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Physically active: Why and how as a weelchair user?

Rikke Damkjær Moen - Physiotherapist and Medical Manager
Rikke Damkjær Moen - Physiotherapist and Medical Manager
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Active wheelchair user

As a wheelchair user, you have many positive health benefits of staying physically active. It affects physiological functions in your body, as well as mental health, but most importantly, it helps you manage daily life.

How physically active do I need to be?

Weather you have paralysis, multiple sclerosis (MS), Cerebral palsy (CP) have suffered a stroke or have any other conditions causing motor impairment, it is better being a little physically active every day, than not being physically active at all. 

It doesn't mean you have to work out hard, be in a gym or participate in organised training. The most important thing you can do is find one or more activities you enjoy and want to do on a regular basis. When you have found your preferred activity, and perform it over time, it will end up being a habit - and being in-active is no longer a question.

When that is being said there are some physical activity recommendations you can follow. 

The World Health Organisation (WHO) has made some general recommendations about how physically active we all should be, and they can be followed by people both with and without a disability. 

They advise adults between 18-64 years to do:

  • at least 150 minutes of moderate-intensity aerobic physical activity throughout the week 
  • Muscle-strengthening activities should be done involving major muscle groups on 2 or more days a week. Ref. WHO

Looking at these recommendations may make you lose courage because it can seem impossible for you to reach these goals due to you disability limitation. However, exercising should not be considered all-or-nothing. In fact, a lot of people start small and gradually progress over time, so it’s fully possible to reach new fitness levels by doing less than recommended (AACPDM).

What type of health benefits will I experience from physical activity?

By being active you can expect many health benefits, both physically as well as mentally. Activity mobilises the big muscle groups and stimulates the cardiovascular system, meaning your heart rate increases and blood is pumping with increased speed around in your body. These mechanisms influence blood pressure, cholesterol levels and blood sugar. And during regular exercise you reduce the risk of developing lifestyle diseases such as diabetes and heart disease. 

Physical activity has also shown beneficial effects on sleep quality and energy level, as well as influencing self-esteem and mood. There is also evidence for lowering the risk of stress and depression when you are regularly physically active. 

The positive effects you get from physical activity have made many researchers phrase it as “the cheapest medicine available and without negative side effects.'' So yes, there are many good arguments for being regularly physically active when it comes to health benefits. But how does it influence your daily life?

Physical activity and daily life

If you increase your endurance through aerobic exercise and muscle strength through strength training,  this can absolutely influence your daily life. Here are some examples of improvements you can gain through an active lifestyle:

  • increased ability to push your wheelchair on your own 
  • increased ability to push your wheelchair over longer distances 
  • more energy to be social with friends and family
  • more energy to take initiative to be active
  • increased ability to handle daily routines (like dressing, transfer etc) on your own or with less assistance 
  • less muscle skeletal pain 
  • less painful spasms 
  • less gastrointestinal issues
  • etc. 

The list is not complementary, and benefits you experience will of course depend on your functional ability and how active or in-active you are before you start out. The outcome of physical activity will also be connected to what type of activity you are doing. You may have heard the sentence: “You become what you practice”. This means that it is a good idea to define what your personal goals are and adapt your exercise in accordance to this. For example, if your goal is: “I want to be able to push myself in my wheelchair to the shop 700 meters away from my home to independently do my shopping”, first of all you will need to break down the goal into intermediate goals and the exercise program should be adapted to meet these. An exercise program should contain muscle strength training in the arm muscles needed to create the force to push the wheelchair and aerobic interval training to increase endurance. The program should have a starting point, at a level where you experience mastery and have a progression over time when you increase strength and endurance.

Maybe you are more likely to have a goal like this example: “I want to increase my level of physical activity for overall quality of life”. You enjoy the company of other people and your body profit from warm water. Swimming may be a relevant activity. Many pools are fully accessible for wheelchair users, and many even have a hoist available if needed. Either you can join a group together with other people with disabilities or maybe you prefer to do the exercise in the pool together with a friend or family member. 

No matter what you choose to do or what your goal is, the most important thing is to find an activity you enjoy and would like to do over time.

Sometimes it can be a good idea to discuss possible activities available in the area where you live with your physiotherapist or other relevant people in the community who have the knowledge and overview of what is offered close to your home.

A physiotherapist can also assist you in adapting physical activities to fit your needs and limitations. Maybe you’ll be able to do your training in a typical training studio, as long as the exercise is adapted to you. 

Physical activity with CP

What type of activities can I do?

There are many different activities available for you, and luckily over the last few years there have been even more focus on making exercise activities accessible and adaptable for you with a disability.

Here are some examples of activities: 

  • Swimming
  • Wheelchair race
  • Racerunning
  • Cycling
  • Wheelchair basket
  • Horseriding 
  • Skiing 
  • Wheelchair dance
  • Climbing 
  • Volleyball 
  • Gymnastics
  • Etc. 

Activities for you having a severe disability

If you have a severe disability and are depending on assistance to move, you should know that physical activity is still possible and as important. Bicycling can be an opportunity, and bikes are available in many different adapted versions to be able to fit the individual person’s needs. Another option available in many countries is RaceRunner. This is a three-wheeled bike without pedals, where you are supported with a seat. The device rolls very easily and therefore possible to use even if you have limited independent function. RaceRunning is offered by many Clubs today around the world. 

Assistive devices to enhance physical activity at home can also be a solution. New knowledge has revealed that transition from a sitting to a standing position is light physical activity if you have a severe disability. This is great news, and many different alternative standing aids are available to be used for this matter. It can be a static standing device or a more dynamic standing device. Innowalk is a dynamic standing device that allows for movement of the legs and arms while you are weight-bearing. The movements of your legs are driven by a motor, allowing you to experience close to normal gait pattern. You can almost compare it with a cross-trainer, with the advantages of supporting your body safely in standing position. This means that even if you can’t move your legs on your own, you can get up and move. 

Fighting her way back up - How Stefanie recovers from TBI using the Innowalk.

Physical activity is possible

We all have somebody who inspire us, because they do something extraordinary, push their limits or show us possibilities. Johannes is an inspiration to me. He shows that despite his severe disability he has dreams he’s chasing. 

Johannes is wheelchair user with cerebral palsy, a young man who wants to be more independent,  study and live by himself in an apartment. To be able to reach his goal he needs to increase strength and endurance to cope with daily tasks. He shows that physical activity is possible, and it affects general health and makes a difference in the way he lives his daily life. See the interview with Johannes here: “I’m not made of porcelain!”

 

Who and what inspires you to be more physically active?

 

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Rikke Damkjær Moen - Physiotherapist and Medical Manager
Rikke Damkjær Moen - Physiotherapist and Medical Manager

Rikke Damkjær Moen brings many years of experience as clinical physiotherapist to the Made for Movement team. Her mission is to ensure that everybody, regardless of mobility problems, should be able to experience the joy and health benefits of physical activity. As our Medical Manager, Rikke is passionate about sharing knowledge so that individuals with special needs, families, and clinicians can discover the possibilities and solutions provided by Made for Movement.

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