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NCHPAD - Building Healthy Inclusive Communities

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Balance, Flexibility, and Functional Motor Skills (FMS)


Balance exercise is often neglected in an exercise program. However, balance is a key component of exercise for populations with disabilities as it assists them with the performance of activities of daily living and reduces the risk of falling. Falls are a major cause of injury and mortality in people with disabilities. Balance exercises should be catered towards the needs of the individual. Static (non-locomotive) sitting, static standing, and dynamic balance (locomotive, e.x. walking), should be considered when designing an exercise program. Examples of balance exercises may include: unsupported chair sitting, unsupported chair reaching, unsupported chair ball tossing, or nudging. If falls are of concern, parallel bars or weight support (via aquatic balance exercise or overground weight support systems) is recommended when performing standing balance exercises.

Child performing yoga.
Limited flexibility is common among children with disabilities and may interfere with the performances of their activities of daily living. Spasticity or rigidity, characterized by stiffness of the muscle, often causes deviations in posture, which can hinder performance and functional capability. While flexibility may not always provide a complete fix/cure for these deficiencies, it often improves range of motion. Flexibility should be performed after strength/cardiovascular exercise to reduce exercise-induced skeletal muscle tension. However, light active or passive stretching may be performed prior to exercise as a warm-up to facilitate blood flow and range of motion. Flexibility should consist of 3 sets of 10 second end-point holds (30 second stretching may be strenuous). Communication is critical to safely finding end-points of flexibility in people with disabilities.
Below is a video example of various flexibility exercises in the seated position:
http://www.youtube.com/watch?v=vsODgCiiUwA

Child playing with Tic-Tac-Toe pegs.
Functional motor skills (FMS) exercises are incorporated in regimes to promote functional independence. FMS is typically used during the early stages of rehabilitation and when performance of activities of daily living is impaired. Examples of FMS may include: positional changes (lying prone to sitting or standing), passive exercise to facilitate blood flow (especially in the lower extremities), and fine motor skills (e.x. stacking cones or moving pegs).


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