Monday, December 5, 2011

Accessible Gyms and Adaptive Fitness - A Ticket to Greater Adventure

While recovering from a serious illness fifteen years ago, I started to work out at my local gym. I've been working out ever since because it feels good and keeps me in reasonable shape. A friend helped me get started and now as my partner supports my regular routine. (A tip-o-the-laptop to you Meb!) Over time, I've come to realize that fitness habits of stretching, cardio, nautilus weight training, and that rewarding sauna afterwards not only contribute to my greater health, but support my outdoor activities, from yard work to long bike rides.

The benefits of good health and fitness can't be underestimated yet it seems that our society is increasingly losing its grip on how to maintain healthy habits. While there are many known factors for this sad trend, people with disabilities have significant risk for poorer health according to a recent report. You don't have to be a serious athlete to benefit from exercise. Those benefits can be as simple as feeling better, making more social connections, gaining strength, endurance, resilience, and self confidence.
Over the years I've met people with disabilities working out, but not as many or as frequently as I expect. My local YMCA is an accessible facility, with an elevator, accessible locker room, swimming pool, jacuzzi, and some disability specific programs. Of its 5300 members, about 100 are known to have disabilities, a staff member tells me. There is a "special needs" swim takes place four times a week and is very popular. I'm sure it is safe to to presume there are others with less obvious impairments using the facilities. It sounds like the Y has put in good effort to be disability friendly and create accessible fitness opportunities, but is it enough?

I haven't found a clearly identified area designed for wheelchair access or indication that equipment can be easily adjusted to accommodate wheelchairs. I don't see any therapeutically supportive equipment, just the standard training apparatus. None of the instructional charts include images of people with disabilities using equipment. Such equipment does exist - but is most likely found in therapeutic settings, Paralympic training centers, and at the homes of people who can invest in it for themselves. What about community fitness centers?

I'd like to see all YMCAs take after the South Shore YMCA in Quincy, which pro-actively offers state-of-the-art accessible cardio and strength training equipment and a partnership program that matches individuals with disabilities with a strength trainer and workout buddy. Inside that facility, you might see eight people in wheelchairs working out at any given time. Even a single fitness center can offer an integrated setting that appeals to people with disabilities - Fit Together in Hadley is run by ServiceNet to address the needs of people with developmental disabilities and emotional challenges and is open to everyone. TheraFit Gym in Maryland
offers health building to people with severe physical and cognitive impairments. Pro-active accessible gyms are out there!

An on-line search reveals a portable exercise machine called Wheelchair Gym that can be used by seniors, people with spinal cord injury, cerebral palsy, multiple sclerosis, and other disabilities for easier access to upper body exercise. The Theracycle is designed to help users improve their leg function. The Quadraciser is a motorized therapy system that helps passive users simulate walking movement - upright, lying down, or in between - and active users to improve limb mobility and strength.  Equalizer Exercise Machines make single purpose equipment and stations designed to accommodate multiple users with and without disabilities.

Choices can be made when purchasing fitness machines and modifications can be made to conventional equipment for better access. Machines designed with seats that swing out and allow for wheelchair users to access the machines in the same way as ambulatory users is a great example of universal design. Extra belts can be added to some conventional machines to prevent falling off for those with compromised function that would impair balance or stability.

According to Disaboom, many gyms often do not have staff trained specifically to work with people with disabilities, who represent a wide array of function and limitation not conventionally taught in fitness trainer programs, although this is beginning to change. Some fitness training certificate programs are including disability exercise training now. Physical therapists are also ideal experts who can help make modifications to exercise routines. Personal care attendants can assist with transfers and engage weights to a comfortable starting point. Adaptive fitness can include a wide variety of practices including yoga, tai chi and Pilates, but how many fitness centers make these popular classes fully accessible, welcome individuals with disabilities, and integrate them with appropriate expertise?

Some commercial fitness chains have begun to address accessibility on a broad scale. Gold's Gym consults with people with disabilities to improve their gyms and 24 Hour Fitness provides elevators (not usually required on buildings 2 stories tall) and allows workout support companions free admission. All this and yet a quick look at their websites reveals nothing about accessibility! 24 Hour Fitness also supports Paralympic athletes heading to London in 2012 by providing state-of-the-art equipment and expertise at training centers in Colorado, California and New York.

Paralympic athletes have long been paving the way for others with disabilities to improve their fitness by modeling what is possible and striving for improvement. This has inspired a better response from the fitness industry and more individuals with disabilities to work out and compete. Yet this is only one aspect of a whole spectrum of possibilities. More accessible community gyms would serve more of us ordinary mortals who really need the health benefits. Thankfully there is a combination community/medical option available at Healthtrax Fitness and Wellness Centers which team up with local hospitals to provide exceptional fitness support and expertise for people of all abilities. There are 17 Healthtrax locations in the eastern U.S. including N. Dartmouth, Hanover, East Longmeadow and West Springfield in Massachusetts.

I would love to know what the experts have to say about how to support and improve the relative fitness of those who cannot exercise, something I've been wondering about for awhile. It seems that some of the benefits of exercise (circulation, detoxification, accelerated heart rate, muscle stimulation, and endorphin release) can be gained through the use of saunas, steam rooms, and hot tubs; bodywork; and the experience of movement and speed. The spa elements of fitness centers should definitely be accessible to all.

I particularly like outdoor fitness trails, because I feel more alive in an a natural setting. Also known as parcourses, they are located within a park and use loop trails with regularly placed exercise stations that encourage basic calisthenics. Parcourses don't seem to exist where I live but I recently used one in Ann Arbor and loved it. Such fitness trails were popular in the 1970s but faded with the advent of commercial gyms. You can still find them around and there has been a mini-revival in some areas with more contemporary and durable installations. There are some outdoor exercise stations in Massachusetts parks that include instructions for people in wheelchairs - with images - on using the exercise station, and the range of equipment offers wheelchair access. I've seen these at Piers Park in Boston, Middlesex Fells Reservation in Stoneham (next to the Flynn Rink) and Breakheart Reservation in Saugus, and I"m sure there are others -  remnants of earlier days but still quite usable.

You may have to dig to find accessible fitness opportunities in your area, and like everyone else who aspires to better health, find ways to keep at it to reap the benefits. I highly recommend creating a routine with a friend or family member. You'll stay in shape for cycling, kayaking, skiing and any other outdoor activities you already do or would like to try. Improving your fitness supports your comfort level and helps you stay out longer, go farther, and achieve new goals!

If you need more specific information to get started, check out The National Center on Physical Activity and Disabilities web page on Exercise and Fitness! They have great articles on a variety of topics and a web-based personal training program that promotes your fitness training with ordinary items wherever you are!

Now is a great time to get a fitness routine started - at home, your local fitness center or on the trail!


Phil Dzialo said...

The YMCA has been determined by numerous courts to be a "public accommodation" under Title III, the America With Disabilities Act. Access to all programs, to equipment, facilities, activites, child care, etc must be accessible and accommodate the needs of the disabled, regardless of the level and the need and the severity of the disability. YMCA's must in all cases held to this standard and not allowed any excuse. Disability swim times, in my mind, are quite discriminatory and should be at times where all people are included and integrated. This is not the 1980's? Why should there be a separate swim time for disabled people? Simply wrong and contributes to stignatization of the disabled.

Marcy Marchello said...

Thanks for your comment Phil! The swim I mentioned at the Y is open to everyone - I'm not sure I had the actual name of it right FYI, though it is a particular designated time for people with disabilities to attend. I might have slightly misrepresented it and it is probable that it is not the only time people with disabilities are allowed in the pool. I'll have to check into that further. I do agree that integration is the way to go!

Phil Dzialo said...

Thanks for the quick reply, Marcy. I guess what I meant to say and believe deeply is that there should be swim time for all...period. Any mention of a swim time for the disabled is fundamentally flawed and stigmatizes a protected group...there should be swim times period and everyone who shows up needs to be accomodated!

Marcy Marchello said...

To follow up after writing this post I asked for a tour of my local Y to find out more about access. It is well worth asking, because not everything is obvious to gym-goers used to their particular routine or the casual visitor. YMCAs vary in service orientation from one facility to the next, depending on their community and resources I found out.

I was impressed to learn that the pool is heavily used for therapeutic programs staffed by medical professional from the local hospital, that the Y has an Exercise is Medicine program linking local doctors and their patients to the community facility, and that there are 2 new Nu-Step exercise machines that were donated by a caring member in a room designed for new members. This machine does have a seat that turns 90* allowing for transfer in, then exercises both arms and legs from a seated position.

My local Y is more focused on attracting and sustaining people who are out of shape than in shape, to help build healthy habits. That seems like a vital starting point to address the overall fitness crisis. This certainly keeps the door open to include people with disabilities who are falling by the wayside too. Apparently only 20% of Americans actively stay in shape.

I also see more clearly now that my Y approaches serving people with disabilities as best they can and is open to input. There are significant funding limitations as with so many community services, but with each improvement on site, greater access is included. We agreed everything is a work in progress. I made a nice connection and hope to offer more input on accessibility over time.