Adequacy of Evidence for Physical Activity Guidelines Development Workshop Summary (2007) / Chapter Skim
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7 Physical Activity and Considerations for Persons with Disabilities
7 Physical Activity and Considerations for Persons with Disabilities
Pages 125-140
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From page 125... ...
Rimmer proposed that the term be used to describe people who are generally excluded from studies of physical activity, such as persons with severe back pain, persons using assistive devices, persons with cognitive or sensory deficits, and persons having various comorbidities. This presentation included background information on disabilities in the United States, evidence of associations between physical activity and health outcomes for selected types of disability, and the proposed nature of physical activity guidelines for people with disabilities.
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From page 126... ...
. It is inappropriate to equate disability with poor health: disability and disease are different concepts.
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From page 127... ...
Effects of Exercise on Persons with Spinal Cord Injury Muscle strength If there is not complete paralysis (for example, with incomplete spinal cord injury) , exercise training generally can produce significant gains in strength in paretic muscles through increased motor unit recruitment (Hicks et al., 2003)
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From page 128... ...
The remaining studies were descriptive. The randomized controlled trials found significant increases in VO2 peak and in duration, workload, and/or distance.
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From page 129... ...
represents greater than a 10 percent change in the direction shown by the arrows; HDL = high density lipoprotein; LDL = low density lipoprotein; m/s = meters per second; a VO2 is a measure of oxygen consumption. b Barthel Function Index is a general measure of performance in activities of daily living.
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From page 130... ...
, muscular strength, pain (including wheelchair user's shoulder pain) , stress, quality of life, physical function, body composition, blood lipids, gait speed, and fatigue.
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Taylor and colleagues (2004) , in a review of 48 randomized controlled trials of exercise training and 8,940 patients, reported the following benefits of 30- to 40-minute moderate-intensity endurance exercise performed three to four times per week over about 2.5 years: • Twenty percent reduction in all-cause mortality and 26 percent reduction in cardiac mortality • Improvements in physical function, blood lipids, systolic blood pressure, and selected psychosocial variables
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The large multicenter Heart Failure Action study (an ongoing study) is expected to include more than 2,000 patients, and it will examine the impact of exercise training on heart failure, morbidity, and mortality.
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. Evidence of Benefits from Controlled Trials A randomized controlled trial of 6 months of treadmill training in persons with chronic hemiparetic stroke demonstrated significant improvements in VO2 peak and walking speed and a decrease in the energy cost of walking (Macko et al., 2005)
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From page 134... ...
During treatments, physical activity-related health outcomes of interest include physical fitness and body composition, physical functioning (especially considering the high proportion of older persons affected by cancer) , and acute symptoms such as fatigue, pain, nausea, constipation, sleep problems, neuropathies, depression, anxiety, and cognition.
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Dr. Courneya summarized the findings as follows: Physical activity and physical functioning/quality of life outcomes Physical activity improves fitness, body composition, physical functioning, fatigue, and self-esteem of persons affected by cancer.
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In developing physical activity guidelines, suitable representation of the disability com munity would be useful. • Achieving adherence to physical activity interventions has posed a considerable challenge in the United States.
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2004. Wa ter-based exercise for cardiovascular fitness in people with chronic stroke: A randomized controlled trial.
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2003. Long-term exercise training in persons with spinal cord injury: Effects on strength, arm ergometry performance and psychological well-being.
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2004. Randomized controlled trial of yoga and exercise in multiple sclerosis.
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2004. Exercise-based rehabilitation for patients with coronary heart disease: Systematic review and meta-analysis of randomized controlled trials.
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