How is the participation of individuals with disabilities studied and understood in current research within the sport context? A systematic literature review

Figures & data

Table 1. Inclusion- and exclusion criteria.

	Inclusion criteria	Exclusion criteria
Phenomenon of interest	Papers that study and present data on the participation of people with disabilities in the sport context from the perspective of the athlete(s), caregiver(s) (i.e. when athletes are considered by the researchers as unable to answer themselves), or both. Papers including perspectives from able-bodied athletes in addition to athletes with a disability.	Research that aims to gather empirical data on prerequisites (e.g. barriers or facilitators) or outcomes of participation (e.g. increased fitness, social inclusion). Papers including only perspectives of able-bodied athletes (e.g. exploring able-bodied experiences of Reverse Integration), or purposefully only the perspectives of the caregiver(s).
Disability type	Four main categories; physical disability, vision impairment, hearing impairment and intellectual disability (including neurodevelopmental disorders such as autism spectrum (ASD) disorder and activity-deficit/hyperactivity-disorder (ADHD)).	Studies adopting a broad understanding of disability (e.g. pregnancy, overweight, elderly, anxiety).
Context	Organized sport integrated or segregated, including high-performance events such as Paralympics, Special Olympics and Deaflympics.	Physical activity in general, leisure time physical activity in general, recreation or recreational physical activity, (adapted) physical education, non-recurring sport events, sport venues.
Study design	All study designs are included.	No limitations.
Publication type	Peer-reviewed primary studies.	Reviews, meta-analysis, protocols, commentaries, book chapters, theses, conference proceedings, abstracts and grey literature.
Language	English.	Non-English studies.
Publication year	2001–2022.	Papers published before 2001.

Figure 1. PRISMA flow diagram displaying study selection process.

Table 2. Characteristics of the included studies.

Author/title	Explicit definition of partici-pation	Method/ Design	Source of data	Participation measure(s)		Descriptive theme(s) related to sport participation
				A	I
Allan et al. (2018). Narratives of participation among individuals with physical disabilities: A life-course analysis of athletes’ experiences and development in parasport	Quality participation	Qual:I (CS)	I:a	F (‘How often … ’ (p.9))	‘How did you feel when you were engaged in [parasport activity]?’ (p.10) ‘What were the most valued elements of your experiences in parasport?’ (p.10)	Quality Participation (autonomy, belongingness, challenge, engagement, mastery, and meaning)
Arbour-Nicitopoulos et al. (2022). Quality of Participation Experiences in Special Olympics Sports Programs	Quality participation	Quan:Q (CS)	I:a	Y/N	Measure of Experiential Aspects of Participation (MeAP)	Quality Participation (autonomy, belongingness, challenge, engagement, mastery, and meaning)
Ashton-Shaeffer et al. (2001). Women's Resistance and Empowerment through Wheelchair Sport	UD	Qual:I (CS)	I:a	NM	‘Tell me about some of your wheelchair sport experiences … ’ (p.14)	Contextual features/Empowerment
Bantjes et al. (2019). Troubling stereotypes: South African elite disability athletes and the paradox of (self-)representation	UD	Qual:I (CS)	I:a	NM	‘(…) experiences of participation in disability sport’ (p.823)	Contextual features/Empowerment; Contextual features/Oppression
Basakci Calik et al. (2019). Relationship between balance and co-ordination and football participation in adolescents with intellectual disability	UD	Quan:M (CS)	I:a	F(w)	NM	Outcomes/Body functions
Bates et al. (2019). ‘A level playing field’: Young people's experiences of wheelchair basketball as an enabling place	UD	Qual:I,O (CS)	I:a, other	NM	‘[Interview questions] … were guided by (…) initial visits to training sessions, including (…) embodied experiences of sports participation (…)’ (p. 4)	Outcomes/Well-being; Outcomes/Daily functioning; Contextual features/Empowerment; Prerequisites/Barriers
Bragg et al. (2020). Player and Parent Experiences with Child and Adolescent Power Soccer Sport Participation	UD	Qual: I,O (CS)	I:a	NM	‘What is it like playing power soccer?’ (p.641)	Outcomes/Well-being; Outcomes/Daily functioning; Outcomes/Sport-specific skills; Prerequisites/Barriers
Camacho et al. (2021). Quality of Life: Changes in Self-Perception in People with Down Syndrome as a Result of Being Part of a Football/Soccer Team. Self-Reports and External Reports	UD	Quan:Q (CS)	I:a, other	Y/N	NM	Outcomes/Well-being
Carter et al. (2014). ‘Just kids playing sport (in a chair)’: experiences of children, families and stakeholders attending a wheelchair sports club	UD	Qual:I, FG, PRA, O (CS)	I:b, other	NM	«How do you feel when you are at Cheetahs [Sports Club]?’ (p. 941)	Contextual features/Empowerment
Çelenk (2021). Motivation Affects Sports and Life Skills in Physical Disabled People	UD	Quan:I (CS)	I:a	Y/N	NM	Outcomes/Daily functioning
Charalampos et al. (2015). When sitting becomes sport: life stories in sitting volleyball (SV)	UD	Qual:I,O (CS)	I:a	NM	Somewhat unclear, but reiterates the importance of more knowledge about subjective experiences with sitting volleyball	Outcomes/Well-being; Prerequisites/Barriers; Outcomes/Daily functioning
Crawford et al. (2015). Psychosocial impact of involvement in the Special Olympics	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Well-being
Di Cagno et al. (2013). Psychological well-being and social participation assessment in visually impaired subjects playing Torball: A controlled study	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Well-being; Outcomes/Daily functioning
Everett et al. (2020). Special Olympics: Athletes’ perspectives, choices and motives	UD	Qual: FG(CS)	I:a	NM	‘How do you feel in training?’ (p.334) ‘How do you feel in competition?’ (p.334)	Prerequisites/Barriers; Prerequisites/Facilitators
Fiorilli et al. (2013). Mental health and social participation skills of wheelchair basketball players: a controlled study	Participation restrictions	Quan:Q (CS)	I:a	D(y), F(w)	NM	Outcomes/Well-being; Outcomes/Daily functioning
Fiorilli et al. (2016). Olympics swimming: positive effects on young people with Down Syndrome	UD	Quan:Q (CS)	I:b	D(y) F(w)	NM	Outcomes/Well-being; Outcomes/Daily functioning; Prerequisites/Barriers
Ghosh and Datta (2012). Functional improvement and social participation through sports activity for children with mental retardation: a field study from a developing nation	UD	Quan:Q (CS)	I:ca	D(y)	NM	Outcomes/Daily functioning; Prerequisites/Barriers
Gillespie (2009). Participation patterns in an urban Special Olympics program	UD	Quan: PAD (CS)	I:a	Y/N	NM	Descriptive /Demographics
Groff et al. (2009). Influence of adapted sport on quality of life: Perceptions of athletes with cerebral palsy	UD	Quan:Q (CS)	I:a	D(m)	NM	Outcomes/Well-being; Contextual features/Empowerment
Hartman et al. (2011). Motor skill performance and sports participation in Deaf Elementary School Children	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Body Functions; Outcomes/Sport Specific Skills; Outcomes/Daily functioning
Howells et al. (2020). Can Participation in a Community Organized Football Program Improve Social, Behavioral Functioning and Communication in Children with Autism Spectrum Disorder? A pilot study	UD	Quan:Q (CS)	I:ca	F(sessions)	NM	Outcomes/Well-being; Outcomes/Daily functioning
Ilhan et al. (2021). Sports participation and quality of life in individuals with visual impairment	UD	Quan:I (CS)	I:a	F (w,y)	NM	Outcomes/Well-being
Irish et al. (2018). «Sport saved my life» but ‘I am tired of being an alien’! Stories from the life of a deaf athlete	UD	Qual:A (CS)	I:a	NM	An ‘(…) inward, autobiographical perspective, which focuses the attention on the self and the personal component of experience (p. 7)’ of the athlete/researcher	Contextual features/Oppression; Prerequisites/Barriers
Jeffress and Brown (2017). Opportunities and Benefits for Powerchair Users Through Power Soccer	UD	Qual:I, O (CS)	I:a	NM	‘Tell me about your experiences in power soccer.’ (p. 242)	Outcomes/Well-being; Outcomes/Daily functioning; Contextual features/Empowerment
Jong et al. (2010). Relationships between mainstream participation rates and elite sport success in disability sport	UD	Quan:Q (CS)	I:a	Y/N	NM	Descriptive/ Levels; Descriptive/ Demographics; Contextual features/Empowerment
Kanan et al. (2021). Enhancing Individual with Disability Citizenship through Participation in Sport Activities	UD	Quan:Q (CS)	I:a	F(w), RofA	NM	Descriptive/Level; Outcomes/Daily functioning; Outcomes/Body functions; Contextual features/Empowerment
Kristen et al. (2002). Conceptions of Children and Adolescents with Physical Disabilities about Their Participation in a Sports Programme	UD	Qual:I (CS)	I:a	NM	‘How do you feel about the training in orienteering, golf or archery?’ (p. 145)	Outcomes/Daily functioning; Outcomes/Body functions; Contextual features/Empowerment
Lankhorst et al. (2021). Sports Participation, Physical Activity, and Health Related Fitness in Youth with Chronic Diseases or Physical Disabilities: The Health in Adapted Youth Sports Study	UD	Quan:Q (CS)	I:a	Y/N F(w)	NM	Outcomes/Body Functions; Outcomes/Daily functioning
Lauff (2011). Participation rates of developing countries in international disability sport: a summary and the importance of statistics for understanding and planning	UD	Quan: PAD (Long)	I:a	F(y)	NM	Descriptive/Demographics; Descriptive/Levels
Lepers et al. (2014). Analysis of marathon performances of disabled athletes	UD	Quan: PAD (Long)	I:a	F (race finish)	NM	Descriptive /Level; Descriptive/ Demographics
MacDonald et al. (2020). ‘You Think Differently After Playing This Sport’: Experiences of Collegiate Goalball Players	UD	Qual: I, Art & O (CS)	I:a	NM	‘Tell me what it was like to be on a team of students with and without a disability?’ (p. 142)	Outcomes/Well-being; Contextual features/Empowerment; Prerequisites/Facilitators
Morgulec-Adamowicz et al. (2011). The effect of sports participation on the intensity of psychosocial problems of males with quadriplegia in Poland	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Well-being
Nemček (2017). Self-esteem analyses in people who are deaf or hard of hearing: a comparison between active and inactive individuals	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Well-being
Oggero et al. (2021). Participation and Achievement in the Summer Paralympic Games: The Influence of Income, Sex, and Assistive Technology	UD	Quan: PAD (CS)	I:a	F (PL games)	NM	Descriptive/Demographics
Pan and Davis (2019). Exploring physical self-concept perceptions in athletes with intellectual disabilities: the participation of Unified Sports experiences	UD	Quan:Q (CS)	I:a	Y/N F(y)	NM	Outcomes/Well-being
Perrier et al. (2012). I act, therefore I am: Athletic identity and the health action process approach predict sport participation among individuals with acquired physical disabilities	UD	Quan:Q (Long)	I:a	F(w)	NM	Prerequisites/Barriers; Prerequisites/Facilitators
Piatt et al. (2018). Changing identity through sport: The Paralympic sport club experience among adolescents with mobility impairments	UD	Quan:Q (CS)	I:a	F (hpw)	NM	Outcomes/Well-being; Contextual features/Empowerment
Rauch et al. (2014). Participation in sport in persons with spinal cord injury in Switzerland	UD	Quan:Q (CS)	I:a	F (d,w,m)	NM	Descriptive/Disability; Descriptive/ Demographics
Roberts et al. (2021). Military veteran athletes’ experiences of competing at the 2016 Invictus Games: a qualitative study	UD	Qual:I (CS)	I:a	NM	‘(…) explore the experiences of WIS military veterans in preparation for, during, and post the 2016 IG’ (p. 3553)	Prerequisites/Facilitators;Contextual features /Cultural differences
Robinson et al. (2018). Individual and contextual correlates of frequently involved Special Olympics athletes	UD	Quan:Q (CS)	I:ca	F(w)	NM	Descriptive/Demographics; Prerequisites/Facilitators
Ryan et al. (2018). Patterns of sport participation for youth with autism spectrum disorder and intellectual disability	UD	Quan:Q (CS)	I:ca	F(w)RofA PEMCY	NM	Descriptive /Disability; Prerequisites/Facilitators
Schipman et al. (2021). Involvement in Multiple Race Events Among International Para and Non-disabled Swimmers	UD	Quan: PAD (Long)	I:a	F (events)	NM	Descriptive/Participation; Outcomes/Sport specific skills
Silveira et al. (2017). Association among practice frequency on depression and stress among competitive US male wheelchair rugby athletes with tetraplegia	UD	Quan:Q (CS)	I:a	F(w)	NM	Outcomes/Well-being
Sivaratnam et al. (2021). The Influence of Child-Related Factors on Caregiver Perceptions of Their Child’s Sustained Participation in a Community Football Program: A Study of Children with and without Neurodevelopmental Disorders	fPRC (Imms et al., 2017)	Quan:Q (CS)	I:ca	CoS	Involvement measured by parents’ perceptions of participation with Likert scale (child appears motivated to play, persists throughout the activity, feels a social connection, appears to be happy and appears involved in the activity)	Descriptive/Disability; Prerequisites/Facilitators
Svanelov et al. (2020). ‘Everybody with Disability Should be Included’: A Qualitative Interview Study of Athletes’ Experiences of Disability Sports Participation Analysed with Ideas of Able-Mindedness	UD	Qual:I (CS)	I:a	NM	‘How would you describe participation?’ (p. 298) ‘Can you tell me about your sports?’ (p. 298)	Contextual features/Empowerment; Contextual features/Oppression
Swanson et al. (2008). Motives for Participation and Importance of Social Support for Athletes with Physical Disabilities	UD	Quan:Q (CS)	I:a	D(y)	NM	Descriptive/Demographics; Prerequisites/Facilitators
Swartz et al. (2016). ‘A More Equitable Society’: The Politics of Global Fairness in Paralympic Sport	UD	Quan: PAD (CS)	I:a	F (events)	NM	Descriptive/Demographics; Prerequisites/Barriers
Swartz et al. (2018). ‘They don’t understand that we also exist’: South African participants in competitive disability sport and the politics of identity	UD	Qual:I (CS)	I:a	NM	‘(…) experience of participating in competitive disability sport’ (p. 37)	Contextual features/Empowerment; Contextual features/Oppression
Tasiemski and Brewer (2011). Athletic Identity, Sport Participation, and Psychological Adjustment in People With Spinal Cord Injury	UD	Quan:Q (CS)	I:a	F (hpw)	NM	Outcomes/Well-being; Outcomes/Daily functioning
te Velde et al. (2018). Associations of sport participation with self-perception, exercise self-efficacy and quality of life among children and adolescents with a physical disability or chronic disease – a cross-sectional study	UD	Quan:Q (CS)	I:a	Y/N, F(w)	NM	Outcomes/Well-being; Outcomes/Daily functioning; Outcomes/Sport specific skills
Tozoğlu et al. (2014). Studying the effects of sporting habits on the self-esteem of disabled individuals	UD	Quan:Q (CS)	I:a	Y/N, F(w)	NM	Outcomes/Well-being; Descriptive/Disability
Uchida et al. (2015). Predictors and correlates of self-esteem in deaf athletes	UD	Quan:Q (CS)	I:a	D(y)	IDES (overcoming injury and failure, self-contribution, finding solutions as a team, achievement and flow)	Outcomes/Well-being; Contextual features/Competitive nature of sport
Weiss et al. (2003). Involvement in Special Olympics and its relations to self-concept and actual competency in participants with developmental disabilities	UD	Quan:Q (CS)	I:b	F (hpw, CinSO), RofA	NM	Outcomes/Well-being; Prerequisites/Barriers; Contextual features/Competitive nature of sport
Weiss et al. (2020). Individual and contextual predictors of retention in Special Olympics for youth with intellectual disability: who stays involved?	UD	Quan:Q (Long)	I:ca	F(w), RofA	NM	Prerequisites/Facilitators; Outcomes/Daily functioning
Westendorp et al. (2011). Are gross motor skills and sports participation related in children with intellectual disabilities?	UD	Quan:Q (CS)	I:a	Y/N	NM	Outcomes/Body Functions; Prerequisites/Barriers; Prerequisites/Facilitators
Whiting et al. (2022). Community organization factors affecting veteran participation in adaptive sports	UD	Quan:Q (CS)	I:a	F (MTPY)	NM	Descriptive/Participation levels
Yazicioglu et al. (2012). Influence of adapted sports on quality of life and life satisfaction in sport participants and non-sport participants with physical disabilities	UD	Quan:Q (CS)	I:a	D (m,y)	NM	Outcomes/Well-being
Yilmaz et al. (2018). Comparison of Loneliness and Social Skill Levels of Children with Specific Learning Disabilities in Terms of Participation in Sports	UD	Quan:Q (CS)	I:a	Y/N	NM	Outcomes/Well-being; Outcomes/Daily functioning

Note: A = Attendance, I = Involvement, UD = Undefined, ASD = Autism Spectrum Disorder, Qual = Qualitative, Quan = Quantitative, A = Autoethnography, Art = Artifacts, I = Interview, M = Measurements (anthropometric, coordinative), Q = Questionnaire, O = Observation, FG = Focus Groups, PRA = Participant Research Activities, PAD = Publicly Available Data, CS = Cross Sectional, Long = Longitudinal, D = Descriptive; CoS = Completion of Season, D(m,y) = Duration(months,years), F = Frequency, d,w,m = dailiy,weekly, monthly, hpw = hours per week, n,o,r = never, occasionally, regularly, CinSO = Competitions attended in SO, MTPY = Median number of total disabled participants per year in reference to age distributed as percentage of programs with disabled participants, RofA = Range of Activities an individual partakes, PEMCY = The Participation and Environment Measure for Children and Youth (Coster et al., 2012), IDES = Inventory of Dramatic Experiences in Sport (Anan, 2012), Y/N = Yes/No, NM = not measured, i:a = individual(athlete), i:b = individual(both athlete and caregiver), i:ca = individual(caregivers), other = teachers, stakeholders or coaches.

Table 3. Summary of study characteristics of the included studies.

Study characteristics	n	% of sample
Methodology
Quantitative	43	74.1
Qualitative	15	25.9
Design
Cross sectional	53	91.4
Longitudinal	5	8.6
Measure of participation
Attendance only	40	67.0
Involvement only	14	24.1
Both (attendance and involvement)	4	6.9
Sources of data
Caregivers only (ca)	6	10.3
Athletes only (a)	49	84.5
Both (ca and a)	3	5.2

Note: a = athlete(s); ca = caregivers.

Figure 2. Analytical themes related to the study of participation in sport for people with disabilities.

Table 4. Descriptive themes generated from findings of the included studies.

Themes related to the study of parasport participation		n	% of themes
Prerequisites of sport participation		21	18.4
Barriers (e.g. financial, accessibility)		11
Facilitators (e.g. preferences, athletic identity)		10
Outcomes of sport participation		55	48.2
Improved body functions (e.g. anaerobic fitness, balance)		6	24.5
Sport specific skills (e.g. ball skills, target shooting)		4
Increased daily functioning (e.g. better self-care and life skills)		18
Increased well-being (e.g. higher QoL, alleviate anxiety symptoms)		25	23.7
Quality Participation (autonomy, belongingness, challenge, engagement, mastery and meaning)		2
Contextual and environmental features of (para)sport		19	16.7
Sport as empowering (e.g. ‘becoming someone’, overcoming deviant labelling)		12
Sport as oppressive (e.g. reinforcing disability stereotypes)		4
Other features of the sport context (competition, inspiring role models)		3
Describing the participation of PWDB in sport		19	16.7
Participation levels (e.g. in (major) events, between countries)		6
Athlete demographics (e.g. age, gender, income level)		9
How disability affects participation (e.g. before and after a SCI)		4

Note: Four overarching descriptive themes were generated from the data. As one article might have more than one theme there are more themes depicted in the table than the total number of studies included. Features of the context and/or the environment are interpreted as the experiences of disabled people unique to parasport, except from the competitive nature. PWDB = people with disabilities; SCI = Spinal Cord Injury.

*Allan, V., Smith, B., Côté, J., Martin Ginis, K. A., & Latimer-Cheung, A. E. (2018). Narratives of participation among individuals with physical disabilities: A life-course analysis of athletes’ experiences and development in parasport. Psychology of Sport and Exercise, 37, 170–178. https://doi.org/10.1016/j.psychsport.2017.10.004

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*Hartman, E., Houwen, S., & Visscher, C. (2011). Motor skill performance and sports participation in deaf elementary school children. Adapted Physical Activity Quarterly, 28(2), 132–145. https://doi.org/10.1123/apaq.28.2.132

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*Jeffress, M. S., & Brown, W. J. (2017). Opportunities and benefits for powerchair users through power soccer. Adapted Physical Activity Quarterly, 34(3), 235–255. https://doi.org/10.1123/apaq.2016-0022

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Data availability statement

The data that support the findings of this study are available from the first author, Linn Engdahl-Høgåsen, upon reasonable request.