Before implementing a series of goals, most people will identify their motivation for starting the fitness process. By virtue of the complications from changes in behavior and personality, and the impairments to cognition in individuals with a head injury, you may suggest ideas and provide knowledge in order to instill and maintain this motivation.
There are many parallels that can be drawn from comparing individuals with developmental disabilities to those who have acquired brain injuries. Dr. Rimmer points out the following regarding persons with developmental disabilities:
It will be extremely difficult to change the lifestyle patterns of persons with developmental disabilities if staff or family members are not proactive in encouraging physical activity participation.
The first step is to start with a very basic goal. For some people, that may be starting the program. For others, it may be walking the first 100 yards or mile.
There are two types of goals that will be helpful in allowing the participant to attain a higher level of physical fitness:
- Short-term goals are realistic and attainable. They should be set to allow for easy and timely completion. When Rob had his first training session, his goal was set in 20-pound increments on the bench press, which he met each week in the gym.
- Long-term goals may encompass two different categories. While some goals involve a dream for the future, other goals are more relevant to the immediate short-term goals. On Rob's first trip to the gym, he benched 100 pounds. He then set his long-term goal to bench 300 pounds, which he accomplished in six months. His other long-term goal was to be more presentable to the opposite sex in his quest for involvement in an intimate relationship.
One of the most effective ways to support an individual with a head injury is to work out a plan of action that is realistic and that can foster more motivation.
Another effective way to instill motivation is to encourage the participant to "buy into" the program so he or she "owns" the program. Re-enforce that the regimen developed is specifically for him or her and that the time designated for fitness training assists in accomplishing goals. Frequently discuss the positive changes taking place as a result of the training. After each training session, Rob was told what accomplishments he had made. He was so enthused that he wanted to go to the gym daily to strive for more progress.
Periodically challenge the participant without promoting discouragement. Emphasize that this is part of the process and that not being able to walk a certain distance or lift a specific weight does not mean failure.
After a few months of consistent training under his belt, Rob became more at ease with his fitness program. Increases in self-confidence and lowered anxiety made it possible to challenge him on various exercises when he was not challenging himself. Frequently provide encouragement. Praise can be a powerful motivator for anyone participating in a fitness program. Simply phrases such as, "I enjoy sharing this experience with you", "excellent job", and "I cannot believe how well you are doing", may provide your participant with the motivation he/she needs to continue the schedule.
Sam responds very positively to encouragement while training. He is very sensitive to others noting his progress and at times will ask for this confirmation.
Provide honest and positive feedback whenever possible. Rob becomes enthralled with the challenge of lifting higher weight totals. Periodically he becomes discouraged if he fails to lift a certain poundage. Reminders are given to Rob to realize how far he has come and how well he is doing. Progressing from 100-lb to 300-lb bench presses in six months is a wonderful accomplishment.
Consistency is important in maintaining an individual's interest and providing an activity to look forward to. A consistent schedule will allow the program to be successful. When necessary, prepare the participant for times that must be missed by scheduling for the next day or having a qualified coach take over for the day.
This consistency is key to Sam's continued participation. Once out of a regular schedule, he will balk at attempts to restart a fitness program. The same holds true for all the men participating.
Make the program a fun experience. Choose settings that are enjoyable for the participant, i.e., home, residential setting, public facility. Develop and offer a reward system for a task completed, i.e., lunch out, a movie, a shopping trip.
Sam, Don, and Rob all enjoy receiving little incentives for making it to the gym. Supplemental outings will usually revolve around light lunches, renting a movie, or another activity of their choosing.
The ability of the trainer to use adaptation is a great asset. It is necessary to use all possible resources at his or her disposal to deliver a successful program. Adaptation to physical limitations and behaviors is important.
Because Don experienced anxiety, it was necessary to start the fitness program in his domain, his room. By purchasing some handheld dumbbells, it was possible for him to participate within the security of his room.
Patience plays a large role in the success of the program. Acknowledge that each day presents new challenges and that success will be measured in small increments. Behaviors may change from day to day. Consequently, the trainer must be prepared with the right game plan to avoid discouragement. After Sam had missed only a few workouts, it took three months to get him back on a regular schedule.