NCPAD:Exercise/Fitness: Exercise Guidelines for People with Disabilities

General Exercise Guidelines

Exercise is for EVERY body. This slogan appears in a number of places on the NCPAD Web site, and for a very good reason. Exercise is a key factor in maintaining and improving overall health. In 1996, the Surgeon General of the United States reported that "significant health benefits can be obtained with a moderate amount of physical activity, preferably daily." More recently, the 2008 Physical Activity Guidelines for Americans provides science-based guidance to help individuals with disabilities aged 6 and older improve their health through appropriate physical activity. These benefits are even more important if you have a disability, since people with disabilities have a tendency to live less active lifestyles. Yet, it is just as important for your body to get exercise. This factsheet provides some general exercise guidelines you should review. Throughout this site are resources on physical activity and exercise programs of all sorts: indoor and outdoor, sports or recreational, solitary or team. It doesn't matter what you choose, so long as you choose to get a moderate amount of physical activity each day.

Benefits of Regular Physical Activity and Exercise

Increased cardiac (heart) and pulmonary (lung) function
Improved ability to perform activities of daily living
Protection against development of chronic diseases
Decreased anxiety and depression
Enhanced feeling of well-being
Weight control
Lowered cholesterol and blood pressure

Before You Begin

Inform your physician or primary caregiver that you are considering starting an exercise program.
If possible, participate in a graded exercise test to determine your current level of fitness.
Find out the effects of your medication on exercise.
If possible, consult a trained exercise professional for an individualized exercise prescription.

Safety Considerations

Stop exercising if you experience pain, discomfort, nausea, dizziness, lightheadedness, chest pain, irregular heart beat, shortness of breath, or clammy hands.
Drink plenty of fluids, especially water.
Wear appropriate clothing.
Set realistic short-term and long-term goals.
Find and follow an exercise program that meets your specific goals.

Kinds of Exercise

Cardiovascular - primarily benefits your heart, circulatory system and lungs.
Strength and muscle endurance - primarily benefits you by making you stronger and/or giving you better endurance, so you can do things longer.
Flexibility - primarily aimed at giving you greater range of motion in joints and more suppleness in your body.

Common Exercise Terms

Heart Rate (HR): Determine your heart rate by finding your pulse: place a finger on the thumb side of the bottom of your forearm or against the side of your neck, and count your pulse beat for 15 seconds. Multiply this figure by four to calculate your heart rate per minute. Note that as you exercise more regularly, your heart rate should decrease.
Maximum Heart Rate: Subtract your age from 220 to determine your maximum heart rate. Example: a 40-year-old person would have a maximum heart rate of 180 (220 - 40 = 180).
Target Heart Rate: Calculated at 60% to 80% of your maximum heart rate. For the range's lower cutoff point, multiply .60 to your maximum heart rate; for the top cutoff point, multiply .80 to your maximum heart rate. In the previous example, this calculates a range of 108 to 144 beats per minute.
Blood Pressure (BP): A measure of the blood's pressure upon the arterial walls which consists of two values: systolic blood pressure, as the heart contracts or pumps the blood to the circulatory system (90 to 140 mmHg), and diastolic blood pressure, as the heart fills up with blood following a contraction (60 to 90 mmHg). If possible, have a trained professional monitor your blood pressure throughout the exercise session.
Ratings of Perceived Exertion (RPE): This is a scale of how hard you feel you are exercising. The Borg scale ranges from 6 to 20. To use the scale, monitor how you feel while exercising, with a general goal of 12 to 13 RPE.

Other Considerations

Intensity: (how hard?) - Intensity can vary from very light to very hard and can be monitored on the basis of training heart rate or your own subjective impression of how hard you are working.
Frequency: (how many?) - Start with three days a week and work towards seven days a week.
Duration: (how long?) - Begin with a minimum of 20 minutes throughout a day with a goal of increasing to 60 minutes a day. This can be done in multiple 10-minute sessions or in one longer session.
Mode: (what kind?) - Structured (walking, running, cycling, swimming, resistance training) or unstructured (gardening, household cleaning, walking to work)

Exercise Routine

Warm-up: Five minutes of light activity, such as slow walking or cycling
Activity: Cardiovascular, muscular strength or flexibility training
Cool down: Five minutes of light activity with some flexibility exercises built in

Suggestions for Each Type of Exercise

Cardiovascular:

Vary your workout each session.
Be creative! Enhance your exercise routine by walking throughout the day: during lunch and coffee breaks, around the house during commercials.
Choose a pace that feels good to you; use the Ratings of Perceived Exertion scale or the "Conversation Rule": you should be able to converse while exercising.
Take slow, deep breaths and "think tall" to maintain good posture.
Types of cardiovascular training: walking (outside, treadmill), cycling (outside, stationary bicycle, ergometer) and swimming

Strength:

Perform each movement through a complete range of motion.
Do not hold your breath while strength training. Instead, exhale or breathe out while pushing the weight up or out and inhale or breathe in while letting the weight down or in. "Think tall" to maintain your posture.
If your goal is to increase your muscular endurance, you should use lighter weights and perform eight to 12 repetitions.
If your goal is to increase your muscular strength, you should use heavier weights and perform five to eight repetitions.
Types of strength training: Weight machines, free weights, plastic tubing, "toys" (medicine balls, plastic buoys), and circuit training

Flexibility/Functionality:

The focus of flexibility/functionality work is to improve range of motion, balance, coordination, and ability to carry out the regular activities of daily living.
Flexibility training should be incorporated before and after every cardiovascular and strength workout.
Be sure to hold stretches and progress slowly.
Every muscle group used in a workout should be thoroughly stretched. Spend more time on tight muscle groups.
Stretching should not be painful.
Types of flexibility training: Stretching, Yoga, Pilates

More information on this and related topics may be available in the NCPAD Citation Database. Try searching with keywords: fitness, etc.

Note

The information provided here is offered as a service only. The National Center on Physical Activity and Disability, University of Illinois at Chicago, the National Center on Accessibility, and the Rehabilitation Institute of Chicago do not formally recommend or endorse the equipment listed. As with any products or services, consumers should investigate and determine on their own which equipment best fits their needs and budget.

National Center on Physical Activity and Disability
http://www.ncpad.org
ncpad@uic.edu
(800) 900-8086 (voice and TTY)
(312) 355-4058 (facsimile)

This fact sheet was last updated on 03-05-2009.