Printer Friendly

Facilitating leisure-time physical activity in individuals with disabilities using general systems theory: recommendations for therapeutic recreation specialists.

The importance of physical activity (PA) to health and disease prevention for all people, including individuals with disabilities, has been well-documented (U.S. Department of Health and Human Services [USDHHS], 2000). In an effort to increase activity in a largely sedentary population, research has focused on identifying factors that cause people to be active or inactive and developing interventions that remove barriers to physical activity participation (Trost, Owen, Bauman, Sallis, & Brown, 2002). However, it should be noted that finding singular causes or factors predicting inactivity is unlikely given unique attributes found in many segments of the population, such as individuals with disabilities, and attempts to design interventions accordingly have been largely unsuccessful (USDHHS, 2000). In addition, the dynamic nature of human existence makes it difficult to identify the relative contribution of PA determinants at certain points in time. This makes the practitioner's job of trying to promote adoption and maintenance of PA behavior by clients particularly daunting.

The purpose of this paper is to present an alternative framework to viewing PA promotion and programming for people with disabilities that may result in more successful interventions. After reviewing the existing literature on PA for persons with disabilities, general systems theory (GST) is presented as a theoretical base on which to develop PA programs. These sections are followed by recommendations for therapeutic recreation (TR) specialists.

Existing Literature on Physical Activity Behavior

To examine existing literature, two subheadings of material were reviewed. First, a section outlining research specifically targeting existing PA research in persons with disabilities is provided to help the reader understand the current status of this behavior in this population. Second, a section on traditional theoretical foundations used to study and understand PA behavior in the general population is presented in light of limitations of the current knowledge base.

Physical Activity Behavior in Adults with Disabilities

The existing literature on PA determinants and people with disabilities is limited and widely dispersed across different disciplines, which makes it difficult to synthesize and ultimately draw conclusions regarding this topic. This situation is further complicated by inconsistent definitions of disability and a large diversity within disabling conditions. For purposes of clarity, disability in this paper refers to adults with congenital or acquired conditions, not secondary to aging, metabolic syndromes (obesity or diabetes) or other disease processes such as cardiovascular disease and cancer. It is also important to clarify terminology and how it will be used in this paper. Physical activity refers to any movement that leads to energy expenditure and should not be confused with exercise, which is planned and repetitive with the explicit purpose to improve fitness (Casperson, 1989). Leisure is what a person or a group chooses to do during discretionary time (Bouchard, Shephard, & Stephans, 1994). The term leisure time physical activity (LTPA) is often used to describe physical exertion, at varying levels of intensity that occurs during discretionary or free time, and this term will be used in the rest of the paper.

People with conditions across the disability spectrum are generally reported as less active than people without disabilities (Cooper et al., 1999; Durstine, et al., 2000; Kozub & Oh, 2004; Rimmer, Braddock & Pitetti, 1996, USDHHS, 2000). The majority of research in this area is descriptive and focused on PA levels. There are few studies on assessment, physiological responses, health outcomes, epidemiology, determinants, interventions, and programming related to PA and people with disabilities. There are also few reports that use a theoretical approach to explain LTPA behavior in this population.

Limited empirical research has identified many similar LTPA determinants among adults with and without disabilities, but the context is likely different for each group. For example, potential contributors and inhibitors of LTPA behavior in people with mental retardation include environmental constraints (e.g., time, weather) (Frey, Buchanan, & Rosser, 2004; Messent, Cooke, & Black, 1997), physical status (e.g., motor delays, level of impairment) (Draheim, Williams, & McCubbin, 2002), health problems (e.g., obesity, disease state) (Draheim et al., 2002; Frey et al., 2004), and social/culture (e.g., family, attitudes) (Frey, et al., 2004; Kozub, 2003). Research on people with a variety of mobility impairments suggests similar factors affect PA such as psychological traits (e.g., self-perceptions, coping, mood) (Bouffard & Crocker, 1992; Guthrie & Castelnuovo, 2001; Hendersen & Bedini, 1995; Maher, Kinne, & Patrick, 1999; Wu & Williams, 2001), accessibility/physical barriers (Henderson & Bedini, 1995), social/culture factors (Ayvazoglu, Oh, & Kozub, 2006; Heller, Ying, Rimmer, & Marks, 2002; Henderson & Bedini, 1995; Wu & Williams, 2001) and impact of disability (Hedrick & Broadbent, 1996). It is difficult to draw definite conclusions from these studies because results are often conflicting. While it appears that there is a large body of knowledge on this topic, it is minimal compared to that conducted in people without disabilities, and, as a result, less comprehensive. Nevertheless, it is clear that there is an interaction between the individual and environment that affects LTPA behavior in this population; however the dynamic nature of these interactions has not been explored.

Limitations of Traditional Theoretical Approaches to Physical Activity Behavior

Literature on the application of theory to PA research has increased exponentially in the last twenty years (King, Stokols, Talen, Brassington, & Killingsworth, 2002). The focus has been on modifying intrapersonal processes (e.g., self-efficacy, perceptions), but recently interest has diverted to other approaches that address relationships between individual, micro-environment (e.g., social supports), and macro-environment issues (e.g., public policy) (Ayvazoglu et al, 2006; King et al., 2002). The Surgeon General's report on PA and health (U.S. Department of Health and Human Services [USDHHS], 1996) outlines the eight commonly studied theories of PA behavior that include individual theories (classic learning theories, health belief, transtheoretical, and relapse prevention), interpersonal theories (social cognitive theory, theory of planned behavior, and social support), and environmental theories (ecological perspective). It is beyond the scope of this paper to review each theory, and readers are referred elsewhere for a more comprehensive discussion (King et al., 2002; USDHHS, 1996).

Operating under the assumption that there are few fundamental differences between people with and without disabilities, additional theoretical concepts have been applied to explain some aspects of PA behavior in people with disabilities. Clearly defined theoretical approaches to explain PA behavior in this population have included Foucauldian and Merleau-Pontian analyses (Guthrie & Castelnuovo, 2001), transtheoretical and value-expectancy models (Kinne, Patrick & Maher, 1999), Lazarus and Folkman's coping theory (Bouffard & Crocker, 1992), and the social or cognitive models (Heller et al., 2002). Again, the reader is referred to these original sources for additional information. The impact of disability on PA and other factors were addressed within the context of these theories, but the concern is that only one or two aspects of human behavior are considered. Theories typically attempt to isolate factors, among the multitude of possible individual, interpersonal, and environmental influences, which explain the most variance in PA behavior (Epstein, 1998; King et al., 2002). It is unlikely that this variance remains stable, and the dynamic aspect of determinants across multiple levels of analysis is confounding and seldom studied (Epstein, 1998). There is a complex nature to LTPA in people with disabilities, and a need to consider a more comprehensive theory that takes into account the dynamic interrelationship between individuals and the environment. Once these interrelationships are better elucidated, therapeutic recreation specialists will be able to identify factors that can be modified.

General Systems Theory

General systems theory (GST) is a potential framework to help practitioners and researchers alike understand LTPA based on how systems interact. The differences between this perspective and other theoretical models is most illustrated by first introducing the reader to GST, then following with a more in-depth model and a hypothetical situation using GST as an example of LTPA outcomes for individuals with disabilities based on three categories of influences consistent with constraint models found in other disciplines.

Theoretical Premises of GST

General systems theory is a broad-based concept that has been applied across science and the humanities to explain various complex systems. Over the past 30 years, a variety of models under the umbrella of general systems have emerged and provide a unique perspective for studying human behavior that is based on how systems interact. Authors in social fields, such as Hudson (2000), argue that many similar theories exist such as complex systems and chaos theory, which are extensions of earlier work labeled GST. For the purposes of this discussion, we agree with Hudson's (2000) assertion and refer the reader to this reference for further information on these similar systems based theories. Within the context of GST, a system can refer to a collective of people, either a family or perhaps a community of individuals, who interact on a regular basis. A system can also be within an individual such as the nervous system. The current paper utilizes similar interpretations of systems in relation Newell's (1986) human motor behavior and other GST models describing complex social phenomenon. Our specific interests are factors which afford LTPA behavior or the decision to use learned patterns in LTPA. Affordances, adaptation, equilibrium, attractors, and rate limiters are important concepts in GST that are explained in greater detail in the following sections.

Affordance. Affordance is a term used by Gibson (1988) to describe how an individual matches what the environment affords and what the individual in turn can and will do. We contend that LTPA and affordances by an environment are related to sociological systems where humans interact as agents in the environment. Therefore, individuals with disabilities interact with others and are afforded opportunities based on other collective factors that result in each organism's decision to either engage in or avoid LTPA. Affordances refer to how an individual with a disability perceives LTPA and determines if this is the best solution or use of free time.

Adaptation. Adaptation is a key premise to understanding systems theory as relevant to LTPA behavior in humans. The concept of adaptation is an important staple in complex systems research in social sciences (Macy & Willer, 2002). These adaptations are believed to occur in a manner that is functional, so in this regard an organism or a group of individuals (such as a family) self-organizes in a way that is considered "best" or where equilibrium is found (Hudson, 2000). In our use of systems theory to explain LTPA, successful adaptation represents a steady response where each individual is afforded opportunities within daily life to engage in behavioral patterns resulting in adequate amounts of LTPA. Maladaptive outcomes for systems would be where an individual is unable to match daily schedule, abilities, skills, and motivation to suitable activity options.

Equilibrium. An important concept to grasp in understanding GST is the contention that systems, whether an individual, community, or organization, are more than the sum of their parts. Social phenomena emerge based on dynamic, non-linear interactions between system components (Hudson, 2000). Complex systems adapt to ever-changing circumstances and individuals, as well as groups, and engage in the process of self-organization in an effort to reach equilibrium (Ottino, 2003). In our application of General Systems Theory to LPTA, systems reach equilibrium in relation to LTPA as a behavior and the interactions between systems make inactivity or activity the best solution. Equilibrium represents a steady pattern of behavior that can either result in activity or inactivity depending on how an individual adapts.

Indirectly, the concepts of equilibrium and decision making by persons with disabilities have been studied by Latash (2000) using dynamic systems (another similar theory) consistent with complex systems premises. However, Latash (2000) refers to the decision making process about motor behavior in relation to proper form versus functional patterns. This issue is related to how an individual chooses to move within a physical activity setting. Self-organization is discussed in Latash (2000) as a process of selection by individuals with disabilities to use a functional movement pattern rather than adopting the common form found in persons without disabilities. This in turn may contribute to the decision to engage in physical activity in general if the functional pattern is safer and represents the best solution for the individual. Specifically, some movement solutions may represent different or diverse patterns that play a role in LTPA behavior.

Programs that allow for different movement forms within the activity are most likely to attract diverse movers such as individuals with disabilities based on the premises of GST. Although it is somewhat controversial to allow a person with a visual impairment to use a shuffling gait during a community walk, it may also be a safer solution for that individual and one that affords opportunity to engage in LTPA. The alternative may be for an individual to only walk where he finds a smooth predictable surface such as a gymnasium floor. However, this may require access to a school or other recreational settings unavailable during an individual's free time. A community walk over the less predictable terrain may require a diverse movement form, in the mind of the walker for safety reasons, and this is acceptable if walking behavior increases.

Latash (2000) strengthens this concept in that effort spent on refining movement form or encouraging the "correct" pattern in an individual with a disability may be counterproductive, if the pattern serves a functional purpose and is in fact safer. In other words, people adapt to changes within themselves and the environment so that a certain level of personal stability can be achieved (equilibrium). Stability in our use of GST refers to a consistent decision by an individual to engage in LTPA based on a program that does not overemphasize "correct" or a limited range of movement solutions. Consistent with Latash's work and Newell's (1986) model is our preference to place equal weight to internal and external factors. This includes individual influences such as level of vision loss and gait patterns as only one internal factor and other external categories explained later are equally as important to consider by TR specialists.

Attractor. In adapting and reaching equilibrium, each individual is drawn to a stable place where the system rests (Thelen & Smith, 1994). An attractor draws the system to this resting place, and in an ideal LTPA scenario this could be an individual selecting a daily exercise routine that is done independent of a therapeutic recreation (TR) specialist, or in a less desirable sense a person could choose to not engage in LTPA. Either way, this represents a preferred state or outcome that would be considered self-organization in a systems perspective (Thelen & Smith, 1994). Attractors to LTPA differ from equilibrium described earlier in that the former represents an influence and the latter is the outcome. The nature of an attractor to physical activity is complex and a matter of individual preference. For example, where time constraints may represent an attractor to inactivity for a busy person, an abundance of free time due to unemployment may impact in an opposite direction and make LTPA a meaningful solution or "best pattern" for that individual. Either way time becomes an attractor for each individual to find equilibrium.

An example of finding the best solution or adapting to find equilibrium is for a person who works in the evenings to watch and participate in a morning yoga program that follows his favorite news show. The yoga may target flexibility and may even represent movements that the individual cannot do at the level of others. Further, this individual may actually benefit more from an aerobic type program to target increased energy expenditure; however, the selection of the morning program may represent the "best" physical activity solution. The attractor, or "best solution", refers to selecting the LTPA option that fits an individual's time and schedule constraints. This again leads to the ultimate goal of engaging in LTPA over more sedentary pastimes or finding a favorable attractor. This and the earlier motor pattern example provides a rationale for why therapeutic recreation and other specialists should allow for varied movement and program solutions in persons with disabilities, as long as enjoyment, safety and participation outcomes are not compromised.

Rate Limiter. One final consideration for understanding GST and how systems interact is the concept of the controller or rate limiter (Thelen & Smith, 1994). A rate limiter is the system or aspect of the interactions between systems that is the slowest to develop. For example, if an individual with mental retardation is involved in a community softball program and she does not understand the rules of the game, this lack of knowledge may be a rate limiter for her. Attention to this aspect of learning may be critical for the individual to be comfortable in the activity. Program providers can work on skills such as catching, acceptance by other teammates of this individual, and make sure the team has a good field to practice on, but the emergence of decision making by the individual with MR to participate independently with free will in this program may be tied to one key variable or rate limiter. This slowest of the relevant systems to develop and therefore the controller of the larger behavior must reach a certain level of development and once this happens behavior emerges (Thelen & Smith, 1994). In the above case, it is strategic knowledge and understanding of softball that limits the rate of adoption of increased PA.

We believe that GST explains why people with disabilities choose to be active or sedentary according to the interaction between personal traits, social influences, and the nature of the physical activity programs available. A desire to engage in LTPA is generated from the participants and not the result of mandates or solely created by program leaders. In an effort to achieve individual equilibrium health-related motives, such as using exercise to maintain weight or other more internal autonomy reasons related to feeling more able, are important. There are many factors that influence each individual's decision to include LTPA and these are the factors that need to be of interest to the TR specialist.

Collective, Individual, and Contextual Influences in General Systems Theory

Based on GST, individual and collective influences exist and are believed to be influential in LTPA behavior in a manner consistent with other social phenomenon (Suematsu, Takadama, Nawa, Shimohara, & Katai, 2003). Our figure builds on this premise for LTPA decision making. Combining Suematsu et al. (2003) and Newell's (1986) constraint model we believe that collective, individual, and contextual influences interact to create LTPA decision making and behavior (Figure 1).

Collective Influences. Collective influences refer to the social system that surrounds an individual such as laws mandating accessibility, program leaders, communication between caregivers, work schedules (of not only the individual but caregivers), and collective knowledge within the community. All of these represent things outside of the individual with a disability and related to the interactions between people. This can even refer to the quality of communication between two program providers who work in the same setting with the same clients. An example of collective influences in swimming would include the foresight of community leaders to provide the ramp or other options that help individuals with disabilities choose LTPA in a community pool.

Collective influences are a broad category of constraints that include many factors including the communication between staff and patrons, leadership by community individuals of power who advocated for varied accessibility options, and the general knowledge about disability found in a community where, for example, a pool exists. Further, the collective influences have pathways to individual influences where program leaders focus on skill development or provide exciting programs that motivate individuals with disabilities. Both of these overlap with the next category of individual influences as both criteria of collective influences and factors within an individual that either facilitate or inhibit LTPA behavior in individuals with disabilities.

The decision to engage in LTPA is more complex than earlier research studying individuals with and without disabilities acknowledges. This is clear in the earlier swimming example where a participant may be able to swim independently in a pool that is accessible and require a large amount of assistance in a barrier filled setting. Further, skill development alone may not result in LTPA if community physical activity options are missing entirely as is the case for many elite level athletes with disabilities who may desire disability sport options but find they are not available in many locales (Kozub & Porretta, 1998). Kozub and Porretta (1998) infer that a lack of social structure and limited opportunities impacted on the ability of adolescents with disabilities to engage in LTPA during school age years and into adulthood. Hedrick and Broadbent (1996) found that PA participation during college and perceived disability severity predicted PA participation in people with severe physical disabilities. It is unclear if perceptions by others in relation to disability severity or those by the actual participant are the cause. This further highlights a potential interaction between collective and individual influences.

Individual Influences. Individuals with disabilities have the potential to engage in LTPA in any number of settings, ranging from a family centered leisure activity to a more structured adult recreation option found in the community with adequate leisure skills. Those factors within the individual include the many personal characteristics that potentially impact on the decision to engage in LTPA (individual influences). Motivation, ability, and skills are examples of individual influences. We believe autonomy or self-determination (individual influences) are interwoven with the systems that are represented in both collective and contextual influences (Figure 1). For example, in considering the swimming example mentioned in collective influences, the skills possessed by the individual are now important. Further, the adaptive behaviors or independent skills such as ability to enter the water independently using a ramp or ladder are factors that vary within individuals with disabilities. The presence of a ramp represents the products of legislative initiatives such as the Americans with Disabilities Act and leadership by facility planners to afford the accessibility option. However, individual skill related to strength and coordination is related to how successful a ramp is in facilitating autonomous LTPA decision making by an individual with an orthopedic impairment.

Contextual Influences. The nature of deciding on LTPA settings is contingent upon environmental factors. In our earlier swim example, the contextual influence has to do with all the factors associated with the presence of the ramp, how steep, path to the ramp, and even locker room set up that affords an individual access to the pool without assistance These factors create task oriented constraints (contextual influences) that interact with collective and individual factors that parallel constraints identified in Newell's (1986) model explaining motor behavior. The community itself contains an additional level of external contextual influences that exists over and above the social elements cited in collective influences. Contextual influences are related to the environment or context that become part of the decision making process for participation in LTPA for individuals with disabilities. The actual activity becomes more difficult or easier depending on the context or the task required by different settings. This could be related to terrain in routes to places in the community, the weather, or any number of physical factors outside of the individual and unrelated to social interactions between people. Further, the nature of the physical activity options, such as a fitness facility where locker room facilities are used, a backyard in the home where equipment has been adapted, or a pool at the local YMCA that may not have a shallow end are contextual influences. These factors for individuals with disabilities impact on independence associated with adult leisure time decisions to engage in physical activity.

For individuals with disabilities, the context is important since many individuals with disabilities fail to generalize skills and may have difficulties with engaging in physical activity based on associated tasks such as the ability to independently navigate the barrier in swimming such as getting into the water for a wheelchair user. Independence, and in the end the behavior of swimming in a community pool during leisure time, may be related to how the pool exists in an environmental sense (presence of a ramp) or interrelated with existing skills (individual influences) such as the ability to perform independent transfers. The arrows in Figure 1 demonstrate the non-linear interaction of the constraints that influence autonomy where systems interact and become critical factors believed important for persons with disabilities to successfully engage in activities and act as primary causal agents in their own lives (Wehmeyer, 1994). Further, the different levels of constraints are equal and interrelated to affect LTPA decision making in individuals with disabilities.

A Hypothetical Situation and GST

Hypothetically, GST could explain LTPA behavior in a number of situations with all kinds of clients. What follows is an example that demonstrates a community based scenario where engaging in LTPA by an individual with a disability is consistent with the model found in Figure 1. The factors are pointed out to show the reader how GST principles show up in existing LTPA program options and highlights potential intervention areas for TR specialists.

   Max is a 25 year old man with autism who has
   unique motor needs, along with other comorbid
   conditions such as obsessive compulsive
   disorder, obesity, and depression. Depression
   is related to an inability to find meaningful
   friendships within his peer group. Often he
   engages with others in terms of concepts that
   interest him such as cars, but peers are seldom
   interested in discussing his obsession at the level
   that suits Max leading to others perceiving him
   as "different". None of the obsessions that Max
   has are related to physical activity and he is now
   beginning to gain weight at an alarming rate. What
   types of LTPA opportunities are there for Max?

As an individual with autism, Max needs structure and repetition of activities, with limited demands for complex social skills. Structure is in direct relation to Max's individual influence related to his feelings of comfort. Competition, in general, is socially complex and has the potential to accentuate motor and social deficits. The level of competition that each individual desires and that leads to more participation is again an individual preference or influence that may impact on LTPA decision making. In this, it is not uncommon for individuals with Autism to dislike competitive situations. As a program provider, it would be important to assess Max's interests, resources, and perhaps the interest levels of other members of Max's family (Kozub, 2001). Further, it may be necessary for program providers to help Max find a suitable activity to try if he lacks knowledge of community program options. Martial arts programs have been specifically identified as having desirable aspects for people with autism (Scott, Kozub, & Goto, 2005). These popular activities are available in most locales. These types of activities result in systems with great potential to highlight how collective influences can impact on Max's decision to engage in LTPA with peers.

Consistent with the model found in Figure 1, Suematsu et al. (2003) lists many essential elements that interact resulting in social phenomena. Group size is an important collective influence because smaller groups are necessary, particularly when we desire individuals to influence one another. In martial arts, this collective influence (i.e., small groups) is important and a large part of the training, since more experiences and higher skilled members influence newer and less skilled members (Scott et al., 2005). If this did not occur, it would be impossible to allow new members to join the group without affecting the learning of the more advanced students. Experienced players are expected to teach newer members the rules and skills of the group. Suematsu et al. (2003) would refer to this as a "tidy system" because the numbers are at a level where social influences can reach all participants. For individuals with disabilities, smaller group sizes are traditionally more favorable.

Another reason why a smaller system would benefit an individual like Max, who has both motor and social needs, is that he would get the necessary attention from the group leader. Additional attention would also occur from the other members who have learned the basic skills, and are socially rewarded for helping the less skilled members of the group. This situation overlaps with the knowledge (collective influence Fig. 1) cited earlier in that the group would have to be sensitive to Max's diversity. A lack of knowledge by the group on such factors as Max's obsessive compulsive disorder could lead to avoidance behaviors by other group members if a supportive program leader did not understand the role that such behaviors serve in Max's individual make up. This again highlights the earlier collective influence found in Figure 1. Typically, someone like Max could be "expelled" from the group for being different, which is also consistent with systems theory outcomes and chaos theory (Macy & Willer, 2002), but this is obviously undesirable from a LTPA standpoint. Knowledge about diversity issues, such as limitations in communication skills and in general accurate information about factors related to disability that are both unavoidable and in many cases not tied to successful participation for Max or the group, must be recognized by others participating with Max for rewarding experiences by all participants.

Peers become powerful socialization elements for Max given the open nature of some LTPA programs where there is movement in a small area (contextual influence) and skilled participants serve as motor models. Further, peer influences impact each individual's autonomy if the group as a whole is accepting and willing to see each member as similar, based on the activity preferences rather than individual characteristics. Max chooses to become a martial artist, or for that matter a weight lifter (the type of program is not the critical issue), and the group decides to see this individual as similar rather than different. Others in the community who are not martial artists now become different and disability is assimilated as just another factor in this unique activity with powerful collective influences that strengthen the choice to engage by the individual with a disability.

Programming dictates the ability of both inexperienced and diverse participants to engage in LTPA together in a group setting. Contextual factors related to how buildings are set up and even a surface that provides for safe falling, in a high risk activity such as martial arts, may be relevant contextual factors in LTPA options. These factors interact with the collective influences and the rules/objectives for participation. Most non-competitive group leisure pursuits are flexible and this allows diverse learners to participate. These activities are also not dependent on each individual member performing at a high level, such as in softball where those with poor skills can negatively affect the outcome of the game, thus only the most skilled are accepted by the group if success is outlined by winning. This again highlights the interrelationship between skills and the collective influences where the goals of the group are influenced by the leadership and structure of the activity (competitive versus cooperative outcomes). These are important considerations for leisure time consultants aiming to help individuals with disabilities find LTPA options. Examples of community softball leagues where participation and social outcomes are highlighted over winning exist, but this is not a concept that is universally accepted by all softball leagues. However, many martial arts and other active recreation programs are evaluated by having consistent returning members who individually progress to the highest levels. The cooperative element and individual goals are part of the activity. Therefore, success is flexibly defined according to each individual, whereas in other activities, performance of the group is measured in a relation to traditional winning and losing outcomes.

Regulation design is a factor cited in Suematsu et al. (2003) and directly ties into the leadership structures mentioned throughout the GST sections and a collective influence in Figure 1. Regulation mechanisms are either direct or indirect (Suematsu et al., 2003). Regulation refers to a mechanism that monitors the system and insures that rules are followed vital to the system. Supervisory structures and legal systems are examples of regulation designs in the workplace and in broader society. In our example, the head instructor for the martial arts program would be the direct mechanism to regulate behavior of the group. Further, indirect influences such as more established members of the club also exist and provide role models, or indirect regulation, of behavior. These refer to the social rewards or in some cases punitive behaviors. From a direct perspective, other participants are rewarded by the program leader through a ranking system depicted by colored belts. In general, program leaders using sound educational principles reward participants for positive behaviors and set the example for how individuals are to be treated regardless of level of ability. This type of program leadership influences not only Max's behavior but also sends a message to the group on how diverse members of the group are treated. A program leader who models high age appropriate expectations for each member of the group and is sensitive to levels of diversity helps others find meaningful ways to interact with individuals with disabilities such as Max. The indirect influence refers to modeling by peers as well as social rewards at appropriate times, such as attention by the group and meaningful praise. In this sense, interactions by the group leader and others in the group towards new participants are a distinct avenue for collective influences related to encouraging LTPA. Further, the structure of the activity, with an instructor who has the highest rank and other students who with improvement are rewarded with visible belts that signify achievement, creates an ideal situation to explain how systems theory works in relation to a hierarchical structure in a LTPA setting (Suematsu et al., 2003).

By complying with the head instructor and working though the activities, Max will be eligible for promotions in rank, which will positively influence many individual influences that are part of Figure 1. Specifically, if Max is allowed to develop both his motor and social skills in an environment that his suited to his unique needs, and become part of the group based on activity interest, his perceived competence, self-determination and feelings of control will improve. This will directly affect his autonomy and choice-making abilities, which will hopefully lead to greater participation in LTPA that will extend beyond the initial martial arts group. In relation to contextual influences, Max may develop skills related to concentration and technique where more advanced training in another setting, such as a martial arts seminar or even an actual competition (based on a change in the Max's perception of competition), may be relevant. This, in turn, would affect the other collective and individual influences and again could result in either more or less LTPA participation. General systems theory provides a direct theoretical premise that explains why smaller group sizes, flexibility for individuals to perform at their own level without detracting from the group, rewards for improvement on an individual level, and the presence of a hierarchical structure works to facilitate individual factors that lead to increased participation in LTPA by people with disabilities.

Recommendations for Program Providers

Caldwell (2001) calls for the use of theories in therapeutic recreation to assist in evaluation of overall program effectiveness. General Systems and related theories are based on simple premises that when considered individually, can be easily understood and used by interested practitioners (Hudson, 2000). The theory of action, as referred to by Caldwell (2001), is to focus on " ... how what is done produces what happens" (p 351). Whether it is the practitioners mentioned in Caldwell (2001) or the sociologist referred to in Macy and Willer (2002), the question is "how" GST explains LTPA behavior in individuals with disabilities. Below are recommendations we feel practitioners should use in conjunction with objective evaluation of program interventions to set up programs using general systems theory as a framework. Objectively evaluating outcomes of program interventions using both qualitative and quantitative methods will help practitioners and researchers understand if LTPA programs based on GST are effective (Baldwin, Hutchinson, & Magnuson, 2004). The specific recommendations for TR specialists in addressing these issues related to LTPA for people with disabilities include:

1. Identifying leadership/policy structures and attitudes within the community.

2. Creating knowledge by training staff, as well as other interested parties, and educating consumers.

3. Identifying aspects of the collective influence, such as resources that increase knowledge and enhance the social support systems, that may affect LTPA.

4. Establishing a system of open and accessible communication between staff and individuals with disabilities to promote LTPA.

5. Ensuring that individuals with disabilities have all the available information to make informed LTPA choices based on available resources and personal preferences.

6. Providing people with disabilities opportunities to gain the necessary skills to allow greater LTPA choices.

7. Providing people with disabilities the necessary skills related to independence and the ability to access a variety of settings where LTPA occurs is recommended. The goal is that individuals with disabilities adapt in a manner that achieves stability and includes participation in LTPA in a variety of settings.

8. Keeping in mind that consistent with GST, the slowest system or rate limiter that affects LTPA will be the one that determines when decision making within individuals occur. This rate limiter must be identified by TR specialists or autonomous behavior to choose LTPA may not occur.


This article concludes with two major premises for helping TR specialists view LTPA as a changeable outcome. The two major premises are that first, disability, although a contributing factor to inactivity, need not be a barrier prohibiting an individual from becoming more active. Consideration must be given to the social influences that impact activity choices. Second, no single cause exists for inactivity, and LTPA is explainable based on multiple, interacting individual (i.e., psychosocial, ability, skills, fitness), collective (leadership/policy, communication, physical structure, knowledge), and contextual influences that lead to autonomous decisions. The goal is to promote situations where individuals with disabilities choose to adopt and maintain regular participation in LTPA. General Systems Theory proponents view the home or community as a "microworld" where individuals with disabilities interact with others under many circumstances to form social phenomena characterized by the choice to engage in LTPA. Both TR specialists and researchers can use these concepts to help address the growing concern over inactivity in persons with disabilities.



Ayvazoglu, N., Oh, H., & Kozub, F. M. (2006). Explaining physical activity in children with visual impairments: A family systems approach. Exceptional Children, 72, 235-248.

Baldwin, C. K., Hutchinson, S. L., & Magnuson, D. R. (2004). Program theory: A framework for theory-driven programming and evaluation. Therapeutic Recreation Journal, 38(1), 16-31.

Bouchard, C., Shephard, R. J., & T. Stephens. (1994). Physical activity, fitness, and health: International proceedings and consensus statement. Champaign, IL: Human Kinetics.

Bouffard, M., & Crocker, P. R. E. (1992). Coping by individuals with physical disabilities with perceived challenge in physical activity: Are people consistent? Research Quarterly for Exercise and Sport, 63(4), 410-417.

Caldwell, L. (2001). The role of theory in therapeutic recreation: A practical approach. In N. J. Stumpo (Ed.). Professional issues in therapeutic recreation: On competence and outcomes. (pp. 349-364). State College, PA: Venture.

Casperson, C. J. (1989). Physical activity epidemiology: Concepts, methods, and applications to exercise science. Exercise and Sport Sciences Reviews, 17, 423-473.

Cooper, R. A., Quatrano, L. A., Axelson, P. W., Harlan, W., Stineman, M., Franklin, B., et al. (1999). Research on PA and health among people with disabilities: A consensus statement. Journal of Rehabilitation Research and Development, 36, 142-154.

Draheim, C. C.,Williams, D. P., & McCubbin, J. A. (2002). Prevalence of physical inactivity and recommended physical activity in community-based adults with mental retardation. Mental Retardation, 40, 436-444.

Durstine, J. L., Painter, P., Franklin, B. A., Morgan, D., Pitetti, K. H., & Roberts, S. O. (2000). PA for the chronically ill and disabled. Sports Medicine, 30, 207-219.

Epstein, L. H. (1998). Integrating theoretical approaches to promote physical activity. American Journal of Preventive Medicine, 15(4), 257-265.

Frey, G. C., Buchanan, A. M., & Rosser, D. D. (2004). "I'd Rather Watch TV": An examination of physical activity behavior in adults with mental retardation. Unpublished manuscript submitted for publication.

Gibson, E. J. (1988). Exploratory behavior in the development of perceiving, acting, and the acquiring of knowledge. Annual Review of Psychology, 39, 1-41.

Guthrie, S. R., & Castelnuovo, S. (2001). Disability management among women with physical impairments: The contribution of physical activity. Sociology of Sport Journal, 18, 5-20.

Hedrick, B. N., & Broadbent, E. (1996). Predictors of physical activity among university graduates with physical disabilities. Therapeutic Recreation Journal, 30(2), 137-148.

Heller, T., Ying, G. S., Rimmer, J. H., & Marks, B. (2002). Determinants of exercise in adults with cerebral palsy. Public Health Nursing, 19(3), 223-231.

Hudson, C. G. (2000). At the edge of chaos: A new paradigm for social work? Journal of Social Work Education, 36(2), 215-230.

Henderson, K. A., & L. A. Bedini (1995). ""I have a soul that dances like Tina Turner, but my body can't": Physical activity and women with mobility impairments." Research Quarterly for Exercise and Sport, 66(2), 151-161.

King, A. C., Stokols, D., Talen, E., Brassington, G. S., & Killingsworth, R. (2002). Theoretical approaches to the promotion of PA: Forging a transdisciplinary paradigm. American Journal of Preventive Medicine, 23(2S), 15-25.

Kinne, S., Patrick, D. L., & Maher, E. J. (1999). Correlates of exercise maintenance among people with mobility impairments. Disability and Rehabilitation, 21(1), 15-22.

Kozub, F.M. (2001). Adapted physical activity within the family- The family systems theory. Palaestra, 17(3), 30-38.

Kozub, F. M. (2003). Explaining physical activity in individuals with mental retardation: An Exploratory study. Education and Training in Developmental Disabilities, 38, 302-313.

Kozub, F. M., & Oh, H. (2004). An exploratory study of physical activity levels in children and adolescents with visual impairments. Clinical Kinesiology, 58(3), 1-7.

Kozub, F. M., & Porretta, D. L. (1998). Interscholastic coaches' attitudes toward integration of adolescents with disabilities. Adapted PA Quarterly, 15, 328-344.

Latash, M. L. (2000). Motor coordination in Down syndrome: The role of adaptive changes. In D. Weeks, R. Chua, & D. Elliott (Eds.). Perceptual-motor behavior in down syndrome. (pp. 199-221). Champaign, IL: Human Kinetics.

Macy, M. W., & Willer, R. (2002). From factors to actors: Computational sociology and agent-based modeling. Annual Review of Sociology, 28, 143-166.

Maher, E. J., Kinne, S., & Patrick, D. L. (1999). 'Finding a good thing': the use of quantitative and qualitative methods to exaluate an exercise class and promote exercise for adults with mobility impairments. Disability and Rehabilitation, 21(9), 438-447.

Messent, P. R., Cooke, C. B., & Black, K. (1997). The measurement of physical activity in community-based programmes for adults with learning disabilities. Journal of Sport Sciences, 15, 30-31.

Newell, K. M. (1986). Constraints on the development of coordination. In M. G. Wade & H.T.a. Whiting (Eds.), Motor development in children: Aspects of coordination and control (pp. 341361). Amsterdam: Martin Nijhoff.

Ottino, J. M. (2003). Complex systems. American Institute of Chemical Engineers, 49, 292-299.

Rimmer, J. H., Braddock, D., & Pitetti, K. H. (1996). Research on PA and disability: An emerging national priority. Medicine and Science in Sports and Exercise, 28(8), 1366-1372.

Scott, S., Kozub, F. M., & Goto, K. (2005). Tae Kwon Do for children with autism spectrum disorder. PALAESTRA, 21(1), 40-43; 60.

Suematsu, Y. I. L., Takadama, K., Nawa, N. E., Shimohara, K., & Katai, O. (2003). Analyzing the agent-based model and its implications. Advances in Complex Systems, 6, 331-347.

Thelen, E., & Smith, L. B. (1994). A dynamic systems approach to the development of cognition and action. Cambridge, MA: MIT Press.

Trost, S. G., Owen, N., Bauman, A. E., Sallis, J. F., & Brown, W. (2002). Correlates of adults' participation in physical activity: Review and update. Medicine & Science in Sport & Exercise, 34, 1996-2001.

U.S. Department of Health and Human Services. (2000). Healthy people 2010: Disability and Secondary Conditions (2nd ed.). Washington, DC: U.S. Government Printing Office.

U.S. Department of Health and Human Services. (1996). PA and health: A report of the surgeon general. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996.

Wehmeyer, M. L. (1994). Perceptions of self determination and psychological empowerment of adolescents with mental retardation. Education and Training in Mental Retardation and Developmental Disabilities, 29, 9-21.

Wu, S. K., & Williams, T. (2001). Factors influencing sport participation among athletes with spinal cord injury. Medicine & Science in Sports & Exercise, 33(2), 177-182.

Francis M. Kozub and Georgia Frey

Indiana University

Francis M. Kozub, Department of Kinesiology, Indiana University; Georgia Frey, Department of Kinesiology, Indiana University.

Correspondence concerning this article should be addressed to Francis M. Kozub, Department of Kinesiology, 179 HPER Building, 1025 East 7th St., Indiana University, Bloomington, IN 47405. Email:
COPYRIGHT 2005 American Therapeutic Recreation Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2005 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Kozub, Francis M.; Frey, Georgia
Publication:Annual in Therapeutic Recreation
Date:Jan 1, 2005
Previous Article:The changing contextualization of therapeutic recreation: a 40 year perspective.
Next Article:Application of learning theory to leisure education.

Terms of use | Privacy policy | Copyright © 2019 Farlex, Inc. | Feedback | For webmasters