THE FITNESS PRIORITY BY KRISTIN MCNEALUS, DPT, MBA, ATP
Exercise can also lower risk for complications associated specifically with spinal cord injury and spina bifida, such as the development of some forms of cancer, respiratory illness, and UTI.
Are you an Exceptional Parent of a child with a spinal cord injury, spina bifida, or cerebral palsy? It is important to encourage your child to get a sufficient amount of exercise! Even if it is difficult, it is important to get them to adopt healthy habits to last a lifetime! Just because your child does not move like you do, does not mean that it is any less important to stay fit.
Why is it so important to exercise with paralysis? Whether your child relies on a manual or powered wheelchair, or even if s/he can do some walking, the amount of daily mobility is less than an able-bodied person who can use all of their muscles, and this increases the risk for all health complications associated with a sedentary lifestyle to be diagnosed earlier in life! These illnesses include coronary heart disease, hypertension, diabetes, impaired glucose tolerance, abnormal lipid profile. It is important to add exercise early in life to limit these conditions.
Exercise can also lower risk for complications associated specifically with spinal cord injury and spina bifida, such as the development of some forms of cancer, respiratory illness, and UTI. Exercise can also decrease feelings of anxiety or stress; it can manage pain with less reliance on pain medications. And it can decrease constipation and improve a bowel program.
Exercise for children with cerebral palsy can help maintain range of the joints and help manage tone.
There is a perception that exercise will contribute to a faster deterioration of shoulder health. This is not true. Overuse shoulder issues are greatly attributed to an imbalance of strength. Due to repetitive action and seated posture, the anterior shoulder musculature gets stronger and shorter, pulling the scapulae into an anterior tilt. The posterior musculature is put into a lengthened position, and is weakened. Adding a stretching and strengthening program to combat this will ward off shoulder pain.
Exercise can improve muscle strength, endurance, self-image, and ability to fall asleep and sleep well. And the goal is to reduce hospitalizations! Ultimately improve your child’s quality of life and maintain independence.
Yes, there are things to be cautious about when your exercises. Exercise does put the body into a state of stress; it’s a good stress, but stress nonetheless. So there are some things that you want to consider and monitor. Is your child at risk for autonomic dysreflexia? Or orthostatic hypotension? Know what his or her symptoms are for either of these, what your signs are, and make sure they know when to ask for help!
If your child has trouble with heat, can’t sweat, think about how you are going to keep your body temperature down. Consider air conditioned facilities, ice water, shady parks, etc.
Watch your child’s skin! I am sure you already are diligent about this, but have your child check his/her skin after every workout. Your child may fall, especially while playing sports. Coaches and other players would be able to give guidance for appropriate straps to secure your child into any wheelchair.
So now that you know exercise is important, what can you encourage your child to do to get this physical activity? There are many wheelchair sports! They may enjoy team sports like basketball or rugby, they may enjoy a team sport that races individually, like track or swimming. Tennis, fencing, cycling. There are sports for kids who use powered wheelchairs as well, like power soccer. They may not get as much physical activity, but the social benefits cannot be overstated. Learning to participate in a team will have social and emotional benefit. And your child may be motivated to work on their physical well-being to maximize their performance during games. Really, there are so many options that they can keep trying different sports until they find one that they really enjoy!
Participating in physical activity also has a tendency to encourage better eating habits. Children with spina bifida or spinal cord injury need to be aware of maintaining a healthy weight; gaining weight beyond what is normal for height could decrease the ability to transfer independently. Children with cerebral palsy may have difficulty keeping weight on. Exercise may help stimulate appetite if your child has difficulty consuming enough calories.
Are you convinced? Look for local events and organizations that often allow children to try various sports before they are committed to a team. In Southern California, we have a rehabilitation hospital that sponsors two events like this every year for water sports, and another for land sports. There is also a local college that has Saturday open gym, with different sports per week. If you cannot find any resources like this, check with your local Children’s Hospital, or rehabilitation hospital. If there are any recreational therapists on staff, they would be the person who would know the options in your area. Another option to look into is the Challenged Athletes Foundation (www.challengedathletes.org). They have clinics and camps that may be interesting for your child, and that could be a great place to start.•
THE FITNESS PRIORITY
Kristin McNealus, DPT, MBA, ATP received her Masters in Physical Therapy from Boston University then went on to earn her Doctorate in Physical Therapy from MGH Institute of Health Professions. She has been a staff physical therapist on inpatient rehabilitation for people with spinal cord injuries at a number of hospitals in Southern California, as well as Director of a community adaptive gym for people with neurological injuries. She is a member of the International Network Spinal Cord Injury Physiotherapists, and has contributed to the APTA Guidelines for Exercising with a SCI. She has completed 3 marathons, and 25 triathlons, including the Ironman! SCI Total Fitness is designed to promote health and wellness for people with physical disabilities.