Functional and Environmental Factors Are Associated With Sustained Participation in Adaptive Sports.
BACKGROUND
Although community-based adaptive sports have become a popular means of rehabilitation for individuals with disabilities, little is known regarding the factors that lead to sustained participation.


OBJECTIVE
To determine the demographic, environmental, disability-related, and functional factors associated with sustained participation in a community-based adaptive sports program.


METHODS
Retrospective cohort study.


METHODS
Community-based adaptive sports program.


METHODS
Adults with mobility-related disabilities.


METHODS
Data were collected from registration forms and participation logs. Participants were described as "sustainers" if they attended ≥2 sessions, or as "nonsustainers" if they attended 0 or 1 session. We examined the associations between sustained participation and demographic, environmental, disability-related, and functional factors in bivariate and multivariable analyses.


METHODS
Sustained participation in the adaptive sports program.


RESULTS
Of the 134 participants, 78 (58%) were sustainers and 56 (42%) were nonsustainers. In multivariable analyses, participants who ambulated independently had lower odds of being sustainers (odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.11, 0.96), and those who used an ambulatory assistive device had twice the odds of being sustainers (OR = 2.0, 95% CI = 0.65, 6.2) compared to those who used a manual wheelchair. Moreover, participants who lived within 5.3 miles of the program site (OR = 3.8, 95% CI = 1.1, 13.0) and those who lived between 5.3 and 24.4 miles from the program site (OR = 2.8, 95% CI = 1.0, 7.7) had significantly higher odds of sustained participation than those who lived more than 24.4 miles from the program site.


CONCLUSIONS
Sustained participation in community-based adaptive sports is associated with living closer to the program site and the presence of a moderate level of functional impairment. These findings suggest that programs might consider increasing the number of satellite sites and expanding offerings for individuals with mild or more significant mobility-related disabilities to effectively increase program participation.


METHODS
II.
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and the Brigham and Women's Hospital, 300 First Ave, Charlestown, MA 02129(∗). Electronic address: cblauwet@partners.org.
Cheri A
CA
Blauwet
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA(†).
Heidi Y
HY
Yang
Spaulding Rehabilitation Hospital, Boston, MA(‡).
Sebastian A
SA
Cruz
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA(§).
Jamie E
JE
Collins
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA(‖).
Karen C
KC
Smith
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA(¶).
Elena
E
Losina
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, MA(#).
Jeff N
JN
Katz
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010349:Patient Compliance; D011237:Predictive Value of Tests; D016730:Program Development; D015397:Program Evaluation; D012189:Retrospective Studies; D064846:Sports for Persons with Disabilities; D014481:United States; D055815:Young Adult