It is no surprise that health and fitness remain top priorities for persons with movement impairments. As mobility declines, one’s risk for developing chronic conditions such as heart disease, diabetes or hypertension increases which can add another layer of disability and further impair quality of life. Physical impairments such as difficulty or inability to walk, difficulty using the hands or upper extremities, impairments in balance and so forth can pose a challenge when it comes to going to the gym or participating in an exercise routine. 

The good news is that with a little creativity there are almost always ways to participate in physical exercise that meet your individual needs and abilities.

According to the Physical Activity Guidelines for Amercians 2nd edition, adults with disabilities or chronic conditions should be getting 2.5 to 5 hours of moderate intensity or 75-150 minutes of high intensity activities throughout each week (or a combination of both). Additionally, those that are able to do so should aim to complete at least 2 bouts of strengthening exercises involving major muscles each week (Physical Activity Guidelines for Americans, 2018). In these cases it is important to first get clearance from your doctor that it is safe to begin an exercise plan and then consult with an exercise specialist or physical therapist to attain an individualized exercise program. 

If you are ready to begin exercising many states have adaptive fitness centers outfitted with equipment that might be tailored to your needs. If you are looking to use your local gym facility or stock your own home gym these are examples of equipment that can be used to get you on the path to health and fitness.

**IMPORTANT DISCLAIMER: this information is meant to alert you to the equipment that exists to help you but is not intended as a training module to use it safely. Please contact the manufacturer of each device or a qualified therapist to help you select devices most appropriate to you and to teach you how to use it safely.

**This post may contain affiliate links from Amazon Associates or other affiliate programs through which I may earn a portion of qualifying purchases

Aerobic Conditioning

Recumbent bike/ seated elliptical: a great option for cardiovascular training for those who aren’t confident or able to walk for exercise but can move their legs well enough to use the bike. The Vanswe Recumbent Exercise Bike is a great option for those looking for a reasonable price and good adjustability. The recumbent seat fully supports the back to limit challenges to balance or core strength. Pro tip: if transferring into and out of the seat poses a challenge, look for a model like the HCI Fitness PhysioStep Recumbent Elliptical with Swivel Seat that has a swivel seat that will turn 90 deg to the side to allow for easier access. While certainly pricier, it is likely a better investment than a cheaper model that will end up sitting in the corner collecting dust because it’s too difficult to get in and out of it.

Ski ergometer: this upper body exerciser that can be used in sitting or standing, focuses on building strength in the posterior shoulder and trunk muscle which is important for healthy shoulders and neck especially for wheelchair users. The Concept2 SkiErg is a common model found in some fitness centers but with its narrow design could easily be used in the home too.

Concept2 SkiErg

Vita glide: seated upper body exerciser targets the chest muscles, the shoulder muscles and upper back. The Vita Glide consists of alternating push/pull with the upper extremities and can be used while sitting in a chair.

Upper Body Ergometer (UBE): think of a bicycle for your arms. This device sits on the tabletop and you use your arms to move the pedals forward and back while you sit or stand. These devices range in price and adjustability such as the more basic Vaunn Medical Folding Pedal Exerciser which is fully powered by your arms (or legs) and in comparison the Exerpeutic 2000M Motorized Electric Legs and Arms Pedal Exerciser which actually has a motorized assist program which helps you to move through the full cycle

Exerpeutic 2000M Motorized Electric Legs and Arms Pedal Exerciser

FES bike: FES stands for functional electrical stimulation. While this device comes at a hefty price and is most often seen within rehabilitation clinics some home options are available. This device uses electrical stimulation delivered to the muscles timed with the cycling of the bike to help re-educate muscles through an external stimulus. This device requires training to learn the proper set up and dosing and you should talk with your doctor or therapist to determine if you are a good candidate as any electrical stimulation can carry risks for certain people. The Christopher & Dana Reeve Foundation has a great resource on FES bikes for home use.

Easy Stand Glider: The Easy Stand Glider is a mix between an elliptical and a standing frame. The user can transfer into the seat easily and then through a variety of straps and supports the device will help them into a supported standing position at which point arms and legs can be moved as though standing on an elliptical. This device gives all the benefits of standing with the addition of exercise!

Pedal exercisers: lower extremity exercisers that look like either bike or elliptical pedals. The device can be placed in front of any chair or wheelchair and allow for cardiovascular and leg training. See the links in the Upper Body Ergometer section to see examples of the cycling style and check out this link to see the under desk elliptical style Sunny Health & Fitness Under Desk Elliptical

Wheelchair roller trainer: think of this as a treadmill for a wheelchair. Set up like an indoor trainer for a bicycle, this device allows a manual wheelchair user to simulate forward or backwards motion while remaining stationary. Some models even allow for modification of resistance to allow for greater challenges. These are available for standard manual wheelchair and for some sport or racing chairs. The McLain Wheelchair Trainer is an excellent example of this equipment.

Strengthening

Active Hands: This is an awesome company that creates gripping aids for persons with weak or insufficient grasp or hand strength. The General purpose gripping aid, Looped Exercise aids and Hook aids can be used with most handles, barbells, dumbbells and other strengthening equipment in a commercial or home gym to secure your grasp. 

General Purpose gripping aid

Cuff weights: these weights can take the place of a traditional dumbbell and provide resistance to arms and legs without worrying about having to hold onto the weight. You can buy them in a set of various weights such as the The Deluxe Cuff Ankle and Wrist Weight – 7 Piece Set or individually depending on what you need (BalanceFrom GoFit Fully Adjustable Ankle Wrist Arm Leg Weights)

Medicine ball with strap handles: hands can be inserted into the handles and the straps can be fastened tightly to compensate for weakened grip

FitBALL MedBalls with Straps – 6 lb –

Resistance bands: these bands come in different resistances and provide variable resistance to strengthen muscles throughout the body. Loops can be tied into the ends of the band if grasp is difficult. Bands can be secured to a door or other areas of the home as well to allow for different muscles to be targeted. Bands such as these AZURELIFE Resistance Bands, are a good example.

Rickshaw: The CanDo Rickshaw Rehab Exerciser strengthens arms and shoulders from a seated position. Weight plates can be loaded on the opposite side to increase or decrease resistance. 

CanDo Rickshaw Rehab Exerciser

Other Accessories

Push gloves: often used by individuals with high level spinal cord injuries but also useful for other wheelchair users, push gloves provide additional grip to decrease effort and increase efficiency of pushing the rims of the chair. Useful for everyday use and athletic endeavors. Prime Wheelchair Gloves Protective Gear Mobility Quad-Push Gloves

Elastic straps: For those with weakness in their abdominals or trunk, elastic straps such as these placed around the upper trunk and the back of the chair can better enable the exerciser to lift weights and move their upper body against resistance.

Bodypoint Universal Elastic Strap for Wheelchair

Bibliography

Physical Activity Guidelines for Americans (U.S. Department of Health and Human Services, Compiler; 2nd ed.). (2018). U.S. Department of Health and Human Services. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf