Influences of the built environment in physical activity participation in individuals with disabilities: a systematic review.

BACKGROUND: Physical inactivity remains a critical public health concern for individuals with disabilities, who often encounter environmental and structural barriers to participation. Although research on built environment characteristics and physical activity (PA) has expanded, evidence specific to individuals with disabilities remains fragmented and requires clearer conceptual integration. This systematic review synthesises evidence on built environment characteristics associated with PA participation among individuals with disabilities. METHODS: A comprehensive search was conducted across eight databases - PubMed, Scopus, Medline, Web of Science, NARIC, CINAHL, Embase and IEEE Xplore - for studies published between 1990 and June 2025. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Data were synthesised using a hybrid deductive-inductive thematic approach informed by the International Classification of Functioning, Disability and Health (ICF) and established built environment domains; the Built Environment - International Classification of Functioning, Disability and Health (BE-ICF) model was developed and refined during synthesis to organise the final themes and potential pathways. RESULTS: Twenty-six studies met the inclusion criteria. Built environment features, including accessibility, safety, aesthetics, land-use diversity and street connectivity, were reported as facilitators or barriers to PA participation among individuals with disabilities. The synthesis organised these findings into potential functional and psychosocial pathways linking environmental characteristics with participation. Most studies were cross-sectional and used heterogeneous measurement tools, limiting causal interpretation. CONCLUSIONS: Built environment characteristics are associated with physical mobility and psychosocial engagement in PA among individuals with disabilities. Inclusive, accessible and well-designed environments may support health equity by reducing participation barriers and expanding opportunities for active living.