Are gyms fit for all? A scoping review of the barriers and facilitators to gym-based exercise participation experienced by people with physical disabilities

Living with a physical disability (PD) withholds serious health problems that can be significantly alleviated through participation in regular exercise. Gyms offer a legitimized and safe exercise environment, however people with PD are limited in their opportunities to integrate within gyms. In this scoping review, the current knowledge on barriers and facilitators of gym-based exercise among people with PD were reviewed to gain a domain specific understanding of exercise participation in this population. Potential agents of change who may foster equal exercise opportunities for individuals with PD were mapped. Exercise barriers and facilitators, and agents of change were identified at the personal, social, and environmental levels. Lack of gym accessibility lack of social support, and oppressive attitudes within gyms were the most reported barriers to gym-based exercise participation. Enhanced opportunities to interact with others within gym settings and committing to exercise were identified as main facilitators of exercise participation in people with PD. The findings presented herein point to the necessity of multi-level actions to enhance the current low exercise participation of people with PD, specifically in gyms. These actions can be employed by people with PD, as well as by local community members, gym managements, healthcare providers, and policy makers to create more inclusive gym environments that meet the needs of people with PD. Strategies for enhancing the integration of people with PD within gym settings are offered.