a fitness guide for people with SCI
Adaptive Fitness
Adaptive Fitness
Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity. John F. Kennedy
a fitness guide for people with SCI
Adaptive Fitness
Content Intro to adaptive fitness
1-2
Warm-up
3-4
Training
5-26
Stretching - Cool down
26- 34
Increasing difficulty
35- 36
Intensity Classification
37- 38
Exercise Planning
39- 40
1
Intro to Adaptive Fitness
A fitness guide for individuals with spinal cord injury with the desire to incorporate physical activity into their daily lives.
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Intro to Adaptive Fitness To live a healthier more active life this guide will improve the fitness strengths of people with SCI. 1. Engage in at least 20 minutes of vigourous intensity aerobic activity 2 times per week 2. Engage in strength training 2 times per week consisting of 3 sets of 8-10 repititions of each exercise for each major muscle group.
3
Sample warm-up 10 times each
Exercises: 1. Wrist rolls to the left on each hand. Wrist rolls to the right on each hand. 2. Arm circles backwards on each arm. Arm circles forwards on each arm. 3. Shoulder rolls backwards on each shoulder. Shoulder rolls forwards on each shoulder. 4. Wheeling forwards and backwards for 2 minutes.
Warm-up Upper back muscles
4
Sample warm-up
Warm-up Wrist rolls
Shoulder rolls
Arm circles
Wheeling
5
Back Row 3 sets of 8-10 reps
Steps: 1. Loop the exercise band around a pole or any study anchor. 2. Position your chair a few feet away. 3. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 5. Put hands into exercise band and then face hands down. Position exercise band so that it is at an equal height with shoulders. Keep head, neck and spine in neutral position. 6. Exhale and pull hands towards chest by bending the elbows. Keep back upright and straight as you bring your elbows beind you while squeezing your shoulder blades together.
Training Upper back muscles
6
Back Row Start | End position
Training Midpoint
7
Lat Pulldown 3 sets of 8-10 reps
Steps: 1. Attach exercise band to a sturdy structure directly above you in order to pull the band down. 2. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 3. Keep head, neck, and spine in a neutral position. 4. Put hands into exercise band and then face hands palms down. Position exercise band so that it is at an equal height with shoulders. Keep head, neck and spine in neutral position. 5. Exhale and pull hands towards chest by bending the elbows. Keep back upright and straight as you bring your elbows beind you while squeezing your shoulder blades together.
Training Upper back muscles
8
Lat Pulldown Start | End position
Training Midpoint
9
Bicep Curl 3 sets of 8-10 reps
Steps: 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Keep head, neck, and spine in a neutral position. 3. Place the exercise band underneath the chair. 4. Put hands into exercise band and then face palms up while your arms extend straight down by your sides. 5. Exhale, bend elbows and bring the exercise band towards shoulders (keep elbows tucked into your side) Inhale, slowly lower the band back to sides (do not straighten arm completely.) Keep tension on the muscle throughout the movement.
Training Front of upper arm (Bicep muscle)
10
Bicep Curl Start | End position
Training Midpoint
11
External Rotation 3 sets of 8-10 reps
Steps: 1. Position chair 1 foot perpendicular from a pole or other anchor. The side you want to work is facing away from the pole. 2. Loop the exercise band around the pole at waist height (make sure it is sturdy.) Hold the exercise band so that it is not too slack or too tight when holding it in the starting position. 3. Put hands into exercise band with your thumb facing the ceiling. Make sure your elbows are at your side bent at 90 degrees. 4. Exhale, slowly bring exercise band outwards, away from body (keep elbow at side.) Inhale, bring exercise band back to starting position in controlled manner.
Training Rotator cuff muscles
12
External Rotation Start | End position
Training Midpoint
13
Internal Rotation 3 sets of 8-10 reps
Steps: 1. Position chair 1-2 feet perpendicular from a pole or other anchor. The side you want to work is on the same side as the pole. 2. Loop the exercise band around the pole at waist height (make sure it is sturdy.) Hold the exercise band so that it is not too slack or too tight when holding it in the starting position. 3. Put hands into exercise band with your thumb facing the ceiling. Make sure your elbows are at your side bent at 90 degrees. 4. Exhale, slowly bring exercise band outwards, away from body (keep elbow at side.) Inhale, bring exercise band back to starting position in controlled manner.
Training Rotator cuff muscles
14
Internal Rotation Start | End position
Training Midpoint
15
Chest Press 3 sets of 8-10 reps
Steps: 1. Put hands in exercise band and around the back of your shoulders under your shoulder blades or place it around the back of your chair and under the handlebars. 2. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 3. Keep head, neck, and spine in a neutral position. 4. Bend elbows and bring hands up to shoulder level. Palms are facing away from you. 5. Exhale, push the exercise band straight out in front of you (do not lock elbows at the end of the motion) Inhale, bring the exercise band back to starting position.
Training Chest (Pectoralis muscle)
16
Chest Press Start | End position
Training Midpoint
17
Chest Fly 3 sets of 8-10 reps
Steps: 1. Put hands in exercise band and around the back of your shoulders under your shoulder blades or place it around the back of your chair and under the handlebars. 2. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 3. Keep head, neck, and spine in a neutral position. 4. Bring arms out to the sides and up to shoulder level with palms facing forward. Slightly bend elbows and maitain this natural curve throughout exercise. 5. Exhale, bring palms together until they are almost straight in front of you. Inhale as you return them to starting position.
Training Chest (Pectoralis muscle)
18
Chest Fly Start | End position
Training Midpoint
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Reverse Fly 3 sets of 8-10 reps
Steps: 1. Loop exercise band around a pole or other anchor (make sure it is sturdy.) 2. Position chair a few feet away so the exercise band is not too slack or too tight. 3. Keep head, neck, and spine in a neutral position. 4. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 5. Put hands into exercise band with palms facing each other. Position exercise band so that it is at an equal height with shoulders. 6. Exhale, pull exercise band out towards sides in an arching motion. Inhale, and return the band to starting position.
Training Upper back muscles
20
Reverse Fly Start | End position
Training Midpoint
21
Lateral Shoulder Raise 3 sets of 8-10 reps
Steps: 1. Place the exercise band underneath the chair. Put hands into exercise band. 2. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 3. Keep head, neck, and spine in a neutral position. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 4. Hold exercise band down at sides with palms facing in towards your body. 5. Exhale, slowly raise both arms straight out to your side until they are at shoulder height. Inhale as you bring them back down to starting position (lower in slow controlled manner.)
Training Shoulder (Deltoid muscle)
22
Lateral Shoulder Raise Start | End position
Training Midpoint
23
Front Shoulder Raise 3 sets of 8-10 reps
Steps: 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Stabilize yourself in your chair (try using chest strap.) Keep head, neck, and spine in a neutral position. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 3. Put exercise band underneath chair. Hold exercise band down at sides with palms facing behind you. 5. Exhale, slowly raise both arms straight out in front of you until they reach shoulder height. Inhale as you bring them back down to the starting position. Lower in a slow and controlled motion. (This exercise can be done with both arms simultaneously or by alternating the arms)
Training Shoulder (Deltoid muscle)
24
Front Shoulder Raise Start | End position
Training Midpoint
25
Shoulder Shrug 3 sets of 8-10 reps
Steps: *Note: If you do a lot of wheeling in a manual chair you may skip this workout since that alone sufficiently works your upper back and neck muscles. 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. Stabilize yourself (try using a chest strap.)Put exercise band underneath chair making the distance short from the floor to your hands. Place arms down at sides of chair with palms facing behind you. 3. Exhale, slowly raise shoulders up without bending at your elbows (shrug shoulders.) Your hands should be perpendicular to the floor during the movement. Inhale, slowly lower shoulders in a controlled manner.
Training Upper back and neck (Upper trapeqius muscle)
26
Shoulder Shrug Start | End position
Training Midpoint
27
Lateral Neck Flexion
Stretching - Cool down
Hold for 15-30 seconds
Steps: 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Bring right ear to right shoulder. Go to the point of tension without causing pain. 3. Breathe in through nose and out through mouth while holding the stretch, then switch sides.
28
Lateral Neck Flexion Start | End position
Stretching - Cool down Midpoint
29
Neck Flexion Hold for 15-30 seconds
Steps: *Note: Avoid stretch if you have hardware in your neck. 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Bring chin down to chest, go to the point of tension without causing pain. 3. Breathe in through nose and out through mouth while holding the stretch.
Stretching - Cool down
30
Neck Flexion Start | End position
Stretching - Cool down Midpoint
31
Neck Rotation
Stretching - Cool down
Hold for 15-30 seconds
Steps: 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Rotate your neck to the right side of body, go to the point of tension without causing pain. 3. Breathe in through nose and out through mouth while holding the stretch, then switch sides.
32
Neck Rotation Start | End position
Stretching - Cool down Midpoint
33
Chest Stretch
Stretching - Cool down
Hold for 15-30 seconds
Steps: 1. Sit up straight with feet flat on the floor or on footplates, shoulder width apart. 2. Extend arms straight out to the side, go to the point of tension without causing pain. Either do both arms at the same time or one at a time. 3. Breathe in through nose and out through mouth while holding the stretch.
34
Chest Stretch Start | End position
Stretching - Cool down Midpoint
35
Increasing difficulty How do I increase the difficulty of my at-home exercise? Steps: 1. When you begin to feel that an exercise requires “mild effort” to complete, you should increase the difficulty. 2. Increase the number of repititions. If you started with 3 of 8 work up to 3 of 10. This will help increase muscle endurance. 3. Increase the weight/resistance you are using if 3 sets of 10 becomes a “mild effort.” 4. If performing an exercise that uses an object (i.e soup can, water bottle filled with pebbles, wrist weight) other than exercise band, try to find a different object 1-2lbs heavier. Then try to perform 3 sets of 8 with new weight. If you are not working with moderate to heavy effort find a heavier object
Reaching goals
36
Increasing difficulty Steps: 5. If performing exercises that use the exercise band, you need to increase the resistance of the band when performing your exercises. To do this tie the loops closer to it’s attachment point. 6. You can use a pen to make marks on your exercise band to remember where you should be tieing the band for more resistance. Be sure to mark the attachment point and the points closest to where you hold it. You can use this marker system as a way to measure your progress.
Reaching goals
37
Chart
Intensity classification
How hard are you working? Normal
Mild
Moderate
Heavy
Activities that require little effort. Feels as if not working (walking).
Physical activities that require light work. Feels as if working but not too hard.
Physical activities that require some physical effort. Feels as if you are working somewhat hard but you can keep going for a long period.
Physical activities that require a lot of physical effort. Feels as if you are working very hard (almost at your maximum). You can only do activity for short period before getting tired.
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Chart
Intensity classification
How does your body feel? Normal
Mild
Moderate
Heavy
Breathing & Heart rate
Everything is normal.
A little harder & faster.
Noticeably harder & faster but not extremely hard or fast.
Fairly hard and much faster.
Muscles
Everything is normal.
Feel loose, warmed up and relaxed.
Feel pumped & worked. Feel Burn & feel tight & tense. warmer and starting to get tired. Feel a lot warmer & tired.
Skin
Everything is normal.
Normal temperature or a little warmer but not sweaty.
A little bit warmer and might be a little sweaty.
Much warmer and might be sweaty.
Everything is normal.
You might feel very alert. No effect on concentration.
Requires some concentration to complete.
Requires a lot of concentration to complete.
Mind
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Weekly Exercise Plan Steps: 1. Detailed weekly exercise plan. Write down the activity, where you will do the activity, what day you will do it and at what time. 2. Schedule at least two strength training sessions per week, consisting of 3 sets of 8-10 repititions for each exercise for each major muscle group. 3. Avoid strength training 3 days in a row. 4. If you need, break up fitness routine throughout the day. 5. Post the calender somewhere you will see it. 6. Create a reward system for weeks that you complete your exercise plan.
Exercise Planning
40
Planning A Workout Sunday
Monday
Exercise Planning Tuesday
Wednesday
Thursday
Friday
Saturday