Safety

Ensuring safety is the most critical feature of exercise adaptation. The individual's medical status, abilities, and the activity they choose determine the adaptation strategies. Know the disability and get clearance from a physician before exercising

Before starting any exercise regime, it is essential to get clearance from a physician. The doctor may give guidelines. A physical or occupational therapist can lend their insights. Adaptive physical educators and specialized personal trainers can also be helpful.

Occasionally, avoiding certain activities may be necessary. For instance, some people with excessive joint mobility syndromes, may have laxity of the upper neck joints. In a small fraction of these cases, the condition may result in severe neurological injury. For this reason, doctors may advise avoiding tumbling and contact sports. But adaptations make activities possible for most impairments.

Safe location and equipment: Exercising in safe spaces is crucial. A sample of environmental and spatial factors to consider is:

• For outdoor exercise, be sure the air quality is good.
• If there are issues with balance or any risk of falls, prioritize soft surfaces like: exercise mats, carpeting, grass, or wood chips
• Avoid cluttered spaces.
• Make sure all equipment is safe to use and in good condition. This is especially true of treadmills and resistive equipment. Avoid trampolines or use them with caution.
• Avoid uneven surfaces unless the athlete has sufficient balance and agility.

Important note on spotting: Where possible, do not rely on catching the athlete. Training in spotting is helpful, but not always reliable. Provide something stable to grab or have the athlete stand close to a wall. Standing in a corner works for some individuals.

Decreasing the difficulty of the exercise to minimize fall risk is a commendable strategy.

Socially/emotional safety: Be sure the athlete is comfortable with the social situation. Observers or other athletes should be supportive.

Examples

A few hypothetical cases show how adaptation can be done. The athletes described here have fairly typical impairments. They could resemble someone you know, but that is coincidental.

Kay gets moving: Kay is a friendly 15-year-old female high school student. She has low muscle tone. She has mild cognitive deficits, some auditory processing problems, and speech delays. Kay attends a public high school. She loves flowers, animals, clothes, and hip-hop music. She dislikes physical exertion. Kay is gaining weight, and her mother is concerned. Motivating Kay to exercise is a challenge.

Kay's mom speaks to Kay's PE instructor, doctor, and a physical therapist. Taking their advice, she focuses on walking. She includes Kay's best friend Bea on the walks and making the walks into a scavenger hunt. At first, they do only 15 minutes of consistent walking. Over time, Kay no longer needs the scavenger hunt or even her friend. She counts squirrels and chipmunks. She observes plants and birds. Her stamina improves. She is so fascinated with what she sees that she stops complaining and walks for at least 45 minutes.

Kay's mother aims for Kay to walk three days each week. She finds parks with hills to challenge Kay. Sometimes, they walk in town and window shop. On rainy days, they either walk in a mall or put on rain gear and walk in the rain. With her improved endurance, Kay is more spontaneously active. On days they cannot go out, she turns on music and dances.

SWITCHING IT UP : MODIFYING ACTIVITIES FOR DIFFERENTLY ABLED ATHLETES

It is best if the athlete chooses the activity and has a personal goal. Otherwise, incorporate their interests. After choosing an activity and addressing safety, it is time to implement modifications. Professionals like adaptive physical education teachers, physical therapists, occupational therapists do a formal assessment.

A sample of key information to obtain includes:

• Know and understand any precautions needed.
• Know and understand the person's physical abilities.
• Know the athlete's sensory and/or perceptual abilities.
• Know the athlete's interests and goals.
• Make sure equipment is safe to use and in good condition. This is especially true of treadmills and resistive equipment. Avoid trampolines or use them with caution.
• Know common injuries associated with the activity and how to prevent them.

Some options for adjusting exercise are:

• Reduce the parameters of the activity: Reduce the speed, the force, the weight, the duration, the distance, or the number of sets or repetitions
• Change the equipment: Change the size and weight of the equipment. Substitute large lightweight balls for small, harder or heavier ones or visa versa
• Add assistive equipment or technology: Use electric assist pedaling devices, standers, or electrical stimulation.

• Change the position of the activity: Go from standing to sitting, sitting to lying, standing far from a target to nearer or visa versa.
• Change locomotor features: Go from running to walking, from walking to rolling (using a wheelchair), from jumping to bouncing in place, from balancing on one foot to standing on two or the other way around.
• Substitute another person to do parts of the activity.
• Change the setting: Go from a noisy room to a quiet space, go from outdoors to indoors. Change the height, the incline, the type of surface (slippery or hard tile to resilient like carpet or mats, even or uneven, cluttered to unobstructed.)
• Adjust activities recognizing cognitive issues: Decrease the complexity. Decrease the number of components of a motor skill. Where safe, accept modifications in form. Make rules easier to follow.
• When simple measures do not work, consider apps or programs to motivate the athlete.