What I did
"Loved One" in this instance is a close female friend who uses a wheelchair, is like myself aging and retired. Aging has resulted in additional conditions that exercise can reduce the ill effects of, notably weight gain and scoliosis. The origin of her use of the wheelchair is cerebral palsy, a condition (caused by brain damage around the time of birth and marked by lack of muscle control, especially in the limbs--"Encarta Dictionary") that I knew little about when I took on the challenge of developing and practicing partnering exercises with her about a year ago.
How I did it
We began with standard flexibility, strength-building, and cardio-vascular exercises performed in gym settings, adapting them in the safest manner, with fitness equipment of a compact kind--wrist weights, dumbbells, fitness ball, and body bar, given that she lives in a small apartment with little storage space.
A good resource is About.com, Paige Waehner, 30-day fitness program. We sought this continuum: theory, exercise, workout, program and from Kraemer and Fleck, 2007, "non-linear periodization."
A palsy condition does not permit all of the concentric or eccentric movements in an exercise; thus, the partnering.
We began using a selection of the exercises I individually perform at my fitness club.
We logged them: first by type, dividing them by major and minor body group; then our use of each type; finally with details. The about.com fitness website provides hundreds of examples of the correct way to define or depict exercises.
We work our way exercise-by-exercise through fitness books alternating between the flexibility, strength-building, and cardio-vascular standard ones.
Our version of the squat is done as follows: First the constraints—her legs are atrophied, one effect of the cerebral palsy, and she can’t bend them at the knees and, of course, her gym space is a wheelchair. She can’t stand alone except to pivot from one location to another. She also has some chronic injuries of the arm, shoulder, hip, and neck, plus scoliosis. We put safety at the start of every exercise and at the start of every movement, for any further injury can be a cause for requiring her to be hospitalized and deprive her of her independence.
Her legs can be involuntarily bent at the knees and upward from the hip. Then she is free to and has the strength to straighten them once they have been pushed up. Thus the partnering. I provide relative resistance when she pushes back to the starting position, recommending in the same effort, chest expansion, abdominal flexing, and rhythmic breathing.
Needless to say pictures are essential and I again recommend the about.com website for theirs; Kraemer and Fleck, 2005, and others as well.
Lessons Learned
- The partnering activity I am able to perform with my "loved one" does not meet the minimum requirement for weekly physical activity outlined in the 2007 ACSM and AHA guidelines on physical activity. A home gym is at best a poor substitute for a fitness center, whether it is a club gym of the kind I personally attend or one like the one at the rehabilitation hospital where she spent some time as a child and more recently in an emergency. Gyms in general are not wheelchair accessible or wheelchair amenable. Ultimately these are social and political constraints, which I can't relate here.
