AI Insight
This systematic review of 21 studies examined the psychological and mental health benefits of aquatic physical activity for individuals with disabilities, using the ICF framework and Self-Determination Theory. The analysis found that aquatic interventions significantly reduce depression and anxiety while improving social skills and peer interaction. Physical improvements in motor function and balance served as mediators that enhanced perceived competence and autonomy, reducing fear of movement.
Why it matters
The findings provide evidence-based guidance for developing inclusive aquatic programs that address both physical and psychological barriers faced by individuals with disabilities. The research suggests that aquatic environments function as accessible spaces that reduce stigma while simultaneously improving mental health outcomes and social integration.
Understand the Science
PurposeIndividuals with disabilities face a high risk of physical inactivity, leading to severe mental health challenges and social isolation. Aquatic physical activity, due to its unique physical properties, is considered an intervention with profound psychological potential. Guided by the International Classification of Functioning, Disability, and Health (ICF) framework and Self-Determination Theory (SDT), this study aims to systematically review the psychosocial, mental health, and functional benefits of aquatic physical activity for individuals with disabilities.MethodsThis study strictly followed the PRISMA guidelines to search for high-quality literature published up to February 2026 in Web of Science, PubMed, Scopus, and SPORTDiscus. Two independent researchers conducted the screening based on strict PICOS criteria.ResultsFollowing the search and screening, 21 core articles were included. The extracted data confirmed that aquatic interventions act as profound psychological facilitators. They significantly reduce depressive symptoms and anxiety (Z = −2.294) and enhance social skills and peer interaction (Cohen’s d = 0.76). Furthermore, physiological improvements (e.g., in gross motor function and balance) act as critical mediators that boost perceived competence and autonomy, effectively reducing kinesiophobia (fear of movement).ConclusionAquatic physical activity is a safe and highly effective adaptive health intervention. The aquatic medium serves as a “natural de-marginalisation space” that mitigates internal psychological barriers and societal ableism. These findings provide critical, evidence-based insights for sport psychology practitioners, coaches, and policymakers to design inclusive, confidence-building interventions.