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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 Quadriplegia
Lower limbs affected: may All four limbs affected
be complete paralysis or May retain some control
slight impairment of arms/hands
Full control of upper limb Lesion occurs above T1
Lesion occurs below 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
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