Abstract

Inclusive physical education (IPE) is one of the most practical ways schools can advance equity, meaningful participation, and whole-child development for learners with diverse abilities, especially in low- and middle-income, resource-constrained settings. This systematic review brought together evidence on the teaching approaches, teacher preparedness, and policy conditions that shape IPE in school physical education. Using PRISMA-guided procedures, peer-reviewed studies published between 2000 and 2024 were searched across multidisciplinary databases. Forty-eight studies met the inclusion criteria, spanning qualitative, quantitative, and mixed-methods designs within school-based PE contexts. Across the evidence, commonly reported approaches included adapted physical education, cooperative learning, peer-assisted instruction, and universal design for learning. Where teachers were able to tailor activities to local realities, these models were linked to better participation, stronger social inclusion, and improvements in motor skill development. However, consistent delivery was frequently disrupted by system-level constraints such as inadequate facilities, crowded classes, and limited access to adapted equipment and teaching resources. Teacher readiness emerged as a decisive factor. Many teachers expressed supportive attitudes toward inclusion, yet gaps in pre-service preparation, limited in-service training, and scarce specialist support often translated into low self-efficacy and uneven instructional differentiation. Policy findings also showed a recurring “paper-to-practice” gap: although inclusive education mandates exist in many settings, weak enforcement, insufficient funding, and limited monitoring reduce their impact on everyday PE. Cross-sector collaboration among education authorities, health services, and disability organizations was uncommon, but where it existed it supported more durable inclusion. Overall, the evidence suggests that the main barriers to IPE are capacity and resourcing challenges rather than resistance to the idea of inclusion, pointing to the need for stronger teacher development, low-cost adaptive strategies, and better policy alignment.Inclusive physical education (IPE) is one of the most practical ways schools can advance equity, meaningful participation, and whole-child development for learners with diverse abilities, especially in low- and middle-income, resource-constrained settings. This systematic review brought together evidence on the teaching approaches, teacher preparedness, and policy conditions that shape IPE in school physical education. Using PRISMA-guided procedures, peer-reviewed studies published between 2000 and 2024 were searched across multidisciplinary databases. Forty-eight studies met the inclusion criteria, spanning qualitative, quantitative, and mixed-methods designs within school-based PE contexts. Across the evidence, commonly reported approaches included adapted physical education, cooperative learning, peer-assisted instruction, and universal design for learning. Where teachers were able to tailor activities to local realities, these models were linked to better participation, stronger social inclusion, and improvements in motor skill development. However, consistent delivery was frequently disrupted by system-level constraints such as inadequate facilities, crowded classes, and limited access to adapted equipment and teaching resources. Teacher readiness emerged as a decisive factor. Many teachers expressed supportive attitudes toward inclusion, yet gaps in pre-service preparation, limited in-service training, and scarce specialist support often translated into low self-efficacy and uneven instructional differentiation. Policy findings also showed a recurring “paper-to-practice” gap: although inclusive education mandates exist in many settings, weak enforcement, insufficient funding, and limited monitoring reduce their impact on everyday PE. Cross-sector collaboration among education authorities, health services, and disability organizations was uncommon, but where it existed it supported more durable inclusion. Overall, the evidence suggests that the main barriers to IPE are capacity and resourcing challenges rather than resistance to the idea of inclusion, pointing to the need for stronger teacher development, low-cost adaptive strategies, and better policy alignment.