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The Daily Exercise Routine for Wheelchair Users

wheelchair exercises

As the population continues to age, the number of adults with decreased mobility gets greater every year.

According to the U.S. Census Bureau, approximately 1.5 million people in the United States use a manual wheelchair. This proportion increases with age; over 864,000 wheelchair users are over the age of 65. The reason for wheelchair use can be a sudden event like a spinal cord injury, stroke, or amputation, or the result of a progressive disease like multiple sclerosis, amyotrophic lateral sclerosis, or osteoarthritis.

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Due to the increased work demand of the shoulders and arms, wheelchair users often have shoulder pain and dysfunction. Upper body resistance exercises are an excellent way to build strength and improve movements. When used in combination with other treatments, strengthening exercises can decrease pain and improve the quality of life of wheelchair users.

A review in Topics in Geriatric Rehabilitation reports that for people who use a manual wheelchair, exercise programs should include training of the larger muscles of the trunk as well as stretching for the shoulders and chest.

Most wheelchair users consistently use their upper body, particularly the triceps and the shoulders, for movement, which puts extra strain on the joints and muscles. In order to prevent injury, it’s important to avoid imbalances by strengthening the muscles of the back and stretching the muscles of the chest.

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Some wheelchair users may have difficulty grasping onto handles, so modifications like the use of loops may be needed. The use of postural devices like a chest strap may be required to maintain balance.

Try these daily exercises to improve your strength, range of motion, and endurance if you use a wheelchair.

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Shoulder Openers

This activity provides a great stretch to the shoulder and chest muscles. It helps maintain mobility in the shoulders and upper extremities leading to decreased injuries and pain.

Equipment needed: broomstick or dowel

Muscles worked: rotator cuff muscles, pectoralis major, pectoralis minor, deltoids

  1. Remove armrests from the wheelchair if possible.
  2. Sit comfortably and hold a broomstick in your hands in a wide grip, about 6 inches wider than your shoulders.
  3. Raise the dowel up above your head, keeping your arms straight.
  4. Adjust your grip if necessary and continue behind your head until you feel a stretch.
  5. Hold for 5 seconds, return to starting position, and complete 10 reps.
  6. Repeat once a day.

Lat Pull Downs

This exercise strengthens the muscles of the mid back, upper arms, and core. The latissimus dorsi, the large muscles that run along the side of the back, are responsible for many of the movements we do everyday like pulling and pushing.

Equipment needed: resistance band with handles, anchor point (bar or hook 3 to 4 feet above head)

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Muscles worked: latissimus dorsi, rhomboids, trapezius

  1. Remove armrests from wheelchair if possible.
  2. Sit underneath and slightly in front of the resistance band, hanging from the bar.
  3. Sit up tall and engage your core by pulling your bellybutton toward your spine.
  4. Holding the handles in each hand, pull your hands toward you, keeping elbows wide.
  5. At the end of the movement, bring your elbows towards your body as if you are trying to tuck them into your back pockets. Squeeze your back muscles for a second, then return to starting position.
  6. Complete 15 reps. Rest 1 minute. Complete 3 sets.
  7. Repeat once a day.

Advanced

You can also perform this exercise on a cable machine at the gym. There are many variations of lat pull downs such as a wide grip pull down, narrow grip pull down, and reverse grip pull down. All of them work slightly different areas of the back.

Reverse Fly

The rear deltoid muscles run along the back of the shoulder and are necessary for shoulder stability and movement during pulling and lifting activities.

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Equipment needed: resistance band

Muscles worked: posterior deltoids, rhomboids, trapezius

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  1. Loop a resistance band around a pole or sturdy object in front of you at shoulder level.
  2. Hold the band securely in each hand and raise your arms out in front of you to shoulder level.
  3. Move your arms straight out to the side, focusing on sitting up tall and keeping your shoulders down and back. Squeeze the area between your shoulder blades on the end of the movement.
  4. Adjust length of the band to increase or decrease tension if necessary.
  5. Complete 15 repetitions. Rest 1 minute. Repeat 3 times.
  6. Repeat once a day.

Advanced

You can also perform this exercise on a cable machine at the gym. Have someone assist you with setup and use wrist loops if necessary. Keep your core tight and don’t sacrifice form for increased weight or repetitions.

Hand Cycling

This exercise is not only great for the arms and shoulders, but as a cardiovascular exercise which benefits heart health and overall well-being.

Equipment needed: hand ergometer (hand bicycle)

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Muscles worked: rotator cuff muscles, deltoids, rhomboids, latissimus dorsi, pectoralis major and minor

  1. Position yourself in front of the hand cycle at a comfortable distance.
  2. Set tension on cycle, start off easy, and increase tension as you get stronger.
  3. Move the pedals in a forward motion with your hands.
  4. Continue for 5 to 30 minutes.
  5. Pause activity if you are feeling any pain or become out of breath.
  6. Repeat once a day.

Warnings

Always consult your doctor beginning an exercise program.

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If these activities cause severe pain or discomfort, stop immediately and seek help. It’s always best to exercise with supervision and ask if help if needed. People with heart problems, muscle injuries, dizziness, vertigo, or high blood pressure should discuss exercise with their healthcare professional before engaging in resistance or cardiovascular exercise program.

Takeaway

Maintaining upper body strength and cardiovascular fitness is important for all people, including wheelchair users. By following a program that incorporates stretching, strengthening, and endurance exercises, you will be better able to complete daily tasks and prevent future decline.

Natasha
Article resources
  • Brault, M. (2010). Americans With Disabilities: 2010. Retrieved from http://www.census.gov/prod/2012pubs/p70-131.pdf
  • Merolla, G., Dellabiancia, F., Filippi, M. V., De Santis, E., Alpi, D., Magrini, P., & Porcellini, G. (2014). Assessment of the ability of wheelchair subjects with spinal cord injury to perform a specific protocol of shoulder training: a pilot study. Muscles, Ligaments and Tendons Journal, 4(2), 165–176.
  • Requejo, P. S., Furumasu, J., & Mulroy, S. J. (2015). Evidence-Based Strategies for Preserving Mobility for Elderly and Aging Manual Wheelchair Users: Topics in Geriatric Rehabilitation, 31(1), 26–41. Retrieved from http://journals.lww.com/topicsingeriatricrehabilitation/pages/articleviewer.aspx?year=2015&issue=01000&article=00005&type=abstract
  • Scheer, J., Groot, S., Tepper, M., Gobets, D., Veeger, D., & Woude, L. (2015). Wheelchair-specific fitness of inactive people with long-term spinal cord injury. Journal of Rehabilitation Medicine, 47(4), 330–337. Retrieved from
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