In-Home, Low Cost Physical Activity Program for Kansans with a Physical Disability Waiver
National data indicated that about 75% of people with disabilities are either sedentary or not active enough to achieve outcomes. Nearly two-thirds of people without disabilities also are sedentary or not active enough to achieve health benefits.
Can a 12-week in-home physical activity program using videotaped adaptive aerobic exercise routines and behavioral programming assist participants to increase their weekly physical activity levels? Can this increase in physical activity improve functioning as measured by improved performance of one or more activities of daily living, such as time, exertion level, or heart rate?
Purpose and Anticipated Benefits
This project devised an in-home, low cost physical activity program for Kansans with a physical disability waiver to improve their fitness.
Dot Nary with Glen White, both with the Research and Training Center on Independent Living at the University of Kansas, worked with five Kansas Physical Disability Waiver participants. All were females and experienced a variety of mobility impairments including multiples sclerosis, arthritis, stroke, quadriplegia, and orthopedic difficulties, as well as diabetes, chronic fatigue syndrome, and asthma.
The program consisted of self-selected adaptive aerobic video routines, education regarding physical activity and disability, a behavioral contract, prompting (mainly through weekly visits) reinforcement, self-monitoring, and social support.
The study had a "single-subject" research design because it offered maximum flexibility for participants to increase activity at an individually desired pace and to accommodate health issues that precluded physical activity at times during the study. Each participant was asked to increase minutes of activity every two weeks; their previous levels served as individual "baselines" for increased activity as the study continued. Three participants increased their weekly minutes of activity as recommended during the study. At the end of the program, participants were set up with people in their own environment, such as a personal assistant who would help them chart their activity or a friend who walk with them.
Participantsincreased their activity each week from none basically up to 27 minutes, three times a week. They started at the number of minutes they thought they could do easily. After two weeks, they increased the minutes by three minutes to five minutes, so by the end they would have five time increases every two weeks. One participant had difficulty adhering to the program because of the nature of her disability; and another dropped out early in the program. However, three participants progressed from engaging in no weekly physical activity to 10 to 20 minutes three times weekly. Participants’ stamina and heart rate didn’t significantly change.
Participants acknowledged that a flexible program geared toward their individual needs and arrangement of social support facilitated their adherence to the program.
“If you don't provide the support element,” Nary said. “It's going to be very hard to change people's behaviors or for them to change their own behavior. So it's really important to pay attention to someone noting their progress or a person doing it themselves, and also that an in-home program can be effective. You don't have to go to the gym or even to the park. There are things people can do in their own homes that are convenient and that addresses barriers like resources, lack of transportation, scheduling, things like that.”
Nary, D. (2005, April 22). Health promotion for people with disabilities. Healthy Kansans Steering Committee, Topeka, KS.
Nary, D. (2005, October 6). Health promotion for people with disabilities. Kansas Nurses Association and Kansas Association of Nursing Students, Topeka, KS.
Nary, D.E. (2004). The prevention of secondary conditions in people with disabilities: What have we learned in 10 years? National Center on Birth Defects and Developmental Disabilities Conference, Washington, DC.
Nary, D.E. (2004). Living well with a disability: Development, implementation, and evaluation of a nationally recognized health promotion intervention for adults with disabilities. Panelist for symposia at the National Center on Birth Defects and Developmental Disabilities Conference, Washington, DC.
Nary, D.E. & White, G.W. (2003, June). Energy for independent living: Using videotaped programs to build stamina and strength. Poster presentation at annual conference of the National Council on Independent Living, Washington, DC.
Nary, D. E., & White, G. W. (2003, September). Energy for independent living: Using videotaped programs to build stamina and strength. Presented at the 17th Annual Meeting of the American Association of Spinal Cord Injury Psychologists and Social Workers, Las Vegas, NV.
Nary, D.E. (2002). Home physical activity programs for people with physical disabilities (brochure). Lawrence, KS: Research and Training Center on Independent Living, University of Kansas. (Received 2003 Health Promotion Materials Award from the Kansas Public Health Association).
ILRU and Research and Training Center on Independent Living. (2002, October 23). Physical activity & independent living: What's the connection? Presented by Dot Nary and Katherine Froelich Grobe. [Webcast].