by Colette Blain
Meet your new clients, Ben, Shelley and Theresa.
Twenty-one-year-old Ben Brown was always active, playing hockey and softball, competing in track and field and whizzing around on a skateboard. Three years ago, Ben misjudged a jump during ATV motocross practice and wound up with a severed spinal cord, leaving him a T-5 paraplegic. But he still races motocross on a fully adapted YFZ 450 Yamaha quad, and is heading to the Canada Games as part of the basketball team and in 400- and 800-meter racing, all in a wheelchair.
An active and versatile athlete like Ben must follow a serious training regimen, and needs the guidance of a professional trainer: "I need help from trainers to design an adapted program for me, to help me adjust machines and brace my chair when I'm working," explains Ben. "Trainers (of disabled athletes) have to pay attention, be open, listen well and understand. I've had excellent experiences working with trainers," he says. "But you need to let them know how to help you."
Shelley Morris was born blind. Now in her 40s, Shelley recalls her early school years spent segregated from the sighted kids during gym class. "The thinking was 'don't let them do it, they'll get hurt,'" she recalls. But her parents recognized that their high-spirited and fully mobile daughter needed an outlet. "They didn't mollycoddle," explains Shelley, "they got me into horseback riding, cross-country and downhill skiing; all kinds of things." As an adult however, Shelley had gotten out of shape and wanted to change that, but she could not find a class for herself anywhere.
"One day, I got a call from the CNIB that changed
my life," Shelley recalls with emotion, "They
were offering aerobics classes for the blind in an assembly
hall where we had to push the chairs out of the way before
we started." The instructor moved away and classes
ended, so Shelley took her enthusiasm and new confidence
with her to the local sports centre and offered to help
guide the instructor so that she could take part in the
classes being offered there. With Shelley's help, the instructor
learned how best to cue a blind person and to remember to
actively correct her form, since the mirrors are useless
to her.
Since then, Shelley has tackled one challenge after another. This year marked her 15th time up the 1776 steps of the CN Tower in a yearly race benefiting the World Wildlife Fund. "The first year was scary, but I finished in 29 minutes. My personal best is 18:11." Now Shelley is training a friend's 16-year-old boy to make the climb and has completed a 5k race.
In the gym, Shelley works with trainers from time to time,
and has only good things to say about her experiences. Like
Ben, she acknowledges that clients must start by being aware
of their own limitations and clear about their goals. The
trainer, in turn, must bear in mind that all blind people
are not alike. This should be nothing new for a trainer-all
clients come with individual needs, abilities, interests,
mechanics, and all need to be treated individually.
Shelley's still a bit uneasy about being in the weight room
alone because she could trip or bump into someone, but with
a trainer's guidance, it works well. Her advice to trainers:
"don't be afraid to ask."
Theresa Galletti lives in Montreal and is a special education teacher in an elementary school. She was born without a left forearm and has worn a prosthetic arm her whole life. She works out at the local YMCA, mostly in aquafit classes. While the arm allows her surprising dexterity, it can't bear much weight and, of course, without the forearm, she can't perform the usual exercises that would help her to develop the arms, shoulders, back and chest. So the gym has not been very attractive to her and, recently she has begun to explore alternatives. She sees a physiotherapist regularly to help undo the muscular imbalances, irritations and tightness caused by the prosthesis, and agreed for him to meet with her trainer. The physio ruled out any major impediments to her participation in exercise and confirmed the trainer's postural assessment and fitness evaluation. The trainer was then able to begin to deal with flexibility, mobility and stability issues and work toward a focus on areas that need to be strengthened.
Because of her disability, Theresa has a heightened sense of her fragility. She'd be in trouble if anything happened to her good arm, so she's pretty careful about what she does-falling is not an option for her. A trainer needs to make allowances for this, and must adapt equipment and exercises to suit her needs. But that's not much different from working with a client who is pregnant, arthritic, has an old knee injury or who is simply afraid of getting hurt. With Theresa, thoracic mobility and shoulder stability need to be addressed before strengthening can be accomplished. Improving her balance and coordination too could take her to new levels of cardio fitness. Like most people, she isn't satisfied with some aspects of her physical appearance and function. But she doesn't want her arm to be the focus of her workout. She, too, fells that a good trainer must be a good communicator, observant, attentive and respectful.
While people with disabilities do have special needs for assistance and fitness programming, they can be approached the same way as anyone else-by treating them as the individuals they are. A thorough assessment is key to developing the right program for their individual needs. So that trainers are not always re-inventing the wheel, however, formal training in adapted fitness programming would be welcome.
In the UK, the YMCA has developed a special course for personal trainers who work with the disabled. It equips trainers with special knowledge and skills and addresses the implications that disability may have for coordination, functional range, balance, proprioception, bodily responses to physical activity, strength, endurance and intensity of exercise as well as flexibility and mobility.
There are no such programs aimed at personal trainers in
Canada. But it's not because there is no need. More than
4.2 million Canadians-15 per cent of the population-are
considered by the World Health Organization to be disabled.
Unfortunately, while new sports and fitness facilities must
be wheelchair accessible, there is no requirement for providing
specialized or adapted equipment, and clients and trainers
are often left to their own devices, using the Smith Machine
and Cable Crossover in new and creative ways, and piling
plates onto the chair to hold it steady. The seats on the
machines are usually too narrow for anyone who uses a wheelchair.
Trying to hoist oneself onto some of them can be dangerous.
While some gyms are adapted, with sufficient space for wheelchairs
and wheelchair-in showers for example, most people still
have to make do with the standard equipment.
But organizations like the Active Living Alliance for Canadians with a Disability, and their All Abilities Welcome campaign which is a movement to promote inclusive recreation among Canadians with a disability, are working toward making all gyms disability friendly. Through an inclusion toolkit available by request, and through speakers who deliver free inclusion workshops Canada-wide, they offer tips to instructors and personal trainers working with the disabled in their Eight Steps to Providing Inclusive Services:
1. Assess fully. Ask about the disability and adjust your program and equipment accordingly;
2. Ask about the person's support system and identify the support available to you in your programming;
3. Define safety concerns to prevent injury to the client, yourself and others
a. Gauge the intensity correctly. For instance, like some
cardiac patients, people with high-level spinal cord injuries
may need to maintain a lower
heart rate, well below the usual prescription for aerobic
training. When in doubt, check with a physical therapist
or other specialist;
b. Ensure equipment safety: go over the possibilities for injury carefully before introducing a piece of equipment to your client;
c. Ensure that you and your client know your facility's emergency procedures;
4. Assess the person's skill level and adjust accordingly.
Make sure that the program you prescribe can be maintained.
Are there any factors such
as simply getting around that will make it harder for your
client to achieve success? Talk to other professionals,
physiotherapists, physical therapists
and others;
5. Set realistic goals based on the person's skill level and the complexity of the task;
6. Select the best activities, rank them and progress your client through them;
7. Make modifications as needed: As you would do with any
client, to equipment and position. Monitor your modifications
to ensure they continue to
provide the necessary challenge and safety;
a. Substitute wheeling for running; rolling ball for throwing, striking a soccer ball with a stick rather than the foot;
b. Change the rules in team sports: restrict contact, change time constraints, allow an uneven number of participants on teams, give more chances;
c. Distance issues can be handled by using a smaller playing area, lowering or otherwise repositioning a target or start or finish line.
8. Implement your plan, keep extensive records and evaluate
your results: is the person achieving the desired results?
Still interested, motivated
and participating regularly?
Their message is: treat disabled, and all clients, as you
would like to be treated yourself. Don't make assumptions
about the needs, abilities, skills or interests of your
client. See the person first, and the disability simply
for what it is. Don't be offended if your help is not needed.
Ask questions and listen well to the answers. Remember that
each disability is as unique as the individual. Trust your
client, the real authority on the disability is always
the disabled person him or herself.
Just as Ben, Shelley and Theresa are at ease with their disability, a personal trainer's best tool will be his or her own ability to be at ease. In other words, don't let your attitude be a disability to either of you.
For more information: www.allabilitieswelcome.ca
