12 Inclusive Recreation, Fitness, and Physical Activity Chapter 12 chapter 12 Inclusive Recreation, Fitness, and Physical Activity Inclusive Recreation, Fitness, and Physical Activity Author name here for Edited books Sheila Swann-Guerrero and Amy Rauworth

A community that excludes even one of its members is no community at all. –Dan Wilkins

Physical Activity Importance of physical activity Required amounts Improves health and quality of life Physical and psychological benefits Prevention of obesity and disease Secondary conditions Required amounts U.S. Surgeon General 2008 Physical Activity Guidelines for Americans

Inclusive Fitness Inclusive Fitness Coalition: Includes all community members The right to participate A shared community value Self-advocacy is critical

Defining Disability to Promote Inclusive Fitness Definitions vary by purpose A social model perspective The loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers Views magnitude of disability in relation to person’s interaction with societal attitudes and environment.

Physical Activity Participation and Barriers Barriers are so extensive that they discourage participation Major barriers Pain, fatigue, deconditioning Inaccessible recreation and fitness environments (see figure 12.1) Knowledge and attitude Programmatic factors The proactive professional

Figure 12.1a Figure 12.1a Before the fitness center makeover and . . .

Figure 12.1b Figure 12.1b . . . after the makeover, with access for all.

The ICF Provides a framework for describing health and health related states. Considers these factors in participants: Body functions and structures Activities and participation Interaction between environmental factors and personal factors Programmatic uses Needs assessment Outcome evaluation

Strategies for Developing Fitness Programs Fostering motivations Motivational interviewing Focuses on motivation, not information Considerations for assisting people with disabilities. Communication Etiquette Behavior (continued)

Strategies for Developing Fitness Programs (continued) Considerations for assisting others: Universal approach Client centered Pain Fatigue

Basics of Exercise and Disability U.S. Department of Health and Senior Services physical activity guidelines Adults: 2.5 hours of moderate physical activity a week. Kids: 1 hour or more of moderate physical activity per day. (continued)

Basics of Exercise and Disability (continued) Adults with disabilities who are able: 2.5 hours of moderate activity per week OR 1.25 hours of vigorous activity per week Muscle strengthening activities 2+ days per week When unable, adapt to fitness abilities and avoid inactivity.

Designing Plans for People with Disabilities Assess the participants’ fitness and ability. Learn precautions and contraindications. Medical history and health status Medications Blood pressure Check for restricted range of motion. Consider emotional and behavioral status. Keep in mind impact of ability. (continued)

Designing Plans (continued) Monitor rating of perceived exertion Clothing, hydration, sickness Adhere to typical stages of exercise Stop immediately if abnormal symptoms: Dizziness Nausea Clammy hands Shortness of breath

Components of a Comprehensive Exercise Program Cardiorespiratory endurance Muscular strength and endurance Flexibility Body composition Balance Pulmonary function Provide equipment that allows adjustments to be made to allow access to everyone who comes to the fitness center.

Accessible Environments Usable equipment Swing-away or removable seating Velcro straps or additional supports Ensure use is safe Body positioning Uncontrolled movements (continued)

Accessible Environments (continued) Potential usefulness Can the participant perform at least one repetition of the exercise? Alternative equipment and activities Elastic bands, wrist or ankle weights Aquatics, yoga, tai chi, gardening Choosing the environment Home vs. gym Fee considerations Aquatic vs. land environment

Assessments and Activities Graded exercise testing VO2max Maximal vs. peak oxygen consumption Muscular strength and endurance One-repetition max Number of reps performed in a minute Number of submax reps performed until fatigue (continued) .

Assessments and Activities (continued) Body composition BMI to assess overweight or obesity BMI may not be valid indicator for SCI Flexibility (range of motion) Goniometers and electrometers Tape measures and sit-and-reach Balance assessment Seated and standing Static and dynamic

Summary Everyone benefits from physical activity. People with disabilities encounter barriers that often prevent full participation. These barriers affect their right to a healthy lifestyle. Recreation facilities and fitness professionals have an opportunity to address this inequity.