Summary:  Whitney Neal

Source Article:  Dolbow, D. R., & Figoni, S. F. (2015). Accommodation of wheelchair-reliant individuals by community fitness facilities. Spinal cord.

Although physical activity has been long recognized as one of the best ways to sustain health benefits, it is especially important for individuals with physical disability because of their greater tendency towards sedentary behavior. According to the Health People 2010 report, only one in three individuals with a disability participate in leisure-time physical activity as compared with over half of the population without disability. The Physical Activity Guidelines for Adults with Disabilities from the U.S. Department of Health and Human Services are similar to those for individuals without disability. They recommend adults with disability perform moderate-intensity exercise for a least 150 minutes per week, vigorous-intensity for at least 75 minutes per week, or an appropriate combination of the two. In addition, the guidelines recommend moderate- or high-intensity resistance training of all the major muscle groups on two or more days per week.

Because decreased mobility renders individuals with disability susceptible to a plethora of physical barriers, adhering to physical activity guidelines can be difficult. For example, stairs or curbs may prevent access to fitness facilities to those who use wheelchairs to ambulate. Entrance to buildings can be hindered by non-automated doors for those who lack the grip strength to turn door knobs or grasp door handles. Once individuals who use wheelchairs have gained entrance to a fitness center, passageways wide enough to accommodate wheelchairs are needed, including areas to and around exercise equipment.

Title III of the ADA of 1990 mandates that individuals with disability have equal access to public facilities and that they should be provided the opportunity to benefit from equal goods or services. Despite the reduction of barriers to community services thanks to the ADA, obstacles to accessibility still remain. Because of mobility impairments associated with paralysis, exercise equipment that is adapted to accommodate individuals with disability is required to allow full participation in the activity. Although specialized adaptive equipment to address this, such as upper body ergometers and functional electrical stimulation cycles, are found in rehabilitation centers, access to such equipment is rare in community fitness centers. The purpose of the this current study was to both assess the level of compliance with the Title III ADA law by fitness centers in the Hattiesburg, MS area, as well as the level of accommodation of individuals who use wheelchairs beyond ADA regulations. This included availability of specialized adaptive exercise equipment and facility staff trained for the special needs of those with paralytic conditions.

Using yellowpages.com to search, 10 facilities provided consent to participate in this study. An 82-item compliance/accommodation checklist was used to evaluate each facility. Once the informed consent process was completed, a researcher used an ADA Accessibility Stick to check for ADA compliance of parking areas, entrance ramps, exterior door entrances, routes of travel throughout the public area, elevators, restrooms and locker rooms, drinking fountains and accessibility to and around exercise equipment. Facility managers were questioned about the training of facility staff and available adaptive equipment in order to get information concerning accommodation of individuals who use wheelchairs beyond the ADA accessibility guidelines.

Even though all fitness centers in the Hattiesburg, MS area were found to be partially compliant with ADA regulations, none were found to be in complete compliance. The areas of greatest compliance were parking, ramps, elevators and water fountains. The areas of least compliance were accessibility to exercise equipment and locker rooms. Six of the 10 facilities provided acceptable routes to exercise rooms, but all 10 facilities failed to provide adequate exercise space between and around exercise equipment. Restrooms and locker rooms were also among the most inaccessible areas, with only 20 percent compliance, typically centered on inadequate toilet stall dimensions and mirror placement being too high for individuals sitting in wheelchairs. Despite the fact that providing specialized exercise equipment and staffing particular to individuals who use wheelchairs is not specifically mandated, two facilities did provide limited adaptive equipment. No facilities provided staffing with specialized training.

The results of this study indicate that access to community fitness centers is severely limited for individuals who use wheelchairs, in spite of the ADA mandate. Many of the impediments to passage in and around exercise equipment resulted from exercise machines being placed too closely together; in many cases, equipment could simply be rearranged to allow adequate room for individuals who use wheelchairs to move around. The absence of adaptive equipment such as upper-body ergometers and functional electrical stimulation cycles in fitness centers could be due to the fear of lack of use. However, Dollow et. al found that when individuals are given access to such equipment, the participation rate was double the exercise rate of the general population. Staff training for the additional needs of those who use wheelchairs should also be considered. Although this study cannot be generalized to fitness facilities nationwide, it does provide an example of non-compliance with ADA standards and could be used as encouragement for other fitness centers to check their accommodation and accessibility levels.