Exercise and fitness needs for paraplegia
By Thomas Goodwin and Zarah-ann Hooper
People with physical disabilities, also known as physically disabled people, have a physical impairment which has a significant/ long term effect on their ability to carry out day-to-day activities [1]. The proportion of people with disabilities globally is rising and now stands at 1 billion, accounting for 15 per cent of the world’s population, according to the first official global report on disability [7]. Other than their individual needs, disabled people may require an accessible home, with or without assistances and adaptations [1]. Paraplegia is what many people first identify with a physical disability. Paraplegia results from injury to the spinal cord, occurring below the neck [2]. Paraplegia is also the inability to move from the waist down.
Society generally think that people with paraplegia end up in a wheelchair, but this is not the case. The spinal cord damage has been split into two groups and these are either complete or incomplete. In a complete paraplegic is where all function below the level of spinal cord injury is absent and in an incomplete paraplegia some function below the level of spinal cord injury remains undamaged. For example, a person who is an incomplete paraplegic may be able to walk again with physical therapy, or may have control of his or her bowel and bladder. Paraplegics can have very different abilities based on their level of injury. For example, a person with a high injury in the middle or upper back may have more trunk weakness than a person with a lower back injury [4]. The common characteristics of paraplegia are the loss of movement, loss of sensation, including the ability to feel heat, cold and touch, exaggerated reflex activities or spasms below the level of the spinal injury, possible Changes in sexual function, sexual sensitivity and fertility, pain or an intense stinging sensation caused by damage to the nerve fibres in your spinal cord, difficulty breathing, coughing or clearing secretions from your lungs and loss of bowel and bladder control [5 & 6].
Many people with paraplegia need other items to cater for their disability. Usually paraplegics will be in hospital for around 5 months, whilst they undergo rehabilitation and physiotherapy before they are released from hospital; the hospitals do this to help them be able to increase their potential, help them get used to life in a wheelchair, and to help teach them ways to make everyday life easier [8]. Having positive social interactions helps the paraplegic, felt that they were valued and was supported by friends, family, and neighbours. It is commonly known for a person with paraplegia to carry out mental/ psychological issues, as these may occur there is also treatment regarding these issues. Depression is one of them and treatment may include a combination of psychological or ‘talking’ therapies, medication, community support programs and education. [9] Exercise is important for a paraplegic as the feel as if they have accomplished something and are still capable of doing activities. They achieve physical and psychological benefits from exercise and that training programs for the person with disabilities can increase maximum oxygen consumption, decrease heart rate at a given work load, increase grip strength, increase arm work capacity, and increase general well-being, creating a more positive life style[10].
The constraint for participation of activities is the imagination required to invent the modification to be inclusive rather than