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Monitoring the Safety of the Fitness Program


Whether the therapist is going to work directly with the child or recommend a fitness program to another professional (i.e., physical education instructor), it is important to establish safety guidelines for exercise. Most children with physical and intellectual disabilities should not have difficulty participating in high intensity sports and fitness activities unless there is evidence of a cardiac or pulmonary disorder. In this case, the child should be screened by a physician and a specific fitness program may have to be conducted in a clinical setting with the appropriate supervision. Nevertheless, it is always wise to start off slowly and follow certain procedures to assure maximum safety. General guidelines for a safe fitness program are listed in Table 3.

 

Table 3. General Safety Guidelines for Conducting Fitness Activities for Children with Disabilities.
  • Check medical history to make sure there are no contraindications to fitness-related activities (i.e., heart condition, exercise-induced asthma, osteopenia, drug interaction).
  • Monitor cardiovascular exercise by using rating of perceived exertion (RPE) and an intensity level between 60 and 85% of target heart rate range to assure safety of the activity. If discomfort is exhibited at a 60% threshold, drop to 50%.
  • Avoid conditions where there is likelihood of hypothermia or hyperthermia. Some children with paralysis have difficulty retaining or dissipating heat.
  • Teach the physical education instructor how to transfer a child from a wheelchair so that fitness activities can be performed in different positions (i.e., mat, exercise machine).
Note: Target heart rate range is equal to maximum heart rate (220 - age) minus resting heart rate multiplied by the intensity level (60 to 85%) and then added to the resting heart rate.

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