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Move those muscles!

It is well-known that exercise is associated with many health benefits. Among these are reduced development and progression of many chronic diseases, including coronary artery disease. According to guidelines set forth by the American College of Sports Medicine, most Americans would improve their health if they performed some type of cardiovascular exercise of moderate intensity every other day. It is important for everyone (with physician consent) to participate in a regular exercise program.

The Risks of Inactivity

Coronary artery disease is the leading cause of death of adults in the United States. Also called atherosclerosis, this process is a progressive build-up of plaque within the coronary arteries, which supply blood to the heart muscle, or the carotid arteries, which carry blood to the brain. The plaque build-up causes narrowing of the blood vessels and may lead to a heart attack or stroke.

Americans are particularly affected by coronary artery disease because of our poor lifestyle habits: a diet high in cholesterol, fat (particularly saturated fat), and sodium; smoking; and the lack of physical activity. When these habits are combined with a predisposition to high blood pressure or high cholesterol, a greater risk of developing the disease exists. Reducing our risk of developing heart disease means we must become familiar with risk factor modification.

Risk-factor Modification

The "big three" risk factors for heart disease are high blood pressure, high cholesterol, and cigarette smoking. Another important factor is lack of regular physical activity. These major risk factors are modifiable--in other words, we can change them. Although some risk factors such as age, sex, and family history are not modifiable, reducing those we can change--by controlling blood pressure (with medication, if necessary); converting to a low-fat, low-cholesterol diet; quitting smoking; and exercising regularly--may greatly reduce the risk of coronary artery disease and improve the quality of our lives. Cardiovascular exercise and strength training is of universal importance for disabled and able-bodied individuals.

The Exercise Prescription

The American College of Sports Medicine has developed guidelines that recommend performing cardiovascular exercise a minimum frequency of three to four times per week for maximum benefit. Cardiovascular exercise or the mode (type) of exercise is that which is continuous and rhythmic in nature and uses large muscle groups. The duration (length of time performed) of the exercise should be at least 15 minutes or longer. Cardiovascular exercises for people with spinal-cord injury (SCI) include swimming, arm crank, and pushing a regular or racing wheelchair on rollers or outdoors.

The intensity of the exercise, or workload, is calculated from a test to measure an individual's capacity. For those who do not have access to exercise testing, intensity can be estimated in most cases by using the Rating of Perceived Exertion scale. This rates exercises on a scale of very, very light to very, very hard.

Cardiovascular exercise should be performed at difficulty levels described between fairly light and somewhat hard. If the exercise is described as hard, the person should reduce the intensity. The idea that exercise needs to be painful to be effective is a myth. Most people will benefit more from a long, slow workout than from a short, difficult one.

Another component of a well-rounded exercise program is strength or resistance training. The concept behind resistance training is that lifting weights tears down muscle fibers and, after a recovery period (usually one day), the muscle rebuilds stronger. Over a period of time, the muscles can show significant strength gains. To build muscle endurance (the ability to perform repetitive tasks) and to tone (to "firm," not necessarily to build size), an individual should perform the exercise with lighter weights and higher repetitions. For instance, lift 15 times, rest, and repeat two more times.

To gain muscle strength and power and increase muscle size, perform the routine with heavier weights and fewer repetitions. For instance, lift eight times, rest, and repeat two more times.

As the exercise becomes less challenging, the weight may be increased and the repetitions decreased. As a person becomes accustomed to the heavier weight, repetitions may be gradually increased. Strength-training exercise should be performed two or three times a week. Remember to leave a day of rest between workouts and not to work the same muscle groups two days in a row. Trial and error may be used to determine appropriate weights to begin a program; always keep in mind that proper technique is essential.

Getting Started

There are several ways to start an exercise program. One is to find a health club with adapted equipment or a club with a professional, trained staff willing to purchase or adapt existing equipment. Another is to see a physical therapist or exercise physiologist for several sessions to set up a home program with equipment you can purchase yourself. Many adapted versions of cardiovascular and weight equipment are on the market.

You may also hire a personal trainer to supervise your workouts at home or at a health club. A trainer should be a licensed physical therapist or exercise physiologist and have extensive experience working with disabled individuals.

With the consent of your physician and the advice of a fitness professional, you can begin to make positive changes in your life and realize the benefits of a healthy lifestyle.

Facility Facts

Marianjoy Rehabilitation Hospital and Clinics is a 110-bed comprehensive physical rehabilitation hospital in Wheaton, Ill., 32 miles west of Chicago. Since 1972 the facility has offered programs in seven diagnostic groupings: spinal-cord injury, stroke, brain injury, pain management, pediatrics, neuromuscular and orthopedic injuries, and surgery. Participants are evaluated at three months, nine months, and yearly.

The program at the Health and Fitness Center was developed to meet the needs of disabled individuals who would bene fit from regular cardiovascular and resistance-training exercise. It offers a comprehensive, preventive wellness and fitness program in a safe, barrier-free environment; adapted equipment to accommodate individuals with various disabilities; and professionally trained staff to assist members with special needs.

Specialized exercise equipment at the center includes treadmills, Airdyne bicycles, upper-body exercisers, a Versaclimber, Stairmasters, Nordic Track skier, pulleys, weight stations (Universal, Paragym, and Versatrainer), and hand weights. Formal educational classes address risk-factor modification techniques. Exercise facilities are accessible, as are showers in the locker rooms.

The facility also has three competitive sports teams: swimming, track and road racing, and quad rugby. Marianjoy athletes have regular practices and a challenging travel schedule for competition.
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Title Annotation:Special Section: Emphasis on Exercise
Author:Sieg, Suzanne
Publication:PN - Paraplegia News
Date:Feb 1, 1994
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