Sheltered Workshops and Residential Facilities Must Encourage Physical Activity
|James H. Rimmer, Ph.D., Director|
While many other jobs such as office work require a tremendous amount of sitting, including my own job which keeps me in front of a computer screen for much of the day, I am often required to be up and around, checking on various staff and their ongoing projects, running across campus to a college meeting, hiking up and down seven flights of stairs for any number of reasons (my office is on the 7th floor), lecturing for 2.5 hours using lots of hand gestures and moving from side to side, walking across the hall to check my mailbox, or getting water from the cooler to make a pot of green tea. This may not sound like a great deal of movement, but I'm guessing that in any given hour of work, I'm moving (standing or walking) at least 15 to 20 percent of the time.
Unfortunately, this is not the case for many adults with developmental disabilities, who are often transported to their place of employment and must sit for much of the work day. (Note: Some adults with developmental disabilities have jobs that require a great deal of energy expenditure, including food service and janitorial work.) Often there are a few short breaks during the day and a half-hour or hour for lunch. But this time is often spent consuming caloric-dense snacks rather than taking a stroll around the building. At the end of the workday, the person is escorted back to the van parked directly in front of the building and returned to a group home or some other type of residence. The staff member or caregiver in charge of the residence encourages the person to sit in the living room and watch television, or take a nap while the staff member prepares dinner. After dinner, there is more television followed by a period of sleep before another day of work in the same posture and with the same low level of movement.
While it doesn't appear that my small "movement breaks" during a typical workday would amount to anything worth discussing in terms of calorie expenditure, over time these short but frequent bouts of physical activity actually add up to an impressive number by the end of the day. Let's say, for example, that my moving 16 percent of the time in a one-hour period, or 12 minutes, results in a calorie expenditure of 3 kcal per minute. Three calories x 12 minutes results in an energy expenditure of 36 calories an hour. Over a 12-hour period (my average work day), I'm burning 432 calories. In a one-week work period, that adds up to about 2,000 calories - not so bad for a few minutes of movement every hour on the hour. There are about 3,500 calories in one pound of fat, so in a one-week period, I'm theoretically avoiding a half-pound weight gain from occurring, whereas my friend in the sheltered workshop is storing those additional calories (keeping everything else equal). Over time, this can result in a huge disparity in energy expenditure, and we haven't even mentioned the word, "exercise!"
Where it all gets really bad is when we start to throw in the rest of the day's activities. The trip to and from work is a "wash" because I drive in and park adjacent to my building. But I walk up seven flights of stairs to get to my office; add another 20 calories. I'm up before the sun rises jogging 2- to 3 miles and performing some strength and stationary cycling activities; add another 400 calories. On the return home from work, my devoted dog, Mica, is anxiously waiting at the door for his first of two walks around a long block; add an additional 15 calories per walk. Adding these additional 450 calories to the 432 calories obtained from my general activity during the workday increases the differential between me, and my friend who works in the sheltered workshop, by 882 calories!! Let's not even discuss what may happen on weekends when the residential facility is short-staffed and there is not much to do for the residents.
The field of developmental disabilities has made great strides in closing inhumane residential facilities and providing opportunities for employment and integration into the community. It's now time for directors of residential programs and sheltered workshops and policy makers to turn their attention towards health promotion. The next big push for social change must include more opportunities and incentives for people with developmental disabilities to engage in higher levels of physical activity throughout the day. Promoting enjoyable and rewarding physical activity opportunities will, in the long run, result in substantial improvements in health and quality of life.