. Only 4 studies explicitly stated a theoretical or conceptual framework. Major findings suggest that low physical activity levels of school-age individuals with visual impairments may be related to perceived participation barriers including the availability of appropriate opportunities rather than visual acuity or educational setting. Keywords: blindness, physical education, sensory impairment, adapted physical activity
Research indicates that school-age individuals with visual impairments tend to be less physically active than their nondisabled peers (Kozub & Oh, 2004), and those individuals self-report limited physical activity participation compared with those with other disabilities (Longmuir & Bar-Or, 2000). Factors identified that limited physical activity participation include a lack of parental encouragement (Ward, Fansworth, Babkes-Stellino, & Perrett, 2011), knowledge of opportunities (Stuart, Lieberman, & Hand, 2006), typically developing peers with whom to participate (Stuart, et al, 2006), and professional training of teachers (Lieberman, Houston-Wilson, & Kozub, 2002). Not only do those with visual impairments tend to be less physically active, but they also become even less active as they get older (Ayvazoglu, Oh, & Kozub, 2006; Oh, Ozturk, & Kozub, 2004). According to the Centers for Disease Control and Prevention (2011), developing an overall physically active lifestyle at an early age may decrease one’s chances of developing health-related problems such as obesity, diabetes, and cardiovascular disease. Unfortunately, because individuals with disabilities, especially those with The authors are with the Dept. of Human Sciences, The Ohio State University, Columbus, OH. Address author correspondence to Justin Haegele at
[email protected] 68
Physical Activity and Visual Impairment 69
visual impairments, are less physically active than their nondisabled peers, they are at greater risk for experiencing health-related problems. Over the years, a number of literature reviews have been conducted relative to physical activity and school-age individuals without disabilities (Kriemler et al, 2011). Kriemler et al. conducted a review of reviews covering school-based physical activity and physical-fitness interventions. They found that multicomponent school-based interventions combining instructional (e.g., physical activity homework), curricular (e.g., extra unit lessons), and environmental (e.g., adaptations to playgrounds or fields to encourage activity during breaks) components are more successful than instructional or curricular components alone. To date, three literature reviews have been published regarding school-age individuals with visual impairments. The reviews focused essentially on motorskill performance and fitness and lacked studies pertaining specifically to physical activity (DePauw, 1981; Houwen, Visscher, Lemmink, & Hartman, 2009; Skaggs & Hopper, 1996). In 1981, DePauw completed a review focusing on physical education for individuals with visual impairments. The review found six empirically based studies published between 1970 and 1980 comparing motor-skill performance (developmental factors, posture/balance, and gait patterns) and selected fitness factors (biological functioning and cardiovascular endurance) between school-age individuals with visual impairments and their typically developing peers. However, the review included no articles pertaining specifically to physical activity levels of individuals with visual impairments. Furthermore, because of few data-based studies, definitive statements about the value of physical-activity-related programming (e.g., physical education) could not be made. Therefore, DePauw suggested further examination of physiological and physical-fitness differences between school-age individuals with visual impairments and typically developing peers through additional research. The Skaggs and Hopper (1996) review addressed physical-fitness and motorskill-performance differences between school-age individuals with visual impairments and typically developing peers. The review included 19 empirically based studies published between 1950 and 1993. Of the 19, 10 dealt with physical fitness (degree of vision loss, environmental setting, and successful fitness programs), 5 dealt with motor-skill performance, and 4 dealt with balance. Their review found that across almost all components of fitness, school-age individuals with visual impairments demonstrate lower scores than their typically developing peers. The authors found that lower fitness may be associated with lower overall physical activity levels, and school-age individuals educated in residential schools may be more physical active than those in public schools. Furthermore, physical-fitness differences could be attributed to shortcomings in school programs because of a lack of physical- and motor-fitness opportunities, qualified teachers, and opportunities to participate with typically developing peers. When compared with typically developing peers, children with visual impairments also tend to have lower motor-skill performance. Gender and degree of visual impairment are found to be additional variables that affect motor performance, with boys being more successful than girls and children with some vision being more successful than those with no vision. Most recently, Houwen, Visscher, Lemmink, and Hartman (2009) conducted a literature review that addressed the motor-skill performance of school-age individuals with visual impairments. The review included 39 articles (26 data-based and 13 others reporting suggestions from experts). The review categorizes variables
70 Haegele and Porretta
that may influence motor performance. They are individual variables (e.g., degree of eye condition, age of onset), environmental variables (e.g., opportunities for movement, physical environment variables), and task variables (e.g., nature of task, adaptations). Their review suggests that previous research provides little evidence to support relationships between degree of vision loss and dynamic balance, amblyopia/strabismus and fine motor skills, and movement interventions with motor-skill performance. Finally, the effects of other variables on the motor-skill performance of children with visual impairments are inconclusive. Aside from the 19-year-old Skaggs and Hopper review (1996), which included little physical-activity-related research, little attention has been given to a comprehensive review of physical activity in school-age individuals with visual impairments. With the greater emphasis being placed on physical activity and its impact on reducing health-related diseases, especially for those with disabilities, more empirical work is now being conducted. For example, Cervantes and Porretta (2013), using a social-cognitive intervention, examined the impact of an afterschool physical activity program on adolescents with visual impairments. At a residential school for the blind, a nine-lesson program was offered to four students with visual impairments during a 5-week period. The purpose of the intervention was to enhance leisure-time physical activity. Results indicate that both leisuretime physical activity levels and selected constructs can be enhanced by the afterschool intervention. However, participants had difficulty maintaining those same levels after intervention. A possible explanation is that the intervention was not an embedded curricular offering, which may have led to the lack of physical activity maintenance (Kriemler et al, 2011). Because of the importance of physical activity in the lives of school-age individuals with visual impairments, we conducted a comprehensive literature review. For the purpose of this review, physical activity was defined as any body movement produced by muscles resulting in energy expenditure (Caspersen, Powell, & Christenson, 1985). Furthermore, physical activity is limited to that which was measured by means of standard or commonly used instruments such as accelerometers, pedometers, and self-reports (Cervantes & Porretta, 2010). The purpose of this study was to review published research literature on physical activity for school-aged individuals with visual impairments by describing study characteristics and major findings.
Methods The following databases were searched for relevant studies: Academic Search Complete, Education Full Text, Education Research Complete, ERIC, Masterfile, MEDline, Physical Education Info, PsycINFO, and SPORTDiscus. Article references were searched for additional eligible studies. Studies were identified by searching electronic databases and scanning reference lists of articles identified. The search strategy included three lines of search words, truncated whenever possible: (a) visual impairment, blindness, low vision, sensory impairment; (b) physical activity, physical education, recreation, motor skills, gross motor activities, mobility, sport, psychomotor, exercise, fine motor skills; and (c) children, youth, youngster, adolescent.
Physical Activity and Visual Impairment 71
Inclusion and Exclusion Criteria The inclusion criteria for this review were being published studies in the English language in peer-reviewed journals between 1981 and June 2013 for which full text was available and in which school-age (
