The effects of exercise and a wellness program on participation and secondary conditions on individuals with mobility impairments By: Angie Monzin

“Regular participation in exercise has been proven to significantly reduce the risk for several chronic disease; yet the majority of the population does not exercise or maintain health lifestyles”

Froelich-Grobe & White, 2004

Addressing the Problem

Barriers affecting participation – Lack of accessible and affordable transportation – Lack of accessible facilities and equipment – Lack of knowledgeable professionals – Lack of financial resources

70 80

Prevalence of secondary conditions

60 50 40 30 20 10 0 m o p bi h fa lit ti ys gu y ic p al e ro d b le ec o m n s di tio n in g jo in t p ch ai n ro n ic p ai n sp w ei as g ti ht b ci p la ty d ro b de le r d m s ys fu vi n ct su al io b p n o ro w b el le d m ys se s fu xu n al ct d io n ys fu m n ct ed io co ic n n at tr ac io n tu s re id s e e ff ec ts ar th p o ri ti st u s ra l hy re U s T p pi Is o ra te n to si ry on p co ro m m b u le n m ic s at io an n em dy s ia fu n ct io d n ys re fl ex ia d ia b o et st h es eo ea ri h p n o et g ro er si im o tr s pa h op ir ea h m ic en rt p b t o ro ne b le o m ss s ifi p c at re io ss n u re s al or es ch o am h p ol ut a at io nd n d ru g u s e is m o la en ti d ta o ep l n he re a ss lth io p n A ro cc b le es m s s p ro b le m s Colye et. al., 2000 Secondary Conditions

Theoretical Basis

Independent Living movement

Item Rehabilitation paradigm Definition of problem Locus of problem Solution to problem Social role Who controls Physical impairment/ lack of vocational skill In individual Professional intervention by physician, physical therapist, occupational therapist, voc rehab counselor, etc.

Patient/client Professional Independent living paradigm Dependence on professionals, relatives, etc In environment; in the rehab process Peer counseling Advocacy Self-help Consumer control Removal of barriers Consumer Consumer Desired outcomes Maximum ADL, gainful employment Independent living

ICF

Literature Review: Froelich-Grobe & White Study Despite the multiple health benefits that can arise from participating in exercise programs, almost 75% of individuals with disabilities are sedentary or do not participate enough to remain healthy Randomized controlled trial design – Exercise intervention occurred within the home or community

setting

Results – Fitness data did not show significant improvements, except in

peak heart rate p value of .01

– Self reported data showed significance in increased activity

time, strengthening and cardio activity time increase

Interpretation – The article provides a good basis for an exercise intervention

plan, but modifications need to be made. Increasing physical activity time is a good starting point, but health status and alleviation of secondary conditions need to improve as well.

Literature Review: Catherine Coyle and colleagues study

Study showed that 97% of adults with physical limitations experienced limitations in from secondary conditions and reported having an average of 13 secondary conditions within a year.

A descriptive study

– Examining how secondary conditions and how they

affected or were related to women’s overall well being Results showed

– Women were impacted emotionally, physically, and

socially because of their secondary conditions Further research

– Needs to address which specific secondary conditions

cause the most stress and harm

– The impact of secondary conditions on overall well

being, life satisfaction, and quality of life needs further research

Literature Review: Charlifue Study A prospective longitudinal study – Addressing the health status in individuals with spinal cord injury across duration of injury, type of injury, and age Results: – Common secondary conditions associated with length of injury are: joint pain, fractures, motor or sensory changes, and total cholesterol level increased. – Pneumonia, pressure sores, and an increased serum creatinine level are common symptoms that are associated with the age of the individual. – Symptoms that are prevalent regardless of duration of injury or age are heart conditions, rectal bleeding, and renal stones. – In addition to psychological symptoms, depressive symptoms are common in individuals with a SCI, which may be due to a lack of participation and poor health

Purpose

The purpose of my research is to measure how health and wellness programs with exercise components affects the prevalence of secondary conditions and the impact on participation in the community Similar models – Program Shake-It-Up – PAD model, Physical Activity for People with Disabilities Model

Hypotheses

1) involvement in an exercise program developed for individuals with mobility impairments will reduce the duration, frequency, and severity of secondary conditions; 2) the exercise program will increase the individual’s overall health (strength, heart rate, endurance, self-esteem, etc) therefore 3 ) increasing overall health will be associated with an increase in participation in the community.

Variables

Independent variables – Exercise program – Secondary conditions handbook Dependent Variables – Duration, frequency, and severity of secondary condition – Participation

Measurements

Participation – Community Participation and Receptivity Survey (CPRS) Possible evaluation of secondary condition variables: – Doctor visits – Emergency room visits – Personal log books