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GeteFactsGeteFactsHNationalCenteronHealthPhysicalActivityandDisabilityGeteFactsGeteFacts httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352092LetterfromtheDirector...........................................................................03GeneralExerciseGuidelines...................................................................04ChoosingaFitnessCenter......................................................................10Nutrition........................................................................................................15NCHPADs14-WeekProgram.................................................................16ChampionsCRx..........................................................................................17TableofContents 3LetterfromtheDirectorDearReaderThereareanumberofbarriersthatinhibitphysicalactivityinpeoplewithdisabilities.Walkingoutdoorsforexampleisthesinglemostcommonactivityinthegeneralpopulationbutformanypeoplewithdisabilitiesitmaynotbeanequallygoodoptionforpromotinghealthandwellbeingbecauseofcertainfunctionallimita-tionssafetyconcernsandnaturalandbuiltenvironmentalbarriers.Transportationissuesaccesstocommunityfitnessfacilitiesandhighunemploymentunder-employmentratesareadditionalbarriersthatmaymakeitextremelydifcultforpeoplewithphysicalcognitiveandsensorydisabilitiestoleadactivelives.AttheNationalCenteronHealthPhysicalActivityandDisabilityNCHPADwebelievethatevery-onecanbenetfromregularphysicalactivity.NCHPADsmissionistoencourageandsupportindividualswithdisabilitiesandchronichealthconditionstobecomemorephysi-callyactive.OurcentralofcelocatedatLakeshoreFoundationinBirminghamAlabamaprovidesuswithatremendoustalentpoolofspecialistsinsportsrecreationandtness.GettheFactswillhelpyoubecomemorephysicallyactiveorifyouareaserviceproviderorfamilymemberequipyouwiththeknowledgetoprovideamoreenrichingphysi-calactivityprogramforyourclientsorlovedone.Ifyouseeanythinginthisbookletthatpiquesyourinterestandthatyouwouldlikemoreinformationonpleasedonothesitatetovisitourwebsiteatwww.nchpad.orgorpickupthephoneandcalloneofourinformationspecialistsat800900-8086.Weareheretoserveyou247SincerelyJamesH.RimmerPh.D.DirectorNationalCenteronHealthPhysicalActivityandDisabilityPhotobyNikLaymanandcourtesyofSteveWoodUABPublicRelationsandMarketing httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352094ExerciseisforEVERYbodyTherearecurrently56.7millionpeoplewithphysicaldisabilitiesintheworld.Astriking58percentofthoseindividualsareconsideredobeseleadingtoannualhealthcarecostsofapproximately400billion.Howeverthesebleakstatisticscanbegreatlydiminished.Exercisecanplayaleadingroleinimprovingandmaintainingover-allhealth.ThePhysicalActivityGuidelinesforAmericansprovidescience-basedguidancetohelpindividualswithdisabilitiesagesixandolderachievehealthybenetsthroughappropriatephysicalactiv-ityandexercise.Thesebenetsareespeciallyimportantforindividualswithdisabilitiesasresearchshowstheyleadtolessactivelivesthanthosewithoutdisabilities.Comorbiditieslikehighbloodpressurediabetesandobesityaremuchmoreprevalentforindividualswithdisabilitieswhichmakesphysi-calactivityevenmoreimportantasitcanhelppreventorlessentheimpactofsuchcomorbidities.Inordertoexperiencetheseandotherbenetsofregularphysicalactivityitmustbeincorporatedintoyourdailyroutine.PreliminaryStepstoExercise1.Informyourphysicianorprimarycaregiverthatyouareconsideringstartinganexerciseprogram.2.Ifpossibleparticipateinagradedexercisetesttodetermineyourcurrentleveloftness.3.Findouttheeectsifanyofyourmedicationonexercise.4.Ifpossibleconsultatrainedexerciseprofessionalforanindividualizedexerciseprescrip-tion.5.DetermineyourgoalsandmakesuretheyareS.M.A.R.T.S.M.A.R.T.goalsstandforSpecicMeasurableAainableRelevantIncreasedcardiacheartandpulmonarylungfunctionImprovedabilitytoperformacviesofdailylivingProteconagainstdevelopmentofchronicillnessesDecreasedanxietyanddepressionaswellasenhancedfeelingofwell-beingLoweredcholesterolandbloodpressurePotentialBenetsofExerciseGENERALEXERCISEGUIDELINESandTimeBound.ForinstanceifyousaidyourgoalwastoloseweightthiswouldnotbeaSMARTgoal.IfyoulostonepoundinthenextyearwouldyouhavereachedyourgoalASMARTgoalwouldsayIwant httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352095tolose10poundsintwomonths.Thiswayyouwouldknowwhenyouhavereachedthisgoalintheappropriateamountoftimeandlosing10poundsintwomonthsisarealisticgoalthatisrelevanttosomeonewhoisoverweight.GeneralSafetyPrinciplestoBeingActiveStopexercisingifyouexperiencepaindiscomfortnauseadizzi-nesslight-headednesschestpainirregularheartbeatshortnessofbreathorclammyhands.Drinkplentyofuidsespeciallywater.Wearappropriateclothingtypi-callysomethingthatmoveseasily.Makesureyourbloodpressureandbloodsugarlevelsarewithinappropriatelimitsbeforebeginning.Findandfollowanexerciseprogramthatmeetsyourspecicgoals.Pe-ExerciseConsiderationsBloodPressureNumbers12080NormalBloodPressure120-13980-89Pre-Hypertensive140-15990-99Stage1Hypertensive160100Stage2HypertensiveCheckwithyourdoctorbeforestarnganexerciseprogramifyouarestage2hypertensive.BloodPressureBPisthemeasureofthebloodspressureuponthearterialwallsandconsistsoftwovaluessystolicBPrstnumbergiventhepressurewhentheheartcontractsandpumpsbloodanddiastolicBPsecondnumbergiventhepressurewhentheheartllsupwithbloodfollowingacontracon.ItisparcularlyimportanttoknowyourBPbeforeyouexerciseasexercisewillcauseittoincrease.AssuchmakesureyouarenotstarnganexerciseprogramwithdangerouslyhighBPnumbersandifpossiblehaveatrainedprofes-sionalmonitoryourBPthroughouttheexercisesession.InthelongrunexercisewillloweryourbloodpressureandcanbeveryhelpfulinregulangBPnumbers. Pe-ExerciseConsiderationsBloodSugarNumbersNormal60-100LowLessthat70HighAbove250andketonespresentIfyoufallintothelasttwocategoriesyoushouldcheckwithyourdoctorbeforeexercising.BloodSugaralsoknownasbloodglucoselevelreferstotheamountofglucoseinthebloodstreamandisveryimportantforindividualswhohavediabetes.Thesenumbersareimportantinrelaontoexercisebecauseexercisecancausebloodsugartodroprapidly.Thisdropcanresultinhypoglycemialowbloodsugarwhichshouldbeavoidedifpossible.Youshouldalsoavoidexercisingwhenyourbloodsugarisdangerouslyhigh.Checkwithyourdoctorifeitheroftheseissuesoccur.ACSMexercisemanagementforpersonswithchronicdiseasesanddisabilities3rdedition2009GENERALEXERCISEGUIDELINEShttpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352096SETSAcompletedroundofagivennumberofrepeti-tionstypicallyreferringtojustoneexercise.Youshouldalwaysrestafteryounishasetofexercises.REPSThenumberoftimesyoushouldperformanexerciseinarow.AtypicalroutinemightstateCompletethreesetsof10reps.Inthiscaseyouwouldcomplete10repsofagivenexerciserestandrepeattwomoretimes.AEROBICTRAININGAnycon-tinuouslargemuscleexercisethatincreasesyourheartrate.Itworksyourheartlungsandcirculatorysystem.STRENGTHTRAININGAnexerciseprogramthatworksyourbodysmusculaturetoincreaseoverallstrengthandmuscletone.Setsandrepsarecommonlyusedtodenetheexerciseregimen.FLEXIBILITYTRAININGAimedatimprovingyourrangeofmotioninyourjointsallowingyoutoperformmoreandgreatermovements.BALANCEBeingabletokeepyourcenterofgravityaboveyourbaseofsupport.FUNCTIONALTRAININGExercisemovesthatwillhelpimproveyouractivitiesofdailyliving.CommonExerciseTerms httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352097BEFITTWhendesigninganexerciseprogramitisimportanttoalwaysapplytheFITTprinciple.Frequency-howoftenvarioustypesofexerciseshouldbeper-formed.Aerobicexercisesshouldbedonemostdaysoftheweekwhilestrengthtrainingexercisesshouldbedonetwotothreetimesperweek.Intensity-howhardanactivityorexerciseis.Thiscouldrelatetothespeedorinclineinvolvedinaerobicexercisesortheamountofweightusedinstrengthtraining.Intensitycanvaryfromverylighttoveryhard.Thenextsectionwillteachyouhowtomonitoryourexerciseintensity.Time-appropriateexercisedu-ration.Foraerobicexercisesthisismeasuredbytimewhileforstrengthtrainingitismeasuredwithsetsandreps.Anaerobicexercisecouldbeginwithaminimumgoalof20minutesthroughoutthedayandalonger-termgoalofincreas-ingdurationto60minutesperday.Thiscanbedoneinmultiple10-minutesessionsorinonelon-gersession.Forstrengthtrainingyoucanstartwithaslileasonesetof10repsandworkuptothreesetsof15.Type-ormodereferstothevarietyorkindofexercisesyouwillperform.Structuredexamplesincludewalkingwheelingrunningcyclingswimmingandresistancetraining.Unstructuredexamplesincludegardeninghouseholdcleaningandwalkingorpushingtowork.Whenplanninganexercisepro-gramandestablishinggoalsconsiderandincorporateeachofthesecomponents.BEFITTF2-3timesweekIModeratetovigorousT30mnaday150mnweekTAnyvariation httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352098DeterminingExerciseIntensity1.HeartRateHRDetermineyourHRbyndingyourpulse.Placeangeronthethumbsideoftheboomofyourforearmnearyourwristoragainstthesideofyourneckandcountyourpulsebeatfor10seconds.MultiplythisgurebysixtocalculateyourHRperminute.Youshouldneveruseyourthumbtotakeyourpulseasithasapulseofitsown.2.MaximumHeartRateMHRSubtractyouragefrom220todetermineyourMHR.Forexamplea40-year-oldpersonwouldhaveanMHRof180220-401803.TargetHeartRateTHRCalculatedat60and80percentofyourMHR.FortherangeslowercutopointmultiplyyourMHRby0.6.Forthetopcut-opointmultiplyyourMHRby0.8.BasedontheaboveexampleMHR180theTHRrangeis108to144beatsperminute.WhendoingcardioexerciseyourgoalshouldbetomaintainthisTHRrange.ItisimportanttonotethatpeoplewithneurologicalconditionshighlevelspinalcordinjuriesorthosetakingbetablockersmayhavealterationsintheirHRsthereforethismethodmaybeinaccurateforthoseindividuals4.RatingsofPerceivedExertionRPEAnothermethodofmeasuringexerciseintensitythatmaybemoreappropriateforthosewhocannotusetheTHRmethod.Thisisascaleofhowhardyoufeelyouareexercising.TheBorgscalerangesfromsixto20withsixbeingnoexertionand20fullexertion.Tousethescalemonitorhowyoufeelwhileexercisingwithageneralgoalof12to13RPE.5.TalkTestAnotherwaytomeasureexerciseinten-sity.Ifyoucansingwhileperformingcardioexerciseyouarenotworkinghardenough.Ifyoucantalkwhilestoppingoccasionallytotakedeepbreathsthatisgood.Ifyoucannottalkatallyourintensityistoohigh.1.Warm-upEngageinatleastveminutesoflightacvitysuchaswalkingorwheeling.2.ExerciseThisincludescardioexerciseandstrengthtraining.3.CooldownFinishyourworkoutwithatleastveminutesofalightacvitythatwillbringyourheartratebackdown.Thisisalsoanopmalmetoperformexibilityexercises.READYTOBEGINYOUREXERCISEROUTINEGENERALEXERCISEGUIDELINES httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL352099SUGGESTIONSFOREACHTYPEOFEXERCISECardiovascularVaryyourworkouteachsession.BecreaveEnhanceyourexerciserounebymovingmorethroughoutthedayduringlunchoncoeebreaksoraroundthehouseduringcommercials.Chooseapacethatalignswiththeintensityyouwanttoachieve.UsetheBorgscaleorTalkTesttomeasurethatintensity.Takedeepbreathsandthinktalltomaintaingoodposture.Examplesofcardiovasculartrainingincludecyclingwalkingpushingandswimming.StrengtrainingPerformeachmovementthroughacompleterangeofmoon.Donotholdyourbreathwhiletraining.Insteadtrytoexhaleyourbreathwhilepushingtheweightuporoutandinhalewhilelengtheweightdownorin.Ifyougoalistoincreasemuscularenduranceuselighterweightsandperformeightto12repeonsforthreetovesets.Ifyourgoalistoincreasemuscularstrengthuseheavierweightsandperformvetoeightrepeonsforonetothreesets.Typesofstrengthtrainingincludeweightmachinesfreeweightsplasctubingandotherequipmentlikekelebellsandmedicineballs.FlexibilityandFunctionaltrainingThefocusofexibilityfunconaltrainingistoimproverangeofmoonbalancecoordinaonandabilitytocarryouttheregularacviesofdailyliving.Flexibilitytrainingshouldbeincorporatedaereverycardiovascularandstrengthworkout.Holdstretcheswithoutbouncing.Graduallyincreasetheamountofmeyoucanholdthem.Everymajormusclegroupshouldbestretchedandmoremeshouldbespentonghtmusclegroups. httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520910CHOOSINGAFITNESSCENTERMakingerightchoiceisalwaysimptantchoosingaftnesscenterisnoexception.Fitnesscenterssometimescalledhealthclubsrangefromupscalebusinessestoneighborhoodgymswitharangeofoptionsinbetween.HowdoyoundtherightoneFirstdetermineyourtnessgoals.Considerschedulingaconsultationwithahealthprofessionaltohelpyoudecidewhattoworkonandtoreceivearealisticassessmentofyourgoals.Beforeyoustartusingatnesscenterstashouldoeryouahealthquestionnairetodetermineyourriskfactorsandthemostsuitableactivitiestomeetyourneedsandinterests.KEYFACTORSLocationThegeneralconsensusisthattheeasieritistogettoatnesscenterthemoreoftenyouwilluseit.Ideallythefacilityshouldbenearyourhomeandorworkplace.Youmaywanttolocateatnessfacilitythatcanbereachedbyanaccessiblemeansofpublictransportation.CostMembershipfeesduesvary.Generallyyouwillbeaskedtopayaxedamounttojoinandthenamonthlyfee.Ensurethatyouunderstandexactlywhatisincludedinthefeesoftensuchitemsasstatimeclassespoolusechildcareandeventowelsareextra.IfthefacilityusesacontractreadtheneprintasyouwouldwhenbuyingacarAvoidsigningupforamembershipthatextendsbeyondoneyearasyoucanloseyourmoneyifthefacilitycloses.Donotbeafraidtoaskquestions.Forexampleiftheequipmentorotherpartsofthefacilityarenotaccessibletoyouaskthefacilityifitispossibletoreceiveadis-countonyourmembershipfeesdues.Somefacilitiesoerslidingfeescalesbasedonyourincome.Otherclubsoerfamilyorjointmembershipstocouplespartnersorfriends.Manytnesscenters httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520911waivemembershipfeesatcertaintimesoftheyearsuchasthepeakseasonJanuarywhenalloftheNewYearsresolutionsaremadeorsummertimewhenmanyindividualsdecidetoexerciseoutdoorsHoursManytnesscentersopenearlyandcloselateandsomeareopen24hours.Howeverothershavelimitedhours.Operatinghoursmustmatchyourschedulemakesuretovisitthefacilityduringthetimethatyouwouldmostlikelyuseit.Addi-tionallytrytondoutwhatthepeakusagetimesforthefacilityareandiftheyoverlapwithyourplannedexercisetimes.EquipmentThereshouldbeavarietyofequip-mentanditshouldbewell-maintained.Ifyouarelookingforspecictypesofequipmentaskaboutthem.ItisalsoimportanttonotethelocationofequipmentspecicallyisitaccessibletoyouSometimeshavingfewerpiecesofequipmentspreadoutprovidestheuserthechoiceofgeingontheequipmentfromtherightorleftsideandallowsforspacetomaneuverandplaceamobilitydevice.TypeThereareseveralvarietiesoftnesscenters.Multi-purposefacilitiesgenerallyincludeswim-mingpoolstennisracquetballcourtsandotheramenities.Gymstendtofocusmoreonweighttrainingandgeneraltness.Personaltrainersmayrunstudiosoeringone-on-onesessions.OtherspecializedfacilitiesincludePilatesyogaandmartialarts.Determinewhichfacilitytypewillbesthelpyoumeetyourtnessgoals. ClassesIfyouwantspecictnessclassesdoesthecenterprovidethemAreenoughclasssessionsscheduledsoyouwillnothavetowaitformonthstogetinDoesthetnesscenteroeranythinginadditiontobasicclassessuchaseducationalpro-gramsspecialeventsorworkshopsForexamplesometnesscentersnowoerbookclubsorothersocialeventsthatallowtheirmemberstogettoknoweachother.Theseandotheramenitiessuchasjuicebarsspasandon-sitedrycleanersmaynotbeincludedinyourmembershipfeesandcostextra.Makeadecisionbasedonwhatisessentialforachievingyourtnessgoalsnottheavailableextras.StaFindouthowmanystamembersarelikelytobeon-sitewhileyouarethere.Ifyouexpectone-on-oneaentionrequestthisinitially.Youshouldreceiveagrouporpersonalorientationtoalloftheequipmentatnochargewhenyoujoin.Manyfacilitiesprovidestathatwalktheoorsandareavailabletoansweryourquestionswhileyouworkhttpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520912CHOOSINGAFITNESSCENTERouthoweverotherfacilitieschargepersonaltrain-ingfeesfordetailedadvice.Thesefeescanrangeonaveragefrom25to75perhour.TrainersandinstructorsshouldbecertiedthroughanationalorganizationsuchastheAmericanCollegeofSportsMedicineACSMAmericanCouncilonExerciseACEortheNationalStrengthandCon-ditioningAssociationNSCA.SomecerticationssuchastheCertiedInclusiveFitnessTrainerACSMNCHPADCIFToeredbyACSMandNCHPADrequireknowledgeofspecicdisabilitiesandchronichealthconditionsastheyrelatetoexer-ciseinordertoprovideacomprehensiveexerciseprogramthatissafeandeective.WordofMouthIfthetnesscenterhasbeenrecommendedbysome-oneyouknowaskabouthisorherexperiences.Youmayalsowishtocheck httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520913withyourlocalBetterBusinessBureautolearnifcomplaintshavebeenregis-teredagainstthefacility.AccessibilityIfyouarelookingforspecicac-cessibilitypointsbesuretotakeatour.Isthebuild-ingaccessibleArethereacces-sibleparkingspacesneartheentranceIsthereanelevatorArelockersshow-ersandrestroomsaccessibleDoesthepoolhavealiftthatcanbeusedindependentlyIsthestaknowledgeableinprogramdesignandadapta-tionIstherecardiovascularequipmentthatcanbeoperatedbytheupperbodyonlyThebestadviceistotryoutthefacilityforyourselfanddetermineifitisrightforyou.YoucanlearnaboutmanyofthekeyfactorslistedabovethroughaphonecallortheInternet.How-everbeforegoinganyfurtheritstimeforavisit.Mosttnesscenterswillgladlyoeryouatourifthefacilitydeclinesconsiderlookingelsewhere.Whenyouvisitthetnesscentertakeagoodlookaround.Youshouldfeelcomfortablewiththepeoplebothclientsandstatheplaceandtheatmosphere.DothepeopleseemfriendlyDoesanyoneseemtoreactnegativelytoseeingsomeonewithadisabilityDoesthefacilityappeartobecleanclimate-controlledandwell-ventilatedIsthereenoughsignageDoestheequipmentlookwell-maintainedTrytoscheduleyourtouratatimeyouwouldnormallyusethefacility.HowcrowdedisitIsparkingreadilyavailableincludingaccessiblespacesArethererampsatentrancesandexitsArethereclearpathstoequipmentASKQUESTIONSWhileyouareaskingyourselfquestionsabouthowthefacilityfeelstoyoudonotmisstheopportunitytoaskyourtourguideandotherstamembersplentyofquestions.Bepolitebutpersistent.Thisisyourbestchancetodetermineifthisistherightfacilityforyou.QuestionsmayincludeDoesthefacilityprovideorientationandinstructionsonhowtouseequipmentHowoldistheequipmentandhowoftenisitreplacedHowoftenisequipmentcleanedandmaintainedIstherecardiovascularequipmentthatcanbeoperatedwiththeupperbodyonlyDoesthecardiovascularequipmentsuchasthestationarybikesrequireaminimumspeedtouseArethereshowersandchangingfacilitiesIstherefamilychangingareaIsthestarequiredtohaveadegreeinexercisescienceorkinesiologyIsthestarequiredtopursuecontinuingeducationWhatistheturnoverrateofthestaWhatarethebusiesttimesforthefacilityWhatareasaremostcrowdedandwhenWhattypeofclassesdoesthetnesscenterprovideIstherealimitonclasssizeDoinstructorsknowhowtoadaptclassesforyourabilitiesHowmuchone-on-onestainteractionwillbeavailableArepersonaltrainersnutritionconsultantsmassage therapistsorotherspecialistsavail-ableAretheycertiedWhatisthecostHowdoesthefacilityhandleemergencysituationsHasstabeentrainedincardiopulmonaryresuscitationandrstaidDoesthefacilityhaveanAutomatedExternalDebrillatorAEDCanmypersonalassistantaendthefacilitywithmewithoutextrachargesAreserviceanimalsallowedinthefacilityCanyoureachthefacilitybypub-lictransportationAreparkingorchildcareavail-ableandatwhatextracostifanyTryItOutFitnesscentersshouldbewillingtooeryouatemporarypassforasmalldailyfeeoratnocost.Ifyouknowamemberofthefacilityaskifheorshecangetyouaguestpass.Considertryingmorethanonetnesscentertomakesureyouhttpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520914CHOOSINGAFITNESSCENTERpicktherightone.Donotsuccumbtoahigh-pressuresalespitchthinkitover.Studythecontractcarefully.Howlongofacommitmentisrequiredayearormoreorcanyouchooseamonth-to-montharrangementCanyouoptoutifyoudecideitisnottherightplaceforyouorifyoumovetoadierentcityDopricesvaryforpeakando-peakhoursArethereanynancechargesorotherfeesDonotsignanythingyouarenotcomfortablewith.ItsUpToYou-Afteryoudotheresearchvisitfacilitiesandgothroughtrialperiodsitwillbetimetomakeyourchoice.Themostimportantelementofyourdecisioniscomfort.DoyoutrulyfeelcomfortablewiththetnesscenteraswellasitsstaclientsequipmentamenitiesandpoliciesIfsotaketheplunge.Ifyoundagoodtnesscenterandstickwithityouhavetakenakeystepto-wardmeetingyourpersonaltnessgoals. httpwww.nchpad.orgemailnchpad.orgToll-Free1-800-900-80864000RidgewayDriveBirminghamAL3520915ResearchhasshownthatwhenanindividualsweightreachesalevelcategorizedasoverweightorobesetheyareatanincreasedriskfordevelopingthefollowingconditionsCoronaryheartdiseaseType2diabetesCertaintypesofcancersHypertensionhighbloodpressureHighcholesterolStrokeLivergallbladderdiseaseSleepapnearespiratoryproblemsOsteoarthritisGynecologicalproblemsSourceCentersforDiseaseControlandPrevention.Whatcausesover-weightandobesitywww.cdc.govobesityadultcausesindex.html.Theprevalenceofobesityinthegeneralpopula-tionisbetween17and22percent.Forindividualswithaphysicalorintellectualimpairmenttheprevalenceofobesityisestimatedtobebetween27and62percent.SourceMudgeetal.Livingwellwithdisabilityneedsvaluesandcom-petingfactors.InternationalJournalofBehavioralNutritionandPhysicalActivity201310100.The2010DietaryGuidelinesforAmericansweredesignedtoencourageallAmericanstoeatmorehealthfully.ThefollowingstrategiesaretohelpbuildahealthierdietbyfocusingonkeybehaviorsBalancingCaloriesoEnjoyyourfoodbuteatlessoAvoidoversizedportionsNUTRITIONEatingahealydietandmaintainingahealyweightaretwoveryimptantcomponentstolivingahealylifestyle.FoodstoIncreaseoMakehalfyourplatefruitsandvegetablesoMakeatleasthalfyourgrainswholegrainsoSwitchtofat-freeorlow-fat1milkFoodstoReduceoComparesodiuminfoodslikesoupbreadandfrozenmealsandchoosefoodswithlowernumbersoDrinkwaterinsteadofsugarydrinksCreditUSDAsCenterforNutritionPolicyandPromotionTipsforovercomingbarriersReduceportionsizesPlanmealsaheadoftimeAskforhelpwithgroceryshoppingandcookingUsesimplemealrecipesUseadaptivetoolsandtechniquesinthekitchentocookwithgreatereaseandenjoyment LookingforafuninteractivenewprogramtohelpyougetmovingandmakinghealthychoicesIfsocheckout...NCHPADstoaHealthierYouTheNationalCenteronHealthPhysicalActivityandDisabilityinvitespeoplewithmobilitylimitationschronichealthconditionsandphysicaldisabilitiestoparticipateinthispersonalizedweb-basedprogramthatcanbedonefromhomewithlittletonoequipment.Thisprogramoers14weeksofNewpersonalizedweeklyexercisesPhysicalactivityandnutritiontipsMotivationalresourcesWeeklyrecipesFeaturestohelpyoutrackyouractivityandwhatyoueatOptionalremindersandalertsOpportunitiestoconnectwithotherparticipantsAccesstoknowledgeable14-WeekcoachesWhetheryouarenewtophysicalactivityoralreadyactivethisprogramisdesignedforyouSignupatWeekProgram14-www.nchpad.org14weeks ClassAThoseabletouseallfourlimbstosomedegree.ThismayincludeindividualswithlimblossorambulatoryCP.ClassBThoseindividualsthatareabletouseeverythingfromthewaistchestandabove.Thisincludesindividualswithparaplegia.ClassCThoseindividualsthathavesomebutnotfullfunctionintheirupperextremities.Thisincludesindividualswithquadriplegia.WhatisCRxAninclusivehighintensityworkoutprogramWeinviteyoutocheckoutourFREEonlinedailyworkoutprogramdesignedtochallengeyourclientsorathletesregardlessoftheirabilitylevels.CRxisahighintensityprogramforathletesofallkindstodevelopspeedagilitypowerandendurance.MondaysWednesdaysandFri-daysconcentrateonstrengthtrainingwhileTuesdaysandThursdaysarecardio-based.Ath-letesarealsoabletoaccesspreviousdaysworkoutswithinthesameweek.Eachworkoutconsistsofexercisescompletewithwrittendescriptionsandpictures.Thesehighintensityworkoutsaregreatforcompetitiveathletesplayingsportslikerugbyandwheelchairbasketballaswellasrecreationalathletes.AthletesandinstructorsarealsoabletosubmitworkoutstobeaddedtotheCRxprogram.Checkitoutatwww.nchpad.orgCRxFormoreinformationcontactKellyatkellyblakeshore.orgorcrxnchpad.orgOrcheckoutourvideosontheNCHPADYouTubechannelandsearchCRxPromo3ClassesofExercisesScanhereforaPromovideo