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Exercise

wheelchair exercise for the elderly

Nursing home residents are physically frail, and possibly approaching the end of their lives. So what’s the point of exercise, especially for someone in a wheelchair?  Too often, I believe, professionals and staff in long-term care environments accept this defeatist attitude.

Unfortunately, this then passes on to the resident and becomes a self-fulfilling prophecy: Long-term care residents in wheelchairs avoid exercise and decline further.

Lack of activity leads to joint degeneration, heart problems, stroke, congestive heart failure, diabetes, and a range of other chronic medical conditions including blood clots and painful, persistent pressure sores.

On the other hand, study after study lately has shown that exercise, even by frail elders, improves cardiovascular health, cognition, and overall quality of life. The Centers for Disease Control and Prevention says that exercise benefits people with arthritis by reducing pain, delaying disability, and improving mobility, function, and mood. Other studies have shown that strength training was as effective as medication in reducing depression in older adults. It can help improve breathing for residents with asthma and emphysema, while burning fat and calories, lowering cholesterol, and helping to alleviate symptoms of osteoporosis, osteoarthritis, arthritis, bursitis, tendonitis, fibro/polymyalgia, and neuropathy.

 

Obviously, nursing home residents in wheelchairs are as prone as anyone to sedentary living. One of the most common consequences of using a wheelchair is weight gain, resulting from a more sedentary lifestyle. Yet even for this population, physical exercise is essential for increasing blood circulation, spine stability, posture, and flexibility.

Exercise generates endorphins, body awareness, and muscle strength, while relieving stress and enhancing self-esteem. What’s more, exercise improves a patient’s ability to achieve a deeper and more restful sleep, which is essential for preserving emotional and physical health.

For some residents, medical conditions may exclude certain chair exercises. Also, for those just starting out their exercise regimens, it is imperative to discuss any exercise plan with a physician. Yet in my years as a rehabilitation specialist caring for individuals recovering from strokes and traumatic brain injury, and now as a supplier of wheelchairs to people needing them, I have concluded that, regardless of the resident’s age, physical condition, or whether or not the person exercised in the past, there are a number of techniques for helping a chair-bound individual overcome mobility issues.

Exercises for Wheelchair Users

Any type of exercise will benefit wheelchair-bound residents’ health, but in general, clinicians should aim to incorporate these important types of exercise into their routines:

Basic Leg Crosses — These are good options for seniors who have at least mid-range leg strength. The goal is to simply get the muscles working.

  • Have the patient carefully kick one leg out, cross the legs, and then alternate. Repeat this task a number of times. Finish up the exercises with ankle circles.

Cardiovascular – A series of seated repetitive movements will raise the patient’s heart rate and help the person burn calories.

  • Wrap a lightweight resistance band under the wheel chair and have the resident perform resistance exercises, such as chest presses, for a count of one second up and two seconds down. Have the person try several different exercises to start, with 20 to 30 reps per exercise, and gradually increase the number of exercises, reps, and total workout time as endurance improves.
  • Have the wheelchair bound resident punch the air with or without hand weights.

Strength Training – If the resident has limited mobility in his or her legs, focus on building upper body strength.

  • Have the person sit straight in the wheelchair and lift both arms toward the ceiling and then slowly bring them back down. Have them alternate the movement by lifting up one arm while the other is stretched out toward the ground, similar to picking apples off a tree. Repeat these movements 8 times each.
  • Have the person do shoulder presses, bicep curls, and triceps extensions using light weights. Aim for 2 to 3 sets of 8 to 12 repetitions for each exercise, adding weight and more exercises as strength improves.
  • Instead of weights, resistance bands can be attached to furniture, a doorknob, or the wheelchair. They can be used for pull-downs, shoulder rotations, and arm and leg-extensions.

Flexibility is important for enhancing range of motion, preventing injury, and reducing pain and stiffness. Even with limited mobility in the legs, a resident can delay further muscle atrophy by stretching. Stretching can be performed by having the resident use the floor or their body weight to provide resistance to the muscle group being stretched. An occupational therapist should be on hand to help them target muscles and joints and to stretch beyond their usual range of motion.

 

  • Chair Chi is an exercise program based on the principals of Tai Chi and Qi Gong, tailored to people in long-term care environments. Requiring no special equipment, the movements are circular and never forced; the muscles are relaxed rather than tensed; and the joints are not fully extended or bent. Motion remains mostly slow – the slower, the better. Working against the body’s weight provides resistance as great as some weight lifting, with zero impact.

 

  • Yoga poses can be modified or adapted to the resident’s physical condition, weight, age, medical condition, and any injury or disability. Wheelchair yoga is an exceptional option for residents with chronic obstructive pulmonary disease or multiple sclerosis.

 

Exercising is just as important, and perhaps even more important, for wheelchair users as for able-bodied long-term care residents. Despite mobility restrictions, wheelchair users can find exercise a rewarding way of maintaining good health and mental ability. As a group activity, wheelchair exercise also can serve as a social activity in the weekly schedule.

 

Better flexibility and range of motion, greater strength and energy, improved breathing capacity, relief from pain, increased tranquility—who would want to deny any of that to a person just because he or she is sitting in a wheelchair?

 

About the Author

Craig Hood is executive vice president of Allegro Medical, a supplier of home medical supplies and equipment. He has worked as a rehabilitation specialist caring for individuals recovering from strokes and traumatic brain injury. He formed Allegro Medical to supply products for post-acute care and the treatment of chronic conditions.

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Safe, inexpensive, portable. Those are just a few reasons why colored resistance bands are popular for exercise, fitness goals, and rehabilitation.  You may have tried resistance bands yourself or have had them recommended to you by a physical therapist or personal trainer.

What are these bands and how do they work?

The bands are made from various thicknesses and strengths of high-quality latex and non-latex material.  The resistance comes as you try to stretch and lengthen the band itself.

These bands can offer a safer way to stretch out the muscles and help reestablish a normal range of motion (ROM)1. The bands use positive resistance to shorten the muscle during a curl and negative resistance to lengthen the same muscle when fighting the resistance back to start.2 Resistance training also offers a less costly option to weight training as the bands are relatively inexpensive. The small, compact size makes them perfect for traveling too.  Other health and fitness benefits of a band-based progressive resistance program include increasing bone strength, building muscles boosting stamina, and improving sleep efficiency3.

At  AllegroMedical.com, our top selling brands include Thera-Band®  Cando® and REP Band which all come in a variety of lengths and colors. Most are available in 6 yards and 50 yards strips which can be cut to the necessary length.  Some brands even make a loop band. These loops are great for lower body adductor and abductor exercises.

But how do you choose from so many colors and thicknesses and determine which is the best for your needs?

One of the most popular brands is Thera-Band  that offers the following colors and resistance levels:

Color Resistance Muscle Group
Yellow Thin/Easy/X-Light Shoulders and shins
Red Light Biceps and triceps
Green Medium Legs, Chest & Back
Blue Heavy Legs, Chest & Back*
Black X-Heavy Legs, Chest & Back*

*Great for working out with someone else

The Cando Band varies slightly as they carry a wider range:

Color Resistance
Tan XX-Light
Yellow X-Light
Red Light
Green Medium
Blue Heavy
Black X-Heavy
Silver XX-Heavy
Gold XXX-Heavy

 

Finally, if you come across a band that doesn’t follow one of these models, one of the easiest ways to figure out the resistance is the price. The thicker the band is; generally the higher the price will be.

Getting Started with Simple Resistance Band Exercises

To begin, select a color according to the charts above.  You know you have the correct color when you perform two to three sets of 10 -15 repetitions using slow controlled motions while gaining mild fatigue on the last set.  Once you can do all sets with no fatigue3, you are ready to move up to the next resistance – or color – level.  Below are a few simple exercises to help you get started.

Resistance Band Squats4

  1. Start by stepping on the resistance band with both feet shoulder width apart.
  2. Hold the resistance band at shoulder level with both hands. Start into a full squat while holding the band at shoulder height.
  3.  Return to the starting position and repeat.

Biceps Curls with Resistance Band5

  1. Stand with feet shoulder width apart, knees slightly bent, and at a staggered stance.
  2. Step onto middle of tubing with back foot or both feet.
  3. Start position: Grasp ends with underhand grip (palms facing forward) with arms hanging down at sides. Elbows should be close to sides.
  4. Flex at the elbows and curl band up to approximately shoulder level. Keep elbows close to sides throughout movement
  5. Return to start position.
  6. Remember to keep back and head straight in a neutral position throughout movement. Shoulders should be stabilized by squeezing shoulder blades together slightly – only the elbow joint should be moving.

Triceps Extension with Resistance Band6

  1. Start by holding the tubing in one hand and placing that hand behind your back.
  2. Now grab the other end of the band with the arm that is over your head.
  3. Extend the top elbow until your arm is fully extended.
  4. Return to the starting position and repeat for the prescribed repetitions.

Using resistance bands is an affordable way to your fitness or rehabilitation goals.

 

1“Rogue Fitness Equipment.” Rogue Fitness. N.p., n.d. Web. 06 Mar. 2013.

2 “Thera-Band® Exercise Bands.” Thera-Band. N.p., n.d. Web. 11 Mar. 2013.

3Resistance Training – Beginners.” Better Health Channel. N.p., n.d. Web. 07 Mar. 2013.
4-6 “Resistance Band Exercises.” Resistance Band Exercises. N.p., n.d. Web. 07 Mar. 2013.

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