Exercise is for everyone, or should I say everyBODY. It is for anyone who wants to take an active role in improving his or her health and well being. In the Surgeon General’s 1996 Report on Physical Activity and Health, it states people of all ages can “substantially improve their health and quality of life by including moderate amounts of physical activity in their daily lives.” But what is a moderate amount of exercise, you ask? It can be anything from walking or wheeling for 30 minutes, gardening for 45 minutes, 20 minutes of basketball or 30 minutes of household chores. The bottom line is that physical activity does not have to be strenuous for you to gain health benefits. Just start moving.

People with physical disabilities tend to lead a more sedentary lifestyle than people without a disability, yet both have similar needs to promoting health and preventing unnecessary diseases. Increased muscle strength and endurance affects your body in many positive ways: opening heavy doors, wheeling up a steep hill, lifting groceries. Social support has been consistently related to staying physically active, so get your friends and family involved in your quest for better health.

The benefits and the precautions discussed will be for Spinal Cord Injury (SCI), Traumatic Brain Injury (TBI), and Multiple Sclerosis (MS). I realize that there are many diverse characteristics within each of the disabilities. Physical activity plays an important role in improving functional ability and improving quality of life, so make the most out of your physical function. It is a strong part of promoting good health.

Benefits of Exercise for Individuals with SCI

• Increases ability to perform activities of daily living
• Increases blood flow to the upper and lower extremities
• Increases physical independence
• Increases efficiency of the heart
• Increases self confidence
• Improves healthy body image
• Promotes social interaction
• Decreases risk of heart disease
• Reduces harmful LDL cholesterol levels
• Decreases secondary complications of SCI.

Exercise Precautions for Individuals with SCI

• Autonomic dysreflexia—A sudden rise in blood pressure due to over activity of the autonomic nervous system in response to harmful stimuli below the level of injury, usually from bladder/bowel overdistension or blocked catheter. Symptoms include sweating, sudden elevation in blood pressure, shivering, headache, and nausea.
• Spasticity –A condition that is characterized by high muscle tone and hyperactive reflexes. It typically occurs in the muscles below the site of injury and can be triggered by urinary tract infections, skin breakdowns, or trying new exercises. Stretching spastic muscle groups and avoiding exercises that cause excessive spasms are encouraged.
• Orthostatic hypotension—A drop in blood pressure. It occurs in upright postures, especially moving from supine to upright sitting/standing/head-up tilt. Symptoms include nausea, dizziness, and feeling light-headed. Monitor blood pressure throughout exercise, avoid quick movements, and maintain proper hydration. If orthostatic hypotension occurs, lie in a supine position with your feet elevated.
• Regulation of Body Temperature—Irregular body temperatures are often experienced by individuals with spinal cord injury. The external environment will be a determinant of body temperature during exercise. Anticipate the exercise conditions and plan ahead. Keep a damp cloth or spray bottle nearby.
• Staying Hydrated—You can become dehydrated before you become thirsty, so make sure you drink water before, during, and after your workout.
• Medications—Make sure you are aware of any effects your medications have on your ability to exercise since sometimes medications can change the way your body responds to exercise. Consult your physician prior to starting an exercise program.

Benefits of Exercise for Individuals with TBI

• Helps nerve impulse travel faster to the brain, which improves how quickly you process or think
• Decreases health-risking behaviors such as smoking and depression
• Increases focus and ability to stay on task
• Improves mood and memory
• Increases blood flow to the brain
• Increases body awareness
• Positive effects on balance
• Increase heart and lung efficiency.

Exercise Precautions for Individuals with TBI

• Fatigue—There can be a number of reasons for fatigue: chronic pain, sleep disturbances, and depression. Appropriately timed activities can help tremendously (e.g., certain times of the day, carefully timed bursts of aerobic activity)
• Slowed thinking—Since it can take longer to process the information, make sure to have a clear and concise breakdown and understanding of the exercise.
• Memory and initiation—Poor planning and poor goal-oriented behavior can occur. Have a properly structured workout and use repetitions and review.
• Medications—Understand the effects of the medication on your body. Talk with your physician before starting a fitness program to make sure that it is an appropriate plan of action for you at this time.
• Emotional Behaviors—Impulsivity, disinhibition, indecision, and irritability are all examples. Simply focus on the task or try redirecting the negative behavior.

Benefits of Exercise for Individuals with MS

• Improved strength and cardiovascular fitness
• Helps manage many MS symptoms
• Positive changes in mood and emotional behavior
• Improved bladder and bowel functions
• Helps battle fatigue and depression
• Increased participation in social activities
• Improved functional performance and independence.

Exercise Precautions for Individuals with MS

• Fatigue—Can be diagnosed as chronic or acute. Carefully timed activities, simplifying your workouts can help offset fatigue.
• Changes in cognitive function—This includes memory, attention and problem solving. Keep a detailed workout log that gives step-by-step instruction of that day’s workout.
• Balance and Coordination—Not only does poor balance make things difficult, it could also result in a fall. Use assistive devices or ask for assistance.
• Pain or abnormal sensations—if pain occurs, stop immediately.
• Medications—Since medications can have varying effects on your ability to exercise, talk with your physician prior to starting an exercise routine.
• Heat/Temperature Sensitivity—If you become overheated easily, strategies for easing the effects are using cooling products (neck wraps, bandanas, etc.), wear lightweight, breathable clothing, exercise in a cooled environment (gym with fans and air conditioning or a pool < 85 degrees).

There are many differences between each of the disabilities, but also within each disability group. Workout programs should be appropriate to your capabilities and limitations, and they can always be adjusted to your changing needs.

But what type of activity is best for me?

• Anything that involves movement (shake your groove thing, go gardening)
• It should be enjoyable (something that you find fun and entertaining will help you make it a healthy habit)
• Something that is challenging mentally and physically
• It should be regular and consistent
• If you don’t have time for 30-60 minutes at a time, try for short burst of exercise (5, 10, 15 minutes at a time).

According to the National Center for Chronic Disease Prevention and Health Promotion, “Regular physical activity can help people with chronic, disabling conditions improve stamina and muscle strength and can improve psychological well being and quality of life by increasing the ability to perform activities of daily living.”

Okay, so now what? First, consult with your physician, who will be able to give you the green light to go forward with an exercise program. Secondly, he might be able to give you a recommendation for a professional exercise specialist and maybe even some basic exercises to start with.

Improve your quality of life with the lifelong practice of enjoying physical activity. The time for action is now!