Advertisement

Sports Medicine

, Volume 30, Issue 3, pp 207–219 | Cite as

Physical Activity for the Chronically Ill and Disabled

  • J. Larry Durstine
  • Patricia Painter
  • Barry A. Franklin
  • Don Morgan
  • Kenneth H. Pitetti
  • Scott O. Roberts
Review Article

Abstract

Exercise prescription principles for persons without chronic disease and/or disability are based on well developed scientific information. While there are varied objectives for being physically active, including enhancing physical fitness, promoting health by reducing the risk for chronic disease and ensuring safety during exercise participation, the essence of the exercise prescription is based on individual interests, health needs and clinical status, and therefore the aforementioned goals do not always carry equal weight. In the same manner, the principles of exercise prescription for persons with chronic disease and/or disability should place more emphasis on the patient’s clinical status and, as a result, the exercise mode, intensity, frequency and duration are usually modified according to their clinical condition. Presently, these exercise prescription principles have been scientifically defined for clients with coronary heart disease. However, other diseases and/or disabilities have been studied less (e.g. renal failure, cancer, chronic fatigue syndrome, cerebral palsy). This article reviews these issues with specific reference to persons with chronic diseases and disabilities.

Keywords

Physical Activity Cerebral Palsy Exercise Programming Chronic Fatigue Syndrome Regular Physical Activity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    US Department of Health and Human Services. Physical activity and health: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996Google Scholar
  2. 2.
    Department of Health and Human Services. Research plan for the national center for medical rehabilitation research. Washington, DC: US Government Printing Office; 1993. NIH publication no. 93-3509Google Scholar
  3. 3.
    Evans EP, Tew B. The energy expenditure of spina bifida children during walking and wheelchair ambulation. Z Kinderchir 1981; 34: 425–7PubMedGoogle Scholar
  4. 4.
    Hoffman MD, Sheldahl LM, Buley KJ, et al. Physiological comparison of walking among bilateral above-knee amputee and able-bodied subjects, and a model to account for the differences in metabolic cost. Arch Phys Med Rehabil 1997; 78: 385–92PubMedCrossRefGoogle Scholar
  5. 5.
    Nowroozi F, Salvanelli ML, Gerber LH. Energy expenditure in hip disarticulation and hemipelvectomy amputees. Arch Phys Med Rehabil 1983; 64: 300–3PubMedGoogle Scholar
  6. 6.
    Rose J, Gamble JG, Burgos A, et al. Energy expenditure index of walking for normal children and for children with cerebral palsy. Dev Med Child Neurol 1990; 32: 333–40PubMedCrossRefGoogle Scholar
  7. 7.
    Rose J, Gamble JG, Medeiros J, et al. Energy cost of walking in normal children and in those with cerebral palsy: comparison of heart rate and oxygen uptake. J Pediatr Orthop 1989; 9: 276–9PubMedCrossRefGoogle Scholar
  8. 8.
    Stein RB, Belanger M, Wheeler G, et al. Electrical systems for improving locomotion after incomplete spinal cord injury: an assessment. Arch Phys Med Rehabil 1993; 74: 954–9PubMedCrossRefGoogle Scholar
  9. 9.
    Unnithan VB, Drowling JJ, Frost G, et al. Role of cocontraction in the 02 cost of walking in children with cerebral palsy. Med Sci Sports Exerc 1996; 28: 1498–504PubMedCrossRefGoogle Scholar
  10. 10.
    Barth DG, Schumacher L, Sienko SS. Gait analysis and energy cost of below-knee amputees wearing six different prosthetic feet. J Prosthet Orthotics 1989; 4: 63–74Google Scholar
  11. 11.
    Brandstater ME, de Bruin H, Gowland C, et al. Hemiplegic gait: analysis of temporal variables. Arch Phys Med Rehabil 1983; 64: 583–7PubMedGoogle Scholar
  12. 12.
    Krawetz P, Nance P. Gait analysis of spinal cord injured subjects: effects of injury level and spasticity. Arch Phys Med Rehabil 1996; 77: 635–8PubMedCrossRefGoogle Scholar
  13. 13.
    Lechner DF, McCarthy C, Holden MK. Gait deviations in patients with juvenile rheumatoid arthritis. Phys Ther 1987; 67: 1335–41PubMedGoogle Scholar
  14. 14.
    Olney SJ, MacPhail H, Hedden DM, et al. Work and power in hemiplegic cerebral palsy gait. Phys Ther 1990; 70: 431–8PubMedGoogle Scholar
  15. 15.
    Skrotzky K. Gait analysis in cerebral palsied and nonhandicapped children. Arch Phys Med Rehabil 1983; 64: 291–5PubMedGoogle Scholar
  16. 16.
    Bar-Or O. Exercise in childhood. In: Walsh RP, Shephard RJ, editors. Current therapy in sports medicine. Toronto: CV Mosby, 1985: 1985–6Google Scholar
  17. 17.
    Jackson R, Davis G. The value of sports and recreation for the physically disabled. Orthop Clin North Am 1983; 14: 301–15PubMedGoogle Scholar
  18. 18.
    Santiago MC, Coyle CP, Kinney WB. Aerobic exercise effect on individuals with physical disability. Arch Phys Med Rehabil 1993; 74: 1192–8PubMedGoogle Scholar
  19. 19.
    Ades PA, Hanson JS, Gunther PG, et al. Exercise conditioning in the elderly coronary patient. J Am Geriatr Soc 1987; 35: 121–4PubMedGoogle Scholar
  20. 20.
    Ades PA, Grunvald MH. Cardiopulmonary exercise testing before and after conditioning in older coronary patients. Am Heart J 1990; 120: 585–94PubMedCrossRefGoogle Scholar
  21. 21.
    Ades PA, Waldmann ML, Gillespie C. A controlled trial of exercise training in older coronary patients. J Gerontol A Biol Sci Med Sci 1995; 50A: M7–11PubMedCrossRefGoogle Scholar
  22. 22.
    King AC, Haskell WL, Taylor CB, et al. Group vs. home-based exercise training in healthy older men and women. JAMA 1991; 266: 1535–42Google Scholar
  23. 23.
    Prochaska J, DiClemente C. Transtheoretical therapy: toward a more integrative model of change. Psychother Theory Res Pract 1982; 19 (3): 276–88CrossRefGoogle Scholar
  24. 24.
    Franklin BA, Gordon S, Timmis GC. Amount of exercise necessary for the patient with coronary artery disease. Am J Cardiol 1992; 69: 1426–32PubMedCrossRefGoogle Scholar
  25. 25.
    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273: 402–7PubMedCrossRefGoogle Scholar
  26. 26.
    Convertino VA. Effect of orthostatic stress on exercise performance after bed rest: relation to in hospital rehabilitation. J Cardiac Rehabil 1983; 3: 660–3Google Scholar
  27. 27.
    DeBusk RF, Stenestrand U, Sheehan M, et al. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol 1990; 65: 1010–3PubMedCrossRefGoogle Scholar
  28. 28.
    Franklin BA. Aerobic exercise training programs for the upper body. Med Sci Sports Exerc 1989; 21: S141–8PubMedGoogle Scholar
  29. 29.
    Franklin BA, Vander L, Wrisley D, et al. Training ability of arms versus legs in men with previous myocardial infarction. Chest 1994; 105: 262–4PubMedCrossRefGoogle Scholar
  30. 30.
    Franklin BA. Motivating patients to exercise: strategies to increase compliance. Sports Med Digest 1994; 16: 1–3CrossRefGoogle Scholar
  31. 31.
    American College of Sports Medicine. ACSM’s exercise management for persons with chronic disease and disabilities. 1st ed. In: Durstine JL, Bloomquist LE, Figoni SF, et al., editors. Champaign (IL): Human Kinetics, 1997Google Scholar
  32. 32.
    Burgess EM, Rappoport A. Physical fitness: a guide for individuals with limb loss. Baltimore (MD): Department of Veterans Affairs, Rehabilitation Research and Development Service, 1993Google Scholar
  33. 33.
    Painter P, Blagg C, Moore GE. Exercise for the dialysis patient: a comprehensive program. Madison (WI): Medical Education Institute, 1995Google Scholar
  34. 34.
    Kenney WL, Humphrey RH, Bryant CX, et al., editors. American College of Sports Medicine’s guidelines for exercise testing and prescription. 5th ed. Baltimore (MD): Williams and Wilkins, 1995Google Scholar
  35. 35.
    Roitman JL, Kelsey M, LaFontaine TP, et al., editors. American College of Sports Medicine’s resource manual for guidelines for exercise testing and prescription. 3rd ed. Baltimore (MD): Williams and Wilkins, 1998Google Scholar
  36. 36.
    Cooper RA, Quatrano LA, Axelson PW, et al. Research on physical activity and health among people with disabilities: a consensus statement. J Rehabil Res Dev 1999; 36: 142–54PubMedGoogle Scholar
  37. 37.
    Painter P. The importance of exercise training in rehabilitation of patients with end stage renal disease. Am J Kidney Dis 1994; 24 (1 Suppl. 1): S2–S9PubMedGoogle Scholar

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  • J. Larry Durstine
    • 1
  • Patricia Painter
    • 2
  • Barry A. Franklin
    • 3
  • Don Morgan
    • 4
  • Kenneth H. Pitetti
    • 5
  • Scott O. Roberts
    • 6
  1. 1.Department of Exercise ScienceThe University of South CarolinaColumbiaUSA
  2. 2.Department of Physiologic NursingUniversity of CaliforniaSan FranciscoUSA
  3. 3.Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital and Department of Physiology, School of MedicineWayne State UniversityDetroitUSA
  4. 4.Department of Exercise and Sport SciencesUniversity of North Carolina - GreensboroGreensboroUSA
  5. 5.Department of Public Health Sciences, College of Health ProfessionsWitchita State UniversityWichitaUSA
  6. 6.Department of Physical Education, Health, and Leisure ServicesCentral Washington UniversityEllensburgUSA

Personalised recommendations