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Disability sports and adaptive exercise (Full Size)

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The body is designed on and works best with movement. There is a whole range of studied benefits from regular exercise, whether formal or more casual. If you have physical impairments which limit or prevent movement entirely, working out what you can do is pretty tough, though not impossible.

Not only is something always better than nothing, it can also make life changing differences in things which are overlooked by able-bodied people.  As an example, I've read plenty of forum threads bemoaning the length of time taken and difficulty with bowel care routines - which can be extremely lengthy and demoralising - and I wonder whether they are sedentary all day or whether they take advantage of equipment such as standing frames and active/passive exercise bikes or whether they are stuck working at a computer all day or able to get out and move around (in whatever capacity possible). I know from personal experience that including exercise into daily routine is often the difference between persistent UTIs or fewer problems.

Adaptive exercise and sport is a huge topic and there are organisations which were set up to promote, organise and support disability sports. So the purpose of this page is to look at adaptive fitness and sports equipment as a support to the classifieds listings on this website. It seems sensible to approach an information page with the question of what is available and / or who can help with this part of adaptive life.

Specifically, if you are looking for equipment for neuro-rehabilitation then Neurokinex are an excellent organisation to contact or you can look at any of the other neuro-rehab clinics we have listed on our information page.

Or, click on the links for further detailed information on Handcycling, All Ability Cycling or Sit Skiing equipment - which are each covered separately by DisabledGear.com.


Inclusive Fitness Initiative Logo (Full Size)IFI diagram (Full Size)

Inclusive Fitness Initiative is a programme set up to help support the fitness industry to become more inclusive. They have provided practicle help and resources for gyms to offer greater accessibility for people with disabilities, meaning there is now a large network of inclusive gyms. Their help includes advice on barrier-free buildings, appropriate equipment, marketing stratgies and staff training and procedures. The Inclusive Fitness Mark (IFI Mark) is the quality mark accreditation scheme for gyms and fitness facilities and offers reassurance to people with disabilities of what they can expect from the organisation displaying the mark. The equipment they use is more for organisational rather than personal level purchase, but looking at it may inform you as to what you might expect to be able to achieve. 

Doing Sport Differently "is a comprehensive guide to accessing sports and leisure opportunities in your area. It is written by and for people with lived experience of disability or health conditions, to inspire involvement in sport and fitness and improve access to grassroots sport." You can download the guide via the link.


What Adaptive Equipment Is Available?

As with able-bodied sports eqiupment, prices and brands range hugely. If you are starting, be sensible and do NOT spend huge sums until you absolutely know what it is you need. As ever, research is key. What are you looking to get from your adaptive equipment?

  • Participation in a specific sport? The great news is that sport is hugely social and the best place to get specific advice on which piece/s of equipment will suit you best will be those experienced team mates or organisers who have been doing it themselves and tried out a variety of what is available.
  • Rehabilitation? Starting with a professional and going to different clinics will help you discover what is available. Most likely, you'll find that you can get various items for a home gym but that the bigger pieces are only affordable in a clinical setting. Clinics like Nerokinex do a lot of research and are quite inventive with what they want to achieve, which can lead to healthy partnerships with suppliers. With the help of the rehab staff, you'll be best placed to work out what is right for you.
  • Remember: it doesn't have to be specialist disability equipment to be useful. With the right help or advice, equipment like the TotalGym XLS or Therabands can provide resistance training and help reach defined training or rehab objectives. The bonus of this kind of equipment is the relative inexpense and availability to buy new or secondhand.
  • Accessories and Facilitation: probably worth mentioning Active Hands at this stage. If you have limited hand dexterity and haven't heard of these little beauties, then look them up now!


Standing Frames 
offer a variety of benefits if used regularly. To create a good standing habit, these items do take up a bit of space but they shouldn't be thought of or used as a storage surface and open wardrobe because otherwise you're unlikely to use it daily. What are the benefits of standing and standing frames?

  • Puts weight through your skeletal system which helps maintain bone density and avold the issues of Osteoporosis.  
  • Enables your gut and intestines space to function better, which can aid digestive function and help regulate bowel care.
  • Regularly stretches your tendons, muslces and ligaments to maintain their healthy neutral status.
  • Positive effect on morale, particularly for people who've had an SCI where the individual was used to their standing height and gets to view the world and people at this height regularly - and inversely it reminds those around them not simply to regard them as a wheelchair user.
  • It provides effective pressure relief from constant sitting and allows blood to circulate more easily.
  • For those wheelchair users who are into chi, it provides a better posture to allow chi to flow more easily.
Manufacturers of Standing Frames:
  • Oswestry by Theo Davies & Sons is a UK based company which developed the product in conjuction with a local SIU. It is now provided to most SCI patients for use at home when they leave their spinal injury unit. Other conditions which benefit from use include multiple sclerosis and cerebral palsy. There are various options available including fixed and variable height versions, electric lift assist, knee blocks rather than strap, adjusting height tray, trunk support and clip on hip strap. These are an excellent option for the cost conscious and can regularly be picked up second hand pretty inexpensively.
Oswestry Standing Frame Standard (Full Size)Person Standing in Oswestry Standing Frame (Full Size)
  • Thera-trainer is a sturdy German product which, although sold as a simple standing frame, comes into it's own with the balance trainer addition: the Thera-Trainer Balo or Balance Trainer. This is activated by flipping a lever which enables the user to move about in a small 360 degree motion using their own body weight and balance. As well as all the usual benefits of standing, it adds core strength and greater circulation to the list. Plus, from person experience, I also find that my body feels more supple rather than stiff from extended periods of standing in this frame. The current range goes from relatively lo-tech to inclusion of screens, software and therapy programmes. This is a relatively expensive piece of home (or clinic) equipment but if you understand the goals and benefits and use it regularly, will pay dividends. It is also a solid piece of kit and will likely outlive you...! Again, this comes with a raft of extras, including an electric lift assist. As a low level paraplegic, I can get into mine by myself (with the lift assist) though it requires a little effort and technique, whereas many second hand users prefer to buy with electric assist already added. Buying it as a retrofit is a pointless exercise because of the cost. In fact, every extra or spare replacement is expensive, though you're unlikely to need them if you look after yours. They don't seem to come up that often and when they do prices can vary substantially but expect to pay a 4-figure sum.
thera trainer balo or balance trainer base model (Full Size)thera trainer balo or balance trainer being used (Full Size)
  • EasyStand have a range of products for all ages and sizes. Adult products include the Evolv, Glider and StrapStand which do slightly different things. The Glider is a fully adjustable model which adds a range of movement to its benefits of standing, a bit like a elliptical trainer. Periodically, I've seen the Evolv and Glider available in various second hand forums. They seem to be more popular in the US but there are plenty in the UK also. I'd not seen the StrapStand before and looking at the video (below), it seems a pretty neat standing frame, super easy to use by oneself, gentle on the shoulders and with some clever accessories like the Roho knee cushions or a varity of table tops. The pricing is very clear on both the US manufacturer and UK distributor websites and means that if you see a preloved EasyStand product, you'll have an understanding of how it's priced.


  • R82 is a Danish based company who cater for children and teenagers with special needs. They provide a range of specialist standing products. There's is not the most clear website in terms of pricing (as I suspect that they allow each of their retailers to set pricing) and their standing options include tilt table style standing as well as others. If this is your niche then it's worth popping to their website and finding out more.
R82 range of standing products (Full Size) 

Tilt Tables are an exellent and specialist piece of equipment usually used by people with increased rehabilitation or care requirements. They provide the same benefits as a standing frame but offer more support and the option of moving from horizontal to vertical planes more gradually. THis is useful where a change happening too quickly can cause fainting or autonomic dysreflexia. There are a mumber of manufacturers and permutations and accessories depending on what you need. They can be electrically or manually operated.

Active / Passive Biking: There are a number of manufacturers of active/passive exercise bikes available and these number seems to grow as Korean companies make their models available to the European and US markets. At the better end of the market, these bikes can either do everything for you or they can assist you, so that you are actively exercising yourself while it monitors how much help you need. They continuously feed back this information so you can chart what you are doing and what progress you are making over time. For more news and information, have a read of Medicotech's bike specific blog.

What are (can potentially be depending on your medical condition) the benefits of using an active / passive exercise bike? Regular use can help:

  • maintain and / or improve joint and muscle condition
  • aid circulation which can help avoid infections and UTIs as well as reduce sweling and inflamation or retention of fluids
  • aid pyschological well being 
  • reduction in limb pain
  • improved bladder and bowel function
  • improved sleep
  • reduced spasms
  • Article on Passive / Active Exercise for MS users.
Two particular brands of active / passive exercise bike which always get most interest (particularly if priced correctly, because they're so expensive new) are Reck MOTOmed (via Medimotion in UK - and image below left) and Thera-Trainer (image below right). Both companies offer leg only or arm and leg variants and various options on try before you buy when you buy new. I have bought and used leg only models from both companies and prefer my MOTOmed Viva2 for it's ease of use with active cycling. Though to be fair to both companies, that might be because I bought mine second hand and never had training and I bought because I used the same model at a couple of rehab places. These are German products and are robust machines. The only thing i would say is to get professional input regarding use to get the best out of them. A benefit of these machines is that they can be used from the wheelchair and therefore take up less space than machines which come with their own seat. The two images below are for illustrative purposes only. For more information on models and software currently available, you'll need to use the links to navigate to each manufacturer.
 
MOTOmed active passive arm and leg exercise bike (Full Size)thera trainer active passive arm and leg exercise bike (Full Size)
 
 
  • Saratoga bike is another machine which appears forum discussions though I have never seen or used one...!

FES or Functional Electrical Stimulation is the application of electrical pulses or stimulation to paralysed muscles causing them to contract and relax in order to get them to perform a function such as biking, rowing, walking. People do this for a variety of reasons including, aerobic exercising and strength training, competitive adaptive sport, maintaining and improving neurological and muscular condition and a whole host of possible health benefits including improving circulation (and therefore reduced inflammations and infections), reduced risk of pressure sores, spasms, etc... Equipment is expensive and it is more usual to see / use FES equipment in a specialist clinic or rehabilitation centre. However, it is available for home use and pieces of secondhand preloved and used FES equipment do pop up secondhand from time to time.


Rehabilitation: 
there are quite a number of big and bulky clinic-led machines and equipment available for rehabilitation use, most of which is incredibly expensive and sophisticated to varying degrees, plus they require clinician help to use them. They're not really for mention here as I'm focussing on home use kit. Though if you're looking for equipment which might help you personally, I will add them here as they come to mind. The obvious thing to say is go to a specialist place like Neurokinex

  • Lokomat is a professional gait trainer. 
  • Thera Trainer e-go "can be used for all patients who can stand on the floor in a secured environment. From their first attempts at walking through endurance gait training, the THERA-Trainer e-go is the perfect training partner. The e-go can be used anywhere appropriate, whether in a gymnasium, a walkway that is at least 3 meters wide, or a dedicated gait training studio."
  • The Reha Technology G-EO System bills itself as being "the world’s most advanced robotic-assisted device in gait rehabilitation. It is the only device that offers the unique feature of realistically simulating climbing stairs and can be operated by one therapist only."
  • Biodex Unweighing System can be used independently or in conjunction with a rehab treadmill to reduce the patient's weight while exercising. "Unlike the simple patient lift devices, Biodex Unweighing System incorporates a dynamic suspension system that accommodates the vertical displacement of the center of gravity that occurs during normal gait. Biodex's patented off-loading mechanism maintains constant force." Click on the links for information.
  • tbc...

Cardiovascular and Resistance Training: 

  • Uppertone is designed to upper body conditioning, specifically for wheelchair users. There are no cuffs or straps and all the weight variations are made using sliders so anyone with limited dexterity can use it without needing help. It has been carefully designed to provide a complete range of exercises so that you get a full upper body workout. Bear in mind that the concepts of training are the same as mainstream training and that understanding how to train will get the best out of your routines and help avoid injury. Cyclone Mobilty are listed as the UK distributor although I can't see it on their website. Failing this, contact the Uppertone manufacturer. For detailed product information and exercising guide, read their Uppertone product PDF. I think they cost about £5,000 new but pop up second hand here from time to time. We had one asking about £1,000 recently.
     


  • Versatrainer by Bowflex is another resistance trainer with space for wheelchair users to get in and do a complete upper body workout. Interestingly, I cannot find a seller for this and the one link I came across looks unpromising. However, if you read various forum articles, they seem popular with paraplegics and tetraplegics and other wheelchair users and appear for sale secondhand periodically. 
 bowflex versatrainer wheelchair rehabilitation and resistance training (Full Size)

  • Cyclone Mobility sell a piece of equipment called The Evolution 6000 which is a home multigym which is designed by a paraplegic and works for wheelchair users. They also list a page of exercises to help you get started. Though, like all training, you'll get more out of it if you get professional advice from the start and use their list as a reminder to keep your training varied and incude all your muscle groups.
  • The Apex CH7000 is another home use multigym designed for use by wheelchair users and able bodied people. This looks like a US product and I have yet to see one appear second hand in the UK.

Wheelchair Sports have increased in popularity, aided in part by the London 2012 Paralympics. Generally specialist sports chairs are required for Wheelchair Tennis, Wheelchair Basketball, Wheelchair Rugby (also called Murderball), Athletics Wheelchairs, etc.. These can be highly bespoke and expensive products. However, there are some basic and value-for-money alternatives like the charity Motivation's sports wheelchair products.

Before you pile in and spend a small fortune buying new or take the plunge and buy secondhand sports wheelchairs, we'd recommend you go along to organised sessions, try other people's first and know what you actually want and need BEFORE you make any purchases. 

The great news is that there are are plenty of organisations around to help. Popularity for adaptive sport and exercise has burgeoned, particularly since the 2012 London Paralympics, which, frankly, made me very proud to see such popularity and sell-out attendance.

Disability Sport Organisations:

  • English Federation of Disability Sport is a "national charity, dedicated to disabled people in sport and physical activity. [They] support a wide range of organisations to include disabled people more effectively. [Their] vision is that disabled people are active for life.
  • The EFDS links page offers a comprehensive list of condition or sport specific disability organisations.

Further Reading:

 
Need a Little Motivation? This video is taken from the Adaptive Crossfit - Working Wounded Ganes 2014. It doesn't have to be your thing to enjoy watching such infectious inclusivity and enjoyment at participation....

... and a Huuu-ah! moment from Neurokinex Rehabilitation Training:

A Huuu-ah moment from Neurokinex rehabilitation training (Full Size)

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