This online program is designed to promote health and wellness for people with physical disabilities and their caregivers.
Daniel was paralyzed as a teenager and, a decade later, he required a prolonged hospitalization for a medical complication. He was on bedrest for the majority of his hospital stay, and once he was stable for discharge, Daniel felt weak and realized he had put on weight.
Due to quadriplegia, Daniel uses a powered wheelchair for his mobility, and he relies on his family for all of his grocery shopping and food preparation. He also uses public transportation or paratransport services to get around.
Daniel faced many challenges in the way of his goals of getting his strength back and dropping the unwanted weight. He did not want to inconvenience his family by asking them to prepare different foods, and getting to an adaptive gym that would have equipment appropriate for his disability could take over an hour in each direction with his transportation options.
Fitness facilities for the general public pose many problems for people with disabilities. It may be difficult to get around, as the space between machines is often too narrow to fit through with a walker or a wheelchair. It may be difficult to transfer onto machines either because the set up is difficult, or because the seats are too small. It’s also difficult to balance on the small seats if trunk control is impaired. Changing the weight pins can be difficult if someone has limited fine motor control. There are also limited cardio options for people to use sitting down, and even less for people to roll up to with a wheelchair. And there are not many free weights, or weight machines available for people who are too weak to work against gravity, or who have limited hand function but strong shoulders.
Adaptive gyms are a great option, however limited. Many people do not have local options, and often due to the unique service provided, these gyms can be costly for membership. Being in his twenties, it was important for Daniel to get stronger and feel more confident about his appearance. He wanted to go to college and go out with friends and date, like his peers. Around this time, Kristin McNealus, DPT was working as a physical therapist on an inpatient rehabilitation unit at the same hospital, and was frustrated at the lack of resources that were provided for patients upon discharge to continue strengthening. There was a wait list to get into outpatient therapy services, and then that therapy would only be two or three sessions per week. For many people, this is not enough to make significant changes quickly.
Insurance is often a challenge to get additional coverage, and it is difficulty to justify exercise sessions because insurance reimburses based on improvement of function. This makes it especially difficult for people who have had a
disability for a substantial amount of time to qualify for any therapy coverage.
Dr. McNealus started an exercise class, specifically geared toward the younger population who used wheelchairs, as an option to get stronger while meeting other people who face similar challenges. The class attracted people who were newly disabled to people who were in their wheelchair for nearly 40 years. Family and friends attended the workouts as well. The participants reported feeling more energy and less pain. Unfortunately, this could only benefit people who could get to the class. Transportation still posed an issue.
With a simple webcam, SCI Total Fitness was born, initially designed for people with spinal cord injuries to follow along with the classes online from the convenience of their homes. After three years, the business is expanding (and changing its name) to Every Body Fitness, offering exercise videos-on-demand for people with any physical limitation. There are cardiovascular workouts, strengthening routines, and adapted yoga videos, all available any time and as often as the user wants to workout. The videos are changed regularly so participants don’t get bored. Minimal equipment is recommended for the routines. Every Body Fitness is taking away all the excuses to not get enough exercise!
WHY EXERCISE IS NECESSARY
There are over 75 million Americans who report a limitation in mobility – that is one in seven people in our country!
Limited mobility increases the risk of an early onset of diabetes and heart disease, as well as brings its own risk of respiratory complications, urinary tract infections, and certain cancers. Exercise is necessary to ward off these medical issues. It is also important to exercise for weight management. Moving with excess weight puts added strain on muscles and joints and can lead to pain. It can also be the difference between independent mobility and requiring assistance, which can greatly impact one’s life.
Many people will say that they don’t work out because of pain, and it is true that you do not want to exercise if it will increase pain. However, there are many pains that are caused by muscular imbalances that can be addressed with exercise. Shoulder pain is common for wheelchair users. All the anterior musculature, like the pectoralis major and
minor (chest muscles) and the anterior deltoids and biceps will get stronger and tighter. They all attach to the shoulder blade, and pull it forward, which in turn makes the joint space of the shoulder smaller. This is the space where the rotator cuff tendons, nerves to the arms and blood vessels run. Making the joint space smaller causes more friction among these structures, leading to pain. Stretching these tight muscles and exercising the muscle that hold the shoulder blades back will contribute to less shoulder pain. A similar scenario can be used for low back pain.
The workout routines provided by Every Body Fitness can be performed sitting, standing, or sitting on a physioball. Participants can choose how the workout would challenge them, but still be safe. Weights can be used to increase further increase the intensity. There are tools to help track progress; if you can only complete 10 minutes without resting, aim to get your endurance up to 15 min-utes. If you can complete the workout with 1lb weights and have
energy to spare, you can increase that resistance to 2lbs.
There will also be a caregiver corner with workouts for caregivers, who often do not have time for themselves and have difficulty getting to a gym. They need to make their own health a priority, and need to stay strong for the physical demand of their jobs. Assisting another person with their mobility requires a great deal of strength, specifically in the core. It is important to do strengthening exercises beyond the work in order to prevent injuries, especially of the back and shoulders. If a caregiver is injured, every body is affected.
NUTRITIONAL GUIDANCE
Every Body Fitness also offers nutritional guidance, to assist with making healthier choices and holding participants accountable in order to reach their goals. There are no meal plans, allowing for long-term adherence and success.
Daniel was able to take advantage of the exercise and nutrition services, and in three months, he lost 35lbs! He reported that he felt stronger, and more balanced in his wheelchair. He also returned to college and has since completed his degree.
With the changes in the health care system, it is increasingly more important that people take control of their bodies and make healthier choices. Coverage for hospital stays and medications is decreasing every year. Although this can feel frustrating at times, prevention really feels better – everyone can agree that being sick or in pain never feels good. Exercise is the key to prevention, and truly is the best medicine!
Technology advances are allowing for more possibilities than ever before. People who used to feel isolated because of the difficulty they face with leaving home can now interact with millions of people on a daily basis. Every Body Fitness is one avenue for people with similar limitations to work together toward common fitness goals.
Dr. McNealus is available to problem-solve, find ways to make the workouts challenge any client, do so safely, and make suggestions for things that just are not working. Having easy access to a physical therapist is another benefit
to this program. There are live classes available as well, where people can also see how other people are doing the workouts, and see if this provides other options not explored.
Every Body Fitness is designed to empower individuals to take control of their well-being and improve quality of life, whether by increasing independence, improving performance, decreasing pain, or losing weight. It is an online health and wellness resource that can truly benefit people with disabilities and their caregivers.•
For more information and to preview a free workout video, please visit www.ebfitnessonline.com
DR. KRISTIN MCNEALUS, DPT: “EVERY BODY FITNESS IS TAKING AWAY ALL THE EXCUSES TO NOT GET ENOUGH EXERCISE!”
