Exercising with a Disability

by Holly Gigure

Have you ever thought about why exercise is important for you and your loved ones? Have you ever thought about exercise being even more important for your loved one with a disability? Do you think, "It just won't work in our situation"? As the Fitness and Aquatic Coordinator for Courage Center St. Croix, I've seen first hand how people of all abilities and disabilities can benefit from participating in aquatic, fitness, and recreation programming. Exercise is indeed exceptionally important for people with disabilities, and Courage Center can be the place to help you learn who, what, where, when, and how.

Life After Therapy

Many times people seek out physical, occupational, and/or speech therapy with certain goals in mind. Whatever those goals might be, therapy ends when those goals are met or if health insurance therapy benefits have been capped. What happens in life after therapy?

Courage Center offers a solution with its continuum of care. The way Courage Center looks at services, there is no beginning and end. It's a continuous cycle involving independent exercise and classes, one-to-one exercise with a fitness and aquatic specialist, and therapy. (See diagram.)

Staff work together when treating clients to create goals that overlap between therapy, exercise, and life outside of Courage Center. An example of this is the client who has occupational and speech therapy and also swims one-on-one with an aquatic specialist. When the client is dressing for the pool, he/she works on occupational therapy (OT) goals. In the pool, speech has set goals for speaking clearly, answering questions, maintaining eye contact, etc. During OT and speech sessions, the pool can be used as a reward system.

 

 

Staying active is vital to health, and Courage Center can help find the right post-therapy activity. Programs like "teen fitness" offer teens and young adults with disabilities a chance to exercise while socializing with peers. One instructor leads the group while trained volunteers assist each client. "Water activities" offer the same type of social activity, but in the pool. Adapted yoga is offered for both youth and adults with disabilities. Courage Riders is a therapeutic horseback riding program offered May – October. Camps and a variety of sports and recreation programs are available through our Golden Valley location. A variety of programs are available to meet clients' needs.

Why Is Exercise Important?

The following is an excerpt from an article written by three Courage Center staff (Nancy Flinn, Research and Outcomes; Tom Kelley, Research and Outcomes; and John Tschida, Public Affairs). 

Exercise Rates Are Lower in the Disability Population 

  • Population-based surveys (Heath and Fentem, 1997; Rimmer, Rubin, Braddock, & Hedmann, 1999) show that people with disabilities are participating in physical activity at much lower rates than people without disabilities.
  • Fifty-six percent of persons with disabilities reported engaging in no leisure-time physical activities (U.S. Department of Health and Human Services, 2000).
  • These numbers are even more staggering in marginalized disability populations, as a survey of exercise patterns among minority women with disabilities shows only 8.2 percent of the sample participated in leisure-time physical activity (Rimmer et al., 1999).
  •  Adults with disability are not meeting activity levels recommended by the Centers for Disease Control and the American College of Sports Medicine (Bolslaugh & Andreson 2006).

Being Fit Is Important to Overall Health

  • This trend is alarming because staying fit and active can counter the effects of possible debilitating secondary conditions that decrease the chance that a person living with a disability will experience prolonged independence and continued community integration (Compton, Eismann, & Henderson, 1989; Campbell, n.d.).
  • Exercise has been shown to reduce chronic disease risk, lower blood pressure and cholesterol, increase strength and endurance, inhibit pain, alleviate psychological distress, and increase self confidence (White et al., n.d.; Centers for Disease Control in Kosma, Cardinal, and Rintala, n.d.; Yuen and Hanson, 2002; Mannerkorpi, Nyberg, Ahlmen, & Ekdahl, 2000).

Benefits of Exercise

Staying Fit Means Staying Well

  • Similar to the general population, people with disabilities fluctuate through a continuum from poor to excellent health. The difference being that people with disabilities "often start at the lower end of the health continuum due to secondary conditions that overlap with their primary disability" (Rimmer 1999).  With proper health promotion strategies, it has been shown that persons with disabilities can raise their status on the health continuum and reduce their risk for conditions that would lead to greater dependence on health and support systems. 
  • Exercise, along with nutrition and health behavior, is a major component of health promotion for people with disabilities. Endurance, strength and flexibility training has been shown to combat the effects of a sedentary lifestyle as is often seen in those with heart disease, obesity, and diabetes. Persons with disabilities are at greater risk for these conditions (Stampfer, 1991; Gresham et al, 1979 in Jones and Heinemann).
  • The benefits of staying fit and well have been shown across gender and disability type. Studies using experimental research design have demonstrated the effectiveness of exercise intervention on the health of persons with disabilities. Results from a study of women with disabilities (n=45) has shown that, following a six-week exercise intervention period, women reported experiencing fewer secondary conditions on a chronic basis, and 78 percent reported positive change as a result of participation (White et al., n.d.). 
  • Aerobic exercise and functional electrical stimulation induced exercise was shown to improve cardiac health for persons with spinal cord injury (Phillips et al., 1999; Wheeler et al., 2002).

Cardio and Other Benefits

  • In a study of a circuit-training program for persons with traumatic brain injury (TBI), participants in a 12-week program significantly improved cardio-respiratory fitness (Bhambhani, Rowland, Farag, 2005).
  • Similarly for aquatic exercise, TBI participants, when compared to a control group, improved cardiovascular endurance as well as ability to complete activities of daily living (Driver et al. 2004).
  • In a study conducted by the Centers on Health Promotion Research for Persons with Disabilities, fitness and wellness interventions were introduced with persons with diabetes, osteoarthritis, Down syndrome and stroke survivors. Participants showed "statistically and clinically significant gains in various areas of fitness, nutrition and health behavior" with the greatest gains on measures of cardiovascular fitness and strength (Rimmer & Liu., 2001, p. 71).

Psychosocial Benefits

  • Improved psychosocial outcomes have also been identified in studies emphasizing exercise benefits. A study of spinal cord injured persons participating in a health promotion program where exercise was a component, found improved quality of life (Zemper et al., 2003).
  • Results from the process of qualitative interviewing suggest that conditioning classes were found to produce improved social and psychological as well as physical outcomes (Maher, Kinne, & Patrick, 1999). 
  • This concept is supported by Martin's claim that sports and exercise enhances self-esteem and reduces perceived negative body image (in Kosma et al., n.d.). 
  • Also, a positive effect was found between measures of self-perceived body image and regular physical activity (Yuen and Hanson, 2002). In another study, athletes with disabilities scored higher on levels of social integration, occupation and physical independence than non-athletes with disabilities (Hanson, Nabavi, & Yuen, 2001).
  • The positive effects of exercise have been demonstrated in as little as 8 weeks in some of the literature (Eng, Chu, Kim, 2003), but it has taken longer to demonstrate effects on cost. (Moffett & Togerson, 1999.)

    It is easy to see how important it is to keep people with disabilities moving. Not only are there tremendous physical benefits, but social, emotional, and spiritual benefits are vast as well. Many of our programs are very social, such as classes that do potlucks, celebrate birthdays, and meet outside of Courage Center.

    Courage Center is Here

    Courage Center's Wellness, Fitness, and Aquatics programs have two sites with accessible fitness centers and pools with the knowledge and equipment that allow people with disabilities to exercise in a safe and friendly environment. Locations in Golden Valley and Stillwater have 92 degree pools with wheelchair ramps and attached whirlpools. A lifeguard is on duty at all times and a variety of programs are available: classes, independent exercise times, adapted swim lessons, one-to-one exercise programs (called stay fit), and aquatic bodywork sessions. Private changing rooms are available along with men's and women's locker rooms. Hoyer lifts are available as well as an assisted stander. Family swim times are available and the pools can be rented for private parties.

    Visit our website for more more information on Health, Wellness & Recreation opportunities.  For a tour of one of our facilities or to talk further about programming, please contact Holly Gigure, Fitness and Aquatic Coordinator with Courage Center at 651-351-2325 or holly.gigure@couragecenter.org.