Walking as a meaningful leisure occupation – OT Journal Club

This article is titled “Walking as a meaningful leisure occupation: the implications for occupational therapy” (Wensley & Slade, 2012), published in the British Journal of Occupational Therapy.

This article falls into the category VI level of evidence as seen in the above table, which is based on the effectiveness rating system by Ackley, Swan, Ladwig, Tucker (2008). Both of these articles are linked down below.

Walking is an activity that many of us do regularly and take for granted. We walk to school or work, walk with our friends when we are out on the town or enjoying nature. But for some people walking is more than just a way to get around. It is something that can actually be used therapeutically. **This article is focusing on the therapeutic use of walking as a meaningful activity – there is another whole conversation about how the loss of ability to walk due to injury or illness can create a lack of meaning/independence for people.

This article discusses walking as a leisure activity, meaning that we do it for joy, without being required to do it. Participating in leisure occupations is believed to enhance physical wellbeing, mental health and social functioning, social identity and personal satisfaction.

It is believed by occupational therapists that people have an intrinsic drive to be active and that engaging in meaningful activities is a therapeutic tool that can be used to promote health and wellbeing. Studies have demonstrated physiological and psychological benefits in helping with depression in clinical and non clinical populations. “The benefits of physical activity depend on the individual, the activity and the environmental and social context in which it takes place.” (Wilde et al 2001) Physical activity improves fitness and psychological wellbeing. Walking is said to decrease anxiety and depression, reduce blood pressure and increase functional capacity. It can improve the quality of life of people with serious mental illness, and plays a key role as a preventative and therapeutic intervention for mental distress and promoting physical health benefits. I know for myself, walking is one of my strategies for coping with my anxiety and heavy emotions, and it has definitely been something that has helped me through COVID-19 times.

The study aimed to identify the occupational benefits of walking, to provide evidence for using walking in therapeutic practice and to understand the meaning of walking as a leisure occupation for individuals.

For anyone who is more research inclined, this was a qualitative research study using semi-structured interviews created in reference to the Model of Human Occupational (MOHO) by Kielhofner. It is to be considered that convenience sampling found 6 healthy volunteers (Caucasian members of the university walking club between 21 and 35 years old).

The Key Themes from the interviews were split into different sections:

• Social connectedness
  • Building new social relationships
  • Medium for social interactions
  • Group membership
  • Walking and talking
• Wellbeing
  • Emotional wellbeing
  • Physical wellbeing
  • Escape
  • De-stressing
• Connection to nature
• Achievement from a challenge
  • self-actualization

In the article linked below, you can look into more detail about each category, which are all quite straight forward. The self actualization theme is one that might need a bit more clarity, and in summary, represented the feelings of achievement that the walking group members felt when they challenged themselves to walk a certain distance and proved to themselves they could do it when they achieved the goal. This helped promote feelings of self worth and self esteem. The results of social connectedness also must be noted that this study was done with individuals who were part of a walking group. Of course, we aren’t expecting to build new social relationships every time we go for a walk around our neighbourhood on our own, but when you’re out for a walk with a friend or a group of people, you can get the social benefits as well.

Discussion

The study talks about a number of positive benefits of walking in addition to provision of exercise, and supports it as an intervention in occupational therapy. Walking provided a way to improve quality of life through enhancing social networks (in the walking group) and alleviating daily stressors. As we know from all occupations, the benefits experienced depend on the meaning of walking to the individual, the social context in which walking took place and the environment.

In looking at the results, especially the social enhancement results, it is clear that walking alone vs walking in groups can provide different benefits. The social aspect is something that is interesting to look at as an occupational therapist. Through walking groups, the participants of this study were able to make connections with others and feel that they belong to a group. In relating this back to occupational therapy, we should seize the opportunity to develop prevention and wellness programs outside and in groups. I believe it is important to highlight that “walking” groups, when planned correctly can be more inclusive and include participants who might rely on wheelchairs, walkers, or other devices to get around. In two of my placements, we had clients with a variety of physical, mental and cognitive challenges, and frequently walking became key to therapeutic intervention (which included the involvement of a therapist pushing a wheelchair occasionally). I led walking groups through nature and by the waterfront to get clients outside into fresh air, and to facilitate shared experiences amongst them. This allowed for conversation starters and to push clients together to combat loneliness. I also frequently used walking as a way to talk about emotionally challenging topics – often times going for a walk while talking about deep subjects can provide a reason to not look someone in the eye, to take deep breaths, and to combat the fear of awkward silence. It also gave a change in scenery for those clients who were quite lonely and hardly left their houses on their own.

In the article they talk about how the benefits of walking depend on the environment and the meaning of walking to the individual. I feel like both of these are very individualized. For myself, walking is always a good way for me to process emotions or have time to myself. But if I can take a walk through a path with lots of trees and an absence of cars and buildings, my soul feels more nourished. It gives me a place to be vulnerable, to slow down from my typical city life, and to breathe in some fresh air. Depending on someone’s abilities, the way walking makes their body feel, or who they are walking with, walking can be something unenjoyable or something that is not therapeutic at all. As always, if you are an occupational therapist trying to use walking as a therapeutic tool, it is important to know your client(s) and the terrain that you are going for a walk on. If the physical movement of walking isn’t enjoyable or feasible for the individual or the group, reconsider what your goal was for starting a walking group or going for a walk with your client and brainstorm some other activities that are more meaningful or accessible.

COVID reminds us that leisure occupations are important for health and wellness promotion, and that they impact an individual’s concept of self and group membership. For someone that finds meaning in walking and is able to engage in the occupation, walking can be something that can help combat the closure of gyms, the constant sitting at the computer, and the loneliness that might come from closures of other leisure activities. Walking can be done safely outside at a distance in pairs/groups and can also be a nice way to find some alone time to think, distract yourself from stressors, or if you’re like me, listen to one of your favourite podcasts/playlists to de-stress.

What meaning do you put on walking? Walking has become a strategy for me to deal with heavy emotions, to spend some time on my own outside of my house, to get some time in nature, and to listen to my favourite podcasts. Walking has also become a nice way for me to catch up social distanced with friends, or to spend quality 1 on 1 time with my fiance without the distraction of screens.

Do you find solace in walking? Share your experiences or your opinions about this subject down in the comments!

The article can be accessed by the links below:

Wensley, R. & Slade, A. (2012). Walking as a meaningful leisure occupation: the implications for occupational therapy. British Journal of Occupational Therapy, 75(2), 85-92. DOI: 10.4276/030802212X13286281651117.Retrieved from: https://journals.sagepub.com/doi/pdf/10.4276/030802212X13286281651117

This article can also be accessed from the following link (open link) : https://pearl.plymouth.ac.uk/handle/10026.1/1242

Further references:

Ackley, B. J., Swan, B. A., Ladwig, G., & Tucker, S. (2008). Evidence-based nursing care guidelines: Medical-surgical interventions. (p. 7). St. Louis, MO: Mosby Elsevier.