Exercise Archives - Join NCHPAD Connect

A man in a black shirt, black shorts, and wearing a prosthesis running on a sidewalk with grass on both sides. A bridge is in the background.

E, the seventh letter in the MY SCORECARD acronym used in our MENTOR program, stands for exercise.

Exercise is highly effective in reducing the risk and severity of chronic conditions such as heart disease, cancer, diabetes, depression and anxiety.

Exercise offers significant benefits for both your physical and mental health. Even on days when you’re not motivated, a few minutes of exercise can boost your energy and improve your mood.

Challenges to getting regular exercise

Both people with and without disabilities face exercise barriers like lack of time and interest.

However, people with disabilities often encounter additional challenges, such as pain, fatigue, and depression, which may deter them from exercising due to fears of worsening their condition. Environmental barriers, such as poor transportation access, also make regular visits to fitness centers difficult.

We often assume everyone has easy access to exercise, but people with disabilities may require upper-body routines or modifications to lower-body exercises. Some gyms or exercise areas may not have proper adaptive equipment.

How much do you need?

The U.S. Physical Activity Guidelines recommend that adults get 150 minutes a week of moderate-intensity exercise. You can break this up into small increments throughout the week. Even 1 to 2 minutes of exercise counts!

A simple way to describe moderate-intensity exercise is to remember that while you’re exercising, you need to get to a point where you can still talk but that singing would not be possible. This can be achieved with many cardiovascular exercises, activities and sports, like walking, wheelchair rolling, cycling and swimming (among many others!). The main point is to get moving!

High-intensity interval training (HIIT) is one of the most effective and rapid methods for improving health. If you can handle higher intensity, increasing the challenge of your exercise is beneficial. However, it is very important to make sure that short HIIT sessions do not cause extended bouts of exhaustion or additional health issues.

In addition to simple cardiovascular exercise, strength training is also recommended twice a week for all adults. Those with chronic conditions or disabilities should also engage in moderate or higher-intensity muscle-strengthening activities targeting major muscle groups at least two days a week.

Making exercise accessible

Specialized exercise equipment can help people who use a wheelchair or those with a mobility limitation get effective moderate-intensity exercise.

The standard stationary exercise bike is one option, but there are variations designed for individuals with physical disabilities. An ergometer can be accessible to wheelchair users, as most ergometers use hand or foot pedals. Some arm ergometers feature removable seats for accessibility, and hand grips or foot straps can accommodate various levels of grip.

Strength is crucial for daily tasks such as transferring in and out of a car, dressing, climbing stairs and wheeling up ramps. Both heavy and lighter weights can be beneficial. Strength training can be done using bodyweight, free weights, portable equipment (like elastic bands) and machines.

What about when I don’t feel like exercising?

People with disabilities often experience secondary issues like pain or fatigue that can make them feel unwell and reluctant to exercise. Factors like poor sleep, stress, weather or other unknown reasons can contribute to a lack of motivation. However, exercising or even gentle movement can be beneficial, as it can alleviate some pain and fatigue.

Pushing through these feelings to engage in low-intensity activities like adapted yoga, stretching or light weights can often lead to improved feelings during and after the activity. Even a little bit of movement can contribute to this positive effect.

The acronym SELECT can help keep you motivated to stay physically active:

S is for Social Engagement.

Social interaction can support the maintenance of a regular exercise routine. Most people who consistently exercise do so with others, engaging in activities such as walking, tennis, golf, group aquatic exercises, dance and more.

E is for the Enjoyment Factor.

If an activity isn’t enjoyable, it’s likely to fail once the novelty wears off. To maintain motivation and interest, combine different fitness and recreational activities, such as yoga, pickleball and swimming, especially if you find it challenging to stick with exercise.

L is for Learning Something New.

Learning a new physical activity or enhancing an existing one in a social and enjoyable environment is highly rewarding for many and helps maintain long-term engagement. Golfers, tennis players, line dancers and others in similar groups frequently seek new skills to improve their performance. When choosing physical activities, opt for those where skills can be broken down into manageable steps, fostering a sense of learning and achievement.

E is for Exploration a Key to Discovery.

People who hike or cycle enjoy exploring new trails or roads for hours without getting bored or tired. Their strong commitment to exercise is linked to the pleasure of discovering new surroundings, even on familiar routes. Similarly, mall walkers stay engaged by browsing stores and seeking sales, enjoying the sensory stimulation of the mall. This low-intensity activity is superior to remaining sedentary at home near food, TV or computer screens.

C is for Competition (Friendly Competition).

Elite athletes aren’t the only ones motivated by sports. Many people enjoy challenging themselves. This can be done by beating personal exercise records or competing in groups against others. Competition can push individuals to perform their best and offer a strong sense of achievement. Consider engaging in friendly competitions by setting exercise goals or trying a new sport with others.

T is for Task Completion.

High responders to exercise are often termed “task completers” because they enjoy checking items off their list. Common tasks include daily exercise and chores. Marking something off a checklist can be satisfying and may boost motivation to achieve more, helping to integrate these tasks into your daily routine.

Additional Resources for Exercise

You can check out our home workout playlist on YouTube with adapted exercises for people with disabilities that can be done anywhere!

Participate in adapted exercise classes and get fitness guidance in the NCHPAD MENTOR (Mindfulness, Exercise, Nutrition to Optimize Resilience) program! MENTOR is our 8-week program focusing on physical, mental and emotional health for individuals with an existing disability or a recent diagnosis.

If you’re searching for specialized recommendations or resources, our team of expert inclusion specialists is here to help! You can contact our EIS team through the NCHPAD Call Center. Our Call Center team works with individuals to enroll them in NCHPAD Connect, answer questions about programs or connect them to an EIS for community resources and technical assistance. Our EIS expertise is always free and available 7 a.m. – 7 p.m. Monday-Friday.

To contact the NCHPAD Call Center, call 866-866-8896 or email nchpad@uab.edu.

The PEAK Center at Craig Hospital in Englewood, Colorado, is a pioneering adaptive health and wellness facility dedicated to enhancing recovery and promoting lifelong health for individuals with neurologic disabilities nationwide. Learn more about them and their great resources in our newest spotlight article!

When did the PEAK Center at Craig Hospital start?

We started in 2011. Craig Hospital is a world-renowned rehabilitation hospital that exclusively specializes in neurorehabilitation and research for individuals with spinal cord injury and brain injury. Craig is a 93-bed, private, not-for-profit inpatient/outpatient hospital that offers acute, short and long-term follow-up care.

What are your goals or mission?

The PEAK (Performance, Exercise, Attitude and Knowledge) Wellness Center at Craig Hospital offers specialized health and wellness programs focused on enriching the quality of life for those affected by neurological conditions. With knowledge and passion, we inspire our community to live healthier lives through unique, innovative and traditional wellness strategies.

Where are you located?

Craig Hospital is located at 3425 S Clarkson St, Englewood, CO 80113.

How many employees do you have?

3 administrators
2 Physical Therapists
8 Clinical Exercise Specialists
3 Aides

What do you all do?

We are an adaptive health and wellness center serving individuals across the United States with neurologic disabilities to optimize their recovery and create a lifelong plan for their health and wellness. Our services are open to anyone in the community with a neurological diagnosis. Clients do not have to be current or former Craig patients and we accept clients with any neuro diagnosis. Our services include:

Personal training
Group classes
FES bikes
Open gym – fully accessible gym with a variety of strength and cardio equipment

Tell us a success story or brag about yourselves. What would you like us to highlight or share about your organization?

We provide specialized personal training programs to clients in the community as an adjunct to their outpatient therapy services. We are also available to clients who are no longer in therapy as an accessible and inclusive environment to continue their health and wellness journey. We utilize traditional training methods and have access to state-of-the-art technologies to provide clients with the opportunity to move and exercise in ways they can’t do on their own. Some of the specialized equipment we use includes:

Robotic exoskeletons
Body weight support devices to safely walk clients overground or over a treadmill
Several different functional electric stimulation technologies
A pool and an underwater treadmill

Here is a link to an article about a few of our clients! https://craighospital.org/blog/achieving-goals-at-the-peak

When did PEAK/Craig and NCHPAD start working together? What do you all hope to gain (or for your participants to gain) from this partnership?

In the fall of 2020! During the COVID-19 pandemic, we needed to be very careful about exposure, as many of our clients were at a higher risk of severe illness due to their injuries. We saw it as an incredible opportunity to provide our clients with a free online training program to improve their understanding of the mind, body and spirit connection. The information provided in the MENTOR program is extremely valuable to our clients, and this program offers an invaluable form of peer mentorship and education about the health and wellness of the body and the soul.

Tell us about your resources. Do you have a current resource campaign you’d like to highlight? What resources have been the most successful or important to you all?

We are thankful to have the incredible support of the Craig Hospital Foundation, which works with our generous donors to provide three essential resources for our clients:

Specialized, state-of-the-art technologies to get our clients out of their wheelchairs and safely moving their bodies for exercise
A scholarship program for our general gym memberships, which allows our clients who may need some financial assistance to access the open gym at no cost
A strong electrode donation fund, which allows us to provide the electrodes we use for many of our services to our clients at no cost

What are some resources or services you provide that people may not know about?

One-on-one personal training services for any neurological injury or diagnosis
Group classes currently include:
- PEAK Beats (cardio)
- Happy Hour
- Weights on Wheels
- Glutes, Core and More (strength classes)
- Adaptive yoga
- Tai Chi

FES (functional electrical stimulation) bike program – utilizing the RT300 from Restorative Therapies or the MyoCycle by Myolyn
Open gym membership for independent use, including access to standing frames, weights and cardio equipment

A man and a woman reaching across a raised garden bed to pass a plant to the other.

The fifth letter in MY SCORECARD from the NCHPAD MENTOR Program, O, can have a powerful effect on improving your health. It stands for Outdoor Time in Nature. Spending time outside may seem like an obvious way to improve health, but it has more benefits than you might think. Being in nature with trees, flowers, plants and birds has enormous physiological and mental health benefits.

We spend so much time indoors looking at screens, so connecting with nature has become even more important. If you have recently acquired a disability or have a new diagnosis, spending time in nature can help you reconnect with your inner self and identity.

When you fully immerse yourself in the outdoors (parks, forests, trails or gardens), your mind, body and spirit connect. Some areas of the world refer to this as forest bathing, a term used to describe the connection to all forms of life found in nature, including animals, birds, trees and flowers.

Benefits of Being Outdoors

Research shows that a significant part of a person’s health is influenced by their physical environment, including access to green spaces, outdoor recreation and community gardens. The mind tends to thrive when surrounded by trees, flowers, plants, water and other natural elements.

Research is also beginning to reveal that the part of our brain responsible for negative thoughts, or rumination, is less active when we are in nature. This helps us stay more mindful and spiritual, two essential aspects of wellness [1].

In a significant study conducted by researchers from the University of Exeter in the UK, findings published in June 2019 in the journal Scientific Reports analyzed data from nearly 20,000 participants in England who completed a survey about their outdoor activities. The study revealed that individuals who spent at least two hours per week in natural environments or parks reported better health and a heightened sense of well-being compared to those who primarily stayed indoors with minimal or no exposure to nature. [2].

Getting outdoors is easier for some than others. Depending on your level of mobility or your availability of green spaces, it could be a challenge to feel connected to nature. If you spend less than two hours a week outdoors in green space such as parks, trails, community gardens and other nature areas, try one of these inclusive strategies to add more nature into your wellness routine!

A Purpose-Driven Outdoor Activity – Gardening

Gardening is considered one of the most engaging ways to interact with nature and is a great way to consistently get outdoors!

Gardening requires physical exertion (e.g., planting, pruning, watering, fertilizing), naturally increasing your levels of physical activity. There are also many ways to garden, including boutique gardens such as rock gardens, herbs and flowers.

If you don’t have space for a home garden, consider utilizing a publicly available community garden. Many community gardens can be found through the American Community Gardening Association at https://www.communitygarden.org/. Plan before your visit to ensure the garden has accessibility features that allow individuals with mobility disabilities to participate in gardening using raised boxes and access to water.

If access to a community garden is not feasible or transportation is limited, consider growing an herb garden. You can cultivate herbs outdoors, or if you live in an apartment, create a small windowsill garden to bring nature indoors. Examples of herbs to grow include rosemary (great for chicken or fish), oregano (useful for many dishes), mint (for hot and cold teas), basil (for cooking and salads) and parsley (for fish, meats and vegetables).

Bring a Little of Nature into the Home

Plants and Flowers. If you have limited outdoor access, purchase a plant that you can place in your home. Plants are living, ‘breathing’ gifts of nature and caring for them can provide a sense of purpose. Even flowers can add some perspective of being outdoors in nature. Many grocery stores sell them at inexpensive prices.
Spend Time in a Room with a View. Whenever possible, spend time in a well-lit room with a window (tracking with the sun as it moves from east to west) to connect with sunlight and greenery. Views of trees, bushes and other vegetation can brighten your mood and be good for your mental health.
Frame Photos of Nature. Even hanging photos or inexpensive paintings of nature can have a positive impact on your mood.

Combine Wellness Domains for an Even Greater Health Effect

Combine one of our other MENTOR wellness domains, Mindfulness, with your time outside and have a mindfulness session outdoors! Sitting in the grass, enjoying the breeze and sunlight on a bench or feeling elements of nature allows you to stay grounded and in the moment. Practice mindfulness your way, or try a guided meditation outdoors to connect with nature!

After practicing mindfulness, take notes and make mindfulness in nature part of your wellness routine. Acknowledge the feelings you felt during your mindfulness session. Find out ways to avoid any distractions that might have come up while you were connecting with nature. Try mindfulness in other outdoor settings like the forest, parks or even your backyard.
Find what benefits you and commit to frequent exercises like these!

Take your normal tasks outside!

If you have a meeting planned for work at the office, suggest a meeting on the go so everyone can take a break from the routine indoor schedule and get some fresh air and sunlight. Do you have a normal dinner planned with the family? Make it a picnic and connect with family and nature in a new spot. Shaking up the normal routine can be a fun new way to enjoy your daily life.

Take a break from technology

While technology feels like a nice escape from reality, it can negatively impact your daily life. The constant desire for stimulation is temporarily satisfied by social media or other time-consuming apps, but it can increase stress, envy, fear, depression and poor concentration.

Rather than craving entertainment through media, find a way out of mind-based stress and suffering through the stillness and silence of parks, gardens and other quiet outdoor spaces. Instead of spending hours on your phone or other devices, find a new hobby to try outside that can be done from your home like painting or bird watching.

Get Active!

Try a new physical activity like hiking or biking to make exercise seem less like a chore and more of an adventure going to new places. Join an exercise group that goes running together or participates in yoga together. Find an organization that offers adaptive outdoor team sports for people with mobility disabilities. There are more options than you know. Get creative and get active! You can find resources for outdoor activities in our recent Get Outdoors Month Resources blog!

References

1- Bratman GN, Hamilton JP, Hahn KS, Daily GC, Gross JJ. Nature experience reduces rumination and subgenual prefrontal cortex activation. Proc Natl Acad Sci U S A. 2015 Jul 14;112(28):8567-72. doi: 10.1073/pnas.1510459112. Epub 2015 Jun 29. PMID: 26124129; PMCID: PMC4507237.

2- White, M.P., Alcock, I., Grellier, J. et al. Spending at least 120 minutes a week in nature is associated with good health and well-being. Sci Rep 9, 7730 (2019). https://doi.org/10.1038/s41598-019-44097-3

“Coach” Dave Geslak has been a NCHPAD partner for many years and collaborated with our team starting in 2015 to create the highly popular video series, “Improving the Lives of Individuals with Autism Through Exercise.” Get to know more about him and his team at Exercise Connection!

Tell us about your background and education. Where are you from? How did you become “Coach Dave”? (What’s your career path that brought you to where you are today).

I graduated from the University of Iowa in 2003 with a degree in Health Promotion and as an ACSM Certified Exercise Physiologist. My career in exercise began as a student assistant strength & conditioning coach for the University of Iowa Football Program. While I thought about pursuing collegiate strength & conditioning after I graduated, I left Iowa Football and moved back to the Chicago area. Nine months later, I co-founded a gym, Right Fit, that was intended for children.

In 2004, autism research, programs and interventions were getting a lot of attention, but exercise was largely ignored. It was only the chance encounter (see “success story” question below) between myself and Joseph’s father, that started me on my mission to use exercise as an important intervention for those with autism. When asked to help Joseph, I had no resources other than my exercise background and passion to teach exercise to everyone. If I was going to have a greater impact on this community, I recognized that I needed more education in autism.

In 2008, after four years of teaching exercise to those with autism individually and in small group sessions, I left Right Fit to dedicate myself to improving the lives of those with autism. I became a para-educator at a therapeutic day school for children with autism (Giant Steps). This position is arguably the toughest job in special education. Despite these unexpected difficulties, I was able to experience all therapies (e.g., physical, occupational, speech, behavioral, etc.) that those with autism routinely go through. This experience taught me how this community learned best.

I spent a year as a para-educator until the school asked if I would start their first fitness program for kindergarten through high school students – the entire school! I accepted the challenge. I had an average class size of 12 students (more students per session than any class or therapy session in the school). Using the knowledge gained as a para-educator, and my previous exercise experience, I created a structured and visual exercise program that worked. In a few months, the program received a grant, and all students (of various ability levels) were making the exercise connection.

In 2010, I made the very difficult decision to leave the kids and the program I created, but I was eager to help many more. I started Exercise Connection with the goal to educate autism parents and professionals about the role exercise should play in the lives of those with autism.

To try to shorten this journey, Exercise Connection has had the blessings of working with and lecturing at universities, visiting nine countries to help organizations, parents and professionals, and created a partnership with the American College of Sports Medicine (ACSM) – along with this collaboration with NCHPAD. I am also a published author and continue to write journal articles for several publications.

I became known as Coach Dave after walking into one of my client’s homes to give him a fitness assessment. The client, Brody, who is minimally verbal, tip-toed around his dining room table and glanced at me and said, “No more doctors.” I was taken aback at his comment because I was not dressed in a white coat nor has any client ever said that to me. My immediate response was, “I’m not a doctor, I’m Coach Dave.” And the name has stuck ever since – it’s also trademarked!

How long have you worked with people with disabilities?

Next year (2024) will be 20 years since I started working with my first client on the autism spectrum.

How long have you worked with NCHPAD?

I believe it has been almost 10 years since I first met Amy Rauworth and Allison Tubbs (I like to call them the “A-Team”) and soon after created the Autism Exercise Video Series, which officially launched on NCHPAD YouTube Page on August 3, 2015.

Share a success story. Tell us about a time when you saw something you taught working in the life of a participant/student/etc.

Well, it was definitely my first client with autism. In 2004, I was training a father with a 9-year-old son diagnosed on the autism spectrum. During a session, with both angst and hesitation, the father asked, “Could you teach my son Joseph, sports? Also, he can’t skip.”

Nine months earlier, I had graduated from the University of Iowa with a degree in Health Promotion, but autism was not mentioned in any of my studies. Aside from hearing the word “autism” in the media, I had no idea how exercise impacted children, adults and their families.

While I knew sports could promote physical activity, I decided to focus on teaching Joseph to skip. I knew this fundamental movement pattern would be a building block to his athletic ability and motor planning. More importantly, I knew it would impact his cognitive development. I recalled reading a research study during my undergraduate classes that concluded that when a neurotypical child could skip, they demonstrated better reading abilities than a child who could not skip.

To teach Joseph, I tested the same strategies and protocols that I learned teaching strength & conditioning to freshmen at the University of Iowa Football program. I was responsible for breaking down Olympic lifts to teach proper technique, reduce the risk of injury, and improve the athletes’ strength and performance on the field.

My experiment worked. I was able to teach Joseph to skip in four 1-hour sessions. Joseph smiled from ear to ear, but what took me aback was that his parents were in tears. What I didn’t realize was that Joseph’s family, therapists and physical education teachers, had been trying to teach him to skip for years. They had almost given up.

This gave Joseph and his parents a newfound confidence and optimism. At the same time, my life and career path were forever changed.

What hobbies do you have outside of work?

I guess I am a triathlete, but no Ironman stuff. I compete in sprint triathlons when my body allows it – I’m starting to get old! I also like to cook. But I think my #1 hobby is being a caddie for my 7-year-old son, Andrew.

What’s your favorite food, favorite thing to cook or favorite recipe?

My favorite food is probably tacos or something Mexican. I love cooking and one of my favorite things to cook (because of the response) is eggplant parmesan. And yes, I of course make my own sauce. During the fall and winter in Chicago, I also love trying to make a variety of soups.

Group of older adults sitting in a group exercise class

This is the first blog in a three-part series on exercise and balance, presented with our friends at Allard USA. Please note that if you have severe balance problems or have been losing your balance more often recently, see a healthcare provider before you get started with these exercises.

Balance exercises can not only help you improve your balance but also increase your confidence in exercising and activities of daily living. Including some balance training with your other daily or weekly exercises is also a great way to prevent injury and maintain independence.

What we call our sense of balance is actually a complex combination of multiple body systems working together. Balance is our ability to move and stabilize our center of mass (head to hips) on top of our base of support (hips to feet).

Loss of balance happens when one of those is displaced in relation to the other. When we lose our balance, our visual (gaze stability), vestibular (inner ear fluid) and somatosensory (spatial relationships) systems become flooded with information. In short, you might fall. But you can improve your balance with practice.

“To optimize our ability to improve balance, we must be consistent and deliberate in our practice of balance,” says John Reams, NCHPAD Exercise Physiologist. “Consistency and repetition will improve our ability to stabilize our body position in those moments when we feel out of balance. This is what some people call muscle memory, but it’s really just consistency and repetition.”

A good way to start testing and improving your balance is something called “faces of the clock” weight shifting.

Here’s how it works:

Start from a stable position where you can stay focused and “in the moment.” This can be seated or standing.
Imagine your body is positioned at the center of a clock.
Start by moving your torso and hips toward and away from each number on the clock, then include each of your limbs independently. The goal here is to challenge the distance over which you can shift your weight without losing control.
Try this 10 minutes a day up to 6 days a week.

In this week’s edition of MENTOR Spotlight, we caught up with John Reams, our exercise physiologist here at NCHPAD. As exercise physiologist, John designs and leads our weekly exercise programming in the MENTOR program. We chatted with John about his role, his background, and his many hobbies and talents!

How long have you been with NCHPAD?

I’ve worked on MENTOR with NCHPAD for two years.

Tell us about your background & education. What brought you to NCHPAD?

I have a degree in biology and two master’s degrees: one in exercise physiology and one in nutrition sciences.

Before coming to NCHPAD, I worked at the Lakeshore Foundation for 12 years, transitioned to the UAB Center for Exercise Medicine for 5 years, and now I’m in my second year here at NCHPAD.

How long have you worked with people with disabilities?

18 years.

What do you do?

I am an Exercise Physiologist for MENTOR and NCHPAD. I combine my experience in clinical and wellness settings with my depth of education in exercise physiology and nutrition sciences.

What is your favorite thing about NCHPAD or this program?

I love sharing resources associated with the transformative qualities of exercise and nutrition with underserved populations. One of my favorite things about this job is guiding participants toward discovering resources for health-protective behavioral choices.