Fitness is just as important—or even more important—for individuals with disabilities as for ablebodied individuals. Children and adults with physical, developmental, cognitive, or psychological disabilities often face challenges to achieving and maintaining fitness. There are many ways, however, for people with disabilities to improve their fitness, and almost any fitness activity can be adapted to their abilities.
Improving the health of people with disabilities is an important issue that is garnering increased global attention. Fitness is essential for the health of children and adults with disabilities and contributes to their ability to live active, full lives. Individuals with disabilities have greater health challenges and risks compared to people without disabilities. In addition to improving physical health and lowering health risks, physical fitness can improve or eliminate additional problems that often affect people with disabilities. These include emotional, psychological, and social issues and secondary health conditions such as fatigue, pain, muscle spasms, obesity, anxiety, and depression. Fitness can be extremely important for improving activities of daily living for people with disabilities. In addition to improving strength and stamina, fitness can increase independence, decrease social isolation, and improve an individual's ability to attend school, work, and participate in community activities.
Fitness recommendations are similar for individuals with and without disabilities. In addition to potential physical or cognitive challenges to fitness, however, people with disabilities may face prejudice and/or discrimination. The key interrelated components for overcoming fitness challenges for people with disabilities are inclusion, adaptation, and accessibility.
The U.S. Department of Health and Human Services' Office of Disease Prevention and Health Promotion provides the following physical activity guidelines for adults with disabilities:
If possible, children and adolescents with disabilities should try to meet the guidelines for their peers without disabilities:
In 2005, the U.S. Surgeon General issued a “Call to Action to Improve the Health and Wellness of Persons with Disabilities” with the following goals:
In 2014, the National Center on Health, Physical Activity and Disability, the American Association on Health and Disability, the Center on Disability at the Public Health Institute, and the President's Council on Fitness, Sports, and Nutrition launched the Commit to Inclusion global campaign. The goal of this campaign is to end the exclusion of people with disabilities from physical activity and associated areas and includes the use of guidelines and programming to empower them to follow active healthy lifestyles.
Inclusion requires overcoming barriers to fitness for people with disabilities, including structural or architectural barriers and organizational policies and practices, as well as discrimination and social attitudes, by providing:
To guarantee inclusiveness, adaptations for individuals with disabilities should be used only when necessary and on an individual basis. Examples of adaptive fitness equipment range from a simple cuff that compensates for a poor grip to a hand-cycle that allows cycling without the use of the legs. Adaptive equipment should be made available in fitness centers and other environments to which equipment cannot be readily transported. In addition to equipment, adaptations include:
Universal design goes beyond the requirements of the ADA, building codes, and local ordinances for the development of products and facilities that, to the greatest extent possible, are useable by all people without adaptation or specialized components. For example, family changing rooms benefit families as well as individuals with disabilities. Specific universal design resources are available for health clubs and fitness centers. Principles of universal design include:
Staff and volunteers have important roles in promoting fitness for individuals with disabilities. Because every disability is different and the same types of disabilities affect people differently, each person must be treated as an individual with rights and wishes that are respected at all times. Staff and volunteers must get to know each individual, and people must not be defined by their disabilities. Working with individuals with disabilities requires:
In addition, working with people who are visually impaired or blind requires:
When working with individuals with deafness, it is important to:
Working with people with cognitive impairments requires:
Approximately 56 million Americans live with a disability. Surveys indicate that only about 12% of adults with disabilities are physically active on a regular basis compared with 22% of adults without disabilities. Children and teens with disabilities are also more likely to be sedentary than their peers without disabilities. U.S. adults with disabilities have an obesity rate 57% higher than adults without disabilities, and the obesity rate for children with disabilities is 38% higher than for children without disabilities. People with disabilities also have higher rates of conditions associated with lack of physical activity and poor fitness, including depression, high blood pressure, high cholesterol, and diabetes, as well as lower rates of preventive health screenings and higher rates of smoking.
Fitness has numerous benefits for individuals with disabilities, as well as for everyone else. Adults with disabilities are at greater risk for obesity, depression, and chronic diseases and disorders; fitness lowers the risk of these and other conditions. In particular, fitness can help maintain and improve the ability to perform activities of daily living and help people with disabilities remain as independent as possible.
Fitness is critical to the daily lives of children with disabilities. Children with developmental disabilities tend to be less fit than other children, even though many such children have physical abilities that exceed their abilities in other areas. Research has shown that regular structured physical activity can:
Inclusive fitness opportunities for children with disabilities also benefit children without disabilities by:
Lack of motivation can be a major impediment to fitness for individuals with disabilities. Many people with disabilities have always lived sedentary lifestyles, and many fitness activities initially may be difficult or even unpleasant for them. Learning specific fitness skills and exercises can be harder and require much more time. Although children with developmental disabilities often have a much higher physical capacity than they realize, they may be hampered by slower learning and delayed skill development. Thus, children and adults with disabilities are often dependent on others for motivation, as well as for teaching, transportation, and other assistance.
The most important preparation for improving fitness with a disability is simply to start doing something, even if it is very low intensity. The goal is to stimulate movement first, eventually moving on to improving strength and endurance. People with movement limitations should consult their healthcare providers and possibly a physical therapist or adapted physical educator before undertaking a new fitness regimen. It is important to find appropriate one-onone assistance, if necessary, as well as a suitable environment. Environmental considerations may include lighting and temperature as well as accessibility. Music can be very helpful, because most people move better to music, and children with spasticity tend to move in response to rhythmic clues.
A variety of organizations, programs, initiatives, and resources are devoted to promoting fitness for children and adults with disabilities. The goals of the Inclusive Fitness Coalition include:
The Disability and Health Team at the National Center on Birth Defects and Developmental Disabilities of the Centers for Disease Control and Prevention (CDC) funds research and projects around the country for improving the health and fitness of people with disabilities. Organizations devoted to specific conditions and disabilities also actively promote fitness. For example, the American Diabetes Association's Stop Diabetes @ Work program provides employers with resources, including physical fitness, for helping their employees prevent or manage diabetes.
Examples of other fitness opportunities for individuals with disabilities include:
See also Paraplegic and quadriplegic athletes .
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American College of Sports Medicine (ACSM), 401 W. Michigan St., Indianapolis, IN, 46202-3233, (317) 6379200, Fax: (317) 634-7817, http://www.acsm.org .
American Diabetes Association, 2451 Crystal Dr., Ste. 900, Arlington, VA, 22202, (800) DIABETES (342-2383), AskADA@diabetes.org, http://www.diabetes.org .
BlazeSports America, 1670 Oakbrook Dr., Ste. 331, Norcross, GA, 30093, (404) 270-2000, Fax: (404) 270-2039, email@example.com, http://www.blazesports.org .
Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, (800) 232-4636, 30329-4027, http://www.cdc.gov .
Commit to Inclusion, (800) 900-8086, help@committo inclusion.org, http://committoinclusion.org .
Inclusive Fitness Coalition, Lakeshore Foundation, 4000 Ridgeway Dr., Birmingham, AL, 35209, (205) 313-7400, (800) 900-8086, http://incfit.org .
National Center on Health, Physical Activity, and Disability, 4000 Ridgeway Dr., Birmingham, AL, 35209, (800) 900-8086, Fax: (205) 313-7475, firstname.lastname@example.org, http://www.nchpad.org .
President's Council on Fitness, Sports and Nutrition, 1101 Wootton Pkwy., Ste. 560, Rockville, MD, 20852, (240) 276-9567, Fax: (240) 276-9860, email@example.com, https://www.fitness.gov .
Special Olympics, 1133 19th St. NW, Washington, DC, 20036-3604, (202) 628-3630, (800) 700-8585, Fax: (202) 824-0200, http://www.specialolympics.org .
Margaret Alic, PhD