Many people with spina bifida have latex allergy. If this is the case, always check beforehand to make sure that the exercise equipment is not made of latex. Equipment manufacturers such as Thera-band® offer latex-free versions of their products.
Incontinence (flaccid or neurogenic bowel/bladder) - Individuals may experience a loss of control with their bowel or bladder. KEY:Monitor urinary cycle, be sure to empty your bowel and bladder before starting exercise.
If you have a shunt or have had scoliosis surgery, you should discuss exercise activity with your doctor. Avoid excessive trauma to the shunt and tubing.
Thermoregulation - Irregular body temperatures are often experienced by individuals with SB. KEY:Wear appropriate clothing, drink plenty of fluids and take precautions in certain environments; in warm environments, a fan and water spray will aid in cooling, and in cold environments, wear extra layers.
Pressure sores (decubitus ulcers) - Damage to the skin or underlying tissue caused by prolonged sitting, using old wheelchair cushions, sitting on hard surfaces, shear forces or as a result of a fall. KEY:Check skin regularly and perform regular wheelchair push-ups, or have the individual reposition him/herself regularly especially when engaged in wheelchair sports. (See strength training section for protocol.)
Fractures - the bones of the weak limbs may not be as strong as normal (osteoporosis), and can be at risk of breaking with less force than normal. In areas of poor sensation, the only signs of fracture may be redness and swelling of the limb, without pain. If the individual has a concern, have him/her see a doctor.
Transfers - When applicable, wheelchair users need to know how to transfer him-/herself safely from the wheelchair to an accessible exercise machine. People who provide assistance to wheelchair users should be trained to follow the appropriate guidelines for safe transfers.
Balance - Use straps or other physical assistance to hold the trunk in position during upright exercise.
If during exercise, foot and leg swelling occurs, resolve with leg elevation. If swelling is persistent, the individual should discuss this with his/her doctor. Compression stockings may also be helpful to keep swelling down. Monitor skin closely for breakdown in areas of swelling.
Spasticity - This condition is characterized by high muscle tone and hyperactive stretch reflexes. It typically occurs in the muscles below the site of injury and is aggravate by exposure to cold air, urinary tract infections and physical exercise. KEY:You should stretch spastic muscle groups and avoid exercises that cause excessive spasticity. When you are at home you should extend your legs as often as possible. Discuss ways to reduce muscle spasticity that interferes with activity, with your doctor or physical therapist.
