The effects of exercise and a The effects of exercise and a wellness program on participation wellness program on participation

and secondary conditions on and secondary conditions on individuals with mobility individuals with mobility

impairmentsimpairments

By: Angie Monzin By: Angie Monzin

““Regular participation in Regular participation in exercise has been proven to exercise has been proven to

significantly reduce the risk for significantly reduce the risk for several chronic disease; yet the several chronic disease; yet the majority of the population does majority of the population does not exercise or maintain health not exercise or maintain health

lifestyles”lifestyles”

Froelich-Grobe & White, 2004

Addressing the ProblemAddressing the Problem

Barriers affecting participationBarriers affecting participation– Lack of accessible and affordable Lack of accessible and affordable

transportation transportation – Lack of accessible facilities and Lack of accessible facilities and

equipmentequipment– Lack of knowledgeable professionalsLack of knowledgeable professionals– Lack of financial resourcesLack of financial resources

Prevalence of secondary conditionsPrevalence of secondary conditions

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Secondary ConditionsColye et. al., 2000

Theoretical BasisTheoretical BasisIndependent Living movementIndependent Living movement

Item Rehabilitation paradigm Independent living paradigm

Definition of problem Physical impairment/ lack of vocational skill

Dependence on professionals, relatives,

etc

Locus of problem In individual In environment; in the rehab process

Solution to problem Professional intervention by

physician, physical therapist, occupational

therapist, voc rehab counselor, etc.

Peer counselingAdvocacySelf-help

Consumer controlRemoval of barriers

Social role Patient/client Consumer

Who controls Professional Consumer

Desired outcomes Maximum ADL, gainful employment

Independent living

ICFICF

Literature Review: Froelich-Grobe Literature Review: Froelich-Grobe & White Study& White Study

Despite the multiple health benefits that can arise from Despite the multiple health benefits that can arise from participating in exercise programs, almost 75% of individuals with participating in exercise programs, almost 75% of individuals with disabilities are sedentary or do not participate enough to remain disabilities are sedentary or do not participate enough to remain healthyhealthy

Randomized controlled trial designRandomized controlled trial design– Exercise intervention occurred within the home or community Exercise intervention occurred within the home or community

settingsetting

ResultsResults– Fitness data did not show significant improvements, except in Fitness data did not show significant improvements, except in

peak heart rate p value of .01peak heart rate p value of .01– Self reported data showed significance in increased activity Self reported data showed significance in increased activity

time, strengthening and cardio activity time increasetime, strengthening and cardio activity time increase

InterpretationInterpretation– The article provides a good basis for an exercise intervention The article provides a good basis for an exercise intervention

plan, but modifications need to be made. Increasing physical plan, but modifications need to be made. Increasing physical activity time is a good starting point, but health status and activity time is a good starting point, but health status and alleviation of secondary conditions need to improve as well.alleviation of secondary conditions need to improve as well.

Literature Review: Catherine Coyle Literature Review: Catherine Coyle and colleagues studyand colleagues study

Study showed that 97% of adults with physical limitations Study showed that 97% of adults with physical limitations experienced limitations in from secondary conditions and experienced limitations in from secondary conditions and reported having an average of 13 secondary conditions reported having an average of 13 secondary conditions within a year.within a year.A descriptive studyA descriptive study– Examining how secondary conditions and how they Examining how secondary conditions and how they

affected or were related to women’s overall well being affected or were related to women’s overall well being Results showedResults showed– Women were impacted emotionally, physically, and Women were impacted emotionally, physically, and

socially because of their secondary conditionssocially because of their secondary conditionsFurther researchFurther research– Needs to address which specific secondary conditions Needs to address which specific secondary conditions

cause the most stress and harmcause the most stress and harm– The impact of secondary conditions on overall well The impact of secondary conditions on overall well

being, life satisfaction, and quality of life needs further being, life satisfaction, and quality of life needs further researchresearch

Literature Review: Charlifue StudyLiterature Review: Charlifue Study

A prospective longitudinal studyA prospective longitudinal study– Addressing the health status in individuals with spinal cord Addressing the health status in individuals with spinal cord

injury across duration of injury, type of injury, and ageinjury across duration of injury, type of injury, and age

Results:Results:– Common secondary conditions associated with length of Common secondary conditions associated with length of

injury are: joint pain, fractures, motor or sensory changes, injury are: joint pain, fractures, motor or sensory changes, and total cholesterol level increased. and total cholesterol level increased.

– Pneumonia, pressure sores, and an increased serum Pneumonia, pressure sores, and an increased serum creatinine level are common symptoms that are associated creatinine level are common symptoms that are associated with the age of the individual. with the age of the individual.

– Symptoms that are prevalent regardless of duration of Symptoms that are prevalent regardless of duration of injury or age are heart conditions, rectal bleeding, and injury or age are heart conditions, rectal bleeding, and renal stones. renal stones.

– In addition to psychological symptoms, depressive In addition to psychological symptoms, depressive symptoms are common in individuals with a SCI, which symptoms are common in individuals with a SCI, which may be due to a lack of participation and poor healthmay be due to a lack of participation and poor health

PurposePurposeThe purpose of my research is to measure The purpose of my research is to measure how health and wellness programs with how health and wellness programs with exercise components affects the exercise components affects the prevalence of secondary conditions and prevalence of secondary conditions and the impact on participation in the the impact on participation in the communitycommunity

Similar modelsSimilar models– Program Shake-It-UpProgram Shake-It-Up– PAD model, Physical Activity for People with PAD model, Physical Activity for People with

Disabilities ModelDisabilities Model

HypothesesHypotheses1) involvement in an exercise program 1) involvement in an exercise program developed for individuals with mobility developed for individuals with mobility impairments will reduce the duration, impairments will reduce the duration, frequency, and severity of secondary frequency, and severity of secondary conditions; conditions; 2) the exercise program will increase the 2) the exercise program will increase the individual’s overall health (strength, heart individual’s overall health (strength, heart rate, endurance, self-esteem, etc) rate, endurance, self-esteem, etc) therefore therefore 3 ) increasing overall health will be 3 ) increasing overall health will be associated with an increase in associated with an increase in participation in the community. participation in the community.

VariablesVariables

Independent variablesIndependent variables– Exercise programExercise program– Secondary conditions handbookSecondary conditions handbook

Dependent VariablesDependent Variables– Duration, frequency, and severity of Duration, frequency, and severity of

secondary conditionsecondary condition– ParticipationParticipation

MeasurementsMeasurements

ParticipationParticipation– Community Participation and Receptivity Community Participation and Receptivity

Survey (CPRS)Survey (CPRS)

Possible evaluation of secondary Possible evaluation of secondary condition variables: condition variables: – Doctor visitsDoctor visits– Emergency room visitsEmergency room visits– Personal log booksPersonal log books