Inclusive physical activity for war affected adolescents: a systematic review

Abstract

Background and Study Aim. Armed conflict disrupts education, social interaction, and opportunities for physical development, adversely affecting adolescents’ physical and psychosocial functioning. In post-conflict and trauma-affected contexts, inclusive physical activity is discussed as an approach that integrates rehabilitation, educational adaptation, and social participation. The aim of this study was to examine the conceptual foundations, research approaches, and reported outcomes of inclusive physical activity programs for adolescents affected by armed conflict.

Materials and Methods. A systematic review was conducted in accordance with PRISMA guidelines using the Web of Science, Scopus, and MedLine (via PubMed) databases. Publications from 2013 to 2025 were considered. The initial search identified 647 records, of which 22 peer-reviewed studies met the inclusion criteria and were included in the final synthesis. Data extraction and coding were performed independently by two reviewers following a structured protocol. Each study was classified into one of three analytical categories: fundamental (n = 6), contemporary (n = 9), or applied (n = 7). Quantitative characteristics, including publication year, study design, and thematic focus, were summarized using descriptive analysis. Qualitative synthesis was conducted using a thematic approach focusing on inclusion mechanisms, psychosocial outcomes, and contextual barriers. This mixed analytical strategy enabled integration of numerical patterns and thematic findings.

Results. Among the 22 included studies, research most frequently focused on rehabilitation-related outcomes (45%), followed by psychological dimensions such as emotional regulation and motivation (32%), educational aspects (18%), and sport-related contexts (5%). Observational designs were predominant (59%), while qualitative approaches accounted for 18%, cross-sectional and survey-based studies for 9% each, and mixed-methods designs for 5%. Reported outcomes were clustered around physical functioning, emotional regulation, and participation. Across studies, frequently identified mechanisms included adaptive pedagogical strategies, structured activity formats, peer interaction, and self-regulation practices. Rehabilitation-focused interventions reported changes in functional capacity, mobility, and stress-related responses. Education-oriented interventions addressed motivation and elements of teacher practice, while community-based and outreach initiatives examined social belonging, resilience-related processes, and continuity of participation.

Conclusions. Inclusive physical activity can be described as a framework that addresses physical, psychological, and social dimensions of adolescent recovery. The synthesized evidence indicates associations with educational inclusion and resilience-related processes. It also shows links to social participation in post-conflict contexts. In this way, inclusive physical activity is situated within broader processes of social reintegration.