Wellness and Fitness for the Physically Challenged

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Wheel Chair Aerobics for people with limited mobility and everyone else. | Sit and Get Fit!

Increasing Physical Activity Among Adults with Disabilities

Resources for Doctors and Health Professionals

More than 1 in 4 US adults 18 – 64 years of age has a disability. These are adults with serious difficulty walking or climbing stairs; hearing; seeing; or concentrating, remembering, or making decisions. Adults with disabilities are three times more likely to have heart disease, stroke, diabetes, or cancer than adults without disabilities. Aerobic physical activity can help reduce the impact of these chronic diseases, yet nearly half of all adults with disabilities get no leisure time aerobic physical activity.

Doctors and other Health Professionals can Play a Role

Increasing Physical Activity among Adults with Disabilities Infographic

Doctors and other health professionals can play a role in promoting physical activity among their adult patients with disabilities. Adults with disabilities were 82% more likely to be physically active if their doctor recommended it, than if they did not get a doctor recommendation. However, only 44% of adults with disabilities who visited a doctor in the past year received a physical activity recommendation from their doctor.

Doctors and other health professionals can use these 5 steps to increase physical activity among adults with disabilities:

  1. Remember that Physical Activity Guidelines are for Everybody
  2. Ask about Physical Activity
  3. Discuss Barriers to Physical Activity
  4. Recommend Physical Activity Options
  5. Refer Patients to Resources and Programs

Remember To:

  • Communicate appropriately and respectfully with and about an individual with a disability. People-first language is the best place to start when talking to a person with a disability. It emphasizes the person first, not the disability. For example, when referring to a person with a disability, refer to the person first, by using phrases such as, “a person who …”, “a person with …” or, “person who has …”
  • Use the teach-back method to make sure your patient understands the recommendations.

Remember the Physical Activity Guidelines are for Everybody

Doctors and other health professionals should recommend physical activity, based on the 2018 Physical Activity Guidelines, to their patients with disabilities. Adults of all shapes, sizes, and abilities can benefit from being physically active, including those with disabilities.

2018 Physical Activity Guidelines

  • All adults should avoid inactivity. Some physical activity is better than none, and adults who participate in any amount of physical activity gain some health benefits.
  • Bouts, or episodes, of aerobic activity of any duration may be included in the daily accumulated total volume of physical activity.

For important health benefits, all adults should do both aerobic and muscle-strengthening physical activities.

For Aerobic:

  • At least 2 hours and 30 minutes (150 minutes) a week of moderate-intensity aerobic physical activity (i.e., brisk walking; wheeling oneself in a wheelchair); or
  • 1 hour and 15 minutes (75 minutes) a week of vigorous-intensity aerobic physical activity (i.e., jogging, wheelchair basketball); or
  • A mix of both moderate- and vigorous-intensity aerobic physical activities each week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity.

For Muscle-Strengthening:

  • Activities that are moderate or high intensity and involve all major muscle groups on 2 or more days a week (i.e., working with resistance bands; adapted yoga) as these activities provide additional health benefits.

Key Guidelines for Adults with Disabilities

  • When adults with disabilities are not able to meet the above Guidelines, they should engage in regular physical activity according to their abilities and should avoid inactivity.
  • Adults with disabilities should talk to their doctor about the amounts and types of physical activity that are appropriate for their abilities.

Download the Physical Activity Guidelines (PDF). [14.4 MB, 118 pages]

Ask About Physical Activity

Doctors should recommend to their adult patients with disabilities to get physical activity on a regular basis that is consistent with their abilities. Doctors can ask about physical activity levels of their patients with disabilities by asking questions such as:

  • How much physical activity are you currently doing each week?
    • How often?
    • How long?
    • At what intensity level?
  • What types of physical activity do you enjoy, now or in the past?
  • How can you add more physical activity to your life?

Additional guidance can be adapted from Exercise is Medicine [1.72 MB, 25 pages] Health Care Providers Action Guide

Discuss Barriers with Patients

Adults with disabilities face barriers to getting aerobic physical activity. Discuss the following barriers with your patients with disabilities to help them find ways to get physical activity in the built and natural environment, including:

  • Knowing about and getting to programs, places, and spaces where they can be physically active;
  • Having social support (e.g., setting up a buddy system, making contracts with others to complete specified levels of physical activity, or setting up walking groups or other groups to provide friendship and support) for physical activity;
  • Having limited information about accessible facilities and programs; and
  • Finding fitness and health professionals who can provide physical activity options that match their specific abilities.

Read more about physical activity barriers among adults with disabilities:

Recommend Physical Activity Options

Recommend physical activity to your patients with disabilities, but remember they need to:

  • Engage in the amount and types of physical activity that are right for them;
  • Find opportunities to increase regular physical activity in ways that meet their needs and abilities;
  • Start slowly based on their abilities and fitness level (e.g. active for a few minutes at a time, slowly increase activity over several weeks, if necessary);
  • Include aerobic physical activities that make them breathe harder and their heart beat faster for important health benefits, such as reducing the risk of heart disease, stroke, diabetes, and some cancers;
  • Know that most aerobic physical activity may need to be modified, adapted, or may need additional assistance or equipment; and
  • Avoid being physically inactive. Some physical activity is better none.

Aerobic physical activities may include:

  • Aquatic therapy
  • Ballroom dancing
  • Brisk walking
  • Cross-country and downhill skiing
  • Hand-crank bicycling
  • Hiking
  • Horseback riding
  • Nordic Walking
  • Rowing
  • Seated volleyball
  • Swimming laps
  • Water aerobics
  • Wheeling oneself in wheelchair
  • Wheelchair basketball, tennis, football, or softball

Physical Activity Resources for Doctors and other Health Professionals

Use the following resources and programs to get educated on a wide range of physical activity options and to help you refer and connect your adult patients with disabilities.

For all disability types:

For cognitive, intellectual or developmental disabilities:

  • HealthMattersTM Program is a partnership between community and academia with a common aim to improve health of people with intellectual and developmental disabilities.
  • Special Olympics provide comprehensive, community-based health and wellness plus broad improvements in health systems and policies through the Healthy Communities initiative, which is supported by CDC. Special Olympics also offer a wide range of free health examinations and care through the Healthy Athletes program. The organization also provides tips on coaching and physical activity options for people with disabilities. Contact Special Olympics Healthy Athletes at 1-202-824-0308 or toll-free at 1-800-700-8585, or by sending an email to info@specialolympics.org.

For vision or hearing loss:

For mobility limitations, limb loss or paralysis:

CDC Works to Improve Physical Activity among Adults with Disabilities

CDC funds states are working to help adults with disabilities be more physically active.

Here are a few examples:

The Alabama Department of Public Health is promoting a statewide campaign, Scale Back Alabama, to encourage Alabamians to get healthier by maintaining a healthy weight and doing physical activity.

  • The highlights of the program include:
    • Collaborating with the Alabama Hospital Association, Blue Cross Blue Shield Alabama and the National Center on Health, Physical Activity, and Disability (NCHPAD) on Scale Back Alabama to provide a ten-week campaign to encourage adults, including adults with disabilities, to maintain a healthy weight and be physically active.
    • Providing weekly inclusive health tips to participants via email on how to maintain a healthy weight, be more physically active, and eating more fruits and vegetables.

The Michigan Department of Community Health’s Disability Health Unit is provides an evidence-based, group physical activity program designed for people of all abilities.

  • The highlights of the program include:
    • Partnering with the Michigan Arthritis Program to expand the delivery of EnhanceFitness to adults with developmental, cognitive and mobility disabilities
    • Reaching over 4000 participants with one-quarter being adults with disabilities with attendance at 90 classes across 76 sites statewide.

The South Carolina Research Foundation is providing an evidenced-based wellness program and preventing secondary debilitating conditions in people with intellectual disabilities.

  • The highlight of the program include:
    • Partnering with the South Carolina Department of Disabilities and Special Needs and Able-SC to promote healthy lifestyles, including physical activity through Steps to Your Health (STYH), which was developed, field-tested, and evaluated to be effective in promoting wellness and preventing secondary debilitating conditions in adults with intellectual disabilities.
    • Providing a ten-week, small group instructional program with interactive lessons provided by a trained STYH instructor.

References

  1. Centers for Disease Control and Prevention Vital Signs. Available at www.cdc.gov/vitalsigns/disabilities May 2014.
  2. Carroll D, Courtney-Long E, Stevens A, Sloan M, Lullo C, Visser S, Fox M, Armour B, Campbell V, Brown D, and Dorn, J. Disability and Physical Activity – United States, 2009-2012. MMWR. 2014.
  3. Physical Activity Guidelines for Americans, 2nd edition. Washington, DC: US Department of Health and Human Services; 2018. Available at https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf
  4. Rimmer JH, Riley B, Wang E, Rauworth A, Jurkowski J. Physical activity participation among persons with disabilities: barriers and facilitators. Am J Prev Med 2004;26:419–25.

10 Special Needs Organizations You Should Know About

In case you aren’t already aware, there’s a plethora of organizations offering programs and services to the special needs community of families. What we’ve done here is narrow the group down to 10 must-see organizations that offer said services to all individuals with disabilities and special needs. If you haven’t checked out these fantastic organizations already, please read through the list below to see about which ones would best benefit you and your loved ones with special needs.

1. Easter Seals

What they offer: Resources for autism, seniors, children, adults, military and veterans, employment and training, medical rehabilitation, camping and recreation, brain health. Children and adults with disabilities and special needs find highest-quality services designed to meet their individual needs when they come to Easter Seals. Teams of therapists, teachers and other health professionals help each person overcome obstacles to independence and reach his or her personal goals. Easter Seals also includes families as active members of any therapy program, and offers the support families need.

2. Special Olympics

Special_Olympics_logo.svg What they offer: Real sports, building communities, youth activation, healthy lifestyle promotion, leadership, research. Through the power of sports, people with intellectual disabilities discover new strengths and abilities, skills and success. Our athletes find joy, confidence and fulfillment — on the playing field and in life. They also inspire people in their communities and elsewhere to open their hearts to a wider world of human talents and potential. Here’s a slideshow showing the full spectrum of our activities.

3. United Cerebral Palsy

UCP logo What they offer: My Child Without Limits, My Life Without Limits, family support, employment guides, health and wellness tips, housing help, financial assistance, international resources. UCP educates, advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities. UCP works to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network that has helped millions.

4. The Arc

the arc logo What they offer: Information and referral services, individual advocacy to address education, employment, health care and other concerns, self-advocacy initiatives, residential support, family support, employment programs, leisure and recreational programs. The Arc is the largest national community-based organization advocating for and serving people with intellectual and developmental disabilities and their families. We encompass all ages and more than 100 different diagnoses including autism, Down syndrome, Fragile X syndrome, and various other developmental disabilities.

5. Friendship Circle International

friendship circle international What they offer: Volunteer home visits, Torah circle for children, holiday programs, camp experiences, sports, sibling support, life skills. The Friendship Circle is today’s fastest growing Jewish organization for children with special needs. With over 80 locations worldwide, the Friendship Circle has cultivated friendships between 5,000 special children and close to 11,000 teen volunteers. The Friendship Circle’s unique approach brings together teenage volunteers and children with special needs for hours of fun and friendship. These shared experiences empower the children, our special friends, while enriching the lives of everyone involved. The teen volunteers learn the priceless value of giving, the curative power of friendship, and the vital importance of integrating children with special needs into our communities. The parents and siblings receive much-needed respite and support from the Friendship Circle community, and all those who assist us. Each independent Friendship Circle is operated by its local Chabad Lubavitch Center, and entirely supported by each local community to benefit local children with special needs.

6. Goodwill Industries International

goodwill-logo What they offer: Financial coaching, savings and loan support, tax preparation, education programs, community services, financial aid, transportation, after school programs, housing assistance, clothing assistance, medical rehabilitation. Goodwill works to enhance the dignity and quality of life of individuals and families by strengthening communities, eliminating barriers to opportunity, and helping people in need reach their full potential through learning and the power of work. Goodwills meet the needs of all job seekers, including programs for youthseniors, veterans, and people with disabilities, criminal backgrounds and other specialized needs. Last year, Goodwill helped more than 26.4 million people train for careers in industries such as banking, IT and healthcare, to name a few — and get the supporting services they needed to be successful — such as English language training, additional education, or access to transportation and child care.

7. Parents Helping Parents

parents helping parents logo What they offer: Support groups, family and community services, crisis support, early intervention, assistive technology services. As a parent-directed, community-based organization, PHP’s mission was developed in response to the need in our community for information, training, and support services for families who have children with special needs and the professionals who serve them. Established in 1976 as a nonprofit agency, Parents Helping Parents, meets the needs of one of our community’s most vulnerable populations – individuals with any special need and their families. This includes children of all ages and all backgrounds who have a need for special services due to any special need, including but not limited to illness, cancer, accidents, birth defects, neurological conditions, premature birth, learning or physical disabilities, mental health issues, and attention deficit (hyperactivity) disorder, to name a few.

8. Federation for Children with Special Needs

Federation-logo What they offer: special education center for parents, family support, health advocacy, family and community engagement, parent-professional leadership, summer camp, parent-to-parent support. The Federation for Children with Special Needs (FCSN) provides information, support, and assistance to parents of children with disabilities, their professional partners, and their communities. They are committed to listening to and learning from families, and encouraging full participation in community life by all people, especially those with disabilities. FCSN believes that individual differences in people are a natural part of life, and that disabilities provide children and adults with unique perspectives, insights and abilities which contribute to the overall well-being of society. The Federation values children as the hope for the evolving improvement of humankind, and places great value on the family as a caring protector of children’s vulnerability, as well as a catalyst for their healthy growth and development, and places a tremendous value on parents because of the contributions they make as the leaders of families toward supporting the health, education, and development of their children at home and in society. The Federation also promotes the active and informed participation of parents of children with disabilities in shaping, implementing, and evaluating public policy that affects them. The Federation believes in the power of parents helping parents and has infused a proven model of peer support throughout all its work. Most Federation staff members are parents or family members of children with disabilities and people with disabilities.

9. Special Needs Alliance

special needs alliance logo What they offer: Connection to attorneys in your area that practice disability and public benefits law, covering special needs trusts and wills, Medicare, SSI, estate and tax planning, personal injury, health care, financial planning, guardianships and conservatorships, The Special Needs Alliance (SNA) is a national, not for profit organization of attorneys dedicated to the practice of disability and public benefits law. Individuals with disabilities, their families and their advisors rely on the SNA to connect them with nearby attorneys who focus their practices in the disability law arena. The SNA is an invitation-only organization. SNA membership is based on a combination of relevant legal experience in the disability and elder law fields, direct family experience with disability, active participation with national, state and local disability advocacy organizations, and professional reputation. As a result, an SNA member will have an average of 18 years of relevant legal experience, with no member having practiced law for less than 5 years. The majority have been certified as Elder Law Attorneys (CELAs) by the National Elder Law Foundation, the certifying entity for the National Academy of Elder Law Attorneys (NAELA).

10. Family Voices

family voices logo What they offer: Family-centered care, partnerships, quality, access, affordability and acceptability, health systems that work for families and children, informed families/strong communities and self-advocacy/empowerment. Family Voices aims to achieve family-centered care for all children and youth with special health care needs and/or disabilities. Throughout our national grassroots network, we provide families resources and support to make informed decisions, advocate for improved public and private policies, build partnerships among families and professionals, and serve as a trusted resource on health care.

 

WRITTEN ON January 14, 2016 BY:

Joe Young

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