According to James H. Rimmer, Ph.D., in a 2005 article in the journal, "Physical Medicine and Rehabilitation Clinics of North America," there is a growing body of evidence that supports the use of exercise in older adults to improve functional independence. For individuals in wheelchairs, exercise is paramount in reducing pain, skin ulcers and independent mobility. Older adults who have a preexisting disability are at greater risk of losing independence. An aerobic and strengthening program is vital to maintain or regain independence in activities of daily living.
Types of Exercise Programs
Wheelchair exercise programs can include group or individual programs, rehabilitation programs and home programs. Senior centers often offer chair exercise classes and there are DVDs available for use at home. An occupational or physical therapist may prescribe an individualized program specific to your diagnosis and physical condition.
Guidelines for Exercise Programs
The American Academy of Orthopaedic Surgeons recommends that older adults, including those in wheelchairs, exercise a minimum of 20 to 30 minutes per day, 3 to 4 days per week. It is important to alter your position and bear weight through the legs as often as possible to maximize strength, balance, flexibility and skin integrity. Therefore, performing exercises in a variety of positions is desirable, such as standing, lying down, and even on your hands and knees. If you must stay in the wheelchair, maintain upright posture or use positioning equipment if necessary to ensure alignment.
Strengthening Exercises
If you propel your wheelchair, the muscles in the front of your shoulders may already be strong and you will need to be careful not to overwork these muscles. To improve posture and strengthen less-used muscles, work the upper back and triceps muscles with a resistance band. Attach the band securely to a doorknob or overhead pulley system. Sitting up tall in your chair, pull the bands in a rowing motion with your arms close to your body. To work the triceps, hold a water bottle with your arms extended overhead and elbows close together. Bend the arms so the water bottle drops behind your head and straighten. To strengthen the legs, attach ankle weights and march your legs in place until you fatigue. Lift the knee slightly and extend your foot straight out to strengthen the thighs. Alternate legs. Repeat each exercise 10 to 15 times.
Endurance and Flexibility Exercises
Aerobic endurance is highly correlated with increased independence in activities of daily living. To improve your endurance, try a portable stepper or pedal ergometer from your wheelchair. Your local gym, hospital fitness center or senior center may offer adapted cardio equipment or chair exercise programs. Since prolonged sitting results in shortened muscles, you should incorporate stretches into your exercise regime. Yoga improves flexibility and you can perform many poses from your wheelchair. Keep your arms and legs mobile by frequently lifting your arms overhead, gently rolling the neck and writing the alphabet in the air with your toes.
Precautions
Consult a physician and consider hiring a fitness or rehabilitation professional before beginning any exercise program. Exercise programs should be individually based and carefully monitored. Overuse injuries of the rotator cuff muscles are common, so as such, if an individual propels his wheelchair, avoid or reduce use of arm ergometers. Alter workouts each day and allow for rest.
References
- "Physical Medicine and Rehabilitation Clinics of North America"; Exercise and physical activity in persons aging with a physical disability; James H. Rimmer, Ph.D.; 2005
- The National Center on Physical Activity and Disability;Exercise/Fitness: Resistance Training for Persons with Physical Disabilities: Guidelines for Wheelchair Users; 2005
- U.S. Department of Health and Human Services; Physical Activity Guidelines for Americans; 2008
- The National Center on Physical Activity and Disability; Exercise/Fitness: Resistance Training for Persons with Physical Disabilities; James H. Rimmer, PhD; 2005
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