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Physical Activity & Fitness
for Persons with Disabilities
A Paradigm Shift
An article related to fitness and
activity for persons with disabilities can give rise
to many different questions. Some readers might ask,
"What good would it do for people to exercise who
are already disabled?" People with disabilities
might think, "Exercise will use up my energy before
I get the things done I really need to do on a daily
basis" or "I'm afraid I could aggravate my
condition like making my joints stiff or more painful."
Owners of exercise facilities and administrators of
public facilities have often surmised, "What if
they fall and injure themselves? We may be liable."
Historically, the approach to physical activity for
people with disabilities has been couched in medical
rationale and focused on rehabilitation. Whereas physical
education (physical training) has been a part of school
curriculum for nearly 100 years, the original orientation
was to supplement what was being done in the medical
arena, i.e. rehabilitation. The paradigm was based on
the medical model and one of isolation and segregation.
Rimmer defines rehabilitation as:
"the restoration and/or maintenance
of physical function, which allows an individual to
perform activities of daily living without incurring
high levels of stress or fatigue. These activities
include but are not limited to, ambulating, dressing
and undressing, transferring from a wheelchair to
a bed or commode, carrying or lifting common items
such as groceries or laundry, reaching for objects
above the head, rising from a chair and walking up
and down stairs."(1994,p. 2)
This definition of rehabilitation
does not account for physical activity for the joy of
it as in play, exercise to improve or maintain fitness
or activity required in employment. The new paradigm
of healthy, active lifestyles for people with disabilities
is one of inclusion and integration. Whereas much of
what people do in rehabilitation contributes to physical
fitness, activities designed and engaged in for the
express purpose of improving physical fitness goes well
beyond rehabilitation. Today, adapted physical education
programs in the schools include games, sports, rhythms
and aquatics suited to the individual needs, capacities
and limitations of students with disabilities-a welcome
change over the medical gymnastics of the turn of the
century.
Originally used in 1985 (Casperson
and others) and reiterated in 1995 by Pate and colleagues
in a recommendation from CDC, physical fitness is "a
set of attributes that people have or achieve that relates
to the ability to perform physical activity (Pate and
others, 1995)." The implication of this definition
over others in the past is that it takes into consideration
ALL activities of daily living including the physical
demands of employment, deliberate structured activity
done expressly to maintain or improve fitness, normal
ambulation, play, sport and domestic chores. Unlike
previous definitions, research findings over the past
several decades have modulated the view that to be of
value for improving physical fitness, activity had to
be vigorous. In fact, A Report of the Surgeon General:
Physical Activity and Health (1996) brings together
findings that indicate that physical activity need not
be strenuous to provide health benefits.
Thus, the old paradigm of providing
rehabilitation and practice on activities of daily living
as the sole sum and substance of physical activity for
people with disabilities has been replaced. The model
for fitness development today includes play, sport,
physical demands of employment involving large and small
muscles and daily chores for people with disabilities
and able-bodied people alike. Persons with disabilities
have demanded this shift and research supports it.
Benefits of Activity/Fitness for
People with Disabilities
The statements at the opening of this
digest are common misunderstandings held by people on
the topic of exercise and fitness for persons with disabilities.
The fact of the matter is: individuals with disabilities,
for the most part, can gain very similar benefits from
physical activity and the accrued physical fitness as
people without disabilities.
People with disabilities can enhance
the functioning and health of their heart, lungs, muscles
and bones in most cases through regular physical activity.
Flexibility, mobility and coordination can be improved,
lessening the negative effects of some conditions or
slowing the progression of others. Besides, participation
in physical activity can be fun and provide a chance
to meet people and make new friends. Since physical
activity contributes to the maintenance of health, by
exercising, people actually build stamina that makes
the demands of daily living easier thus leaving extra
energy at the end of the day for additional social activities.
While there may be some minor discomfort by anyone at
the beginning of a physical activity program after being
sedentary, there is no evidence that appropriate activity,
done correctly will aggravate most conditions. It is
important to know how one's body responds to different
conditions and to plan activities accordingly.
Some people with disabilities hesitate
to be active for fear of falling. Anyone can fall and
activity actually improves balance and coordination
to the extent that injury is less likely among people
who exercise on a daily basis. People or entities who
own facilities where activity programs are conducted
are no more liable for injuries to people with disabilities
than they are for injuries sustained by any other consumer
given that the facilities and equipment are properly
maintained and appropriate instruction and supervision
are provided.
Challenges to Becoming Physically
Active
People with disabilities have many
challenges impeding their progress that have to be overcome
or circumvented. These challenges vary depending on
the disability, but here are a few of them:
- Attitudinal and architectural barriers
still exist and require a great deal of energy to
overcome. Architectural barriers alone require considerably
more energy expenditure over that required by people
without disabilities for ambulating up ramps or going
around the building to an accessible entrance (Miller
and others, 1984).
- Most people with disabilities live
very sedentary lifestyles and therefore have weight
problems and other (secondary) health concerns.
- Inefficient movement patterns and
poor body alignment increases the amount of energy
required to do normal tasks. Fatigue results
from this inefficiency leaving the person too tired
for leisure-time activities, reduces job efficiency
and decreases the overall quality of life (Shephard,
1990).
- Mechanical efficiency and energy
levels are negatively effected by: reduced sensory
input as in deafness and blindness, spasticity and
abnormal reflex activity, use of prostheses and aids
like crutches and by loss of functional muscle mass
as occurs in paralysis (Skrotsky, 1983; Kobberling
and others, 1989; Fischer & Gullickson, 1978;
and Wells & Hooker, 1990).
- Depression often accompanies a
disability from accident or disease, but can be ameliorated
by regular physical activity (ACSM, 1995).
- People with learning disabilities
and mental retardation are more likely to be employed
in jobs requiring physical labor and thus need higher
levels of fitness than those in more sedentary job
roles (Beasley, 1982).
- Physical appearance is an important
element in being socially accepted in an exercise
setting for anyone. People with disabilities need
to look as good as possible and follow good hygiene
practices in order to obtain social acceptance (Sherrill,
1998). Physical activity settings can be very social
and "putting the best self forward" is an
important goal.
Effects of Disabilities on Health-Related
Fitness Components
As mentioned earlier, people with
disabilities can attain health benefits from exercise
in much the same way as people without disabilities.
There are individual considerations that must be made
relative to some specific conditions, but in general-everyone
can improve his/her level of fitness.
Cardiovascular Fitness
The ability to sustain prolonged activity
that elevates the heart rate and benefits the heart
and lungs is different for everyone. The previous statement
is the definition of aerobic capacity, sometimes called
cardiorespiratory endurance. Ordinarily, the benefits
of increased aerobic activity include decreased resting
heart rate, decreased resting blood pressure, more efficient
heart function, improved circulation, increased muscular
endurance, increased bone density and mass, increased
elasticity of the skin and decreased % of body fat with
a parallel increase in lean tissue. People with cardiovascular
disease may not experience some of the responses described
above because of the medication they take keeping blood
pressure and cardiac functioning controlled. Impaired
circulation as seen in people with diabetes may not
improve as dramatically as in people without diabetes.
Individuals with brittle bone disease (osteogenesis
imperfecta) may not be able to exercise vigorously using
any high impact activity such as jogging to gain the
health benefit of increased bone mass, due to the fragility
of the bones under stress. Swimming or cycling, however,
may be possibilities for use by these people. In all
cases, a physician should be consulted regarding the
intensity and frequency of exercise and the effects
one can expect based on the condition.
The Surgeon General of the United
States (1996) has reported that adults should exercise
20-30 minutes most days, but at least three days each
week. The modification of that recommendation for children
is 30-60 minutes in developmentally appropriate activity
that is meaningful for the child (COPEC, 1998). Remember,
all types of physical activity can be considered, so
even if done in shorter sessions such as wheeling the
wheelchair down to the corner for lunch, transferring
from the wheelchair into the car and then playing 20
minutes of wheelchair basketball after work-there will
be greater benefits gained than if these lifestyle behaviors
were not developed at all.
When heart rate formulas are used
to establish appropriate intensity of activity, modifications
can be made. Individuals with high level spinal cord
injuries should subtract 20-40 beats from 220 before
subtracting age to adjust for the changes in the autonomic
nervous system from the injury to the spine (Shephard,
1990). Persons with Down syndrome often do not reach
their THR due to lack of motivation or understanding
of the concepts involved. They may also be limited by
lower cardiac output resulting from damaged heart valves.
Individuals with prosthetics or progressive neuromuscular
disorders such as multiple sclerosis may fatigue easily
and thus may not reach the THR. They should be carefully
monitored in order to avoid exhaustion. Persons with
quadriplegia are unlikely to be able to sustain a maximal
heart rate higher than 120-130 bpm because of impairment
to the sympathetic nervous system. For these people,
rating of perceived exertion (RPE) is the best indicator
of intensity of the exercise (Rimmer, 1998). A method
used frequently for people with disabilities is RPE-Rating
of Perceived Exertion (Borg, 1982). Some people with
disabilities and others who cannot meet the heart rate
level because of fatigue, difficulty in monitoring HR
or restrictions caused by cardiac medication, do better
with RPE.
Muscular Strength
The term "muscular strength"
is generally accepted to mean increased capacity to
move weight and results from muscular development. Muscular
development occurs as a result of using free weights,
variable resistance equipment, isokinetics or isometrics.
Athletes have been using strength development techniques
for years to enhance sport performance. Only recently
the summary of health benefits have been brought together
through the Surgeon General's Report (1996). Health
benefits such as increased physical function, increased
independence in daily living activities and fewer medical
complications have been documented for older adults
and people with disabilities (Stone, 1988). Resistance
training additionally contributes to increased heart
muscle thickness, decreased resting heart rate, greater
stroke volume (amount of blood pumped with each beat),
more efficient heart muscle, increased circulation,
increased muscle mass (lean body tissue), increased
bone density and decreased body fat. Performance benefits
include: slower heart rate during activity; increased
coordination, accuracy, precision and balance; increased
self-esteem; easier performance of activities of daily
living (ADL); increased ease of propulsion; decrease
or elimination of pressure sores; decreased injury from
overuse; greater joint stability and decreased risks
of cardiovascular disease.
There are some special considerations
for resistance training by people with disabilities.
Safety is, of course, a primary factor with anyone using
weight training as a form of exercise. It is even more
critical for individuals with disabilities who may have
poor posture, limited range of motion in joints or problems
with joint stability. All who lift weights using a barbell
should use a spotter. People with problems of joint
stability or managing the barbell should definitely
use a spotter.
Muscle development should be balanced.
Exercise both sides of the joint when using weights.
People who use wheelchairs should develop the musculature
that counter-balances the anterior muscles used for
daily ambulation. Spasticity from cerebral palsy, stroke,
a closed head injury or multiple sclerosis can also
cause muscle imbalance. Stretch and strengthen the opposing
muscles being careful not to increase abnormal muscle
tone.
A person's coordination, control and
strength should determine whether he or she should use
machines or free weights. While machines move in only
a predetermined path, they tend to be safer. Free weights
can provide a wider range of resistance, since they
can be obtained in less than 1 pound up through hundreds,
in many increments. They do, however, require balance
and control of the weight, a good grip or special gloves
to keep the weight in the hand and the availability
of equipment in increments that are appropriate for
any given person.
Free weights can also be used in different
ways such as in gravity-reduced exercise training. This
technique, described by Lockette & Keyes (1994),
utilizes gravity to reduce the effects of gravity of
the weight and exercising limb by doing the exercise
in a position in which gravity aids the movement. Another
method used with individuals with very limited strength
as in multiple sclerosis, is manual resistance. This
method, often used in a rehabilitation setting, calls
for another person to provide the resistance. It, of
course, cannot be calibrated like free weights or a
weight machine, but working with the same person all
the time is beneficial in that they can tell when they
are giving more resistance than previously. Positioning
and strapping is also useful for stabilizing the trunk
and extremities to assure an aligned, secure and stabile
position for performing exercises (Lockette & Keyes,
1994, p. 19). This technique is very useful for persons
with amputations who lack the counter-balancing effect
of the missing extremities. A wide strap (29+) should
be used so as not to cut the skin . Any sign of skin
sensitivity or breakdown should be monitored. Resistance
training for individuals with cerebral palsy can be
very useful when strengthening the muscles that oppose
spasticity. Not only can it increase strength, but the
abnormal muscle tone in the spastic muscles can be decreased
achieving better balance between the two muscle groups.
Research has shown that for some neuromuscular
conditions such as muscular dystrophy, strength training
can be beneficial in maintaining strength and cardiorespiratory
function if: 1) the degree of weakness is not severe,
2) the rate or progression of the disease is relatively
slow, 3) consideration is given to the individual's
total daily activity demands and 4) the rate of increasing
the intensity of the exercise is slow and supervised
(Lockette & Keyes, 1994). Strength training should
be approached very cautiously and only after medical
consultation for individuals who have conditions that
directly effect the muscle. Such conditions are muscular
dystrophy, neurological conditions such as multiple
sclerosis, polio or other progressive, degenerative
diseases that result in gradual loss of muscle mass.
The development of muscular strength
is considerably important for individuals who use wheelchairs
or other assistive devices. Miller and others (1984)
reported that circumventing architectural barriers requires
up to 15 times the energy expenditure for persons with
disabilities when compared with persons without disabilities.
People with mental retardation usually have very poor
muscle tone and muscular strength. Furthermore, the
work environment for many people with mental retardation
is likely to demand greater physical exertion requiring
muscular strength.
Flexibility
The ability to move a body part around
a joint is one of the most critical elements in keeping
people moving independently. As implied earlier, one
of the main benefits of flexibility is improved movement
proficiency. In addition, flexibility means increased
range of motion, reduced muscle soreness, improved posture,
reduced musculoskeletal injuries, increased relaxation,
reduced neuromuscular tension and controlled spasticity.
Being able to tie ones own shoes, reach a plate on a
shelf overhead or bend down to pick up a dropped spoon
means so much to the independence of every one of us.
Exercising for flexibility is an imperative component
of any exercise program, especially for those whose
disabilities are severe. Joints that do not move, including
those in the spine, eventually become rigid and inflexible
and the quality of life diminishes measurably.
Stretching and bending exercises are
ones that can be done several times a day and should
be if one is sedentary. Flexibility exercises should
be done at the beginning and ending of any exercise
period. The length of the stretch determines the intensity
of flexibility exercises. For example, when seated with
one leg straight and the other flexed, the stretch is
toward the foot of the straight leg. If, at first, only
the knee is reached, the reach should be a little closer
to the toes with each subsequent attempt until the toes
are reached. It may take several weeks. The amount of
time to hold the stretch varies with a goal of 10 seconds
for warm-up and longer for warm-down. Muscles that are
spastic should be stretched for a longer period of time,
possibly 20-30 seconds until the muscle is relaxed.
If spasms, abnormal muscle tone or nonfunctional primitive
reflexes result from either stretching or resistance
training, the exercise should be discontinued and re-evaluated.
Caution should be exercised if the
condition is one that would be aggravated by stretching.
Medical advice should be sought before including stretching
exercises in a program to learn how this component can
be included and whether or not it should be. Exercise
programs should be re-evaluated on a regular basis as
one's condition changes. The exercise program must be
geared to the person with disabilities and his or her
needs at any point in time, not shaping the person to
fit the program (Lockette & Keyes, 1994).
Some special techniques utilized in
both rehabilitation and athletics include passive and
active range of motion and proprioceptive neuromuscular
facilitation (PNF). This technique may be used in instances
in which the person is unable to achieve the full range
of motion themselves due to contractures or abnormal
muscle tone around the joint. These techniques should
only be used at the direction of medical personnel and
by a trained assistant.
Body Composition
The last element effecting physical
fitness is body composition. This is the relationship
between lean and fat tissue in the body, usually expressed
in terms of percentage of body fat. This is compared
with body density that gives a measurement of lean body
tissue and bone. Regardless of the way one looks at
body composition or the means for measuring it, the
goal is to have a balance between body fat and lean
tissue to support healthy living as identified in research
findings.
Whereas, the desirable thing to do
with the other three components of fitness is to increase
them, with body fat the goal is often, but not always,
to decrease it to healthy levels in people with disabilities.
Disadvantages of having excess body fat include greater
risk of atherosclerosis, hypertension and increased
stress on the heart and lungs. The increased body weight
that often accompanies increased body fat also places
severe strain on joints, adversely effects posture,
decreases self-esteem and can affect interpersonal relationships.
These drawbacks of obesity are no different for people
with disabilities than for people without disabilities.
While all types of disabilities do
not directly affect body composition, some play a significant
role in at least influencing if not determining body
composition. For example, wheelchair users with paraplegia
tend to experience a decrease in lean tissue due to
muscular atrophy and an increase in connective tissue,
lipids and water (Shephard, 1990). Most research supports
the notion that there is an inverse relationship between
body fat and the degree of mental retardation for people
living in the community. That is, the lower the
IQ, the higher the percentage of body fat. This relationship
reverses itself, however, for people with severe mental
retardation residing in institutions. The body composition
of other types of disabilities has been sparsely studied.
A Canadian study of blind children found males to be
slightly lower in body fat than peers and both sexes
slightly lower in lean body mass (Canadian Fitness Survey,
1983). This was quite the opposite of findings in a
New Zealand study in which both sexes were found to
have twice the subcutaneous body fat as their peers.
When testing deaf children ages 10-17, Winnick &
Short (1985) found that they had increasing percentages
of fat when compared with children who hear, the more
hearing loss they had. For both sensory disorders, speculation
is that these findings may relate more to social factors
such as opportunity to participate, rather than having
any direct cause-effect relationship with the disability.
Several techniques for measuring adiposity
have been used successfully with populations of people
with disabilities. The most popular methods are: underwater
weighing, height-weight tables, body mass index and
skinfold thickness. The nature of the condition may
dictate which technique will be most accurate. For example,
individuals with severe contractures from cerebral palsy
may not be accurately compared with height-weight tables,
but underwater weighing can be used successfully. People
with spinal cord injuries may have significant muscle
atrophy in the lower extremities, so the site selection
for measuring skinfold thickness would be critical with
this population. For extremely obese individuals, height-weight
tables are recommended since skin fold calipers may
not be large enough.
Promoting Physical Activity and
Fitness Programs
Every community can provide opportunities
for people with disabilities to enjoy the same privileges
of activity as other citizens if administrators of recreation
and park programs, YMCA and YWCA directors, scout leaders
and other civic-minded citizens would simply look around
when they themselves are out being active. Are there
programs available for participants in wheelchairs?
Are families encouraged to bring their children who
have disabilities to family programs? Are the environments
and facilities designed for activity available and accessible
to people with disabilities? Are there safe, accessible
and attractive trails for bicycles, pedestrians and
wheelchairs?
When a community is planning to develop
or modify facilities for activity, people with disabilities
should be involved before programs are implemented.
No one sees the obstacles to access like someone in
a wheelchair who cannot reach the restroom door, get
their chair under the drinking fountain or wheel up
a grade to reach the outdoor education classroom. Health
care providers should also be as supportive of physical
activity for individuals with disabilities as they are
with anyone else, encouraging them to incorporate regular
activity into their daily lives. Most importantly, schools
should provide high quality, preferably daily physical
education for grades K-12 that is accessible to students
with disabilities. This is where children develop their
lifestyle behaviors and learn skills that serve them
throughout the lifespan.
Moving to Inclusion
In 1975, Public Law 94-142, The Education
for All Handicapped Children Act was signed into law.
Reauthorized in 1990 and again in 1997 as Part B of
PL 101-476, the Individuals with Disabilities Education
Act (IDEA), these laws provide free, appropriate public
education, including physical education to all students
with disabilities through age 21. One aspect of the
laws that is most challenging to implement is the concept
of "least restrictive environment (LRE)."
Through this language (LRE), lawmakers advocated placing
students with disabilities into learning environments
along with their peers who are without disabilities,
to the greatest extent possible. Adults tend to be more
assertive than children and thus, have been left to
make their own way to be included in work, exercise
and other settings.
One of the main barriers for inclusion
has been peoples' attitudes. The first recommendation
to program personnel for including individuals with
disabilities in physical activity, fitness and sport
programs is to have a positive attitude. If program
leaders do not want to include people with disabilities,
if they have negative stereotypes about the performance
capabilities or are fearful they will injure the persons
with disabilities, the effort will most surely fail.
Leaders and teachers should learn as much as they can
about persons with disabilities such as:
- their medical and health problems,
- activities they should not do,
such as tumbling for individuals with atlanto-axial-instability,
- current level of motor performance
and fitness,
- goals or objectives the person
has for him or herself,
- goals defined in programs such
as individualized educational programs (IEP) or vocational
rehabilitation,
- unique learning and communication
styles,
- behavioral concerns,
- special interests and strengths
of the person.
Activity leaders such as physical
educators, recreation personnel, parents, coaches or
aides should ask to be involved in helping to plan the
goals for a person who wants to learn to be more physically
active. Whether in a school setting, worksite program
or local fitness center, the best way to include individuals
with disabilities is to get to know them well. Learn
as much as possible about the person's interests, goals,
ABILITIES as well as their disabilities. Include the
person with disabilities in the program planning; they
have ideas, too, on how to get their needs met.
Use peers to assist the individual
with disabilities to the extent needed. This is not
to say that another member of the fitness club should
spend their entire aerobics class assisting the person
with disabilities, but on occasion there may be a need
to demonstrate a step, modify a movement or spend extra
practice time in order for the routine to be learned.
Some individuals with disabilities may not learn as
fast as their peers, so expect to spend extra time or
enlist peers. In most cases, especially in the schools,
if the educator thinks he/she needs extra support to
help the student have a meaningful learning experience,
then he or she should ask for it and expect to get it.
If the student has a trained assistant during other
parts of the day and in other classes, and the physical
educator believes it would be beneficial to have one
in physical education, then an aide should be provided.
Visit other programs the individual
is in or similar activity programs. If other professionals
are spending time with the individual, find out what
techniques work and which do not. Observe the person
in another setting if possible to observe the nature
of interaction with other program leaders. Try to replicate
the successful styles. Be ready to change styles and
techniques to accommodate individuals' unique learning
needs. Individuals who are mentally retarded, for example,
may benefit more from demonstrations, whereas persons
who are blind, might profit more from having the teacher
"walk them through" the motions or provide
instructions in Braille or large print.
There are also professional organizations
that may provide advice and recommend professionals
in your region who would be willing to assist with problems
encountered by people with disabilities trying to access
activity programs. There is a listing of such organizations
below.
What about Sport?
Certainly sport has become an integral
part of the physical activity milieu that has opened
up dramatically to people with disabilities in the past
30 years. Evolution of Special Olympics International
has gone from a day-camp in the back yard of Eunice
Kennedy and Sargent Shriver in 1963 and the first competition
in Chicago's Soldier Field in 1968 with 1,000 athletes
with mental retardation to similar summer games held
in New Haven, Connecticut in 1995 hosting 7,000 athletes.
Today over 1 million athletes participate in Special
Olympics programs in over 150 countries around the world.
In 1988 the International Olympic Committee signed an
historic agreement officially recognizing Special Olympics
(SOI, 1997).
Many organizations exist that promote sport for people
with physical disabilities. The history of most goes
back to the International Stoke Mandeville Wheelchair
Sports Federation initiating sport for people in wheelchairs
as early as World War II. Since that time multiple groups
have organized which facilitate sport for people with
specific disabilities as well as bringing many disability
groups together such as the International Coordinating
Committee of the World Sports Organizations for the
Disabled (ICC). Although the ICC was in existence a
mere 8 years, it accomplished one feat-it got the attention
of the International Olympic Committee. In 1985 a meeting
with IOC president Juan Antonio Samaranch resulted in
the agreement to use the alternate terminology for their
games of Paralympics. Surprisingly, the root-para-comes
from the Latin meaning "attached to" rather
than referring to paraplegia. So from that time to the
present, the Paralympics have been attached to the Olympic
Games and hosted in the same city (DePawu & Gavron,
1995). The names and addresses of a few sport governing
organizations are listed below.
Professional
Organizations
|
American Association for
Active Lifestyles and Fitness
(ask about a contact in your state)
1900 Association Drive
Reston, VA 20191
(800) 213-7193
http://www.aahperd.org/aaalf/aaalf.html
|
American College of Sports
Medicine PO Box 1440
Indianapolis, IN 46206-1440
(317) 637-9200
http://www.acsm.org
|
American Council on Exercise
(IDEA)
5820 Oberlin Dr., #102
San Diego, CA 92121
(619) 535-8979
http://www.acefitness.org
|
American Occupational
Therapy Association 4720 Montgomery Lane,
PO Box 31220
Bethesda, MD 31220
(301) 652-6611
http://www.aota.org/
|
American Physical Therapy
Association
1111 North Fairfax Street
Alexandria, VA 22314
(703) 706-3201
http://www.apta.org/
|
American Therapeutic Recreation
Association 2308 L Street, NW
Washington, DC 20037-1415
(202) 298-0417
http://www.atra-tr.org/
|
National Recreation and
Parks Association
22377 Belmont Ridge Road
Ashburn, VA 20148-4501
(703) 858-0784
http://www.nrpa.org/
|
|
Selected Disability
Sport Governing Organizations
|
President's Council on
Physical Fitness and Sport
Hubert Humphrey Building
200 Independence Ave., SW,
Room 731H
Washington, DC 20201-0004
http://www.indiana.edu
(for information on fitness testing)
|
Disabled Sports USA
451 Hungerford Dr., Suite 100
Rockville, MD 20850
http://www.nas.com/~dsusa/
|
Wheelchair Sports, USA
3595 E. Fountain Boulevard,
Suite L-1
Colorado Springs, CO 80910
http://www.wsusa.org/
|
Special Olympics International
13525 G Street, NW, Suite 500
Washington, DC 20005
http://www.specialolympics.org
|
United States Cerebral
Palsy Athletic Association
200 Harrison Avenue
Newport, RI 02840
http://www.uscpaa.org/
|
|
Published
quarterly by the
President's Council
on Physical Fitness
and Sports
Washington, D.C.
|
Guest Author:
Dr. Janet A. Seaman,
Executive Director
American Association for
Active Lifestyles and Fitness one of six
national associations
of AAHPERD
|
Co-Edited By:
Drs. Chuck Corbin
and Bob Pangrazi
Arizona
State University
|
|
References
- American College of Sports
Medicine. (1991). Guidelines for exercise testing
and prescription. Philadelphia: Lea & Febiger.
- American College of Sports
Medicine. (1995). Guidelines for exercise testing
and prescription (5th ed.). Philadelphia: Lea &
Febiger.
- Beasely, C.R. (1982). Effects
of a jogging program on cardiovascular fitness and
work performance of mentally retarded persons. American
Journal of Mental Deficiency, 6, 609-613.
- Borg, G.A. (1982). Psychophysical
bases of perceived exertion. Medicine and Science
in Sports and Exercise, 14(5), 377-381.
- Block, M.E. & Garcia,
C. (1995). Including students with disabilities in
physical education. Reston, VA. American Alliance
for Health, Physical Education, Recreation & Dance.
- Canada Fitness Survey. (1983).
Fitness and lifestyle in Canada. Ottawa, ON: Directorate
of Fitness and Amateur Sport.
- Caspersen, C.J., Powell, K.E.
& Christenson, G.M. (1985). Physical activity,
exercise and physical fitness: Definitions and distinctions
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Physical
Activity and Fitness Quote
Individuals with disabilities,
for the most part,
can gain very similar benefits from physical activity
and the
accrued physical fitness as people without disabilities.
Dr. Janet A. Seaman,
Executive Director American
Association for Active Lifestyles and Fitness (AAHPERD)
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