In honor of Bladder Health Week we are posting information on bladder care during exercise.  Today we will focus on Resistance Training for those with physical disabilites.   

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org  

Resistance Exercise Guidelines for Persons with Physical Disabilities

There are several factors that must be considered when prescribing resistance exercise to persons with physical disabilities. Most importantly, the resistance training program will depend on the severity of the disability and its associated conditions. Some clients will be able to train at very high intensity levels, while others will only be able to perform at minimal levels of resistance (i.e., lifting a body part against gravity). The training load (number of sets and repetitions, frequency, rest interval between sets) will also vary in persons with similar and different types of physical disabilities. For example, two individuals with multiple sclerosis may require a completely different training regimen because of the type of multiple sclerosis, length of time they have had the condition, and their age. On the contrary, two individuals with stroke and cerebral palsy may have a similar program, because they exhibit the same associated conditions (i.e, non-progressive hemiplegia, spasticity) and are at the same baseline level of strength.

A major determinant of training volume is the amount of muscle mass that is still functional. Persons with paralysis, hemiplegia, impaired motor control, or limited joint mobility have less functional muscle mass and will therefore require a lower training volume. For individuals who cannot lift the minimal weight on certain resistance machines, resistance bands or cuff weights are recommended. If bands and cuff weights are too difficult, use the person’s own body weight as the initial resistance. For example, lifting an arm or leg for 5 to 10 seconds may be the initial starting point for clients with very low levels of strength.

The training load will also depend on the type of disability. In general, individuals who do not have a progressive disorder (i.e., spinal cord injury, cerebral palsy) will be able to work at higher intensity levels than persons with progressive disorders (i.e., multiple sclerosis, postpolio).

Training volume will also depend on the person’s health status. For example, a person with stroke and hypertension should not perform high intensity exercise. Individuals who are seizure-prone or fatigue easily require a reduction in training volume. Many individuals with physical disabilities who have been inactive for much of their lives need only a small amount of resistance exercise during the initial stage of the program to obtain a training effect. How quickly a person is able to progress during the conditioning stage will depend on the person’s health status. For individuals who start out at very low levels of strength, significant improvements can be made with very light resistance.

Modes of resistance exercise consist of three general categories: free weights, portable equipment (i.e., elastic bands, tubing), and machines. Any of these modalities is acceptable for improving strength levels except in cases where the individual is at risk for injury. For example, persons with multiple sclerosis and cerebral palsy often have impaired motor control and may have a higher risk of dropping a free weight or having an elastic band snap back too quickly. When an instructor feels that the resistance mode presents a danger to the client, the exercise routine should be either adapted (i.e, securing the weight to the hand, changing the movement) or substituted with a safer piece of equipment.

Some experts argue that free-weight exercises have greater value for persons with physical disabilities because the resistance can be tailored to resemble a functional daily activity (Lockette, 1995). Free weights also require the action of stabilizing muscles around the torso and joints while lifting and lowering the resistance, which are muscle groups that need strengthening in persons with physical disabilities in order to maintain the ability to perform ADL and IADL. However, free weights require good trunk stability and may be difficult to perform in individuals who have severe limitations in motor control and coordination.

In clients with very low strength levels, gravity-resistance exercise may be all that the person is capable of doing. Performing 8-12 repetitions of a certain movement, such as abducting an arm or extending a leg, may be a good entry point These exercises can be used with extremely weak musculature while other modes of resistance exercise can be used with stronger muscle groups. Once an individual is able to complete 8-12 reps of a gravity-resistance exercise, the person could progress to free weight, bands or machines. If a client is unable to move a limb against gravity because of extreme weakness (often seen in the late stages of multiple sclerosis or in person with high-level quadriplegia), the instructor could place the limb in a certain position (i.e., should abduction) and have the client hold the position isometrically for a few seconds or longer.

Active-Assistive exercise may be required for certain individuals who do not have enough strength to overcome the force of gravity. The instructor can assist the client in performing the movement by providing as much physical assistance as necessary to complete the repetition. At various points in the concentric phase (against gravity), the instructor may have to help the client maintain the resistance. During the eccentric phase (with gravity), the instructor controls the movement so that the weight is not lowered too quickly. In many instances, active-assistive exercise can be used with severely weak musculature while active resistance exercise (performed without assistance) can used with stronger muscle groups.

The instructor should make every effort to avoid fatigue and delayed-onset muscle soreness in individuals with physical disabilities. Although this is a common side effect of any new resistance training program, it could present a problem for persons with physical disabilities if the soreness prevents them from conducting their normal activities of daily living (ADLs). Even though a client with a physical disability may aspire to make rapid gains in strength and can train at a moderate to high intensity level, the instructor should be cautious in not overworking the muscle groups, particularly in clients with progressive disorders. Use light resistance for at least the first month of the program (30 to 50% of 1-RM) and only proceed to higher training loads if muscle soreness and fatigue are not present.

If soreness in certain muscle groups prevents the person from performing routine daily activities, the exercise should be stopped until the pain subsides. If it continues after the program resumes, the instructor may need to reduce the training volume or avoid certain exercises that incur pain or fatigue. If there are prolonged bouts of pain or soreness 24 to 48 hours after exercise, the client should consult with his or her physician to determine the cause.

Developing the greatest amount of strength in the affected muscle groups may result in a “reservoir”of strength that can be help decrease the severity of an exacerbation. Theoretically, the more muscle strength one has before an exacerbation, the more likely he or she will be able to maintain a high enough level of strength to stay above the “physical dependence” threshold. Progressive disorders (i.e., multiple sclerosis) make it very difficult to determine the success of the resistance training program. However, the general feeling among rehabilitation professionals is that improvements in strength may help delay the progression of muscle weakness and permanent disability. If an individual achieves a gain of 30 to 40 percent in strength before an exacerbation, a loss of strength may still keep the individual at a high enough level to still be able to perform ADL and IADL.

Many physical disabilities result in hand dysfunction. This may make it difficult to grasp barbells or handles on different strength machines. There are several versions of specially-designed gloves that are available commercially that will allow the person’s hand to maintain contact with the resistance equipment. Gloves will also protect the hand from injury while performing resistance training routines. Participants who do not have good grip strength can use wrist cuffs or leather mitts with velcro and buckles to secure their hands to dumbbells or weight equipment. Many individuals with physical disabilities will exhibit asymmetrical weakness or will have a disproportionately greater amount of weakness to the flexor or extensor muscle groups. This will depend on where the injury site is in the brain or spinal cord and whether or not the condition is progressive in nature. It is important to evaluate individual muscle groups on both sides of the body, as well as anteriorly and posteriorly, to isolate the degree of weakness to key muscle groups.

Individuals with asymmetrical weakness will often “hike” their body toward the weaker side in order to compensate for this weakness while lifting the resistance. This could impose mild or moderate muscle strain. Make sure that the client is lifting the weight with proper form. If there is a tendency to “hike” the body, lower the resistance and emphasize good form.

Blood pressure should be monitored frequently during the early stages of the program. In some individuals with physical disabilities (i.e., stroke, SCI), hypertension or hypotension is a common problem. It is recommended that blood pressure be measured before exercise and before and after each set. Once the client adjusts to the program and there no wide fluctuations in blood pressure, it can be measured before and after each training session.

As posted at:

National Center on Physical Activity and Disability

 http://www.ncpad.org  

In honor of Bladder Health Week we are posting information on bladder care during exercise.  Today we will focus on those with Multiple Sclerosis and Thursdays focus will be Resistance Training for those with physical disabilites.  

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org 

Best Exercises and Measurement of Aerobic and/or Strength Capacities

TrainingRegarding best exercises, in 1992 Ponichtera et al. measured muscle torque at several speeds for both concentric and eccentric contraction on 9 subjects with multiple sclerosis and 9 healthy controls who generated isokinetic contractions of the quadriceps and hamstrings on an isokinetic dynamometer. They concluded that strengthening programs focusing on concentric exercises at 90 degrees per second may be the preferred strengthening exercise for subjects’ quadriceps and hamstring muscles.

MeasurementIn 1993, the same team examined maximum aerobic capacity in 9 subjects with multiple sclerosis (EDSS 1-4) and 9 control subjects on recumbent leg ergometers on land and in water. They determined that some persons with multiple sclerosis (depending on level of impairment) could attain maximum aerobic capacity without side effects, whereas those with more physical impairments would need more adjustments, such as for leg cycling (Ponichtera et al., 1993).

In 1995, Ponichtera et al. studied the best means of exercise testing and practice for persons with multiple sclerosis. Vo2max was measured in a discontinuous, progressive intensity exercise test on 10 subjects with multiple sclerosis and 10 control subjects generating each of 3 modes of ergometry (leg, arm, and leg/arm) on 3 separate days. The investigators concluded that the combined leg/arm ergometry is preferred because (1) upper extremities need more training and training legs alone is insufficient, and (2) using leg and arm power disburses the exercise load over a larger muscle mass and there is less possibility for “localized” fatigue.

Regarding measurement of strength capacities, Pepin et al. (1998), conducted a study of 14 subjects with multiple sclerosis who performed isometric handgrip contractions at 30% maximal voluntary contractions (MVC) to the point of fatigue. The results showed that it is possible to get consistent reliable responses to this exercise, despite motor dysfunction. (The MVC reliability estimates were 0.98.) The authors, however, did question the replicability of their findings for subjects with higher EDSS levels.

FatigueResearchers studying fatigue during exercise have attempted to isolate and measure fatigue and weakness/strength components, and have questioned to what extent the fatigue is due to intrinsic physiological deficits or deconditioning.

Recently, Schwid et al. (1999) studied the quantitative assessment of motor fatigue and strength in 20 subjects with multiple sclerosis and 20 control subjects. Maximal voluntary isometric strength, motor fatigue, and static fatigue were tested and retested by different exercise and strength tests in 2 distinct sessions, in order to measure test-retest reliability. Results showed that though subjects with multiple sclerosis had more fatigue for sustained contractions, repetitive contractions, and ambulation, motor fatigue was different from weakness since the fatigue was not correlated with weakness from individual muscles. This suggests that strength and motor fatigue can be quantified reliably.

In 1994, Kent-Braun et al. studied a sample of 6 subjects with multiple sclerosis and 8 control subjects to investigate the role of metabolism in muscle fatigue during exercise. They measured the peak force generated from a maximal voluntary isometric contraction during 3 sessions and determined that for mildly impaired persons with multiple sclerosis, muscle fatigue during exercise is not related to metabolic, but to activation failures. It was observed that decreases in force during exercise were because of peripheral, not central mechanisms. In 1995 and 1996, the same team studied electrically-stimulated exercise training for subjects with multiple sclerosis and discovered that the fatigue during exercise is because of muscle intrinsic, not metabolic, properties (Kent-Braun et al., 1996)(Sharma et al., 1995). 

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org 

In honor of Bladder Health Week we are posting information on bladder care during exercise.  Today we will focus on those with Spinal Cord Injuries.  Wednesday’s focus is for those with Multiple Sclerosis and Thursdays focus will be Resistance Training for those with physical disabilites.  

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org

Importance of Exercise

• Prevents secondary conditions such as cardiovascular disease, diabetes, pressure sores, carpal tunnel syndrome, chronic obstructive pulmonary disease, hypertension, urinary tract infections, and respiratory disease.

• Prevents deconditioning and obesity

• Provides psychological and/or recreational benefits

Best Exercises for Persons with SCI

• Aerobic exercise to maintain cardiovascular health

• Strength training to maintain the ability to perform activities of daily living and mobility, as well as to prevent injury through muscular balance

• Flexibility training to improve range of motion and reduce spasticity

Important Considerations When Exercising

• Incontinence (flaccid or neurogenic bowel/bladder) - Individuals with lesions above the sacral level experience a loss of control with their bowel or bladder.KEY: Monitor urinary cycle, be sure to empty your bowel and bladder before starting exercise.

• Spasticity - This condition is characterized by high muscle tone and hyperactive stretch reflexes. It typically occurs in the muscles below the site of injury and is exacerbated by exposure to cold air, urinary tract infections and physical exercise.KEY: You should stretch spastic muscle groups and avoid exercises that cause excessive spasticity. When you are at home you should extend your legs as often as possible.

• Autonomic Dysreflexia - A sudden rise in blood pressure resulting from an exaggerated autonomic nervous system response to noxious stimuli below the level of injury, usually due to bladder/bowel overdistension or blocked catheter. Symptoms include profuse sweating, sudden elevation in blood pressure, flushing, shivering, headache, and nausea.KEY: Seek medical attention immediately when it occurs.

• Orthostatic hypotension - A drop in blood pressure (greater than 20 mmHg for systolic blood pressure and greater than 10 mmHg for diastolic blood pressure). It occurs in upright postures, especially moving from supine to upright sitting/standing/head-up tilt. Symptoms include nausea, dizziness and light-headedness.KEY: Monitor blood pressure throughout exercise, avoid quick movements, perform orthostatic training (if available), maintain proper hydration, and use compression stockings and an abdominal binder. If orthostatic hypotension occurs, lie in a supine position with your feet elevated.

• Thermoregulation - Irregular body temperatures are often experienced by individuals with SCI.KEY: Wear appropriate clothing, drink plenty of fluids and take precautions in certain environments; in warm environments, a fan and water spray will aid in cooling, and in cold environments, wear extra layers.

• Pressure sores (decubitus ulcers) - Damage to the skin or underlying tissue caused by prolonged sitting, using old wheelchair cushions, sitting on hard surfaces, shear forces or as a result of a fall.KEY: Check skin regularly and perform wheelchair push-ups. (See strength training section for protocol.)

• Transfers - Be sure to follow appropriate guidelines.

• Balance - Use straps or other physical assistance to hold the trunk in position during upright exercise.

Cardiovascular Training Guidelines

The American College of Sports Medicine (ACSM) recommends performing 20 to 60 minutes of continuous aerobic exercise or multiple sessions of short duration (approximately 10 minutes) for three to five sessions per week. For individuals just starting an exercise program, a circuit training program is effective.

Aerobic exercise can be monitored using an individual’s maximal heart rate (MHR) or rating of perceived exertion (RPE). MHR for individuals with SCI is significantly lower than for individuals without SCI while RPE should be moderate to somewhat strong. See NCPAD’s General Exercise Instructions factsheet for more information.

Quadriplegia

MHR typically does not exceed 100 to 125 bpm, and training intensity should be between 50% and 70% maximal heart rate. Therefore, an average target heart rate (THR) falls between 65 and 91 bpm.

Arm ergometry is a preferred type of exercise training for individuals with quadriplegia. Be sure the wheelchair is locked, the hands are secured to the equipment (straps can be used for stability and balance) and the ergometer is in a fixed position.

Paraplegia

The MHR of individuals with a lesion T1 to T6 is suppressed; however, for lesions below T6, the MHR is closer to the age-predicted maximum. Training intensity should not go above 70%.

Types of cardiovascular training that benefit individuals with paraplegia are wheelchair ergometry, upper-body calisthenics, rowing machine, sports: (basketball, track, swimming, quad rugby), and functional electrical stimulation-leg cycle ergometer (FES-LCE).

Strength Training Guidelines

• Training sessions should be held three days per week.

• Refrain from training the same muscle groups on consecutive days.

• Upper-body pushing and pressing exercises (bench press, overhead press) will help transfers and wheeling, while pulling/rowing exercises will help prevent shoulder overuse injuries and improve sitting posture.

• Perform wheelchair push-ups every 10 to 30 minutes and hold for 30 to 60 seconds. When doing wheelchair push-ups, be sure to bend the elbows slightly.

• Use straps or a partner for stabilization and balance.

• Vary exercises to reduce over-use injuries and emphasize muscle groups that are still functional.

Types of strength training that benefit individuals with SCI are free weights, weight machines (Nautilus, for example), medicine ball, wall pulley, and theraband.

Flexibility Training Guidelines

Flexibility training is important to prevent contractures (permanently shortened muscles). Paralyzed muscles should be passively stretched by an exercise specialist; specifically, the hamstrings, adductors, hip flexors, plantar flexors, and lumbar extensors.

Types of flexibility training are:

• Passive resistance

• Theraband

• Standing in a standing frame (if not medically contraindicated).

Important Safety Considerations

• Get physician consent.

• Regularly monitor blood pressure, heart rate, RPE, and symptoms.

• Stop exercising if you feel pain or discomfort.

• Don’t exercise if you are ill (i.e., cold, flu, bladder infection, pressure ulcer, unusual spasticity).

• Check medications and their effect on exercise tolerance.

• Extended periods of inactivity may cause osteoporosis.

Special thanks to Dr. Steven Figoni and Bridget Collins.

Note

The information provided here is offered as a service only. The National Center on Physical Activity and Disability, University of Illinois at Chicago, the National Center on Accessibility, and the Rehabilitation Institute of Chicago do not formally recommend or endorse the equipment listed. As with any products or services, consumers should investigate and determine on their own which equipment best fits their needs and budget.

National Center on Physical Activity and Disabilityhttp://www.ncpad.orgncpad@uic.edu(800) 900-8086 (voice and TTY)(312) 355-4058 (facsimile)

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org 

In honor of Bladder Health Week we are posting information on bladder care during exercise.  Today we will focus on Spina Bifida.  Tuesday will be focused on those with Spinal Cord Injuries.  Wednesday’s focus is for those with Multiple Sclerosis and Thursdays focus will be Resistance Training for those with physical disabilites.  

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org

SPINA BIFIDA 

Importance of Exercise

• Prevents deconditioning, and promotes function and endurance.

• Helps prevent obesity.

• May help improve constipation, resist infection, improve mood, reduce stress, prevent diabetes and atherosclerotic heart disease, and helps lower blood pressure.

Important Considerations When Exercising

• Maintain proper posture at all times.

• Many people with spina bifida have latex allergy. If this is the case, always check beforehand to make sure that the exercise equipment is not made of latex. Equipment manufacturers such as Thera-band® offer latex-free versions of their products.

• Incontinence (flaccid or neurogenic bowel/bladder) - Individuals may experience a loss of control with their bowel or bladder. KEY: Monitor urinary cycle, be sure to empty your bowel and bladder before starting exercise.

• If you have a shunt or have had scoliosis surgery, you should discuss exercise activity with your doctor. Avoid excessive trauma to the shunt and tubing.

• Thermoregulation - Irregular body temperatures are often experienced by individuals with SB. KEY: Wear appropriate clothing, drink plenty of fluids and take precautions in certain environments; in warm environments, a fan and water spray will aid in cooling, and in cold environments, wear extra layers.

• Pressure sores (decubitus ulcers) - Damage to the skin or underlying tissue caused by prolonged sitting, using old wheelchair cushions, sitting on hard surfaces, shear forces or as a result of a fall. KEY: Check skin regularly and perform regular wheelchair push-ups, or have the individual reposition him-/herself regularly especially when engaged in wheelchair sports. (See strength training section for protocol.)

• Fractures - the bones of the weak limbs may not be as strong as normal (osteoporosis), and can be at risk of breaking with less force than normal. In areas of poor sensation, the only signs of fracture may be redness and swelling of the limb, without pain. If the individual has a concern, have him/her see a doctor.

• Transfers - When applicable, wheelchair users need to know how to transfer him-/herself safely from the wheelchair to an accessible exercise machine. People who provide assistance to wheelchair users should be trained to follow the appropriate guidelines for safe transfers.

• Balance - Use straps or other physical assistance to hold the trunk in position during upright exercise.

• If during exercise, foot and leg swelling occurs, resolve with leg elevation. If swelling is persistent, the individual should discuss this with his/her doctor. Compression stockings may also be helpful to keep swelling down. Monitor skin closely for breakdown in areas of swelling.

• Spasticity - This condition is characterized by high muscle tone and hyperactive stretch reflexes. It typically occurs in the muscles below the site of injury and is aggravate by exposure to cold air, urinary tract infections and physical exercise. KEY: You should stretch spastic muscle groups and avoid exercises that cause excessive spasticity. When you are at home you should extend your legs as often as possible. Discuss ways to reduce muscle spasticity that interferes with activity, with your doctor or physical therapist.

Important Safety Considerations

• Inform your physician that you are starting a regular exercise program.

• Start slowly, beginning with only a few sets and/ or repetitions, or with lesser resistance/ weight. Then gradually build these elements up as you go.

• Warm-up for approximately 10 minutes before starting your exercises, and cool-down after your exercise session.

• Regularly monitor blood pressure, heart rate, and rate of perceived exertion (RPE). (See NCPAD’s General Exercise Guidelines factsheet for more information.)

• Stop exercising if you feel pain or discomfort.

• Don’t exercise if you are ill (i.e., cold, flu, bladder infection, pressure ulcer, unusual spasticity).

• Check medications and their effect on exercise tolerance.

• Extended periods of inactivity may cause osteoporosis.

Cardiovascular Training Guidelines

• Aerobic exercise is important for everyone to maintain cardio-respiratory fitness and endurance.

• The American College of Sports Medicine (ACSM) recommends performing 20 to 60 minutes of continuous aerobic exercise or multiple sessions of short duration (approximately 10 minutes) for three to five sessions per week. For individuals just starting an exercise program, a circuit training program is effective.

• Aerobic exercise can be monitored using an individual’s maximal heart rate (MHR) or rating of perceived exertion (RPE). MHR for individuals with SB may be significantly lower than normal, while RPE should be moderate to somewhat strong. (See NCPAD’s General Exercise Guidelines factsheet for more information.)

• Types of cardiovascular training that benefit individuals with spina bifida are upper-body calisthenics, using the rowing machine, hand cycles and arm ergometers, functional electrical stimulation-leg cycle ergometer (FES-LCE), and adapted sports such as, basketball, track, swimming.

Strength Training Guidelines

• Individuals should strength train all active muscle groups. Start with low weights and gradually build up the program as you get stronger. A fitness trainer may be helpful in setting up a program for you.

• Training sessions should be held three days per week.

• Refrain from training the same muscle groups on consecutive days.

• In order to maintain proper body posture, balance, and equilibrium, wheelchair users need to strengthen the muscles of the shoulder and upper back.

• Upper-body pushing and pressing exercises (bench press, overhead press) will strengthen muscles used for transfers and wheeling, while pulling/rowing exercises will help prevent shoulder overuse injuries and improve sitting posture.

• Perform wheelchair push-ups every 10 to 30 minutes during the day, and hold for 30 to 60 seconds. When doing wheelchair push-ups, be sure to bend the elbows slightly. Lock the wheels and keep anti-tip bars in position. One way to remember this is the “rule” 30 second push-up off the chair every 30 minutes. Some people find it helpful to get a digital watch that beeps every 15 minutes as a reminder.

• For individuals who have movement in their legs, leg exercises can include knee lifts from a sitting position (marching movement), and foot lifts from a sitting position (straightening the knee). Do up to 10 on each side once or twice a day, and add sets of 10 as you gain strength. You can also add ankle weights as your strength improves.

• Use straps or a trained partner for stabilization and balance.

• Vary the type of strengthening exercises to reduce over-use injuries.

• Types of strength training that benefit individuals with spina bifida are free weights, weight machines (Nautilus, for example), medicine ball, wall pulley, and Thera-band®.

Flexibility Training Guidelines

• Flexibility training is important to maintain range of motion in joints, as well as to prevent shoulder injuries in persons who use wheelchairs or crutches.

• Flexibility training also helps to prevent contractures (permanently shortened muscles). Paralyzed muscles should be stretched by a physical therapist, exercise specialist, or by a trained assistant or family member. Muscles that need to be stretched include the hamstrings (the back of the thigh), adductors (inner thigh), muscles that flex the hip, muscles that flex the foot, and muscles that extend the back. Having the individual lie on his/her stomach for rest periods can also help stretch muscles of the hips and back of the thighs.

• Stretches for the muscles of the chest and front of the shoulder are recommended especially for wheelchair users, who tend to have a crouched posture.

• Stretch the shoulders by grasping the elbow with the arm overhead, and pulling back to stretch gently. You can also stretch the front of the shoulder by placing your hand on a wall, fingers pointed backwards with the arm outstretched, and lean forward towards the wall. Hold for one minute each side.

• Stretching the calf muscles helps to decrease swelling, especially if combined with leg massages.

• Types of flexibility training are passive resistance, Thera-band® elastic bands or tubings, standing in a standing frame (if not medically contraindicated), yoga and Pilates.

Note

The information provided here is offered as a service only. The National Center on Physical Activity and Disability, University of Illinois at Chicago, the National Center on Accessibility, and the Rehabilitation Institute of Chicago do not formally recommend or endorse the equipment listed. As with any products or services, consumers should investigate and determine on their own which equipment best fits their needs and budget.

As posted at:

National Center on Physical Activity and Disability

http://www.ncpad.org

As written by: Ben Smith 

As posted at: www.jg.net Nov. 9th, 2008

Emily Shryock chases a loose ball in rugby practice. Quad rugby is one of the newer sports at Turnstone.

The latest trophy sits on the receptionist’s desk, adorned with a handwritten note: “Bandits won this!” And if it had elbows, they would be up.

How else, if not with a tiny, well-placed elbow, will this latest treasure clear a space in the laden trophy case at Turnstone Center for Children and Adults with Disabilities?

Tucked away down a back hall here are basketball trophies and power soccer trophies and more basketball trophies, one gleaming inscribed surface melding into the next. Beribboned medals of all shades spill across the shelves. There are team photos and handsome wood plaques and more team photos.

It’s the most visible evidence of what Kevin Hughes is talking about this November night in the Turnstone gym, where the Fort Wayne Bandits adult wheelchair basketball team has turned over the practice floor to the quad rugby players.

“When I was first getting involved with adaptive sports, the only real option was basketball.,” says Hughes, as the quad rugby players gleefully bash into one another. “I kind of got that going, and that was a lot of fun. But to see the last five years or so, to see it expand to power soccer, quad rugby, tennis, sled hockey …

“It’s good. It’s good because you can’t always assume everybody’s just gonna love one sport. You can’t lock everyone into that one category.”

No problem these days. There’s basketball, first off; the nationally ranked prep Turnstone Flyers, whom Hughes coaches, and the varsity Flyers, and the two-time Mid-American Wheelchair Basketball Conference champion Bandits. There’s the Fantastic Flyers power soccer team, the defending national Division II champions. There’s quad rugby. There’s tennis. There’s Gold Ball, which is soccer for the blind that uses a beeper ball.

There’s even sled hockey, the newest Turnstone adaptive sport, which started last year thanks to the cooperative efforts of Turnstone, Parks and Recreation and the MAC ice facility at McMillen Park. In February, over Valentine’s Day weekend, Turnstone will play host to its first tournament, the Bob Chase Frostbite Sled Hockey Championships.

“It’s still in the building stages,” says Hughes, noting there are only between 7 and 11 players right now. “We’ll get there, little by little.”

Larry Smith knows all about little by little. Forty-eight years old, he’s been in a chair since he was 18, long enough to remember a time when not even wheelchair basketball was available locally. So he took up wheelchair marathoning to stay active … after which he moved to California … after which he met a Vietnam vet from South Whitley named Tim Davis, who introduced him to wheelchair hoops … after which he got involved in wheelchair tennis and skiing, too.

Now he plays basketball for the Bandits, undefeated at 7-0 this season and annually one of the top adult teams in the nation. They’re rated second nationally at the moment.

“Yeah, we’ve become a pretty darn good ballclub over the years,” Smith says, as longtime teammate Dan Jacquay, 56, nods in agreement. “We love it, man. It’s a blast. It’s a great way to get rid of your aggressions and work up a sweat.

“Me, I always liked playing basketball as a ‘wholly’ (aka, able-bodied person). The competition, that’s the key, you know. We like going out and kicking people’s butts just like we did when we were young. That’s the best part of it.”

The adult game is played by college rules, with a 35-second shot clock. It is, Smith says, “fast and physical and you beat on each other.” And it isn’t age-specific; the Bandits’ roster includes the Smiths and the Jacquays to players such as Nate Silvers, who’s 23.

“When I first started, there weren’t as many sports around here,” Silver says. “We’d see rugby on the road and stuff when we’d go to tournaments. But now there’s a lot more of them out there than there used to be even two years ago.”

Better add on to that trophy case.

Group huddle of the Turnstone Fearless Flyers Power Soccer Team.

Picture from http://www.powersoccerusa.net/ which was taken at June 13-15, 2008 USPSA Nationals.

At the November 15, 2008 ‘Power Soccer Challenge’ hosted by Turnstone the two local teams dominated the field by going a combine 5-1 with the only loss coming from the Turnstone Fantastic Flyers in the head to head match-up against their sister team Turnstone Fearless Flyers 2-0.

Below are tournament scores along with stats from both Turnstone teams (Fantastic & Fearless Flyers)

Game 1      Kokomo Spinners 1                    Turnstone Fantastic Flyers 6

Luke Labas 2 Goals 1 Assist

Robin Gibson 1 Goal

Julie Myers 3 Goals 1 Assist

Tiffany Shoda 2 Assists

Quick Nugget: Turnstone Fantastic Flyers athletes 11 Lucas Wable, 23 Chris Martinez, and 5 Eric Barron all playing in first tournament

Game 2      RHI Indy Cruisers 3                    Turnstone Fantastic Flyers 5

Luke Labas 1 Goal 1 Assist

Robin Gibson 1 Goal

Julie Myers 3 Goals

Quick nugget: Robin Gibson score the game winning goal while Julie Myers notched back-to-back hat-tricks

Game 3      Kokomo Spinners 0                    RHI Indy Cruisers 1

Game 4      Ball State Cardinals 2                 Kokomo Spinners 1

Game 5      RHI Indy Storm 0                       RHI Indy Cruisers 5

Game 6      Turnstone Fantastic Flyers 0       Turnstone Fearless Flyers 2

Colin McIntire 2 Goals

Quick Nugget: Both goals came in the 1st half

Game 7      Ball State Cardinals 0                 Turnstone Fearless Flyers 5

Zachary Kieser 2 Goals

Brandon Stump 3 Goals

Colin McIntire 1 Assist

Quick Nugget: Former Fantastic Flyers player Kent Romy, who graduated from Northrop High School last year, is now a freshman at Ball State University and plays for their power soccer team.

Game 8      Ball State Cardinals 5                 RHI Indy Storm 2

Game 9      RHI Indy Storm 2                       Turnstone Fearless Flyers 11

Chad Cahill 1 Goal 1 Assist

Zachary Kieser 3 Goals 2 Assist

Brandon Stump 3 Goals 1 Assist

Colin McIntire 2 Goals 1 Assist

Greg Buse 1 Goal   

Autry Keener 1 Goal

Quick Nugget: Autry Keener played in his first tournament.

Both Fort Wayne teams look solid this season as they try to recap last season (07-08) impressive finish when the Turnstone Fantastic Flyers edge out their sister team the Turnstone Fearless Flyers 2-1 in the Championship game (June 15, 2008) to be crowned the best D2 Power Soccer team in the Nation. To read last season final recap go to the following link:

http://blog.myspace.com/index.cfm?fuseaction=blog.view&friendID=395135847&blogID=449317987&Mytoken=BFA26633-040B-4EAA-A5520B6DE684122E143460771

During the middle of the tournament the games were paused to honor Laurie Williams who passed away July 9, 2007. A framed jersey In Memory of Laurie will be displayed at Turnstone with the following words:

Laurie was a valued member of the inaugural Flyers Power Soccer team. Through her determination and competitive spirit she inspired us all to reach higher. Never one to sit on the sidelines in life or in her new found sport; she always displayed a positive and supportive attitude to her teammates and everyone she met. She exemplified toughness by playing through a major tournament after suffering an injury, which she would not discuss for fear it would keep her sidelined. A True Champion, she is loved, missed and most of all… will always be remembered.

     Lunch Time Tennis Series

   Weekly Adult Clinics 

WHAT:   Do you have a flexible schedule?  Looking for a fun new way to get your exercise?  Try Lunch Time Tennis brought to you by RHI Sports and the Indianapolis Community Tennis Association.  Participants will receive hands-on tennis instruction and training!

WHO:    All RHI adult athletes.  Whether you are a beginner looking to learn—or—an advanced player looking to hone your skills.

WHEN:   Every Tuesday starting November 18th, 10:00a.m. - 12:00p.m.

PLACE:    Butler University Tennis Bubble, located due north of

Hinkle Fieldhouse.

                         Hinkle Fieldhouse:

510 W. 49th Street

Indianapolis, IN 46208

Follow Boulevard Drive to the intersection of 52^nd St. and head west until you see the Butler Bubble.

RSVP:    Please contact Pat Dean to inform us of your interest! You can email him at pat.dean@rhin.com or call 317-329-2281.  Hope to see you there!

Real Talk.Real Answers. Living with MS in Your 20s and 30s.Web Cast

Tuesday, November 18 join young adults living with MS nationwide for the second installment of Real Talk. Real Answers. Living with MS in Your 20s and 30s.

If you’re in your 20s and 30s and living with MS, please join us on Tuesday, November 18 for candid conversation about the topics that matter to you.

Issues including communicating with family and friends about your MS, finding meaningful ways to get involved in support networks, learning to be your own best advocate,personal planning and more.

The event includes an interactive panel discussion with an opinion leader and a panel of your peers in their 20s and 30s who are living with MS. A moderator will lead the panel discussions to answer your most challenging questions.

You will be able to participate LIVE from wherever you are — virtually!

Register today at www.RealTalkRealAnswers.com. You can then access the Web cast from the same website. You’ll also find lots of other great resources on the site about living with MS in your 20s and 30s, including tips from opinion leaders, journal entries from your peers who are living with MS and much more.

Participants will have the opportunity to submit questions “real time”. For those who can’t watch live, the information will be posted on http://main.nationalmssociety.org/site/PageServer?pagename=HOM_REAL_homepage after the event.

Building & Maintaining Connections with Dr. Mary-Frances O’ConnorNovember 18, 20088:00 p.m. ET/7:00 p.m. CT/6:00 p.m. MT/5:00 p.m. PT

Real Talk. Real Answers. Living with MS in your 20s and 30s is brought to you by the National Multiple Sclerosis Society and MS LifeLines (R), a free resource sponsored by EMD Serono and Pfizer.

Date: Tuesday, November 18, 2008

Time: 8:00 PM

Indiana State Chapter

7301 Georgetown Road, Suite 112Indianapolis, IN 46268Phone: 317-870-2500Fax: 317-870-2520Email: FIGHTMS@MSINDIANA.ORGWebsite: Indiana State Chapter website

As posted at: www.powersoccerofindy.com

Saturday, Nov 15, 2008 9:00a to 5:00p

Turnstone Tournament:The Turnstone Center in Fort Wayne Indiana will host a six team tournament. The team will include Turnstone Fantastic Flyers, Tournstone Fearless Flyers, RHI Indy Cruisers, RHI Indy Storm, Kokomo Spinners and Ball State Cardinals. Good luck to all teams!

Monday, Dec 15, 2008 7:00p to 9:30p

Holiday Party:Join us for our annual Power Soccer of Indy holiday party at Riverside Park Gym. Dinner, gift exchange and holiday goodies for all athletes and immediate families. Please RSVP so we can expect your family.