16 March 2009

Exercising with a disability

Getting exercise should be a daily goal for everyone, but for people with disabilities, exercise is even more important.

Getting exercise should be a daily goal for everyone, but for people with disabilities, exercise is even more important. It does, however, pose its own challenges, depending on what type of disability one has, and which part of the body and muscles are affected.

The first difficulty is getting a good recommended regime. Since every disability is different, it's nearly impossible, and very unwise, to assign general exercises across the board, said Corne C. Rossouw from the Department of. Sport Science at Stellenbosch University.

"Depending on the type and severity of the disability, there are always specific factors that need to be kept in mind, such as one's present physical fitness status; how to safely adapt movements to prevent injuries; how long a workout should be; what are specific warning signs and so on," he said.

He also pointed out that certain medications might restrict the ability to perform physical activities or alter responses to exercise – something one should be aware of before embarking on any exercise programme.

He suggested that a medical history and a physical examination are the first steps in starting an exercise programme. "Together they can detect the presence of disease, identify exercise restrictions, and help direct the exercise programme’s focus. Special considerations should be given if complications such as diabetes, cardiovascular disease, and so on, are present."

The importance of exercise
Rossouw said that regardless of whether one has a disability or not, often the primary reason people start exercising is because they have set a specific goal for themselves such as running or wheeling the comrades, to lose weight, to get stronger or more toned, or because they would like to “feel better”.

However, for people with certain disabilities, the importance of daily exercise is far more pressing. People with some forms of cerebral palsy for instance, need daily exercise to keep their muscles flexible and to maintain muscle strength.

The mental and emotional benefits afforded by exercise should also not be overlooked, Rossouw added, and said that participation in appropriate exercise programmes could allow one to become more independent in daily living activities.

"Increasing one’s physical strength and power, cardiovascular endurance and flexibility, improving co-ordination and balance, and influencing self-image in a positive way are all aspects that are possible through participation in regular physical activities, including exercise programmes. It allows us to observe other people who exercise, to understand what it takes to keep on despite the difficulties sometimes, and includes us in a group where the value of improving one’s own quality of life, is understood and respected," he said.

Adhering to a structured exercise programme also helps one focus on developing a sense of self-discipline. "If you do not exercise regularly, you can not claim to have any self-discipline. But sticking to the programme indicates a willingness to manage time to allow for daily exercises, and therefore shows that they want to bring about positive change for themselves."

And it's all about change – no exercise means no change, no improvement in strength and power, cardiovascular endurance and flexibility, no improved co-ordination and balance, or self-image.

Personal trainer or a physiotherapist?
Rossouw said that in the beginning it is wise to have a personal trainer or physiotherapist. This is to ensure that whatever exercises are done are performed correctly with the proper body alignment while executing the movements, and to ensure that the correct number of repetitions and sets are done, with all exercises executed in such a way that no damage can be done.

"It is always wise to talk to a personal trainer/physiotherapist and share with them what your goals are, what it is what you want to achieve – you will hopefully be talking to someone that will be able to give you quality feedback," he advises.

"A personal trainer generally focuses on fitness and strength training, and is more often found in a gymnasium or health spa. A physiotherapist is generally found in a practice where specific post-operative, rehabilitative exercises are done, usually over a specific period of time after which the 'patient' moves on. I would advise using the person with whom you feel most comfortable, and who you know has specific knowledge about your situation and condition."

Exercising at home
If your disability allows for you to exercise at home, and you can afford to set up a gym with the right equipment, Rossouw suggests the following equipment to stock up with:

  • Arm ergometers
  • Pulley machines
  • Weight lifting equipment.
  • Bean bags
  • Sticks
  • Hand and wrist weights
  • Elastic bands (therabands)
  • Floor mats
  • Balls of different sizes and weights

"If you are a wheelchair user, do not forget that you might need proper stabilising devices to secure the wheelchair and benches safely; there might also be the need for different Velcro straps to fasten hand/wrist weights or the body to ensure good body alignment during exercises."

Tips for getting started
You are responsible for making it work – make time for yourself and remember, it's investment you are making, so take the following into consideration:

  • A physical examination/clearance is the first step in starting an exercise programme.
  • Select an exercise method(s) that you enjoy: water exercises, exercises to music, gym work, etc – be kind to yourself. You can even do exercises while lying in bed, before the daily tasks start.
  • There will be a time when you “feel” that it is not helping you – do not believe this “feeling”. Be positive and stay positive.
  • Do not “overdo” the first few sessions, work progressively and thoroughly, use correct and appropriate methods.
  • Listen to your body when it is “talking” to you.

Source: Corne C. Rossouw, Department of. Sport Science, Stellenbosch University

(Amy Henderson, Health24, March 2009)


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