Balancing Act - Exercises for Wheelchair Users

Most of us continually juggle work, family, health, and other daily ventures that life throws our way. Exercise and proper nutrition is something we all strive for, but finding the time to work out and eat properly can seem impossible to achieve.

As a wheelchair user, I know that it is important for me to make the time to exercise at least three times a week. As I am struggling with my own weight loss and exercise regimen, I am reminded that everything in life demands balance including our emotional, physical, and spiritual health.

When thinking about the highs and lows of workouts, the word "balance" keeps coming to mind. We want to share with you our thoughts on body balance in order to help you plan, implement, and maintain a healthy exercise program that will strengthen your physical and mental balance.

Living Well
Fitness is more than just strength, endurance, and flexibility. Balance plays a major role in how we function, and for some people poor balance can become an obstacle to functional living. Think about transferring in slow-motion as you levitate between your wheelchair and another chair. In those few seconds, you are, in a sense, suspended between two objects. That takes balance and coordination. You are able to do what you can because of proprioceptors- muscle receptors that tell your brain the position of your joints and muscles, as well as your position and that of the two objects. You must train your proprioceptors just like you do any muscle. Balance and coordination are equally important and, just like muscle training, both improve with practice. The way to improve your balance is to challenge your senses with creative exercises. Your level of paralysis will determine the kind of balance exercises you are able to do.

Because I have a T2 injury, balance is an issue for me but Delia Carper helps me work on it with various activities. We encourage you to create your own balance exercises by modifying the examples listed below. Remember to customize these for your specific needs by making them easier or more difficult.

1. Sitting unsupported on the edge of a therapy table. I lift my arms (with and without weights) and slowly move them in different directions. If I use weights, they are usually 3-5 pounds (you can use bottles of water); I also uses one weight at a time as I moves my arms. This challenges my proprioceptors and uses the abdominal and back muscles. If you do not have a massage or therapy table, remove your arm rests to increase the workout.

2. Transferring with eyes closed. Carper has me do this in a safe environment with her husband nearby. This creates more proprioception awareness as the visual senses have been turned off. The auditory and core musculature have to be more aware of what is going on around you. The muscles have to now learn to work differently, keeping them stimulated and challenged.

3. Carper instructs me to bend over and pick up a light-weight from various angles. I bends forward, to the sides, and even reach for things behind me. This has tremendous benefit to the core musculature.

4. Ball tossing is a fun exercise. As I sit on the edge of a therapy table, Carper and I throw a weighted ball (about 2-3 pounds), the size of a baseball. I catch with one hand and then the other. The ball is tossed in different planes to use different muscles.

Exercise Plan
A lot can be said for proper planning regarding your exercise needs and activities. Not only does it save precious time, but you should also not go to the gym without a conscious plan regarding what muscle groups you are going to work and what exercises you will do. For example, if you plan to take an outside stroll, decide on a route that will maximize the effect of this workout session. Before going to the gym, select specific exercises such as weight lifting, bicycling, etc. Make a list of what you complete during each session to help you track your program and to provide some variety to your workout sessions.

The following is a sample program design for four weeks. If you have questions, talk to a certified personal trainer for additional ideas and safety techniques.

Week One: Train your major muscle groups three times this week. Choose 1-2 exercises for each major muscle group. Do 10-12 reps with a weight heavy enough to cause momentary fatigue within this range. Do 1-3 sets of each exercise. Also, do three days of cardiovascular activity – 30-40 minutes each time in a lower heart-rate range. To find your target heart rate, do an Internet search and plug in your personal information. In addition, vary your cardio sessions to avoid tedium. You want to keep your body and mind challenged and continue moving toward your goals.

Week Two: Train each body part twice, choosing 2-3 exercises for each major muscle group. Do 2-3 sets of 15-20 repetitions with a weight heavy enough to cause fatigue within this range. Rest 60-90 seconds between sets. Do five cardio sessions this week- 30-40 minutes at a moderate heart-rate range.

Week Three: Flexibility training can greatly enhance your range of motion, therefore decreasing the chances of injury and enhancing your workouts. Dedicate 20-30 minutes to stretching all the muscle groups you train throughout the week. Before stretching, warm up 5-10 minutes. When stretching, remember to execute each move slowly, do not bounce, and keep proper body alignment (neutral spine, keeping shoulders, hips, and knees in line.) Do 4-5 cardiovascular sessions this week – 25-30 minutes at 75-80% of your maximum heart rate.

Week Four: Do balance workout every day this week. Combine Week 2 and Week 3 into Week 4 for strength and flexibility training. Do 2-4 cardiovascular sessions this week at moderate intensity.

Remember to consult your physician and develop a safety plan before beginning any exercise program and above all, have fun!