Adapted

Fitness
Olivier Collin,Jeremy Lynn & Emilie Noble
EPHE 447
 Overview
Background
What is Adapted Fitness?
Facilities
Common Disabilities
Equipment
Case Study
Canadian Perspective on Disabilities
Roughly 14% of population (4 million)

**
**
**

Statistics Canada, 2012

Breaking it down
of disabilities are severe

8/10 require assistive aids

are unemployed

dependent on non-employment income

Median income is 10,000 less than Canadian average

Challenges of Daily Living
Cooking / Eating
Personal Hygiene
Cleaning
Transportation / Mobility
Marital status / caregivers
Finances
What is Adapted Fitness?

Exercise that is modified to overcome

challenges experienced by those with
disabilities
Adapted Gyms
Facilities That Offer Adapted
Pacific Institute of Sport Excellence:
9 adapted programs for children
2 programs for adults
Integrative Sports
Personal Training

CARSA:
New: Adapted Climbing
Facilities That Offer Adapted Fitness
MOVE Adapted Fitness and Rehabilitation:
Dedicated specifically to people with physical disabilities
More directed towards the adult population
Common disabilities at MOVE
Spinal Cord Injury
Multiple Sclerosis
Stroke
Parkinsons
Brain Injuries
Spinal Cord Injury
Characterised by mechanical
trauma to grey and white matter

Paralysis, loss of sensation, loss

of some internal organ function
Forms of SCI
Paraplegia
Lower limbs affected: may
be complete paralysis or
slight impairment
Full control of upper limb
Lesion occurs below T1
Quadriplegia
All four limbs affected
May retain some control
of arms/hands
Lesion occurs above T1
May also affect abdominal
& chest muscles
SCI and Exercise

Endurance training shown to

produce highest degree of nerve
fiber regeneration and
myelination

Ilha et al., 2008

Resistance vs. Endurance
Both endurance and resistance
training shown to improve
functional independence measures

Resistance training showed greater

improvements
Multiple Sclerosis

Prevalence of MS in Canada/BC...
Demyelination of white matter
Development of plaques
Multiple Sclerosis
Symptoms
General fatigue
Weakness
Spasticity
Ataxia
Cognitive and autonomic
dysfunctions
MS: Benefits of Exercise
Fatigue reduction

Improved mobility

Improved QOL and mood

Contraindications to Exercise

Increased risk of fractures

Impaired sweating ability

Loss of sensation sores

Fitness Challenges
Supervision/aid

Specialized equipment

Creativity

Transportation

Social stigma
Guidelines for all...
Consequences of being Sedentary
Wheelchairs and sitting
Linked to type-2 diabetes, cardiovascular disease and early mortality
CVD is NOW leading cause of death in SCI population
Muscular atrophy
Bone Mineral Density

Cholesterol HDL
Psychological distress
Goals of Exercise
Spasticity reduction

Improved functionality

Improve quality of life

Slow progression of disease

Social Benefits
Adapted Fitness: It's all about planning!
Step 1: Complete assessment of individual to establish capacity

Step 2: Establish goals and objectives

Step 3: Design adapted program

Equipment
Parallel Bars
Nu-Step
APT Legs/Arms
Sit-to-stand
Standing Frame
Paramount
Activity Balls

Vs.
Parallel Bars
Standing and walking

Squats

Balance exercises
NuStep
Aerobic training
APT: Active Passive Trainer

Arms

Use while seated in wheelchair

Varying range of motion

APT: Active Passive Trainer

Legs
Varying range of motion
Sit-to-Stand
Counterweight system
Standing Frame
Weight bearing
Paramount & Hand Grips
Can be done from a wheelchair
Aids with closed hand grip
Paramount & Hand Grips
Lokomat
https://youtu.be/1MgpCOr3BfM?t=151
Case Study
Disability

Personal Goals

What else has he tried

What changes has he seen

Areas for Improvement
Lack of follow-up

Depends upon a plethora of volunteers

MOVE monthly membership

Questions?
References
Bhambha ni, Y. (2002). Physiolo gy of whe e lc hair racing in athlete s with spinal cord injury. Sports Medicine , 32(1), 23 -
51.
Krassioukov, A. V., Karlsson, A. K., Wecht, J. M., & Wuermser, L. A. (2007). Assessment of autonomic dysfunction
follo wing spinal cord injury: rationale for additions to Interna tio n al Standard s for Neurolo gic al Assessme nt. Journal
of rehabilitation research and development, 44(1), 103.
Hamilton, M. T., Hamilton, D. G., & Zderic, T. W. (2007). Role of low energy expenditure and sitting in obesity,
metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes, 56(11), 2655 -2667.
Jrgensen, L., Jacobsen, B. K., Wilsgaard, T., & Magnus, J. H. (2000). Walking after stroke: does it matter? Changes
in bone miner al density within the first 12 months after stroke. A longitud inal study. Osteoporosis interna tio n al,
11(5), 381-387.
Myers, J., Lee, M., & Kiratli, J. (2007). Cardiovascular disease in spinal cord injury: an overview of prevalence, risk,
evaluation, and management. American journal of physical medicine & rehabilitation, 86(2), 142 -152.
Brenes, G., Dearwater, S., Shapera, R., LaPorte, R. E., & Collins, E. (1986). High density lipoprotein cholesterol
concentrations in physically active and sedentary spinal cord injured patients. Archives of physical medicine and
rehabilitation, 67(7), 445-450.
Drory, V. E., Goltsman, E., Reznik, J. G., Mosek, A., & Korczyn. A. D. (2001). The value of muscle exercise in
patients with amyo tr op hic lateral sclerosis. Journal of the Neurolo gic a l Scienc e s, 191, 133 -137.
Dal Bello -Ha a s, V., & Florence , J. M. (2013). T herape utic exercise for people with amyo trop hic lateral sclerosis or
motor neuron disease (review). Cochrane Database of Systematic Reviews, (5)..
Miyai, I., Fujimoto, Y., Ueda, Y. Yama mo to, H., Nozaki, S., Saito, T ., & Kang, J. (2000). T readmill training with body
weight support: Its effe c t on Parkinson s disease . Phys Med Rehabil, 81, 849 -852.
Goodwin, V. A., Richard s, S. H., T aylor, R. S., T aylor, A. H., & Campbe ll, J. L. (2008). T he effe ctiv e ness of exercise
interve ntio ns for people with Parkinson s disease : A syste m atic revie w and meta -a na lysis. Moveme nt Disorder s,
23(5), 631640.
References
Dalgas, U., Stenager, E., & Ingemann -Hansen, T. (2008). Multiple sclerosis and physical exercise: Recommendations
for the application of resistance - , endurance - and combined training. Multiple Sclerosis, 14, 35 53.
Petajan, J. H., Gappmaier, E., White, A. T., Spencer, M. K., Mino, L., & Hicks, R. W. (1996). Impact of aerobic
training on fitness and quality of life in multiple sclerosis. Ann Neurol, 39(4), 432 -441.
Romberg, A., Virtanen, A., Ruutiainen, J., Aunola, S., Karppi, S. L., Vaara, M., Seppnen, A. (2004). Effects of a
6-month exercise progra m on patients with multiple sclerosis: A randomiz ed study. Neurolo gy, 63, 2034 -2038.
Lopes de Almeida, J. P., Silvestre, R., Pinto, A. C., & de Carvalho, M. (2012). Exercise and amyotrophic lateral
sclerosis. Neurol Sci, 33, 915.
Plowma n, S. A., & Smith, D. L. (2007). Exercise physio lo gy for health, fitne ss, and perfor ma nc e (3rd ed.).
Philadelphia, PA: Wolters Kluwer. McArdle, W. D., Katch, F. I., & Katch, V. L. (2010). Exercise physiology:
Nutrition, energy, and human performance (7th ed.). Santa Barbara, CA: Macmillan Publishing.
Baechle, T. R., & Earle, R. W. (Eds.). (2008). Essentials of strength training and conditioning (3rd ed.).
Champaign, IL: Human Kinetics.
Sage, M. D., & Almeida, Q. J. (2009). Symptom and gait changes after sensory attention focused exercise vs aerobic
training in Parkinsons disease. Movement Disorders, 24(8), 1132 1138.
Uhrbrand, A., Stenager, E., Pedersen, M. S., & Dalgas, U. (2015). Parkinsons disease and intensive exercise therapy
a systematic review and meta -analysis of randomized controlled trials. Journal of the Neurological Sciences, 353(1 -
2), 919.
Mostert, S., & Kesselring, J. (2002). Effects of a short -term exercise training program on aerobic fitness, fatigue,
health perceptio n and activity level of subjects with multiple sclerosis. Multiple Sclerosis, 8, 161 -168.
Eidenber ge r , M., & Nowotny, S. (2014). Inspirato r y musc le training in patients with amyotrop hic lateral sclerosis: A
systematic review. Neuro Rehabilitation, 35, 349 361.
Lisle, S., & Tennison, M. (2015). Amyotrophic lateral sclerosis: The role of exercise. Current Sports Medicine
Reports, 14(1), 45-46.