Recreational Therapy for Physical Rehabilitation

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Introduction

Recreational therapy (also known as therapeutic recreation) uses recreation and leisure activities within a rehabilitation programme to promote and improve the health and well-being of individuals.1 The four core values of recreational therapy are the right to leisure, autonomy, optimal health, and quality of life.2 Recreational therapy can include activities such as sports, games, dance, arts and crafts, music, and even animal therapy. It can help in the recovery of both physical and mental illnesses, inspiring confidence in activities they may not have thought capable of doing in a fun and interactive way, reducing inactivity.3

For those recovering from an illness or injury, physical rehabilitation provides a way of gradually increasing their mobility and improving their ability to complete activities of daily living (ADLs).3,4 Recreational therapy is one way of doing this; it is not limited by age or ability, as it can be tailored to suit the needs of those involved. It also plays an important role in addressing psychological and social needs, which are often neglected in one-to-one rehabilitation programmes.5 It is, therefore, an essential tool to encourage physical activity in a fun and engaging way to promote safe mobility and maintain independence.3

Goals of recreational therapy in physical rehabilitation

Physical rehabilitation, which can include the use of recreational therapy, looks to improve several important functions to improve quality of life.2 These include:

  • Restoring mobility: this can include reducing reliance on walking aids
  • Increasing the range of motion of joints: so that the full function of a joint or limb can be realised
  • Improving strength and endurance: to increase the individual’s ability to tolerate activities
  • Enhancing flexibility
  • Improving balance and coordination: to reduce the chance of falls and improve overall wellbeing
  • Increase ability to complete activities of daily living, and therefore increase independence
  • Improving mood and psychological wellbeing

Types of recreational activities in physical rehabilitation

The type and variety of recreational activities that can be used in physical rehabilitation are only limited by your imagination! Below are a few examples of what can be used or adapted:2

Adaptive Sports and Games

Examples of adaptive sports and games include:

  • Tai Chi: focuses on gentle movements that can be useful for older patients9
  • Archery: this can be done in both standing and sitting depending on the function of the individual
  • Active ball games: again, these can vary significantly to include walking or sitting variations of popular ball games. A few good examples are walking football, touch rugby, and seated volleyball
  • Dancing: using music and dance has been found to have positive effects on balance and coordination in Parkinson’s Disease patients8
  • Yoga or Pilates: can assist with balance, coordination, flexibility, strength and endurance
  • Wii Fit: focuses on balance and coordination and has been used in many patient groups including amputees and older patients9

Aquatic Therapy

  • Swimming: provides a low-impact option for those who may not be able to tolerate standing for long periods
  • Hydrotherapy: this involves a pool at a much higher temperature than a normal pool, more like your bath temperature and has been used to help with joint stiffness and muscle pain

Outdoor Adventure Activities

There is a vast array of leisure activities that can be done. Some examples include:

  • Walking or hiking: can be done solo or in a group to provide a degree of social interaction that can help improve mood, balance, and cardiovascular fitness10
  • Rock climbing: therapeutic rock climbing has been found to improve mood, flexibility, and general well-being11
  • Water sports, e.g., canoeing or kayaking

Tailoring programmes to individual needs

One size does not fit all when it comes to rehabilitation. Depending on a person’s limitations, whether that be from a long-term condition or a short-term injury, tailoring a session or activity to the needs of the individual is essential. A healthcare professional will consider the following in their assessment:

Assessing physical abilities and limitations

They will start with a comprehensive assessment of the individual’s abilities and any particular limitations they may have. This will include taking a history of how they were injured or the limitations an individual has because of a particular condition or illness. They will then look at their physical movements to understand what the main issues are and will consider other factors such as psychological and emotional well-being.

Customising activities for specific rehabilitation goals

Once there has been a clear conversation between the healthcare professional and patient, there can be a good discussion about what the patient wants to achieve, and negotiating goals that are meaningful to them. This has been shown to increase satisfaction with the results while ensuring they are achievable and meaningful.6

Considering psychological and emotional factors

For many, there will not be just physical issues, but they may also have associated psychological or emotional factors that may influence an individual’s ability to complete particular physical movements or activities. Using this holistic ‘whole person’ approach will assist in understanding what the main drivers are and how recreational therapy can assist.

Incorporating recreational therapy into traditional rehabilitation

Recreational Therapists are an integral part of the wider multidisciplinary team (including doctors, nurses, physiotherapists, social workers, psychologists, and occupational therapists). Recreational therapists are typically employed by hospitals, nursing homes, community health centres, schools, adult care programmes, and prisons. Normally they do not work in isolation but will be part of a team helping an individual.

Collaborating with healthcare professionals

Within the settings mentioned above, a recreational therapist can help with providing specific activities to achieve the individual’s goals. This can include sports or activities that the individual particularly enjoys as this can improve motivation and satisfaction with the rehabilitation process. In some cases, there is no separate recreational therapist; rather this is incorporated as a treatment option for physiotherapists or occupational therapists. 

Integration into rehabilitation plans

Any rehabilitation programme should consider recreational activities, and therefore recreational therapy as an adjunct to more traditional rehabilitation options.11 It can provide some light relief to a programme that may have exercises that are necessary but not as interesting to perform. It must be discussed with the team involved in the individual’s care to ensure that the recreational activity will not adversely impact their ongoing rehabilitation. 

Measuring progress and adjusting programmes

As with any treatment, progress needs to be measured and then adjusted accordingly. For example, a patient may start with seated archery as they are unable to stand for long periods. As their strength and endurance improve, they may be able to progress to standing archery before considering other recreational activities that they may enjoy. Conversely, there may be situations where a particular activity becomes too painful or difficult, and therefore the recreational therapist should be able to adapt or reduce the activity demand depending on how the patient is feeling.

Future developments and trends

With an ageing population, recreational therapists and recreational therapy will continue to be needed to help individuals maintain healthy active lifestyles. They can also expect to work with a diverse population and patient group, from children with disabilities to adult prisoners.7 It is likely that this area will continue to grow along with other therapies such as play therapy.

FAQs

What is recreational physical activity?

Recreational physical activity is any activity that promotes health and well-being whilst encouraging movement. This can include activities such as sports, games, dance, or arts and crafts.

What is another name for recreational therapy?

Recreational therapy is sometimes also called therapeutic recreation.

What are the most common recreational therapy activities?

Recreational therapy activities are only limited by your imagination but generally involve sports, games, arts and crafts, music, and even animal therapy (also known as hippotherapy).

What are the goals of recreational therapy?

Recreational therapy aims to encourage movement, improve strength and endurance, increase mobility, improve balance and coordination, and boost mood by creating a fun and inclusive environment for all.

What is the process of therapeutic recreation?

Therapeutic recreation, also known as recreational therapy, is a systematic process involving recreation-based, leisure-based, and play-based activities and interventions to address the needs of individuals with short-term injuries, or long-term illnesses or conditions.

What domains does recreation therapy cover?

Recreational therapy uses fun and engaging activities to improve function in several areas including:

  • Mental/Cognitive functioning: to work on problem-solving and reasoning skills
  • Physical functioning: to improve your overall well-being and independence
  • Psychological/Emotional functioning: to assess and improve how you manage emotions in challenging situations

Summary

Recreational therapy uses recreation and leisure activities within a rehabilitation programme to promote and improve the health and well-being of individuals. This can include activities such as sports, games, dance, arts and crafts, and music. It can help in the recovery of both physical and mental illnesses, inspiring confidence in activities they may not have thought capable of doing in a fun and interactive way, reducing inactivity. Healthcare professionals and individuals should be encouraged to include recreational activities in their wider rehabilitation programme to promote and enhance a ‘whole person’ holistic approach to rehabilitation.

References

  1. Austin DR, Crawford ME, McCormick BP, van Puymbroeck M. Recreational Therapy: An Introduction. Sagamore Publishing; 2015.
  2. Ann R, Frances Stavola Daly. Therapeutic recreation leadership and programming. Editorial: Champaign, Ill.: Human Kinetics; 2010.
  3. Yang Y, van Schooten KS, McKay HA, Sims-Gould J, Hoang RA, Robinovitch SN. Recreational Therapy to Promote Mobility in Long-Term Care: A Scoping Review. Journal of Aging and Physical Activity [Internet]. 2020 Jul 28 [cited 2021 Oct 19];29(1):142–61. Available from: https://pubmed.ncbi.nlm.nih.gov/32723928/
  4. Rosenberg DE, Bellettiere J, Gardiner PA, Villarreal VN, Crist K, Kerr J. Independent Associations Between Sedentary Behaviors and Mental, Cognitive, Physical, and Functional Health Among Older Adults in Retirement Communities. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2015 Aug 13;71(1):78–83.
  5. Harmer BJ, Orrell M. What is meaningful activity for people with dementia living in care homes? A comparison of the views of older people with dementia, staff and family carers. Aging & Mental Health [Internet]. 2008 Sep;12(5):548–58. Available from: http://content.ebscohost.com/ContentServer.asp?EbscoContent=dGJyMNHr7ESeqa44yOvsOLCmr1Gep69SsK64SLGWxWXS&ContentCustomer=dGJyMPGptk%2B3rLJNuePfgeyx43zx1%2B6B&T=P&P=AN&S=R&D=rzh&K=105562049
  6. Wade DT. Goal Setting in Rehabilitation: An Overview of What, Why and How. Clinical Rehabilitation [Internet]. 2009 Mar 17;23(4):291–5. Available from: https://journals.sagepub.com/doi/abs/10.1177/0269215509103551
  7. Kellar MJ. The Future of Recreation Therapy/Therapeutic [Internet]. www.proquest.com. 2013. Available from: https://www.proquest.com/docview/1508059829?sourcetype=Scholarly%20Journals
  8. Pereira APS, Marinho V, Gupta D, Magalhães F, Ayres C, Teixeira S. Music Therapy and Dance as Gait Rehabilitation in Patients With Parkinson Disease: A Review of Evidence. Journal of Geriatric Psychiatry and Neurology. 2018 Dec 17;32(1):49–56.
  9. Summey HE. A comparison of recreation therapy intervention using nintendo WiiTM bowling with participation in a Tai Chi program on balance, enjoyment, and leisure competence of older adults in a community based setting - ProQuest [Internet]. www.proquest.com. 2009. Available from: https://www.proquest.com/openview/02f1dea20c8e7ee66a8055f56a0260da/1?pq-origsite=gscholar&cbl=18750 
  10. Walter KH, Otis NP, Ray TN, Glassman LH, Beltran JL, Kobayashi Elliott KT, et al. A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder. BMC Psychiatry. 2023 Feb 17;23(1).
  11. Frühauf A, Heußner J, Niedermeier M, Kopp M. Expert Views on Therapeutic Climbing—A Multi-Perspective, Qualitative Study. International Journal of Environmental Research and Public Health. 2021 Mar 29;18(7):3535.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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