Adapted Table Tennis for Disabilities

Official title

Health Promotion Through Adapted Table Tennis for Individuals With Disabilities

Overview

In recent years, sports participation among individuals with disabilities has increased, driven by medical advancements, growing societal awareness, and improved accessibility. However, a significant proportion-about 60%-still do not engage in regular physical activity, often due to limited awareness and environmental barriers. Organizations like the International Paralympic Committee (IPC) have played a key role in promoting disability sports, as evidenced by the growth in Paralympic participation from 400 athletes in 1960 to an expected 4,400 in 2024. Physical activity offers both physical and psychological benefits for people with disabilities, including improved cardiovascular health, motor function, and emotional well-being. Although adapted table tennis is a promising, accessible sport for this population, research on its health effects remains limited. This study aims to evaluate the impact of a 12-week adapted table tennis program on the physical and mental health of individuals with disabilities and to explore its potential as a sustainable health-promotion strategy.

Detailed description

In recent decades, the participation of individuals with disabilities in sports has gradually increased, closely associated with medical advancements, growing societal emphasis on physical well-being, and the expansion of exercise opportunities. According to statistics from the United States Census Bureau, there were approximately 85 million people with disabilities in 2014; however, only around 2 million of them participated in recreational or competitive sports. Despite the growing availability of sports opportunities, about 60% of individuals with disabilities still do not engage in regular physical activity. This indicates the presence of multiple barriers to participation, such as limited awareness about the benefits of exercise and inadequate accessibility of sports facilities.

The International Paralympic Committee (IPC) and various National Governing Bodies (NGBs) have played a crucial role in promoting sports participation among individuals with disabilities by establishing institutionalized competition and training systems that foster the development of sports culture. For example, the number of athletes participating in the Paralympic Games has grown from 400 at the 1960 Rome Paralympics to 4,200 at the 2012 London Paralympics. The 2024 Paris Paralympic Games are expected to host 4,400 athletes, reflecting the rapid growth and increasing recognition of disability sports. This growth not only represents society's greater acceptance of para-sports but also underscores the demand among individuals with disabilities for participation and the potential health benefits associated with such involvement.

The health benefits of physical activity for individuals with disabilities are well-supported by a growing body of research. Exercise has been shown to improve endurance, muscular strength, cardiopulmonary function, and flexibility. It also enhances balance and motor skills. Moreover, physical activity provides significant psychological benefits, including improved self-esteem, body image, self-awareness, and emotional regulation. From a cardiovascular perspective, athletes with disabilities tend to have higher levels of high-density lipoprotein (HDL) cholesterol, lower smoking rates, and a reduced risk of cardiovascular disease. Specific populations, such as individuals with amputations or spinal cord injuries, also benefit from physical activity through improved proprioception, reduced hospitalization rates, lower incidence of pressure ulcers, and decreased infection risk.

Nevertheless, current research on the health benefits of adapted table tennis for individuals with disabilities remains relatively limited. Due to its technical versatility, high adaptability, and low facility requirements, table tennis has emerged as a suitable exercise option for this population. This study will implement a 12-week table tennis training program to assess its impact on the physical and mental health of individuals with disabilities and further evaluate whether this form of exercise can serve as an effective strategy for promoting their overall well-being.

The findings of this study aim to fill the existing research gap regarding the effects of adapted table tennis on individuals with disabilities and provide an empirical foundation for future exercise intervention programs, thereby advancing the promotion and development of regular physical activity among this population.

Interventions

• Other Adapted table tennis training
  Under the guidance of a professional adapted sports coach, participants in the experimental group will engage in weekly 2-hour group table tennis sessions for 12 weeks. The sessions will include warm-up exercises, basic table tennis techniques, skill practice, and cool-down stretching exercises.

Primary outcome measures

• Muscle strength [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• Volume of Forced Vital Capacity (FVC) in Liters [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• 6-Minute Walk/Push Test (6MWPT) Distance [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• Flexibility [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• Waist Circumference in Centimeters [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• Total Score on the Generalized Anxiety Disorder 7-Item (GAD-7) Scale [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2)]
• Bone Mineral Density (BMD) Assessed by Dual-Energy X-ray Absorptiometry in g/cm^2 [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2)]
• Number of Participants with Abnormal Blood Laboratory Values [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2)]
• Volume of Forced Expiratory Volume in 1 Second (FEV1) in Liters [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]
• Ratio of FEV1 to FVC (FEV1/FVC) [Time frame: Pre-intervention (T0), after 12 weeks of intervention (T1), and 6 months after intervention (T2).]

Eligibility criteria

Inclusion criteria

• Individuals aged 18 to 75 years who hold a disability identification certificate issued by the Taiwan government and have been assessed by a physician and a professional coach as suitable for participating in adapted table tennis, with a willingness to take part in the study; Participants must respond "No" to all questions in the first section of the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+ 2024 edition) or, if they respond "Yes" to one or more questions in the first section, must respond "No" to all questions in the second section.

Exclusion criteria

• Individuals with uncontrolled cardiovascular diseases or relevant neurological history.
• Hearing impairment.
• Cognitive dysfunction.
• Individuals with uncontrolled psychiatric disorders who are unable to comply with the assessments.
• Individuals with color vision deficiencies or visual impairments.
• Pregnant women (self-reported).
• Individuals who have undergone lower limb musculoskeletal surgery or experienced musculoskeletal injuries within the past 6 months.
• Individuals with a history of significant head trauma.
• Individuals unable to comply with the testing schedule.
• Individuals advised by a physician to avoid moderate to high-intensity exercise or those deemed unsuitable for physical activity.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Other

Study locations

Taiwan · 1 center

• Kaohsiung Medical University Chung-Ho Memorial Hospital — Kaohsiung City

Identifiers

NCT: NCT07671807 · Para_Tb_PA

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗