Research Annotation Student Name: Jackie Webel Research Paper Title: Leisure-time physical activity and secondary conditions in women with physical disabilities 1. APA- Style Reference: Santiago, M.C.; Coyle, C.P. Leisure-time physical activity and secondary Conditions in women with physical disabilities. Disability and Rehabilitation (2004). 26: (8) 485-494. 2. Study design: The target population for the study was women ages 21-65 with physical disabilities. All of the women lived in an urban, metropolitan area of the East coast of the United States and had their disability for at least one year. Survey packets (cover letter, survey instrument, self-addressed stamped envelope, and information on how to contact research staff) were sent to 700 potential participants. There was a response rate of approximately 30% (n = 208). The survey contained questions regarding health status and health needs and was estimated to take approximately 45-60 minutes to complete. The participants were asked to identify their primary disability as, “your first health condition diagnosed by a physician that routinely limits your activities.” Respondents were then asked about the occurrence and severity of 32 possible secondary conditions. These conditions ranged from those that were caused directly by the impairment/illness to conditions that “result from the interplay between the disability and environmental conditions.” Information about the respondent’s functional status was assessed using an instrument developed from the National Health and Nutrition Examination Survey (NHANES-III). The instrument asks respondents to rate how severely their disability limits their functioning in 14 basic tasks. Leisure-time physical activity was assessed through the use of the NHANES-III survey, which included nine recreational activities (walking, jogging/running, bicycling, swimming, aerobics/aerobic dancing, calisthenics/exercise, gardening/yard work, and weight lifting). The respondent was asked how many times he or she performed the activity in the past month. 3. Problem addressed in the study: The authors sited that the promotion of health in persons with disabilities has gained increasing attention and become a priority of the national health agenda. Increasing the level of physical activity may be effective in promoting health by improving functioning and increasing independence. The authors referred to the Healthy People 2010 document, highlighting that people with disabilities have a higher level of physical inactivity when compared to their able-bodied peers. 4. What were the research questions that the investigator sought to answer? What is the correlation between physical disability and reduced leisuretime physical activity? What is the correlation between reduced leisure-time physical activity and the prevalence of secondary conditions? What is the correlation between reduced leisure-time physical activity and functional status? 5. What were the independent variables and their operational definitions? Independent variables: Presence of a physical disability: described as “MS, CP, polio, arthritis, TBI, and CVA among others” Gender: all participants were female Age: individuals between the ages of 21-65 6. What were the dependent variables and their operational definitions? Dependent variables: Functional Status: defined by a functional status score on the NHANESIII measure. Leisure-time physical activity participation: defined by the level of participation according to the NHANES-III measure. Secondary conditions: defined by the response to a survey of 32 possible conditions. 7. How were the subjects selected? Describe the subjects and sample size. There were 208 participants in the survey study. Participants were recruited through three disability organizations (Chapter of the National MS Society and two independent living centers) and radio and print notices. All subjects were women between the ages of 21-65 with a physical disability. All subjects lived in an urban, metropolitan area of the east coast in the United States. The mean age of respondents was 46.8 years. Respondents were identified largely as Caucasian (78%), followed by African-American (15%). The sample was noted to be welleducated group since 52.4 % indicated that they had completed some college work. Almost half stated that they were unable to work due to their disability. The respondents identified over 40 different disabling conditions as their primary disability (most frequently MS, followed by CP, TBI and arthritis). Respondents had lived with their disability an average of 20.2 +/- 14.5 years. 8. What statistical procedures were used? All statistics were performed using SPSS. Descriptive statistics (means, SD, and frequency distributions) were calculated for demographic variables, disability data and leisure-time physical activity participation. Reported secondary conditions were ranked by percentage of women stating the condition to be a problem. Since MS was the most frequently identified primary disability, independent t-tests were used to investigate possible differences in number of secondary conditions reported, average severity of secondary conditions, functional status score, or leisure-time physical activity participation between respondents with MS and those with other conditions. Correlational analyses were used to investigate the relationship between occurrence and severity of secondary conditions, functional status, and leisure-time physical activity participation. 9. Briefly describe the results Correlations indicated that weekly involvement in leisure-time physical activity was significantly inversely correlated with functional status. The number of secondary conditions was not correlated with weekly leisure-time physical activity participation. There was a statistically significant, but weak, corelaiton between leisure-time physical activity participation, functional status, and the secondary conditions of mobility problems, physical deconditioning, and isolation. Were the research questions answered? The research questions were answered, but they were very indirect questions. The questions sought to determine the correlation between functional status, leisuretime physical activity, and secondary conditions, but no hypotheses were made as to how the variables would be correlated. I found several problems with the study that may have contributed to the lack of statistical significance in many of the results. When selecting participants, the research staff was prohibited from any direct follow-up with potential participants or from reviewing the mailing lists prior to sending the survey packets. The authors commented that this prohibited them from determining if any responses were duplicates, so an exact response rate could not be determined. The wide range of ages surveyed and the extreme variability in the number of years that the women had a disability could also be a factor. Respondents were asked to respond to a very small set of activities when asked about their leisure-time physical activity, which may have misconstrued the true about of time they spend engaging in physical activity. The functional status measurement asked respondents to rate how severely their disability limits their functioning, but it does not allow for them to excel in any area. This negative scoring (much like that discussed with the ICF) may contribute to a functional status score that is not a true representation of the functional status of the individual. 10. What were the conclusions? The conclusions were very general, stating that the current findings are consistent with previous reports of a high prevalence of physical inactivity in women with physical disabilities. The authors stated that this study indicated the prevalence of physical inactivity at a 12% higher rate in women with disabilities than women without disabilities. The findings suggested that when functional status is statistically controlled, prevalent secondary conditions co-exist with reduced levels of participation in leisure-time physical activity. The study cannot determine if the low level of leisure-time physical activity in women with physical disabilities contributes to physical deconditioning and isolation, or if having these secondary conditions leads to lower levels of leisure-time physical activity.