Exercise for Disability: Staying Active

For people living with disabilities, it can present its own unique challenges and difficulties depending on the individual and their functional disability as well as a host of secondary conditions which may be present. The overall health of disabled individuals may be worse due to a more sedentary lifestyle or lack of physical activity. And depending on disability, opportunities may be more limited for community participation and engaging in physical activity.

Exercise Physiology encompasses the assessment of cardiovascular, muscular strength, and metabolic responses to exercise. Enabling the development of personalized exercise interventions. When considering individuals with disabilities these interventions are crucial to addressing unique challenges and improving overall quality of life.

Disability is defined as a limitation in functionality or bodily structure that results in difficulties carrying out daily tasks and participating fully in society according to the World Health Organization. Types of disability include:

1. Physical/motor disability

Reductions in the ability to mobilize, usually because of partial or total loss of function in a body part. Making it more difficult to complete activities independently that require motor skills. Amputation (loss of limb), Cerebral palsy (loss of motor signaling), Paraplegia (loss of lower body function), tetraplegia (both upper and lower body function) and hemiplegia (one side of body) are all forms of motor impairment.

2. Sensory disability

Impairment which affects one or more senses. The most common occurring being visual impairment (partial or total loss of vision) and hearing impairments (partial or total loss of hearing). Sensory disabilities can have a severe impact on a person’s life due to how much rely on our senses to convey and obtain information.

3. Intellectual disability

Limitations or difficulty in cognitive and intellectual functioning. Delayed speech and language, difficulty in learning, attention, memory and problem solving. Normally identified in childhood it can be difficult for individuals to live and work independently in the community.

4. Psychosocial

A disability partially or completely because of a mental health issue, this may impair the individual’s ability to interact with others, concentrate, and deal with emotions, often feeling they are unable to be in social environments. Depression, anxiety, schizophrenia and bipolar disorders can be considered psychosocial disabilities.

Limitations because of disability can impose challenges on an individual’s strength, mobility, cardiovascular health, flexibility, and balance. Exercise physiology is personalized to take into account all of an individual’s specific needs and limitations, and provide a personalized exercise program which may include:

Training for functionality

Exercise Physiology is focused on exercise improving the ability to perform activities of daily living (ADLs) and enhancing overall independence. Reducing the likelihood of further disability and maintaining the highest quality of life possible.

Assistive devices

A variety of devices and technologies are used by Exercise Physiologists to facilitate safe, meaningful exercise which is appropriate for the patient’s goals.

Adaptive exercise

Exercise Physiologists are trained to provide modified exercise programs that consider the patient’s own unique condition and cater to an individual’s abilities ensuring safety and effectiveness.

Physical Fitness

Regular exercise can enhance muscle mass, strength and fitness. in their systematic review on exercise in adults with multiple sclerosis and severe mobility disability Edwards & Pilutti (2017) found 9 of 13 studies reported increased physical fitness and physical function and significant improvements in disability. This can mean increased independence, quality of life and the ability to perform more ADLs.

Cardiovascular health

Individuals with limited mobility and sedentary lifestyles as a result of disability may be at higher risk of cardiovascular and heart disease. Exercise is beneficial in maintaining cardiovascular health. 

Weight management

Disability can often lead to a sedentary lifestyle especially with movement impairments, predicting increased weight gain and a variety of comorbidities including type 2 diabetes, hypertension, and high blood lipid profiles (cholesterol). In addition, individuals with a high body mass index are 3.4x more likely to experience a mobility limitation and x3.7 more likely to have further decline in physical function compared with normal weight individuals (Bell et al., 2017). Regular exercise in conjunction with a healthy balanced diet can help in weight loss and weight maintenance reducing the risk of further decline.

Reduced Anxiety and Depression

Depression and anxiety can lead to a sedentary lifestyle, increased risk of metabolic conditions, and hypokinesia. For individuals with intellectual disability this can result in increased personal and support health and social care costs, and a reduction in quality of life. Exercise triggers the release of endorphins which can help reduce the symptoms of depression and anxiety. 6 months of aerobic exercise and regular physical activity has been shown to significantly decrease levels of anxiety (Carmeli et al., 2009), increasing physical functioning and the ability to complete ADLs independently.

Cognitive Function improvements

Physical activity is known to improve cognitive functioning including memory, and executive functioning. For individuals with disability this can improve concentration, learning, memory, and overall alertness.

Community/Social interaction and inclusivity

Exercise provides opportunities for social interaction and greater community participation in activities. Improved physical capacity also can allow individuals to ambulate for longer within the public space. This can reduce feelings of loneliness and isolation and empower individuals to be more active in the community. Increasing confidence and self-esteem.

So, if you’re interested in finding out how exercise can assist you with your condition, don’t let it hinder your lifestyle and independence. Contact us today to schedule a comprehensive assessment and personalised treatment plan.

Our experienced physiotherapists and exercise physiologists are here to help you find the right program for you.

Call us now on (02) 4721 1222 or book an appointment online.

References

Bell, J., Sabia, S., Singh-Manoux, A., Hamer, M., & Kivimaki, M. (2017). Healthy obesity and risk of accelerated functional decline and disability. International Journal of Obesity, 41, 866-872.

Carmeli, E., Barak, S., Morad, M., & Kodesh, E. (2009). Physical exercises can reduce anxiety and improve quality of life among adults with intellectual disability : original research article. International Sportsmed Journal, 10(2).

Edwards, T., & Pilutti, L. (2017). The effect of exercise training in adults with multiple sclerosis with severe mobility disability: A systematic review and future research directions. Multiple Sclerosis and Related Disorders, 16, 31-39.