Physical Activity Experiences of Youth with Physical Disability After Attending Valnesfjord Healthsports Centre (VHC): An interview and Observation Study

Chanel Shumka, MSc., spesialfysioterapeut ved Finnmarkssykehuset, Hammerfest. chanel.shumka@outlook.com. 

Wenche Bjorbækmo, PhD., professor emerita, OsloMet - storbyuniversitetet. 

Denne vitenskapelige artikkelen er fagfellevurdert etter Fysioterapeutens retningslinjer, og ble akseptert 11.august 2025. Artikkelen er basert på en studie godkjent av SIKT (ref.nr. 416558). Ingen interessekonflikter oppgitt. 

Abstract

Purpose: This study seeks to explore the experiences of youth with physical disability after attending VHC and examine how these experiences impact their understandings of themselves and their physical activity participation.

Methods: A qualitative design was employed; data was collected through observation during activities at VHC followed by individual interviews after youth returned home. Analysis was inspired by phenomenological thematic analysis.

Findings: Youth experience acceptance of differing participation and being offered adjustments in physical activity while being given the opportunity to influence their own participation at VHC, unlike their experiences in their home environments. These experiences promote developing understanding of oneself and own activity participation.

Conclusion: Accepting differences in physical activity participation promotes youth adapting their physical activity participation and allows them to influence their participation, promoting learning in activity and developing understanding of oneself and one’s own needs. These experiences do not impact experiences of activity participation in the home environment.

Keywords: physical disability, physical activity, youth, phenomenology. 

Sammendrag

Erfaringer med fysisk aktivitet hos unge med fysisk funksjonshemming etter opphold på Valnesfjord Helsesportsenter (VHSS): en intervju- og observasjonsstudie

Hensikt: Studien utforsker hvordan unge med fysiske funksjonsnedsettelser erfarer å delta i ulike aktiviteter i etterkant av opphold på VHSS, og hvordan dette får betydning for ungdommenes forståelse av seg selv og sine muligheter for aktivitetsdeltakelse.

Metode: Studien har et kvalitativt design. Datamaterialet er innhentet gjennom observasjon av ungdommer i aktivitet på VHSS og individuelle intervjuer etter at deltakerne kom hjem fra oppholdet. Analysene er inspirert av fenomenologisk tematisk analyse.

Funn: Deltakerne opplever at deres forskjellige måter å delta på i fysiske aktiviteter blir akseptert og verdsatt på VHSS. De opplever også at de blir tatt med på råd når aktiviteter skal tilpasses deres behov og kapasitet. Dette står i kontrast til hvordan de opplever aktiviteter i sitt eget hjemmemiljø. Funnene viser at deltakerne opplever endringer i synet på seg selv og egen deltakelse i ulike aktiviteter.

Konklusjon: Aksept for forskjeller i måten å delta på i fysiske aktiviteter synes å legge til rette for at ungdommene selv bidrar med tilpasninger og tilrettelegginger, og dermed påvirker sin egen deltakelse. Slik blir de aktive i egen aktivitetslæring, selvforståelse og utvikler større innsikt for egne behov. Imidlertid får ikke denne innsikten automatisk noen betydning for deltakernes opplevelse av det å kunne delta i aktiviteter i sitt hjemmemiljø.

Nøkkelord: Fysisk funksjonshemming, fysisk aktivitet, unge, fenomenologi. 

Introduction

Valnesfjord Healthsports Centre (VHC) provides activity focused group rehabilitation stays for over 100 children and youth with disability annually. Through group participation in various indoor and outdoor activities, VHC aims to create mastery experiences and facilitate continued participation after participants return to their local environments (1). It is of interest to explore what youth experience and learn at VHC and the long-term impact of stays, given the time taken away from family, friends, school and daily lives during the rehabilitation program.

Searches in databases Medline and Epistomonikos were conducted, using search terms describing physical disability, rehabilitation and camps; alongside searches of publication lists from Norwegian rehabilitation program providers. These searches sought out literature describing experiences with leisure activity after participation in rehabilitation programs or activities specifically for those with disability. We excluded literature not conducted in group settings, without participants with physical disability or without leisure activity participation as an outcome. Studies from rehabilitation programs describe participants feeling belonging, solidarity, and acceptance; and being a valued participant and role model for others (2-4). After rehabilitation, participants have reported increased knowledge and understanding of their disability and improved physical and social skills, but meeting barriers to participation in the home environment (5). These participation experiences can lead to feeling increased confidence in own capabilities and comfort in managing own disability in activity (4, 6).

Existing literature reviews highlight the need for more research exploring how segregated activity settings may impact youth’s activity experiences, their experiences of self and the development of their individual and disability identities (7, 8), additionally how these experiences may impact future participation and experiences in informal activity settings with peers with or without disability (9, 10). Which aspects of segregated activity programs promote outcomes described in literature should be explored (11). In this study we aimed to examine youths’ experiences with activity participation in a segregated environment adapted for those with disability and how these experiences impact them after returning home.

Theoretical perspectives

In this study we have employed a phenomenological approach, which enables us to examine the youths’ experiences based on a first-person perspective to seek deeper understanding of participation in activity focused rehabilitation stays. The nature of this approach is to explore understanding in light of sociocultural context and philosophical literature allowing different interpretations to be made (12).

Phenomenological perspectives on movement and participation

Participation requires being an experiencing, tactile-kinetic body (13, 14). Prerequisite to kinetics, or moving, is being and having a body. A body that moves and explores itself, objects, others, and its environment. As embodied beings we are in continuous reciprocal relation with our surroundings, implying experiences of being observed and evaluated by others (14). Through moving ourselves we interact with the world, participate in it; and experience both ourselves and the physical and social world we inhabit (13). The tactile-kinetic body that enables participation is not always present in our conscious thought. A body that is moving without effort disappears, consciousness instead turns to the surroundings and the activity we are involved in (15). Our body appears to our consciousness when it becomes strange to us. The body can become strange when movement has an aspect of novelty, such as the learning of new skills. Attention is brought to the capabilities of the tactile-kinetic body when the body in movement is discovered achieving something new, creating an experience of “I can” (13). The body may inversely become strange when it does not move or act as expected. When in pain or not performing as desired, a dysfunctional body appears to consciousness, the body dys-appears. In dys-appearing, our body appears as an object, vulnerable to the gaze and scrutiny of ourselves and others (15).

Method

A qualitative design, using observation and individual interviews to generate data has been applied.

Recruiting and inclusion

Youth aged 11 to 18 who had attended VHC from spring to fall 2023 were invited to participate in individual interviews. Youth were assessed for eligibility by staff at VHC based on age, interest, having a physical disability and ability to participate in an interview. Eight potential participants were contacted by the first author with three (two boys and a girl, all aged 11) agreeing to participate. All participants were living in larger municipalities in Northern Norway and had attended VHC multiple times previously. Their diagnoses included cerebral palsy and congenital heart defect.

Data collection and analysis

The first author visited VHC in spring 2023 and observed two youth groups during activity sessions, writing observation notes after activities. Two interview participants were recruited at this time. Individual semi-structured interviews were conducted in fall 2023, one to three months after participants returned home from VHC. Interviews were conducted in Norwegian over zoom to facilitate access to a rural population in Northern Norway. The first author conducted interviews following an interview guide including themes: “Activity at VHC”, “Returning Home from VHC”, and “Physical Activity Experiences after VHC”. Audio recordings were taken and transcribed in Norwegian. Analysis took inspiration from phenomenological thematic analysis (12), using both interview transcriptions and observation notes to identify essential themes and aspects of the youth’s experiences. In a dynamic process, the texts were re-read multiple times as new interpretations were made to gain deeper understanding and reflect on own interpretations. In this process reflective writing has been used (12) to uncover possible meanings of what the youth are telling. Excerpts from interviews that highlight the main themes and experiences were translated to English and form the basis for our presentation of findings.

Ethics

The study was considered not requiring assessment by the Regional Committee for Medical and Health Research (Application ID 616505). Guidelines from Norwegian National Research Ethics Committee were followed and the storage and collection of data was approved by the Norwegian Agency for Shared Services in Education and Research (reference number 416558). During observation at VHC youth and parents were informed of the role of the researcher, and youth were given the opportunity to moderate their contact during activities. Many expressed their interest in the project and actively included the researcher in activities, while some kept their distance. Prior to participation in interviews youth and parents were given consent forms and the youth were reminded of their opportunity to withdraw consent or stop interview. Ethical considerations were made during all stages of the process following recommendations from Kvale & Brinkman (16) with consideration to the youths’ position as a vulnerable group. Participants seemed comfortable during interviews often having a parent or pet nearby, after the interviews youth commented they found the experience to be positive.

Findings

The presentation of findings is organized in two main themes. Selected excerpts from the empirical material are written in cursive, followed by our analyses in plain text. Participants are presented with fictive names.

It’s nice to be different together

The youth described how they experienced being physically active with peers at VHC and peers at home. Zelda said:

At Valnesfjord I saw the others would get tired. I couldn’t see when I got tired, but I could hear it, my heart would race. We don’t all have the same diagnosis at Valnesfjord, so we like to do different things in different ways. But it’s good to have differences, it would be boring if everything was the same. It’s more fun to do activities at Valnesfjord than at home.

Zelda noticed that her peers at VHC had different ways of participating in activities which she related to them having different medical diagnosis. Additionally, she experienced that she was not the only one to become tired when exercising, leading to her reflecting on her own body in activity. She emphasizes that at VHC differing participation is not only a necessity, but that doing things your own way is accepted and valued. Experiencing this environment where all are participating differently is part of why activity in this setting is more fun for her, giving the impression that this is a novel experience.

Leo and Jacob describe their experiences in activities at home. Leo says:

Gym class is hard sometimes, sometimes things are easier, but most of it is difficult for me. The others comment on how I do things and say it’s my fault. They get angry at me and then I get angry at them. That doesn’t happen at Valnesfjord.

Jacob reflected on his experiences:

I like to swim and play with friends. But lately I don’t really want to do that as often, it’s tiring and takes a toll on me. The others don’t get tired like I do. They get angry with me when I don’t want to play anymore, so I try my best to keep playing when I’m tired, even though I’ll get really tired afterwards. I’m more online now, I watch YouTube and chat or game with people. My friend from Valnesfjord came to visit me, we went to the pool and jumped on my trampoline and just hung out together.

Jakob and Leo describe situations where they felt their peers not considering or accepting their differing performance in activity. Jakob altered his participation to avoid these scenarios. The boys express they do not have these negative experiences at VHC or when participating with others with disability. Jakob presented his activity participation with another with disability in a more direct and straightforward way, without reflection on his participation. Contrasting how he presented his participation alongside peers without disability implying peers influence the focus on his physical capabilities in activity.

Adjustments are helpful

 Participants also discussed how they experienced participating in various activities at VHC, Zelda told:

(The staff at VHC) make it so that it’s not so hard for me. More my level, and I get to decide some things, like if I need a break. It’s different than at home, for example in gym class you can’t just decide to stop or take a break. I’ve learned that I must consider my body, listen to it when it’s tired. I feel my heart beating fast, and my breathing gets faster. Then I need to take a break and wait until I’m not as tired. If I don’t listen then I get very tired, and it just isn’t fun anymore.

Zelda reflects upon how activities at VHC were adapted for her capabilities and that she was given the opportunity to influence her own performance goals, contrasting her experiences in gym classes. Being able to influence her own performance required her noticing and learning how to assess the signals her body gives her in activity and the consequences of overlooking these signals.

Leo discussed how having an adjusted activity environment affected his experience:

It’s different to do activities with the others at Valnesfjord than with friends at home, the activities are adjusted. At home there isn’t much adjustment, and everyone is expected to manage the same things. It can be difficult to do the same things as everyone else. I think it sucks that my gym teacher expects everyone to do the same.

Leo expresses his perception of the difference in participating in activities at VHC and at home and ascribes some of these differences to the adjustments that occur in activities at VHC. He expresses his appreciation of activities being adjusted through his negative commentary on not having adjustments made. The lack of adjustments in gym classes leaves him with the impression that his gym teacher expects him to be able to participate and perform in the same way as his peers without disability. A frustrating experience for Leo as he cannot meet these expectations.

The findings show how the participants’ experiences in activity are shaped by their bodily capacities and aspects of the environment in which activity is occurring. The youth experienced VHC as a place where being different and participating in different ways was a valued part of the activity experience. Staff helped the youth adjust activities, facilitating their participation and creating positive activity experiences and learning situations. Activity experiences in home the environment where youth felt expected to perform as their peers without disability were presented as contrasts to experiences at VHC.

Discussion

This study seeks to explore the experiences of youth with physical disability in segregated activity settings and the impact of these experiences after returning home. In this section we will, informed by the theoretical perspectives and relevant research literature, discuss the main findings: the importance of recognizing differences and the impact of adaptations, both in the environment and of attitudes.

It’s nice to be different together

Participants spoke about how participating with others who were different at VHC led to new activity experiences and outcomes, Merleau-Ponty (14) writes that we all view the world from our own perspectives, perspectives shaped by our tactile-kinetic bodily being in the world. The youth’s experiences with activity are based on their embodiment, them being the bodies they are and have. Their embodiment shapes their experiences and understanding of themselves and the world around them. Seeing and participating alongside others with physical disability were to the participants novel experiences, which to some extent changed their perspectives of themselves and thus changed their views of activity and disability. Historical and cultural context also shape perspective and understanding of oneself and the surrounding world (13), within this view disability can be considered dependent on what is “normal” in a given cultural and historical setting (17). VHC is a setting where all participants perform differently, “normal” is challenged and thusly changed, allowing the youth to experience their bodies as “normal” and experience or interpret their bodies in new ways.

While reflecting on activity experiences at VHC youth spoke of participation and having fun with others. The youth are in a common world at VHC where acceptance of difference seems to prevent or reduce experiences of objectifying gazes. Implying that one’s own body may disappear from consciousness allowing for focus to be the activity they are involved in, sharing experiences and mutual incorporation. Ways of moving, understanding the body and world are shared between individuals without this being verbally communicated (15). In this setting youth may participate in new ways based on the shared experiences they have with their peers. They may manage things they have not before or uncover capabilities they were not aware they had. In suddenly “catching” themselves in the act of moving in this setting the youth speak about experiences of “I can”, a new awareness of own capabilities for moving and being active (13). The experience of physical activity alongside peers with disability at VHC seems to facilitate their learning of own body and its capabilities for activity participation and moving with lasting impact.

Adapting attitudes and environments

The boys discussed physical activity experiences in the home environment where their performance received negative feedback from peers. These experiences exemplify how disability can be experienced through the gaze and expectations of others (17). Merleau-Ponty argues that those with disability do not first and foremost view themselves as disabled as their bodies with disability are their basis for being sentient, sensitive, and experiencing individuals. Despite being aware of differences, their bodies with a disability are their normal and are full of movement potential. It is through the objectifying gaze of others that the body dys-appears and focus turns towards aspects of movements lacking, lacking abilities and to achieve “normal” way of doing things (15). Both Leo and Jakob expressed conflict and frustration with these experiences, they view themselves as capable, however through the feedback of others they experience their bodies falling short of meeting expectations. In these situations, the body dys-appears and a rift occurs between the body as lived, and the body as objectified and measured (15). Being exposed to an accepting environment at VHC does not seem to prevent negative impact from less accepting attitudes the youth may encounter afterwards but highlights to them what is to be desired in these experiences through the new perspectives they have gained.

The youth described both accepting attitudes and an adapted physical activity environment at VHC. Through adjustments being made either to the environment or their physical activity participation, they were given the opportunity to participate alongside others while meeting activity goals. They were also asked how they would like to participate, inviting them to reflect on their bodies in movement, promoting the occurrence of “I can” experiences. Having experienced adjustments being made for them in physical activity and being asked for input on their participation at VHC, the youth gained perspective on how this is lacking to them in activities in their home environment. In activities where another had a deciding role in their participation, such as gym class, the youth felt adjustments were not considered. They had the impression that their teachers expect them to be able to perform as everybody else. Placing an inferred gaze on their bodies, poising them to dys-appear when they failed to meet expectations (15). The lack of adjustments both creates an expectation and makes it more difficult for youth to meet the expectation, limiting learning opportunities by limiting the opportunity for “I cans” to occur (13). The youth have firsthand experience with the impact that adjustments in physical activity can have on their participation experiences and are able to identify when adjustments are required, but this does not seem to improve their access to adjustments in activity settings in the home environment.

The findings of the group environment at VHC creating the feeling of being one among many with differences and promoting learning echoes the results from previous studies in similar environments (3-7, 10, 11). The youth reflecting on their bodies afterwards shows a changed view of self that remains after returning home from VHC, they approach activities with a new self-understanding brought on by participation in the activity environment at VHC. Participation in this environment in this way impacts development of identity as a person with disability, this finding is supported by the findings of factors impacting development of disability identity from Forber-Pratt et al (8). Negative attitudes of others have been found to be a factor that may negatively impact participation experience in the home environment in other studies (2, 9). Unlike the findings in other studies (3, 4, 7) the youth are aware of the adjustments they need and desire but do not describe an increased ability to voice these needs and have them met, showing a need for more action to prepare both youth and the local environment for their return. The importance of environmental factors on experience of activity participation shows a need for more action to adjust environments and explore factors that may contribute to changing attitudes.

Methodological considerations

This study had a limited number of participants, all the same age, limiting the generalizability for youth with physical disability in general. However, through the use of theoretical perspectives and common experiences, the findings in this study may be transferable to youth in similar situations. Interviews provide reflections on previously lived experiences through the lens of current understanding (12). The youths’ views and understandings of their experiences at and after VHC will likely change, this study provides insight into the youth’s understanding of their experiences within the first few months of returning home from VHC.

Conclusion

VHC provides an activity environment that promotes learning about oneself and one’s capabilities for youth with physical disability. The most valued aspects of this environment highlight to youth what they desire in their home environments and how lacking these aspects may hinder their equal participation and learning of oneself through movement. The activity environment at VHC accepts and celebrates difference, whereas at home difference may be purposefully overlooked or judged. Negative attitudes towards differing participation hinder access to adjustments in activity and can create negative activity experiences for participants with disability. Youth view adjustments as an acceptance of difference and as facilitators to participation and learning. Youth experience that being able to influence their own participation facilitates their learning. Future research should be done to explore how local environments can be adjusted to support youth with disability in their participation and learning. 

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