Prevalence of meeting 24-hour movement guidelines and its associations with health indicators in people with disabilities: A systematic review and meta-analysis

Abstract Background Meeting the 24-hour movement guidelines (i.e., physical activity, sedentary behavior, sleep) could generate health benefits to people with disabilities. However, no systematic reviews or meta-analyses have examined the prevalence of meeting these guidelines and associations with health indicators in this group. The purpose of this systematic review and meta-analysis was therefore to examine the prevalence of meeting the 24-hour movement guidelines and associations with health indicators among people with disabilities. Methods Major databases including PubMed, SPORTDiscus, Web of Science, PsycINFO, Embase, and Scopus were searched for studies published in English from inception to May 31, 2023. Studies reporting on the prevalence of meeting overall 24-hour movement guidelines or each of the 3 guidelines in people with disabilities were included. Meta-analyses with the random-effects model were used to determine the prevalence of meeting overall and individual 24-hour movement guidelines. Qualitative syntheses were employed to describe the associations between meeting the guidelines and health indicators. Results Twenty-four cross-sectional studies comprising 77510 participants (41.6% females) with disabilities aged 6–65 years from 8 countries were identified. Overall, 6.97% of the participants with disabilities met all three 24-hour movement guidelines, and 16.65% met none of the guidelines. Children and adolescents with disabilities had significantly lower prevalence of meeting all 3 guidelines (5.10%) than that of adults with disabilities (16.49%; P = 0.006). Participants with sensory impairments had significantly higher overall prevalence (13.89%) than those with neurodevelopmental disorders (4.67%; P = 0.001). The findings of qualitative synthesis generally indicated that people with disabilities who met all 3 guidelines reported better psychosocial health indicators such as social relationship and quality of life (9/9 studies) than those met none or only 1 of the guidelines. There was limited evidence or research for other health indicators (e.g., adiposity). Conclusion There is some evidence showing that the prevalence of meeting all three 24-hour movement guidelines in people with disabilities is low, particularly in groups of children and adolescents and neurodevelopmental disorders. Meanwhile, there is preliminary evidence suggesting that meeting all 3 guidelines is associated with better psychosocial health than meeting none of the guidelines. More studies are needed to provide further evidence.