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The purpose of the study was to investigate the effects of a Special Olympics (SO) Unified Sports (UNS) soccer program on psycho-social attributes of youth with and without intellectual disabilities (ID). Participants were 76 male youth with (n = 38) and without (n = 38) ID. Participants with ID were randomly allocated into a SO athletes group (n = 23, mean age=14.5; SD=1.2 years) and a control group (CG) (n = 15, mean age=14.5; SD = 0.8 years). Twenty-three randomly selected youth without ID formed the partner group (mean age = 14.1; SD = 0.9 years) and 15 youth without ID (mean age = 13.8; SD = 0.5 years) formed the CG. Instruments included the Friendship Activity Scale (FAS) (Siperstein, 1980), the Adjective Checklist (Siperstein, 1980), and the Children Behavior Checklist (Achenbach, 1991). The soccer training program lasted eight weeks, 1.5 h per session, three times per week, in addition to school physical education (PE). The CG did not participate in any sports in addition to PE. The findings showed that the UNS program was effective in decreasing the problem behaviors of youth with ID and increasing their social competence and FAS scores. In addition, the program was found to be effective in improving the attitude of youth without disabilities toward participants with disabilities. In conclusion, the present findings demonstrate the utility of a UNS program for both youth with and without disabilities. (Contains 5 tables.)

Background: Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. Method: Criteria for compliance were the averaged number of times participants attempted to discontinue walking during two 5-min exercise sessions of treadmill walking at an intensity of 65-75% of predicted maximal HR. Fifteen children aged 5-11 with moderate to severe ID participated in the study. Training conditions were (a) close supervisor's position, (b) distant supervisor's position, (c) positive reinforcement, and (d) paired modeling. Results: General linear mixed model statistics revealed significant differences in favor of the paired modeling and positive reinforcement compared to the other conditions. Leaning forward was the most frequent type of participants' attempt to stop exercising. Conclusions: Paired modeling and positive reinforcement should be considered within treadmill training programs for children with moderate to severe ID.

Background: The 6-minute walk test (6MWT) and treadmill walk tests (TMW) are commonly used to assess post-stroke patients (PSP) aerobic capacity. However, these tests are not without their limitations (e.g. limited sensitivity to change and the use of external pacing). Therefore, there is a need for additional tools to assess PSP aerobic capacity. Objective: To establish the feasibility, convergent validity, and metabolic, cardiac, and respiratory responses of a stair climbing test (SC), among chronic PSP. Methods: Nineteen chronic PSP conducted SC, TMW, and 6MWT. Metabolic (oxygen consumption -- VO2 ), cardiac (heart rate), and respiratory (ventilation volume, breathing frequency, and tidal volume) measures were established. Adverse events were documented. Correlations established the convergent validity of the SC test. A repeated measures analysis of variance was performed to compare the participant's physiological responses at the end of the various tests. Results: SC is feasible and safe, as all participants completed the test with no adverse events. The SC demonstrated convergent validity as numerous associations were found between SC and TMW, and 6MWT. Metabolic, cardiac, and respiratory responses to the SC were significantly higher than these of the TMW and 6MWT (e.g. VO2 = 13.43 ± 2.19,11.01 ± 2.0, and 11.26 ± 1.87 ml/kg/min, respectively) (P < 0.05). Conclusions: SC is a feasible and valid test within chronic PSP. SC is more metabolically demanding than TMW and 6MW and therefore, may enable appropriate endurance capacity measurement, especially for high functioning PSP. Negotiating stairs is a common community ambulation requirement. Therefore, it is appropriate to incorporate SC test in PSP testing battery. [ABSTRACT FROM AUTHOR]

Anaerobic exercise testing has been applied since the 1970s as a procedure for estimating the capacity of local energy mechanisms dominating short term exercise. Compared with lower-body anaerobic testing, upper-body anaerobic testing is relatively new and less fully investigated. The reported data in this area are limited, and there is a paucity of reference values. For this review, the literature was searched by computerised inquiries of international and local databases, as well as personal access to PhD theses and congress proceedings. This article reviews the existing literature, covering a period of 20 years from 1976 to 1995. Data are reported concerning the findings of variables relevant to the anaerobic capacity of wheelchair users. The research findings revealed in the literature published so far are analysed here with particular attention paid to the methods and instrumentation used (type of ergometer and protocol utilised in the tests). Limitations in existing instrumentation and research designs and goals for further study have been suggested. Specific sections analyse the relevance of anaerobic performance variables to the classification and activity level of the individuals involved and their relevance to daily life and sports-related physical performance. Inter-relationships observed between anaerobic and aerobic capacity indices are discussed with respect to the limiting nature of local muscular fatigue over central processes. This information may be helpful in better understanding the exercise limitations and potential of wheelchair users with lower-limb impairments. Thus, clinical application of anaerobic fitness testing in these individuals may be enhanced. [ABSTRACT FROM AUTHOR]

Despite its positive impact on physical and mental well-being, adults may refrain from performing regular physical activity, due to inadequate time, accessibility, or funds. Yet remote platforms could overcome such obstacles and increase participation. This study evaluated the effectiveness of remote-synchronous group-Pilates classes compared to in-studio classes in healthy sedentary women. In a randomized controlled design, 40 women, aged 20-45, were assigned to a Zoom or studio group-Pilates training. The intervention included twice-weekly 45 min sessions over an eight-week period. Attendance (adherence) was recorded, and the participants completed physical motor tests (plank, curl-up, stork, push-up, and V-sit and reach), Profile of Mood State Surveys, and Nordic Musculoskeletal Pain Questionnaires. Evaluations were performed at baseline, mid-intervention (4 weeks), and post intervention (8 weeks). Adherence to training was high in the Zoom and studio groups (80% and 74%, respectively). Improvements in physical motor tests were seen in both groups following the Pilates interventions, thereby indicating the effectiveness of group-Pilates Zoom training. In conclusion, remote online physical activity such as Pilates offers a good alternative to in-studio trainings, as a means for improving physical fitness and promoting a healthy lifestyle in adults, by offering a more accessible and less timely alternative to in-studio physical activity programs.

Patient-centered health care (PCC) is a framework of clinical care focused on the patient's individual health care needs. In particular, it emphasizes the development of a partnership between the patient, physician, and healthcare workers to actively involve and empower the patient in their health care decisions. Additionally, PCC goals include ensuring access to care, emotional support, engaging patient support systems, physical comfort, and continuity of care. Technology also provides a platform to engage patients and their families in their care and can be a useful tool to gauge their level of interest, knowledge, and motivations to adequately educate them on the many factors that contribute to their disease, including diet, exercise, medication adherence, psychological support, and early symptom detection. In this article, we summarize the importance of technology in promoting PCC in cardiac rehabilitation and the impact technology may have on the different aspects of patient and physician relationships. Modern technological devices including smartphones, tablets, wearables, and other internet-enabled devices have been shown to help patient-staff communication, cater to patients' individual needs, increase access to health care, and implement aspects of PCC domains., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Cardiovascular diseases (CVD) are a precursor for disabilities and death worldwide. Being overweight or obese in combination with physical inactivity and smoking habits may increase the risk for CVD and other health problems such as lower limb osteoarthritis, diabetes, stroke, and various cancer types among children and adolescents. The literature emphasizes the need to follow such groups and evaluate the risk of individuals developing CVD diseases. Therefore, the current study explores the variety of cardiovascular risks in children and adolescents' profiles clusters with and without disabilities., Methods: Data from 42 countries including Israel, was collected with the support of the world health organization (WHO, Europe) through a questionnaire from 11-19 years old school-aged., Results: The study finding shows that children and adolescents with disabilities demonstrated a higher prevalence of overweight than those who completed the HBSC youth behavior survey. Moreover, the prevalence of tobacco smoking and alcohol use was statisticaly significantly higher among the disabled group than the non-disabled group. In addition, socioeconomic status of responders who presented a very high CVD risk was found as significantly lower than those from the first and second low risk groups., Conclusion: This led to the conclusion that children and adolescents with disability were at a higher risk of developing CVDs than their non-disabled peers. In addition, intervention programs tailored to the needs of adolescents with disability should consider lifestyle habit change and promoting healthy living thus improving their quality of life as well as reducing their risk of being exposed to severe CVD diseases., (© 2023. The Author(s).)

This is an overview of the results from 14 countries or jurisdictions in a Global Matrix of Para Report Cards on physical activity (PA) of children and adolescents with disabilities. The methodology was based on the Active Healthy Kids Global Alliance's Global Matrix 4.0. Data were aligned with 10 indicators (Overall PA, Organized Sport, Active Play, Active Transport, Physical Fitness, Sedentary Behavior, Family & Peers, Schools, Community & Environment, and Government) to produce Para Report Cards. Subsequently, there were 139 grades; 45% were incomplete, particularly for Active Play, Physical Fitness, and Family & Peers. Collectively, Overall PA was graded the lowest (F), with Schools and Government the highest (C). Disability-specific surveillance and research gaps in PA were apparent in 14 countries or jurisdictions around the world. More coverage of PA data in Para Report Cards is needed to serve as an advocacy tool to promote PA among children and adolescents with disabilities.

The purpose was to synthesize information gathered from the interpretation and conclusion sections of the Global Matrix of Para Report Cards on the physical activity of children and adolescents with disabilities. The synthesis was based on the strengths, weaknesses, opportunities, and threats framework. The procedure consisted of three stages: (a) the application of the International Classification of Functioning, Disability and Health as the theoretical framework; (b) identifying and aligning Global Matrix indicators and benchmarks with the International Classification of Functioning, Disability and Health components through a Delphi approach; and (c) using content analysis to identify themes from specific report cards. Outcomes reveal that further attention toward including children and adolescents with disabilities in fitness assessments is needed as well as adapted assessment methods. Program availability, equipment and facilities, and professional training emerged as strengths but need further development to overcome weaknesses. Paralympic inspiration was an opportunity, whereas extreme weather conditions presented potential threats to physical activity participation among children and adolescents with disabilities.

Children and adolescents with disabilities (CAWD) represent 11% of Israeli children and adolescents. The 10 core indicators of the Global Matrix on Para Report Cards of physical activity (PA) of CAWD were used to create the 2022 Israeli Para Report Card. A panel of four experts reviewed resources and synthesized evidence of PA behaviors and policies for CAWD in Israel, converted the data to grades, and charted subcategories of language, sex, and disability across population. Data sources were surveys, reports, and memberships in sport federations and clubs. Among CAWD, levels of participation in daily PA were poor (<20%; Grade F), and participation of CAWD in sports was even lower (<10%; Grade F). A lack of environmental infrastructure may explain the low levels of participation. Females, Arabic speakers, and physiological CAWD need particular attention. Establishing governmental policies and interventions is required to increase overall PA and participation in sports among CAWD.

In Spain, wheelchair basketball competition is well developed and structured; however, reverse integration is not allowed. This study aimed to describe and synthesize the perceptions of Spanish wheelchair stakeholders (players, coaches, referees, and club managers). A mixed-method approach was used, utilizing an ad hoc survey questionnaire (n = 49) and three focus groups (n = 12). Quantitative and qualitative data were interpreted using a triangulation strategy, meaning that both sources of data were combined and analyzed. From the thematic content analysis, two main themes and several subthemes emerged: social context (audience attraction and economic impact, utility and logistics, and promoting inclusion) and sport context (grassroots and elite level). Some reservations at elite level were also reported. From the perspective of the stakeholders explored in this study, reverse integration appears to be well suited for implementation within the Spanish wheelchair basketball framework at all levels.

Background: Physical inactivity among children and adolescents with disabilities (CAWD) is a global public health issue. Policy efforts to promote physical activity (PA) among CAWD have increased. This study summarizes the international policy trend for promoting PA among CAWD, with behavioral and policy insights specific to CAWD from country/regional indicators from the Active Healthy Kids Global Alliance Matrix on Physical Activity for Children and Adolescents to determine policy translation into practice., Methods: International and national PA policy documents on CAWD were assessed. Data from the Global Matrix Para Report Cards on the behavioral and government indicators from 14 countries or regions (grouped by human development index) were reviewed and compared., Results: Policy instruments began promoting PA for CAWD in 1989 via the Convention on the Rights of the Child. International policy has been advocating PA specifically for CAWD recently. In 2020, the World Health Organization published specific PA guidelines for CAWD. Data from the 14 Para Report Car found 14 grades on the average behavioral indicator and 12 on the government indicator. A gap between the average behavioral indicator (D-) and the government indicator (C+) was found in the Para Report Card data., Conclusions: Although international policies are consistent in their attention to the needs of CAWD, national/regional policies vary. Coverage ranges from nonexistent to embedded in broader inclusion concepts. A gap in policies to promote PA of CAWD is prevalent and is more prominent in countries or regions with a lower human development index ranking.

Background: Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility., Objective: To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors., Methods: Twenty-two individuals chronic poststroke participated in the study, and were divided into 2 groups (each group performing an 8-session exercise program): 11 participated in dual-task walking (DTW), and the other 11 participated in single-task treadmill walking (TMW). The study was a randomized controlled trial, with assessors blinded to the participants' allocated group. Measurements were conducted at pretest, post-test, and follow-up. Outcome measures included: the 10-m walking test (10 mW), Timed Up and Go (TUG), the Functional Reach Test (FRT), the Lateral Reach Test Left/Right (LRT-L/R); the Activities-specific Balance Confidence (ABC) scale, and the Berg Balance Scale(BBS)., Results: Improvements were observed in balance variables: BBS, FRT, LRT-L/R, (P < .01) favoring the DTW group; in gait variables: 10 mW time, also favoring the DTW group (P < .05); and the ABC scale (P < .01). No changes for interaction were observed in the TUG., Conclusions: The results of this study demonstrate the potential of VR-based DTW to improve walking and balance in people after stroke; thus, it is suggested to combine training sessions that require the performance of multiple tasks at the same time., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Soccer is the world's most popular sport. The present authors evaluated the effect of the Game of Life (GOL) soccer initiative on soccer skills, fitness and mobility of adults with intellectual disability (ID) and autism spectrum disorder (ASD)., Methods: The programme is comprised of once-weekly sessions., Outcomes: soccer skills, fitness and mobility. Effectiveness was evaluated using within-/between-group analyses (e.g. effect size, ES)., Results: Fifty adults with intellectual disability and 19 with ASD (age = 31.80 ± 10.11) participated in this study. From pre-test to post-test, the intellectual disability group improved their soccer skills (ES = 0.437); physical fitness-the intellectual disability group presented trivial ESs, whereas the ASD group showed moderate-to-large ESs; Mobility-only the ASD group presented a significant improvement (ES=-0.435), and the intellectual disability group presented better ability in most outcomes in pre- and post-tests., Conclusion: The findings indicated differences in entry-level performance and training impact between the two groups. This should be considered when developing training programmes for soccer players., (© 2019 John Wiley & Sons Ltd.)

Background and Purpose: The group of individuals 85 years and over (termed oldest-old) is the fastest-growing population in the Western world. Although daily functional abilities and balance capabilities are known to decrease as an individual grows older, little is known about the balance and functional characteristics of the oldest-old population. The aims of this study were to characterize balance control, functional abilities, and balance self-efficacy in the oldest-old, to test the correlations between these constructs, and to explore differences between fallers and nonfallers in this age group., Methods: Forty-five individuals living in an assisted living facility who ambulated independently participated in the study. The mean age was 90.3 (3.7) years. Function was tested using the Late-Life Function and Disability Instrument (LLFDI). Balance was tested with the mini-Balance Evaluation System Test (mini-BESTest) and the Timed Up and Go (TUG) test. Balance self-efficacy was tested with the Activities-Specific Balance Confidence (ABC) scale., Results: The mean total function LLFDI score was 63.2 (11.4). The mean mini-BESTest score was 69.8% (18.6%) and the mean TUG time was 12.6 (6.9) seconds. The mean ABC score was 80.2% (14.2%). Good correlation (r > 0.7) was observed between the ABC and the function component of the LLFDI, as well as with the lower extremity domains. Correlations between the mini-BESTest scores and the LLFDI were fair to moderate (r's range: 0.38-0.62). Age and ABC scores were significant independent explanators of LLFDI score (P = .0141 and P = .0009, respectively). Fallers and nonfallers differed significantly across all outcome measures scores, except for TUG and for the "Reactive Postural Control" and "Sensory Orientation" domains of the mini-BESTest., Discussion and Conclusions: The results of this study provide normative data regarding the balance and functional abilities of the oldest-old, and indicate a strong association between self-efficacy and function. These results emphasize the importance of incorporating strategies that maintain and improve balance self-efficacy in interventions aimed at enhancing the functional level of this cohort.

Purpose: The comparison of habitual physical activity and sedentary time in teenagers and young adults with cerebral palsy (CP) with typically developed (TD) peers can serve to quantify activity shortcomings., Methods: Patterns of sedentary, upright, standing, and walking components of habitual physical activity were compared in age-matched (16.8 y) groups of 54 youths with bilateral spastic CP (38 who walk with limitations and 16 who require mobility devices) and 41 TD youths in the Middle East. Activity and sedentary behavior were measured over 96 hours by activPAL3 physical activity monitors., Results: Participants with CP spent more time sedentary (8%) and sitting (37%) and less time standing (20%) and walking (40%) than TD (all Ps < .01). These trends were enhanced in the participants with CP requiring mobility devices. Shorter sedentary events (those <60-min duration) were similar for TD and CP groups, but CP had significantly more long sedentary events (>2 h) and significantly fewer upright events (taking <30, 30-60, and >60 min) and less total upright time than TD., Conclusion: Ambulant participants with CP, as well as TD youth must be encouraged to take more breaks from being sedentary and include more frequent and longer upright events.

This study addresses the associations between students' ability beliefs and attitudes toward inclusion in physical education, as well as the impact of gender and previous contact/participation with children with disability on these variables. A cross-sectional study was conducted with 976 students (491 girls and 485 boys; age 11-16 years), who responded to ability beliefs and attitudes questionnaires. Ability beliefs (entity and incremental) and the 3 sociodemographic variables predicted 20.4% and 9% of the behavioral and cognitive subscales of attitudes, respectively. Students with higher scores for entity beliefs of ability had a less favorable attitude toward inclusion. Girls reported more favorable attitudes toward inclusion than boys. Students who indicated previous participation in physical activities with children with disabilities showed attitudes that were more favorable in both the behavioral and cognitive subscales, while those who reported previous contact had more favorable attitudes in the behavioral subscale and lower entity beliefs. However, the 3 sociodemographic variables had a lower contribution to the explained variance of attitudes.

Sufficient and regular physical activity is considered a protective factor, reducing the onset of secondary disability conditions in adolescents with chronic diseases and functional limitations. The aim of this study was to explore whether participation in organized sport may be associated to higher levels of physical activity in adolescents with functional limitations, based on a national representative sample. Data from the Health Behaviour in School-aged Children (HBSC) study collected in Finland from two data collection rounds (2002 and 2010) were conducted and pooled from adolescents aged between 13 and 15 years old with functional limitations ( n = 1041). Differences in self-reported physical activity over the past week and participation in organized sport activity were analysed for each function. Overall, four in ten ( n = 413) participated in organized sport and were significantly ( p < 0.001) more physically active (mean = 4.92days, SD = 1.81) than their non-participating (mean = 3.29, SD = 1.86) peers with functional limitations. Despite low population prevalence, adolescents with epilepsy or visual impairments were the least active if they were not participating in organized sport, yet were the most active if they were involved in organized sport. Participating in organized sport appears to be an important factor promoting resources for maintaining recommended levels of physical activity in Finnish adolescents with functional limitations.

Children with cerebral palsy (CP) are often mainstreamed into the general education system, but are likely to be excluded from physical education (PE) classes. A questionnaire was constructed and utilized to measure PE teachers' self-efficacy (SE) toward inclusion of students with CP in each of three mobility categories (independent, using assistive devices, using wheelchair mobility) and the impact of experience and training on teachers' SE. Participants in the study were 121 PE teachers from different parts of Israel (mean age: 41.02±9.33 years; range: 25.00-59.00 years). Exploratory factor analysis was used to determine the structure of the sub-scales' factors' structure and Cronbach's Alpha reliability was satisfactory (range 0.872-0.941). Independent t-tests were calculated in order to compare the SE of teachers with and without adapted PE experience. Repeated Analysis of Variance was performed to measure within-group differences in SE. Results revealed that the PE teachers' SE in teaching students who use mobility assistive devices or wheelchairs was significantly lower compared to teaching those who walk and run unaided (F=19.11; p<0.001). The teachers' SE towards including CP children who independently ambulate was influenced (p<0.05; d=0.94) by the teacher's experience (elementary school practicum). SE in the mobility with assistive device group was also significantly influenced (p<0.05; d=0.1) by teaching experience (previous experience and having a specialization in adapted PE). Finally, SE when teaching the wheelchair mobility group was influenced by having an adapted PE specialization (p<0.05; d=0.82). Specialized training in this particular area should be enhanced to increase teachers' SE and enable greater participation of children with CP in general physical education classes., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Rapid voluntary stepping has been recognized as an important measure of balance control., Objective: The purpose of this study was to assess the feasibility and convergent validity of a Rapid Stepping Test protocol utilizing a virtual reality SeeMeTM system (VR-RST) in elderly ambulatory and independent individuals living in a community residential home., Methods: Associations between step execution times determined by the system and the Activities-specific Balance Confidence (ABC) Questionnaire, and clinical measures of balance performance in the MiniBESTest and Timed Up and Go (TUG) test, were established in 60 participants (mean age 88.2 ± 5.0 years). All participants completed the study., Results: The correlations of the ABC questionnaire and the clinical tests with VR-RST forward and backward stepping were moderate (ρ rage 0.42-0.52), and weak to moderate with sideward stepping (ρ rage 0.32-0.52). Moderate to strong correlations were found across stepping directions (ρ rage 0.45-0.87)., Conclusion: Findings support the test's feasibility and validity and confirm the utility of the VR-RST as an assessment tool in an elderly population.

This review summarizes the knowledge regarding the effects and recommendations for physical training (PTr) post-stroke. In addition, perceived benefits/barriers to PTr post-stroke are reviewed. PTr is an important post-stroke rehabilitation goal. Before beginning a PTr program it is recommended to conduct a physical examination. There is evidence that aerobic training post-stroke has a positive effect on gait and on risk factors for recurrent stroke. Similarly, strength training is also safe and effective. However, this training modality does not improve.gait functions. Neuromuscular training post-stroke is also a recommended training method. In the various studies conducted, there was diversity with regard to duration and frequency of PTr. It is recommended that individuals post-stroke engage in aerobic training 3-5 days a week. During the acute phase, the rating of perceived exertion should be "fairly light" (less or equal to 11 on the Borg scale, which ranges 6-20). In more advanced phases of recovery, one ca exercise at a higher intensity of up to "somewhat hard" (rating of perceived exertion 11-14; 55-80% of maximal heart rate). It is also recommended to conduct strength training (2-3 days per week, 1-3 sets of 10-15 repetitions), and flexibility and neuromuscular training (2-3 days per week). In order to encourage individuals post-stroke to conduct PTr there is a need for social support (from caregivers and family) and to provide PTr consultation. PTr barriers consist of both personal (e.g., depression, knowledge regarding physical activity centers) and environmental (e.g., lack of transportation) factors.

This review summarizes the existing knowledge regarding the effects and recommendations for physical training (PTr) in patients with multiple sclerosis (MS). In addition, perceived benefits and barriers to PTr in this population are reviewed. One of the primary aims of rehabilitation for patients with MS is to increase their levels of activity and independence. PTr is a central component in the rehabilitation process. Nonetheless, the use of PTr in the rehabilitation of patients with MS has been a controversial issue for years. Nowadays, strong evidence exists that aerobic training in individuals with MS has a positive effect on overall physical conditioning, gait speed, fatigue, depression and cognition. Unlike aerobic training, the number of studies that investigated strength training effects in this population is limited. However, the available data show that resistance training also has beneficial effects on MS patients. It is important to note, that PTr has no deleterious effects in MS patients. In the various studies, there was diversity with regard to the duration and the frequency of PTr, while intensity was often poorly described. It is recommended that individuals with MS engage in aerobic training (at 60-80% of maximal heart rate), strength training (1-3 sets of 8-15 repetitions), the range of motion, balance and ambulation exercises. Awareness of the benefits of physical activity and sense of achievement are not sufficient to promote exercise participation in persons with MS. Factors relating to physical exertion, sports facilities availability and self-efficacy play an important role in promoting exercise participation.