Exercise: Fitness Programs: Disabled: Disabilities: Special Needs

The range of disabilities from various illnesses, injuries and surgeries is extremely wide, from children with special needs, people who are simply weak to those who use wheel-chairs or other assistance for mobility. The majority of rehabilitation patients can be safely and productively trained with standard resistance equipment (machines, free weights, resistance bands, etc.).

We divide our partnership program into two parts: a) rehabilitation phase and b) post-rehabilitation (Typical Workout) phase. Although certainly not inclusive, The table below provides general information for strength training new participants in the categories of stroke, spinal cord injury, multiple sclerosis, cancer, deafness, blindness and brain injury. The chart presents the major rehabilitation emphasis, key aspects of a typical strength-training session and special concerns associated with these conditions.

As patients progress in their strength training, they may perform more specialized resistance exercises, and train somewhat more intensely. Consider the following recommendations for further strengthening post-rehabilitation, stroke and spinal cord injury participants: As stroke patients progress in strength development and functional abilities, they may perform more targeted (rotary movement) resistance exercises, such as hip abduction and adduction for better stability/lateral movement, wrist supination and pronation for better manual dexterity, and shoulder retraction for better scapular stability/control.

As spinal cord injury patients adjust to their strength workouts, more challenging and productive training protocols may be introduced. We recommend active assisted strength exercises in which the client moves into a position of full concentric muscle contraction (with partner's assistance), maintains a brief isometric muscle contraction (without partner's assistance), and performs a controlled eccentric muscle action (without partner's assistance).

There are two points we keep in mind when working with rehabilitation program participants.

 First, special concerns always include medical history information (previous problems, medications, etc.) and recommendations from medical professionals (e.g., physician, physical therapist), as well as feedback from the patients during and after their exercise sessions.

 Second, individuals with physical or mental disabilities may be less likely to exercise on their own and, therefore, more likely to experience health problems associated with sedentary lifestyles (i.e.,obesity, high blood pressure, diabetes, low-back pain and certain types of cancer).

We encourage every fitness trainer to provide appropriately supervised strength restoration programs for at least some of the people who need muscular conditioning following injury, illness or surgery. Whether limited to people who can walk into a facility on their own, or In-Home fitness instruction inclusive for people with major disabilities, rehabilitative strength-training programs provide an important service to a surprisingly large segment of our population.

The following table reflects the typical course for rehabilitation and post-rehabilitation programming. We specifically focus on post-rehabilitation (Typical Workout) programming.;

We suggest you consult specialists in the area of rehabilitation for special needs populations; please consult your physical therapist and/or Doctor before beginning any exercise program. This and any article in our website on injury, disease or dysfunction is intended to inform - not to diagnose, treat or advise.

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