Introduction

People with physical disability are living longer and more active lives. There is growing interest in developing programs to facilitate their independent living, self management and occupational capability. Health professionals in rehabilitation units should be aware of positive (feelings of accomplishment) and negative (anticipatory anxiety) aspects of these changes. Success in this regard can greatly improve the clients’ quality of life (QoL) and decrease the progressive effects of their disability.1,2 Pain, fatigue, deconditioning and mobility problems may all impose substantial limitations on body structures, functions and participation in instrumental activities of daily living such as employment.3 Physical disability manifestations should not be evaluated in isolation, and its treatment should be contextualized from a biopsychosocial perspective. People with lifelong physical disabilities may encounter many obstacles to entering the labor market, including low self-esteem, lack of motivation, preconceptions, prejudice and reduced productive capability. These problems are heightened by the existence of architectural and environmental barriers that hinder access to public places, including leisure facilities and the workplace. In addition, physical disability may have a negative impact on people’s lives, at work and at home, reducing productivity, aggravating the need for sick leave and affecting leisure time. In turn, these factors contribute to health problems that are reflected in the general QoL and, by extension, at work.5,6 The situation of the worker with disability is characterized by the need for constant effort and adaptation, since physical disability may be irreversible. Indeed, the work setting can worsen the condition, exacerbating difficulties in job performance and sometimes obliging the worker to take leave of absence or early retirement.7,8 The latest data from the US National Health Interview Survey show that 47.1% of American adults aged 18-64 years with disabilities are physically inactive, in comparison with only 26.1% of adults with no such disabilities. Moreover, inactive 64 adults with disabilities are 50% more likely to report one or more chronic diseases compared to those who are physically active.