People with Disabilities Need To Start Out With Higher Levels of Fitness
|Graph comparing the cardiovascular fitness levels of those who have had a stroke to those who have not|
As persons with disabilities age, they may experience increasing difficulty performing activities of daily living (ADL) (i.e., dressing, showering) and instrumental activities of daily living (IADL) (i.e., ambulation, doing laundry, grocery shopping) because their 'fitness reserve' is much lower compared to the general population. Not building high enough fitness levels in youth and young adults could create substantial difficulty in later adulthood. Persons with disabilities often require a certain level of strength to push a wheelchair or ambulate with an assistive aid. For example, individuals who have a certain type of cerebral palsy (spastic diplegia) often use higher levels of energy expenditure to ambulate, and certain muscle groups must work continuously to maintain the body's center of gravity to prevent a fall. When combined with the natural course of aging, the likelihood of needing additional support (i.e., personal assistance services, greater support from a caregiver) may occur much earlier in life than among individuals who sustain higher fitness levels. Some experts believe that the high prevalence of physical inactivity and poor health practices observed in many people with disabilities is the reason for higher medical costs, greater reliance on personal assistance services, and greater stress on the individual and/or his/her caregiver. Once chronic disease enters the picture, such as heart disease, type 2 diabetes, or obesity, the multiplier effect is set in motion, and spiraling towards complete inactivity undermines every aspect of quality of life.
People with disabilities would benefit greatly from participating in moderate- to high-intensity cardiovascular and resistance training programs specific to their level of function, resulting in better overall health. Having adequate physical fitness to perform everyday activities could be the difference between physical independence and physical dependence. As Dr. Margaret Nosek wrote in a visionary paper back in 1984 titled, 'The Importance of Physical Fitness for Persons with Disabilities,' she saw the urgency of the issue: 'The need for physical fitness among persons with disabilities is equal to or greater than that of the able-bodied population. Persons with limited physical functioning and/or reduced activity levels are often more susceptible to disease and often require higher than average levels of resistance.' Over a quarter of a century later, we have made some strides, but still have a long way to go in terms of providing accessible and disability-friendly physical activity programs for the vast majority of people with disabilities.
There is no doubt in my mind that all 'roads' to health must pass through the filter of fitness. Even among individuals with significant physical limitations, short periods of movement/physical activity/exercise spread throughout the day for 2-3 minutes at a time creates better harmony between various systems in the body and better connections with the mind. Our challenge over these next few years is to empower people with disabilities to reach their highest level of fitness and to encourage the fitness community to extend their services to the millions of people with disabilities who have not yet discovered that fitness is their path to a better and healthier life.
Please send any questions or comments to James Rimmer, NCHPAD Director at email@example.com.