The Latin term ‘agito’ means ‘to move, to put in motion’. In 2004, the International Paralympic Committee launched a logo known as Agitos. The three elements of red, blue, and green rotate around a central point symbolizing motion reflecting the paralympic motto, ‘Spirit in motion’, and the perseverance of each athlete. With excitement and anticipation of the Paris 2024 Olympics and Paralympics, what better time than now to reflect on motion in young people with disabilities?

The World Health Organization's International Classification of Functioning, Disability and Health framework emphasizes the roles of activities and participation in one's health. Engaging in physical activities (or bodily motion that requires energy expenditure), including sports and active recreational activities, has well-known physical, emotional, and social benefits. Outcomes of aerobic and muscle-strengthening physical activity include improved cardiovascular health, muscular endurance, flexibility, coordination, and bone density.¹ Sedentary behavior has been linked with a wide range of adverse consequences, including overweight and obesity, musculoskeletal disorders, and increased risk of cancer and metabolic disorders.^{1, 2} Improvements in emotional and social functioning are additional outcomes, often overlooked, of participation in sports and recreational activities. Young people with disabilities involved in sports demonstrate increased self-confidence, personal growth, and overall quality of life and decreased depressive symptoms. Participation promotes development of new friendships, teamwork and leadership skills, and a sense of belonging.^{1, 2} Moreover, routine exposure to sports and recreational activities from a young age leads to a lifelong relationship with physical fitness and healthy behaviors that is particularly crucial for young people with disabilities.

Despite known benefits, young people with disabilities are less likely to participate in sports and recreational activities than peers without disabilities.^{1, 3} These young people face barriers to participation at the individual, environmental, and societal levels that supersede functional limitations.² Young people may lose confidence in their ability to be physically active, particularly when sports are more competitive, and are more likely to be bullied than athletes without disabilities.^{4, 5} Parents may perceive participation as too risky and coaches may lack training as to how to safely adapt activities to the child's functional levels. Adaptive sports and recreational activities provide an opportunity for young people to play and compete; however, programs may not be readily available near the child's home and the options offered may be limited or not align with the young person's interests. Transportation, equipment, and the costs associated with modifications may also serve as barriers. While international programs such as the Paralympics and Special Olympics promote sports and recreational activities in individuals with disabilities, societal barriers remain, including implicit biases favoring competition over fun and inclusion, low performance expectations, stigmatization, and lack of policies and infrastructure to develop and maintain equity, as well as high-quality and safe sports opportunities.^{2, 5}

As healthcare professionals and advocates, we promote this ‘Spirit in motion’ by setting expectations for participation and routinely assessing activity levels, addressing perceived risks, and providing education to young people, families, coaches, and policy-makers. Motivational interviewing may help address individual and familial barriers and facilitate decision-making processes and behavioral change. It is critical that parents are involved and buy into the benefits of physical activity, introducing sports throughout the child's development, and providing encouragement, emotional support, and the resources needed for participation. Moreover, creating environments that foster inclusion and equity among peers with and without disabilities may increase self-efficacy, confidence, and enjoyment in all young people.

All individuals can derive benefits from participation in sports and recreational activities. Sports are much more than competition and a winning score. Physical fitness may be gained from the training regimen, but the psychological and social rewards are gained throughout the process, from challenging oneself and learning new skills, to working with and supporting others, as well as overcoming setbacks and defeat. Athletes inspire and motivate regardless of their abilities. Sports and recreational activities provide young people with disabilities opportunities to unite with others, foster positive self-identities, challenge societal attitudes and misconceptions about disability, and most importantly, to have fun.

To all the athletes participating in the 2024 Paralympic Games, Bonne Chance!