Recreation and leisure activities are usually not done as regularly as fitness activities. Examples include taking a weekend ski trip, hiking, going for an occasional bike ride or walk, bowling, boating, and sleigh riding, among many others. Highlighted below are some enjoyable recreational activities that can be performed by individuals who have various levels of ability. Note that some recreational activities, such as swimming, if done regularly, can improve your fitness level and will most certainly improve your general well being.
Aquatic exercise is an excellent low-impact activity for individuals of all abilities and can be performed in either indoor or outdoor pool facilities. There are many different kinds of aquatics activities, from structured classes that improve all aspects of fitness, to swimming laps. if you swim outdoors, be sure to stay out of the sun as much as possible. Also, make sure the pool temperature is at your comfort level. Pools that are too warm can increase your fatigue, and pools that are too cold can increase stiffness in your muscles and tendons. Everyone has a slightly different preference regarding pool temperature, so experiment with what temperature is most comfortable for you. In general, the pool temperature should be less than 85 degrees Fahrenheit. If you have difficulty getting in and out of the pool or the pool does not contain a lift, contact NCPAD and they will explain what options are available for making the pool accessible.
T'ai chi is an ancient Chinese activity and philosophical exercise aimed at harmonizing the mind and body. These series of movements are performed at a moderate intensity and steady rhythm. The exercise builds strength, balance, and endurance. Its smooth, relaxed movements make t'ai chi suitable for individuals with varying levels of MS. T'ai chi can be practiced outdoors or indoors, and does not require any equipment. If necessary, the ways in which the movements are performed can be easily adapted to your specific needs. T'ai chi classes are available at fitness or wellness centers, as well as at park districts or your local YMCA. If you prefer to practice tai chi at home, a number of instructional videos are commercially available. NCPAD contains a library of these videos and can be contacted at 800-900-8086 for more information.
Yoga is an ancient Indian discipline designed to integrate the body and mind. The word yoga literally means "to yoke" or "union." The basic components of yoga include breathing techniques (pranayama), relaxation, and performing the different postures or movements called asanas. Movements can be performed while seated, standing, or in a reclined position, and at a slower pace if you have trouble performing certain movements. The benefits of yoga include increased flexibility, balance, muscle strength, and endurance. There are many different styles of yoga, so find the appropriate style that matches your needs.
Handcycling has become a very popular activity for many individuals who do not have good balance or cannot use their lower legs to propel a bike. Handcycles are just like bicycles, except that the exercise is performed with your arms instead of your legs. The other difference is that you are in a recumbent (seated) position with a supportive backrest. The seats are very comfortable and many people with lower extremity disabilities enjoy taking their bike out to the park and handcycling for a couple of hours on the weekend.
Exerstriding is a type of walking activity that involves holding a set of poles (similar to ski poles). The poles were originally developed for injured athletes who were not able to run or jog, but are extremely beneficial to anyone who has difficulty with their balance. They can even be used by wheelchair users and present an exciting way to "power walk" or wheel. Visit the Exerstrider website at www.walkingpoles.com for an example of how this inexpensive equipment is used.
When feeling too tired or fatigued to perform your regular exercise routine in a standing position, try a few different variations of chair exercises. Numerous chair exercise videos on the market can be used by individuals with varying levels of movement. Several exercise videos allow you to work out in a wheelchair or regular chair. Many of these videos have been adapted for individuals at various levels of fitness. Visit the NCPAD website to access two videoclip series: Quick Seated Stretching Exercises and Strengthening Exercises.
Fatigue. obviously, you know all about fatigue and how much of an impact it can have on your day-to-day activity. Don't assume that exercise is going to cause you to become more fatigued. Some people have noticed that exercise helps them cope better with their fatigue and that they feel better overall after a good workout. However, many people have also expressed that they feel more fatigued after exercise, so make sure you include time to rest after your workout.
The key to avoiding and/or managing fatigue is to perform various types of exercise that are challenging yet do not totally exhaust you. Because everyone is different, experiment with various types of physical activities and select those that make you feel good and do not cause unusually high levels of fatigue. Keep in mind that everyone gets fatigued after a good workout, so expect some temporary fatigue immediately after you exercise. However, if the activity causes you to become excessively fatigued, find a better balance of activities that are more conducive to your ability level. The key is not to overdo it. One way to reduce fatigue is to break up your activity into small segments throughout the day. Most of the research indicates that you'll obtain the same benefits if you exercise three times a day for 10 minutes per session (i.e., 10 minutes before work, 10 minutes at lunchtime, and 10 minutes before dinner), or 30 minutes per day in one session. Find the program that is most suitable to you. On days when you are very tired, reduce the amount of exercise to a few minutes at a time and do light activities such as stretching or performing various balance exercises, rather than your more vigorous workout. Speak with your doctor if you are experiencing a high level of fatigue after exercising.
Avoid the Heat. Heat is clearly your nemesis when it comes to exercise. Make sure the environment you are exercising in is cool and that air circulation is good. Avoid stuffy, warm rooms. Find the right temperature that works for you. In general, temperatures in gyms and workout rooms should range between 67 and 72 degrees. If the facility is too warm, let the manager or owner know that it is too warm, and if he or she is unwilling to accommodate you, find another exercise facility. Also, avoid exercising outdoors when it is very warm and use air-conditioned facilities during hot and humid weather.
Drink Plenty of Water. Water intake is often avoided by many individuals who have difficulty controlling their bladder. Unfortunately, dehydration and lack of fluid intake can be a problem for individuals who are sensitive to the heat and cold. During the warmer months, the body needs an adequate balance of water to dissipate heat and cool the body, and during the colder months, adequate hydration is needed to keep the body warm and insulated. Before embarking on an outdoor recreational activity or joining a gym, make sure adequate bathroom facilities are available, which, of course, should be accessible.
Vision. If you are experiencing blurred vision in one or both eyes, make sure you exercise in a seated position to avoid a fall, or switch to an aquatics program where there is no risk of falling and injuring yourself. If you are participating in a fitness program in a health club, make sure the instructor is aware of your condition so that objects are not left in your path of travel.
Bladder. Exercise can often bring about a spontaneous need to void your bladder. Sometimes certain positions place pressure on the bladder, causing it to empty. Don't worry about accidents. These things are common and should in no way prevent you from exercising. If you are exercising in a facility or a class, let the instructor know that you may have an accident or may need to leave the class on a couple of occasions.
A One-Stop Resource: The National Center on Physical Activity and Disability (NCPAD)
Out of the need for more information on physical activity for persons with various types of disabilities including MS, NCPAD was established through a cooperative agreement with the Centers for Disease Control and Prevention. NCPAD is an information and resource center that offers you the latest information on fitness, recreation, and sports programs. Questions related to specific topics are answered by qualified information specialists who are available during working hours (800-900-8086) or by e-mail ([email protected]). The Center also publishes a monthly electronic newsletter and sends out monthly features via email on new topics and information related to physical activity and disability. You can subscribe to a listserv and receive this information for free by calling the hotline or by e-mailing the staff.
General Exercise Tips
• Keep a close record of performance on static and dynamic balance tasks and make balance an important part of the exercise prescription.
• Avoid embarrassing situations related to urinary incontinence by having a plan before you start exercising.
• Make sure the pool temperature is adequately cool for you (i.e., under 84 degrees).
• Monitor fatigue closely.
• Maintain proper hydration.
• Avoid excessive overheating and workout in comfortable temperatures.
• Use appropriate gloves, straps, ace bandages, etc., to keep feet and hands on exercise machines.
• Use various types of adaptive equipment for your specific needs.
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