Adaptive physical fitness programs for people with a disability

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If you're a paraplegic, for instance, you may be able to take part in chair aerobics, which can be done in a group setting or by viewing a videotape or DVD.

Just about any kind of disability can be accommodated with adaptive exercise equipment or certain technique adjustments.

Exercising with a disability

Perhaps you have a physical disability - paralysis of your legs (paraplegia) or surgical removal of a leg (amputation). Or maybe you have a chronic condition, such as arthritis or multiple sclerosis.

You're adjusting to your disability. But your doctor recommends you get more active, explaining that doing so will help you manage your weight, maintain your independence and improve the quality of your life.

Take your doctor's recommendation to heart. Find out more about the benefits of adaptve physical fitness activity. Then explore your options, set some goals and get started. Not only will you feel better, but you'll probably enjoy what you're doing, too.

The benefits of physical activity for people with a disability

Physical activity and exercise are good for everybody. According to the American College of Sports Medicine (ACSM), an active lifestyle that includes regular exercise can:
* Lower your risk of developing heart disease, stroke, type 2 diabetes and osteoporosis Lower your blood pressure, if it's mildly elevated
•Help you manage your weight by increasing your metabolism
•Help you improve your cholesterol level
•Improve your ability to cope with stress
•Provide psychological benefits, such as improved self-image and self-confidence, better sleep and a more positive outlook on life

An increase in physical activity can help you:

•Maintain your independence. Since you have a disability, you may feel limited in your ability to engage in physical activity. But avoiding physical activity increases your risk of obesity, type 2 diabetes, pressure sores, infections, fatigue, depression and osteoporosis. These conditions can result in even greater limitations, including the loss of your independence.
•Balance your muscle groups. Because you have a disability, your muscles are more prone to underuse, overuse or misuse. For instance, if you use a wheelchair, you may have very developed anterior muscles - those toward the front of your body - from pushing the wheels on your chair. You might need to develop your upper back muscles to balance your physique.
•Improve the quality of your life. Going to the gym, park or swimming pool can be fun, especially if you take along family or friends and engage in an activity you enjoy. It's also an opportunity to meet people and make friends.

Are you convinced of the benefits of physical activity? If not, take some time to think about what's holding you back. Common barriers for people with disabilities include:
•Not having information about options
•Lack of money to buy equipment
•Problems with transportation

If you have any of these or other barriers, discuss them with your doctor or physical therapist. They can recommend ways to overcome your physical limitations and point you in the right direction to get help with financial problems.

See your doctor first

Check with your doctor before you start. Your doctor will ask about your past experience with exercise and can help you determine the level of intensity and frequency with which you should perform specific exercises.

Your doctor also can tell you what benefits to expect from a specific activity based on your condition, and if the medication you take will affect your ability to exercise. A doctor who specializes in medicine and rehabilitation is especially suited to address these needs.

The physical activities you pursue may depend on the type of disability you have. But you have many options. The key is to focus on what you can do. For a balanced approach, your doctor will recommend you focus on three areas - aerobic fitness, muscular fitness and flexibility.

Aerobic fitness for people with disabilities

Aerobic activities improve your body's ability to take in and use oxygen for energy production. Examples of aerobic activity include running, bicycling and aerobic dance. Think these are beyond your ability? Consider these options:

Can't ride a bicycle because of paralysis or amputation? Try a hand cycle instead.

Can't run because you're blind? Try running with a friend or family member to guide you.

Can't take part in high-impact aerobics such as jogging or aerobic dance because of arthritis or brittle bone disease (osteogenesis imperfecta)? Swimming or cycling may be excellent options.

Muscular fitness for people with disabilities

Strength training - the process of building muscle and preserving the muscle you have - can enhance your ability to complete everyday tasks, which in turn can help you maintain your independence.

The three main methods of strength training involve free weights, machines or portable equipment, such as resistance bands.

Your physical ability, coordination, strength, muscle control and personal preference determine the type of equipment you use.

Have trouble using your hands? Try specially designed wrist cuffs that secure your hands to free weights.

Have involuntary movements of your arms or legs? Attaching cuff weights to your arms or legs, or using weight machines, may be a good choice.

Lack access to a gym or equipment? You don't need to join a gym or own high-tech equipment to get a good workout. Resistance tubing, water, ordinary household items - such as soup cans - and even your own body weight all can be used to effectively and creatively challenge your muscles to strengthen them.

Muscles weak because of muscular sclerosis? Strength training exercises using resistance tubing may be your best option.

If you have a condition that directly affects your muscles - such as cerebral palsy, muscular dystrophy or multiple sclerosis - use caution when deciding to pursue strength training. If you have any of these conditions, consult your doctor beforehand to determine if strength training is safe for you. If it is, your doctor may recommend specific modifications to your technique for a healthy workout.

Flexibility for people with disabilities

Maintaining your flexibility - the capacity to move a body part around a joint - can enhance your ability to move independently. Stretching helps your body stay flexible by:
•Maintaining full range of motion around joints that have weakened muscles, which can occur if you've had a stroke
•Preventing permanently shortened muscles (contractures), which may be problematic if you have a spinal cord injury
•Decreasing rigidity and stiffness if you have Parkinson's disease or have muscle spasticity due to spinal cord injury or multiple sclerosis
•Make sure your muscles are warmed up before you begin your flexibility exercises. Doing these exercises midway through or at the end of your program will help ensure you don't pull a muscle or tendon.

Set your goals

Goal setting can help you stay on track with your plan. Work with your doctor or physical therapist to set some short- and long-term goals.

Keep in mind that moderate amounts of physical activity most days of the week can improve your health. You can do this through longer periods of less intense activity, such as wheeling yourself in your wheelchair for 30 to 40 minutes, or in shorter amounts of more strenuous activity, such as playing wheelchair basketball for 20 minutes.

Start slowly

Don't jump into an intense, structured adaptive physical fitness exercise program right away. Instead focus on bringing a small amount of physical activity into your life each day. Remember, physical activity doesn't need to be strenuous to improve your health, and even brief periods of moderate activity will help.

If you're currently inactive, begin with five to 10 minutes of physical activity and increase the time as you progress. By slowly increasing the duration, intensity or frequency of the activity, you can achieve greater health benefits and increase your metabolism.

Keep a journal

Some people find that keeping a record of their physical activity is motivating. Use a small notebook or fill out a spreadsheet on your computer if you'd like.

If you do keep a record, take it to appointments with your doctor or physical therapist. They can evaluate your progress and make sure you don't worsen your condition by pushing yourself too hard or by doing specific exercises improperly.

Consider organized sports

Though activities such as walking around your neighborhood or strength training at a fitness center can be pleasurable, consider taking part in organized sports for people with disabilities.

Besides the benefits of physical activity, playing organized sports can help improve your motor skills, mood and self-esteem. You also gain the companionship that comes with sharing an activity with others.

Numerous opportunities are available to you. Minor modifications and adaptive sports - such as slowing down the pace of an activity, using modified equipment or limiting the size of the playing areas - can usually make the sport enjoyable.
•Soccer. Players walk instead of run. Only six people are allowed per side. Players who use wheelchairs can hold the ball in their laps.
•Volleyball. Use balls that are larger, softer, lighter and brightly colored. Let the ball bounce before you hit it. Lower the net. Play sitting down in a wheelchair or on the floor if you're unable to stand.
•Tennis. Use rackets with large heads. Don't use a net. Use large, lightweight, brightly colored balls.
•Basketball. People who are unable to stand can play in wheelchairs. Organized teams compete throughout the United States.
•Adaptive floor hockey. Children who require wheelchairs, along with children with disabilities who can stand, play hockey on wooden floors instead of ice.

Have fun, enjoy better health

You know about some of the options for increasing your physical activity. Are you ready to find out what's available in your community? Call the local chapter of an association for people with your particular disability. Some organizations sponsor summer camps, classes and sporting events for people with disabilities.

And don't forget to make it fun. Enjoy yourself - whether you exercise alone or with friends or family members. Being physically active can - and should - make you feel good. Your reward for having fun and getting more active will be better health and an improved quality of life.

Fitness Programming and Physical Disability, a publication for Disabled Sports USA by Patricia D. Miller, shows how to adapt existing physical fitness programs to enable people with disabilities to participate and offers guidelines for adapting fitness programs such as resistance training, stretching, and aerobic dance, with exercises illustrated with photos.

Stretch and Strengthen for Rehabilitation and Development, by Bob Anderson and Donald G. Bornell, instructs the disabled, special needs and elderly in simple stretch and strengthening exercises, using an Iso-Band. The book is organized by 29 body areas and there are 3-4 stretches preceding one strengthening exercise for each of the 29 body areas.

"As a wheelchair user, I use my muscles differently than the able bodied person so an exercise book geared for the able bodied is usually not useful to me. I found this book to be very helpful, with the use of theraband exercise aids (those long, stretchy neon colored things you've all seen) I can work out specific muscle groups and areas of my body as I need. A large number of the exercises can be done in a seated position. The line drawings are clear and very helpful. This would be a good book for anyone, able bodied or not who wants to ease into fitness following an injury, surgery, or just years of couch potato life. The spiral binding made it easy to keep the book open in front of my while doing the stretches. This is a very practical consideration usually overlooked by writers of exercise manuals."

Yoga Paths for Health will help find the best yogic path for your health. There are many yoga paths - bhakti, hatha, jnana, karma, kriya, kundalini, mantra, raja and tantra. No form is better than the other, there are just different paths. With this overview, we hope that you may find the yoga path best suited to bring your health and Enlightenment.

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