Physical activity behavior among people with disabilities

Regular physical activity has many health benefits and can help reduce the increasing pressure on healthcare systems caused by population ageing. However, people with a physical disability or chronic disease are more likely to be insufficiently physically active than recommended. This thesis explores the construct physical activity behavior among people with physical disabilities or chronic diseases. It examines what physical activity looks like, how it develops over time, which factors influence it, and how it can be measured. The research is based on data from the ReSpAct study, a nationwide cohort study in which participants were followed up to six to eight years after completing a rehabilitation program aimed at developing and maintaining an active lifestyle. The results show that many participants increased physical activity behavior after rehabilitation and were able to maintain this on the long term. Most physical activity consisted of light, everyday activities, such as household tasks. Motivation, selfefficacy, perceived fatigue, and perceived barriers played an important role in achieving and sustaining an active lifestyle. The (development of) physical activity over time showed large heterogeneity. The thesis also shows that physical activity can be measured in different ways, with no single method capturing the full picture. Overall, the findings demonstrate that physical activity behavior in people with physical disabilities or chronic diseases is complex, multidimensional, and involves both physical and behavioral aspects. This underlines the importance of tailored rehabilitation programs and personalized support in promoting a healthy and active lifestyle.