OBJECTIVES: To evaluate the effects of sport or physical recreation on participation, mobility and quality of life for adults living with disabilities. DESIGN: Systematic review with meta-analysis. DATA SOURCES: Six databases searched from inception to May 2022. ELIGIBILITY CRITERIA: Randomised controlled trials including adults living with a physical or intellectual disability, comparing sport or physical recreation to non-active control. RESULTS: Seventy-four trials (n = 2,954; mean age 55 years) were included. Most (70) trials included people with physical disabilities, none evaluated sport and the most common physical recreation activities tested were traditional Chinese exercise (35%), yoga (27%) and dance (18%). Mean frequency and duration was 65 min/session, two times per week for 13 weeks. Most (86%) interventions were led by people with experience and/or training in the recreation activity, and only 37% reported leader experience and/or training working with people with disabilities. Participation was measured as attendance (mean 81%, 30 intervention groups). Physical recreation improved mobility (standardised mean difference (SMD) 0.38, 95% CI 0.07 to 0.69, n = 469) and walking endurance (mean difference (MD) 40.3 m, 95% CI 19.5 to 61.1, n = 801) with low certainty evidence and balance (Berg Balance Scale, range 0 to 56 points; MD 3.4 points, 95% CI 2.3 to 4.4, n = 906) and quality of life (physical health; SMD 0.37, 95% CI 0.02 to 0.72, n = 468) with very low certainty evidence, but not walking speed (MD 0.03 m/s, 95% CI -0.05 to 0.11, n = 486). CONCLUSION: Physical recreation may confer multiple benefits for people living with disabilities regardless of the activity chosen, thus offering a potentially enjoyable and scalable strategy to increase physical activity. PROSPERO REGISTRATION NUMBER: CRD42018104379.
Reproduced with permission from the BMJ Publishing Group.

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