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Wheelchair Exercises for Fitness and
Confidence by Jean Douglas
Using a wheelchair can make getting around possible for those who are
unable to walk or unable to walk long distances, but it doesn’t
necessarily make it easy. There are a lot of challenges that come with
using a wheelchair, particularly in environments not specifically designed
for wheelchair accessibility. Narrow sidewalks, uncut curbs, and sidewalks
in disrepair can make even short trips difficult. Many public
transportation systems are not fully accessible to wheelchairs. And
getting in and out of an automobile can be awkward and time-consuming.
In addition to the practical difficulties, using a wheelchair can also
affect a person’s level of self-confidence. For many, negotiating life
from a seated position can feel like a disadvantage. Maintaining eye
contact with people who are standing can be difficult and can make
communicating with them more difficult as well. Coping with negative
public perceptions of and attitudes toward people who use wheelchairs can
also be stressful.
Both the practical and the psychological difficulties of using a
wheelchair may be compounded if a person is not physically fit. A person’s
level of physical fitness affects his ability to sit erect comfortably; to
manually propel and maneuver his wheelchair; to transfer himself between
his wheelchair and a chair, bed, toilet, or car; to reach for items; to
regain his balance when lost (because of a crack in the sidewalk, for
example); and even to use his voice effectively.
Many people who use wheelchairs, however, can become more physically
fit by exercising the muscles they are able to use. This article presents
some basic exercises to increase strength and flexibility and to build
self-confidence as well.
Fitness and confidence basics
Good alignment of your body, whether seated or standing, requires the
least amount of energy and projects a sense of self-confidence. Good, or
"neutral," alignment is when major joints are directly above one another.
Ideally, your shoulders are directly above your hips, and your head is
held so that your ears are directly over your shoulders. Being in as good
alignment as possible removes the need for constant attention and
adjustment to body position and allows you to focus on other matters.
To see what good alignment looks like, watch how television announcers
position themselves—and the way they exude confidence and self-esteem.
That same kind of body management can lend assurance to your voice and
appearance, too. Standing or sitting erect is the beginning of asserting
yourself.
Achieving good alignment requires developing the muscles that support
you. For people who use a wheelchair or scooter, the lower back and pelvic
area form the balance base. A person with weak muscles from years of
sedentary living may need mechanical assistance such as a fixed tray to
stay upright seated. Strengthening the body’s core muscles can prevent
such assistance from becoming necessary. Developing a strong upper body
may also enable you to perform unassisted transfers to and from your chair
to places such as a bed or toilet.
Your body responds to exercise frequency, duration, and intensity.
Generally, the more you do, the faster your fitness level improves, but
it’s important to pace yourself to avoid injury and burnout. In addition,
while you may feel some muscle soreness as you start to move in new ways,
acute pain during exercise is a clear sign to stop what you’re doing. A
previously inactive person who begins these
exercises and does them three times each week may notice improvement
in as little as three weeks. Significant strength gains may come in as
little as 12 weeks. It is also possible that a more positive attitude and
a lessening of anxiety and stress will accompany improved physical
fitness.
Tailoring your program
People who use wheelchairs have a broad range of abilities and
disabilities. No one exercise or exercise program is suitable for every
person in this varied population. It’s important to consider your own
physical situation and the recommendations of your health-care provider
when choosing exercises or a form of physical activity. People with
diabetes must also pay attention to blood glucose control while
exercising. If you do not know how to keep your blood glucose level in
target range while exercising, speak to your health-care provider for
guidelines.
Anyone who has retinopathy should consult a health-care provider about
exercise safety before starting a new physical activity program. In
general, exercises or stretches that place the head below the level of the
heart should be avoided by people with retinopathy.
High blood pressure can also make exercising risky, so make sure your
blood pressure is under control before beginning an exercise regimen.
Blood pressure normally rises somewhat with physical activity, but to
prevent it from rising too high, remember to breathe normally while
exercising and to never hold your breath. When strength training, get in
the habit of exhaling with exertion (as you push or pull against a weight
or resistance) and inhaling as you return to your starting position.
The exercises presented here are appropriate for many users of either
manually propelled or motorized wheelchairs. The exercises can all be
performed in a wheelchair, but because a wheelchair can restrict a
person’s movements, it’s preferable to perform them in a sturdy, straight
chair, if possible. Some users of manually propelled chairs may discover
that their upper body is already strong and coordinated and that they have
developed a relatively stable seated posture. If attempting propulsion is
difficult, however, these exercises will be beneficial for upper-body
strength and more balanced seating as well as for increased confidence.
Complete fitness programs include aerobic activity for cardiovascular
fitness in addition to strength and flexibility exercises. The most
suitable type of aerobic activity will be unique to each person using a
wheelchair or scooter. An arm crank, for example, can provide an
effective, seated aerobic workout. For those who are able, water aerobics
can be an excellent aerobic conditioner.
Exercising by yourself works, but many people enjoy doing it more when
they are part of a group. Classes offered by a local branch of a nonprofit
association or community college provide additional physical activity
options and social contact. Your local Area Agency on Aging may provide
classes for seniors. Many such programs are suitable for users of
wheelchairs or scooters. A trained instructor can offer alternative
versions of exercises that are suitable for your abilities. For
individualized attention, you might consider hiring a knowledgeable
personal trainer who can design a comprehensive program tailored to your
unique situation.
Getting started
Practicing the following exercises is a good way to start a program of
regular physical activity. Be sure to speak with your health-care provider
about any special precautions that may apply to you. And remember to keep
at it—you may be surprised to see how much your posture and your
confidence improve.
Jean Douglas owns a fitness training and education service in San
Diego, California. Contact her at http://www.be-fit-again.com/.
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