Of Balloons, Bonds and Brawn

Adaptive Sports for Active Ageing

• Frailty among older adults within the community is expected to rise from about 6% now to 27% in 2030.
• Adaptive sports enable older adults of varying fitness levels to participate using modified play rules and sporting equipment.
• Seniors enjoy opportunities to age actively, socialise, delay frailty and improve overall quality of life.
• With built-in therapeutic elements, adaptive sports can enhance functional capacity and mental health, and reduce the rate of falls.
• In line with national healthcare focus on preventive care, adaptive sports contribute towards reducing the disease burden on society.

A group of 32 wheelchair-bound seniors are gathered in a multi-purpose hall in groups of eight, holding rackets and playing a leisurely game of badminton. However, instead of shuttlecocks, they are hitting slowly-descending balloons. 

Enter the world of adaptive sports, where play rules and sporting equipment are modified to accommodate different levels of functional abilities. At MWS Bethany Nursing Home – Choa Chu Kang (BNH) where 99% of the residents are wheelchair or bed-bound, adaptive sports allow them to enjoy the benefits of exercise despite a lack of mobility.

A group of residents at MWS Bethany Nursing Home – Choa Chu Kang playing adaptive badminton

Play and thrive in the silver years

Staying active is crucial for good health and well-being, especially for older adults. Adaptive sports offer seniors who are frail or have physical disabilities a fair opportunity to participate in recreational sports, improving their overall well-being and quality of life. This enables them to thrive and lead more fulfilling, productive lives in their silver years. 

68-year-old Mdm A Sulosana is one MWS BNH resident who never imagined that she would be able to play badminton again after losing her right leg to diabetes. 

“In my youth, I loved playing badminton with family and friends. But I stopped after marriage due to family commitments. I am glad that at this age, I can go back to playing my favourite childhood sport,” she said, grinning from ear to ear. 

Another resident, 88-year-old Mah Siew Sang, said: “I’m into adaptive sports because it gets me moving. It’s much better than just being stuck in my room all the time. I’m in a better mood and have more energy since I started taking part in adaptive sports – it gets my heart pumping.” 

For seniors like Mdm A and Mr Mah, adaptive sports help inject some joy and vitality into their days, while reducing the physical and mental health risks of a sedentary lifestyle.

A senior playing adaptive soccer at MWS Active Ageing Centre – Golden Lily@Pasir Ris

Independence, dexterity and a confidence boost

Then there are others like Mdm Chew Ah Buck, who have gotten better at everyday tasks and become more independent thanks to adaptive sports and physiotherapy. “I used to need assistance to move around. But now, I can walk independently, and my knee and back pain have improved,” said the 77-year-old. 

Mdm Chew added that the strength and dexterity in her hands and fingers have become better. That has made a difference in how well she does her micro-job at the Nursing Home, where she helps fold and pack towels. “I can complete the task much quicker and with better results now,” she said, skillfully joining the two towel halves.

Active ageing through adaptive sports

Adaptive sports, along with other exercise and therapy programmes, are used to meet the World Health Organization’s recommendation on physical activity for older adults. This includes multi-component physical activity that emphasises strength and functional balance at least three days a week.

With MWS’ adaptive sports programme, therapeutic elements in the form of strength, balance and flexibility training using sports equipment are woven into the 45-minute routine. Imagine volleying a balloon with racket or shooting a basketball into a hoop repetitively for a set amount of time. The aim is to enhance functional capacity, improve mental health and reduce the rate of falls.

The initiative aligns with the shift in Singapore’s healthcare strategy towards empowering seniors to proactively manage their well-being – through preventive health, active ageing programmes and care services. This helps to reduce the risk of people falling ill and further straining the healthcare system.

Upstream intervention for healthy ageing

Frailty is linked to an increased risk of falls, acute illness, institutionalisation, immobility, care needs, decreased quality of life, disability and death. 

A resident at MWS Christalite Methodist Home training his strength and balance by balancing a balloon on a racquet

In Singapore, falls account for 40% of injury-related deaths among older adults. If left unaddressed, fall risks like walking instability lead to recurrent falls and poor quality of life. Older adults who have experienced falls and near-falls may develop a fear of falling and restrict their activities and socialisation, diminishing their quality of life. Limited social engagement can lead to isolation and cognitive decline, raising the health and mortality risks of these seniors. 


82-year-old retiree Mr Liau Vui Hon has made great strides in reversing his frailty since taking up adaptive sports at MWS Active Ageing Centre (AAC) – Fernvale Rivergrove. During his first session, he had a hard time walking and standing steadily. But eight months of adaptive sports have improved Mr Liau’s leg strength and balance.

“After my last fall a few years ago, I sprained my waist and was in pain for about a month. I became fearful of falling. But now I can walk more steadily, which lowers my chances of falling,” he said.

These days, Mr Liau relies less on others to get around. This has improved his quality of life, enabling him to stay socially active and age in place. “I am now more confident in walking around my neighbourhood on my own,” he said.

Social isolation also a frailty risk

While factors such as inactivity, diet and illnesses can contribute to frailty, social isolation presents similar risks. Adaptive sports serve as community-building activities, preventing isolation and promoting social interaction. 

Research has found that seniors who stay socially active have better memory, cognitive function, overall well-being and physical health.

Adaptive sports and proven impact

The programme was initially launched in 2022 during the COVID-19 lockdowns at MWS Christalite Methodist Home (CMH) to combat inactivity and isolation among residents, and enhance their well-being. 

A six-month study using validated tools found that 75% of MWS CMH residents who regularly participated in adaptive sports improved or maintained their physical abilities, despite going through four COVID-19 lockdowns. Moreover, 80% of residents had a reduced risk of fall.

Another survey revealed that when residents spent more time socialising with their peers, their mood and energy levels improved as well.

Programme addresses both social and healthcare needs

On 14 April 2023, the programme was recognised with the People’s Choice Award at the National Healthcare Group Population Health Collective (POPCollect) Annual Workplan Seminar 2023. The programme was one of 14 that were showcased, and it won for its innovation, integration across social and health care domains, and ability to empower frail seniors to take ownership of their overall well-being. 

There is a wide range of activities within the programme and these include boccia, badminton and basketball, among others. Today, the programme has been expanded to MWS’ AACs, Senior Care Centre, and two Nursing Homes.

One size doesn’t fit all

The differentiating factor of adaptive sports is its inclusivity and adaptability to needs. Adaptive sports, for seniors in different settings, are enhanced to meet their differentiating needs. For example, a basketball game played by seniors who are more mobile and active, and living in the community, is more rigorous and requires more skills training on movement on the court to prevent falls during the game. Even within the community setting, adaptive sports can be enhanced further (through change in layout and rules) to allow seniors of different abilities to play together. The same basketball game played by seniors in a nursing home will have different considerations.

“At our AACs that serve seniors living in the community, the activity comprises cognitive elements like following instructions, learning new skills, strategising during games, and having friendly competitions. This helps the players to socialise more, and builds camaraderie among them,” shared Brendon Yam, Manager – Programme Development from MWS’ Allied Health team.

A three-month survey conducted at MWS Christalite Methodist Home found that residents who participated regularly in adaptive sports experienced improved mood and energy levels.
A modified version of Boccia, a Paralympic sport for people with motor impairments, is played across MWS Active Ageing Centres

At MWS CMH and MWS Nursing Homes, adaptive sports serve both as a social activity and a form of therapy for the senior residents. Given that the nursing home residents have limited mobility, they play badminton which helps build their upper body strength and flexibility.

Meanwhile, at our Senior Care Centre, adaptive sports are used to help the clients undergoing community rehabilitation to improve their functional abilities and remain active in the community.

“The seniors are more motivated to engage in therapy when it is disguised as play. They are exercising without realising it!” said Brendon. “Adaptive sports make ageing more empowering and inclusive for seniors, and enable them to live purposeful and dignified lives in their golden years.”

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