I have a disability called spina bifida which does not allow me to move as much. I already have an exercise plan where I’m doing 30 minutes of cardio and abdominal exercises. I can't lose weight that easily, so I give up. Can you think of any enjoyable exercise routines that would fit my disability?

-Craig from North Carolina

If you already have an exercise plan, that’s a great start. Bear in mind that the purpose of an exercise plan is more than just losing weight. There are many things that exercise provides that are more important in terms of assuring quality of life, such as cardiovascular health, muscular strength, mobility, balance, kinesthesia (physical awareness), and metabolic benefits (for example, improving insulin sensitivity). This doesn’t mean that you shouldn’t care about maintaining healthy levels of body fat, especially since excess weight can limit mobility and have various negative effects, but it does mean that there are many things to consider when judging whether an exercise plan “works.” The benefits of regular activity may not always be immediately obvious.

What should you look for in your exercise plan?

There are two main things to consider when looking for exercise that you’ll stick with:

• What your own abilities are (i.e. What movements can you do easily? do with some tolerable discomfort or difficulty? not do at all? What fits best into your lifestyle and schedule?)
• What kinds of things do you personally enjoy? (e.g. Do you like things that are social? Challenging? Sport-based? Etc.)

Exercise plan considerations for people with spina bifida

People with spina bifida tend to have lower levels of muscle mass compared to the general population, which means they require fewer calories overall. It also means that they are likely to benefit from a well-designed resistance training program.

If you need to be seated for much of the exercise, there are plenty of variations on good basic weight training exercises that you can do with free weights (which can be as light as you need). Check out this bodybuilding website and Exercise Rx—there are plenty of seated versions shown in the exercise directories. In addition, check out The National Center on Physical Activity and Disability’s website. They have plenty of ideas for training with spina bifida and mobility disorders.

Also, be creative! I’ve worked with clients who were in wheelchairs because of mobility disorders, and come up with lots of outside-the-box ideas for fun, interesting workouts. For example, we removed the seat from a regular stationary bicycle, pushed the wheelchair up behind it, and voila! instant cheapo recumbent bike! We did shadow boxing, practicing hitting and kicking targets from seated positions. If clients could stand and walk without too much effort, we’d swing a sledgehammer around, squat by getting in and out of a chair for reps, or have walking races uphill. Sometimes they could do quite a lot as long as they had something to hang on to for balance.

Bottom line: Think of the movements you can do, and then think of ways to make them fun and challenging. And add resistance, if possible.

Just a reminder: A good nutrition program is essential for losing body fat. You may wish to consult with a dietitian who can help you work towards your goals.

Krista Scott-Dixon, PhD Contributing Expert

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