QUEST Volume 10, Number 5, NOVEMBER/DECEMBER 2003

Keeping It Moving

by Kathy Wechsler

 

by Kathy Wechsler

People with disabilities make lots of adjustments so they can participate in everyday life. So why should the fact that youre a wheelchair user stop you from keeping your body in motion? In fact, wheelchair users have an even greater need for exercise.

The Oxycycle from Rolli-Moden provides a low-cost exercise solution.

"Keeping muscles strong and limber helps to maintain proper posture and positioning while sitting in a wheelchair," says Minetta Wallingford, an occupational therapist and fieldwork director at Rush University in Chicago.

Wallingford recommends that anyone wanting to begin an exercise regime first meet with his or her doctor to decide what restrictions need to be made in terms of intensity, duration and frequency.

"Some individuals with certain neuromuscular conditions have to be careful not to overfatigue their muscles by overdoing it," warns Wallingford, who works with MDAs clinic at Rush-Presbyterian-St. Lukes Medical Center in Chicago. If your body has had enough and needs to rest, you might show signs of lightheadedness, nausea, irregular heart rhythm, chest pains or shortness of breath. Wallingford urges you to contact your doctor immediately if such symptoms persist.

Each neuromuscular disease has different effects and leads to different degrees of muscle weakness. Depending on your level of function, you can find an exercise machine to meet your needs.

Active/Passive Machines

	Ex N Flex offers three adult models and one pediatric model.

Ex N Flex offers three models of exercise cycles for adult wheelchair users, says Karl Ablack, director of marketing at Ex N Flex International, which specializes in passive/active activity-based therapy.

"Ex N Flex is designed for individuals who have very little active functioning," Ablack says. Ranging in price from $1,695 to $2,095, all three models work on the same premise, which involves a passive/active component. In other words, as the person tires, the computer processor senses a change in the amount of movement and force put forth, and the interactive motor picks up the difference.

New to Ex N Flex is the pediatric model for ages 3 to 8. This version of the passive/active machine is estimated at $800.

"If [users] were able to help assist the motion with some active component, then they would get a greater amount of circulation benefits than they would get if the machine was doing all the work," Ablack says.

Active or Passive: Take Your Pick

David Johnson of Sykesville, Md., uses an Active/Passive trainer, manufactured by Tzora and distributed in the United States by No Boundaries.

People with neuromuscular diseases need to exercise to maintain strength and flexibility, increase circulation, improve balance and coordination, strengthen the heart and lungs, and enhance fitness and well-being, Wallingford explains. Maintaining strength and flexibility for as long as possible helps wheelchair users stay more independent, or at least be able to assist with transfers and other activities for a longer time, she says.

No Boundaries has an extensive line of active/passive trainers that can be used from your chair or scooter, says Michael Federico, rehab manager at No Boundaries. With prices ranging from $895 to $2,645, these cycles have 10 speeds and 10 levels of resistance, and can be used with or without a motor. You decide if you want it to be active or passive, depending on your level of strength and coordination.

Another model, the Saratoga Spirit 630, manufactured by Rand-Scot, allows you to roll into the machine, place your hands and feet on the pedals, and use your upper body to drive your lower body.

For those whod like a simpler exercise machine, the Oxycycle is a one-speed cycling device available from Rolli-Moden for $179. With three levels of resistance, the Oxycycle can be used for either upper or lower body.

Active Only

"Even small amounts of exercise can be beneficial in the training of muscles in their function," says John Doty, chairman of Battle Creek Equipment. "The Pedlar lightweight workout exerciser does provide a way for people who are wheelchair bound (depending on their condition) to get a small amount of beneficial exercise."

The Pedlar is geared to people who may find it difficult or impossible to mount a conventional exercise bicycle. After placing the unit directly in front of your wheelchair, you use the foot straps to pedal your legs, actively working your lower body. Or put it on a tabletop to exercise your upper body. You can easily adjust the amount of resistance you desire as you improve. This cycling device sells for approximately $50.

"Medical professionals recommend exercise that is going to stimulate the heart and the lungs and make them more active," Doty says. All people need exercise, but the Pedlar was made for wheelchair users who may have fewer opportunities to use their muscles.

According to Doty, walking, cycling and swimming are three important types of cardiovascular exercise, but since wheelchair users often have difficulty with walking, "the Pedlar lightweight exerciser can provide some cycling exercise."

Passive Only

Passive exercise also has benefits, says Ablack of Ex N Flex, though "they may not be to the same level as if youre able to actively work."

The pumping action of the legs does wonders for circulation, may help with edema (an abnormal accumulation of fluid in tissues) in feet or legs, and is an excellent range-of-motion exercise as well as a great way to loosen tendons, ligaments and muscles.

"My main motivation [for passive exercise] was the condition of my feet and calves, trying to do something to improve circulation and help avoid the toxins," David Johnson of Sykesville, Md., says.

Johnson, who has ALS and relies on a power wheelchair, uses the passive component of an active/passive trainer from No Boundaries.

Johnson, 59, says, "Any piece of exercise equipment that allows you to move without great effort, develop or go through the range of motions for your limbs, has got to be healthy if youre stationary a lot, which wheelchair users are." Loss of strength is inevitable as his condition progresses, but Johnson is doing his best to take control of his mobility.

"Thats the beauty of passive trainers," Johnson says. "Youre getting the movement, but youre not getting it at the cost of a lot of muscle strength or energy, which you may not have."

More Machines

Another rehabilitation device is the StimMaster Galaxy from Electrologic of America, specially designed for people with partial or no sensation in their legs. This technology allows people with spinal cord injuries or neuromuscular diseases, who may have little or no voluntary leg movement, to actively pedal a stationary bicycle with the power of their own muscles.

The StimMaster uses functional electrical stimulation, in which safe electrical currents controlled by a computer pass through electrodes on the skin, initiating muscle contractions in the paralyzed lower extremities. Priced at $14,641, which includes a years supply of electrodes, the StimMaster makes it possible for anyone to increase circulation and range of motion.

Now Were Getting Somewhere

	The EZ Chair from Premier Designs combines exercise with mobility.

For those who dont want to stay in one place, the stable three-wheel design of the Heritage, from Freedom Concepts, offers exercise and maneuverability. The bike has a low seat and a pull-away handlebar system for easy transferring.

You can choose from seven speeds, for pedaling ranging from easy to difficult. Priced from $2,610 to $3,200 depending on customized options, the bike is designed so that people with limited range of motion can place their legs further forward.

Another device that allows for movement is the EZ Chair from Premier Designs, which combines pedaling motion and independent mobility. Available for $2,395, the EZ Chair exercises muscles with much less effort than standing, walking or using a walker, providing an increased travel range without fatigue. The EZ Chair is easier to propel than a conventional wheelchair, and its lightweight and folds up to fit into a vehicle.

Theres More to Exercise Than Cycles

"Each person is an individual and needs to consult with their doctor, or work with a therapist in conjunction with their doctor to identify what form of exercise is best for that individual," Wallingford says.

The Endorphin Corporations cycles easily convert from floor to table.

Wallingford recommends range-of-motion exercises with or without weights, depending on your capabilities. Resistance bands such as Theraband come in different colors to indicate the resistance level and can be found at your local sporting goods store or online.

Some creative alternatives to traditional exercise are chair yoga, chair dancing and chair tai chi. You can find books and videos on these fun forms of exercise or check them out online.

Even though theres a lot of exercise equipment out there, Wallingford admits that sometimes its easier to maintain strength and endurance through more enjoyable activities. "As an occupational therapist, I find that activity such as gardening and painting are often more meaningful than traditional exercise and provide many of the same benefits," she says.

Before You Buy

"Its too bad when people get discouraged" by exercise, Doty says. You dont want to make your workout too challenging or get muscular pain from overexertion. Instead, Doty recommends that you slowly increase the resistance and exercise periods as your ability improves.

Johnson recommends knowing your exercise needs and choosing the best value from the products available. You need to do some research and find out which machines are covered by your insurance. The active/passive trainers can be used by a healthy person as well, which increases the value and function.

If you cant afford for the accessible equipment to come to you, you can always go to the accessible equipment.

There are more than 2,000 YMCA branches across the country that offer custom programs for special groups of people, including those who use wheelchairs. More and more gyms are also targeting this market by providing accessible exercise equipment. Do some calling around, and look for a wheelchair-friendly gym or community center in your area.

 

Exercise Cycle Resources

Battle Creek Equipment
Pedlar Light Workout Exerciser
(800) 253-0854
www.medwing.com

Electrologic of America
StimMaster Galaxy
(800) 758-3460
www.electrologic.com

Endorphin Corporation
Active/passive cycles
(800) 940-9844
www.endorphin.net

Ex N Flex International
Passive/active activity-based therapy
(888) 298-9922
www.exnflex.com

Freedom Concepts
3-wheel bikes
(800) 661-9915
www.freedomconcepts.com

Jodi Stoloves Chair Dancing
(800) 551-4386
www.chairdancing.com

No Boundaries
Active/passive trainers
(800) 926-8637
www.noboundaries.tv

North Coast Medical
Strengthening putty, pedal and hand exercisers, therapy balls
(800) 235-7054
www.ncmedical.com

Premier Designs
EZ Chair
(800) 438-5630
www.ezchair.com

Quality Fitness Products
Resistance bars, resistance bands and tubes
(708) 602-1386
www.theresistancebar.com

Rand-Scot
Saratoga Cycles
(800) 467-7967
www.randscot.com

Rolli Moden
Oxycycle
(800) 707-2395

Sportaid
Active cycles
(800) 743-7203
www.sportaid.com

Tai Chi Center
ROM dance program
(608) 280-9730
www.taichihealth.com/indexrom.html

Theracycle
Active/passive cycle
(800) 367-6712
www.theracycle.com

 

iBOT GETS FDA NOD

After a long and complicated series of safety tests, the INDEPENDENCE iBOT Mobility System, covered in the July-August issue of Quest, was approved by the Food and Drug Administration in August. Introduced by Independence Technology, a Johnson & Johnson company, the iBOT Mobility System is known for its ability to climb stairs while the users seat remains level. It can also elevate the user to move around at eye level and tackle all sorts of rough terrain.

The iBOT Mobility System should be available in certain clinics across the country for $29,000, and a prescription is needed. For more information or to see if the iBOT is right for you, visit www.independencenow.com.