By: Angie Monzin

1. The effects of exercise and a wellness program on participation and secondary conditions on individuals with mobility impairments By: Angie Monzin

2. “Regular participation in exercise has been proven to significantly reduce the risk for several chronic disease; yet the majority of the population does not exercise or maintain health lifestyles” Froelich-Grobe & White, 2004

3. Addressing the Problem • Barriers affecting participation • Lack of accessible and affordable transportation • Lack of accessible facilities and equipment • Lack of knowledgeable professionals • Lack of financial resources

4. Prevalence of secondary conditions Colye et. al., 2000 Secondary Conditions

5. Theoretical Basis • Independent Living movement

6. ICF

7. Literature Review: Froelich-Grobe & White Study • Despite the multiple health benefits that can arise from participating in exercise programs, almost 75% of individuals with disabilities are sedentary or do not participate enough to remain healthy • Randomized controlled trial design • Exercise intervention occurred within the home or community setting • Results • Fitness data did not show significant improvements, except in peak heart rate p value of .01 • Self reported data showed significance in increased activity time, strengthening and cardio activity time increase • Interpretation • The article provides a good basis for an exercise intervention plan, but modifications need to be made. Increasing physical activity time is a good starting point, but health status and alleviation of secondary conditions need to improve as well.

8. Literature Review: Catherine Coyle and colleagues study • Study showed that 97% of adults with physical limitations experienced limitations in from secondary conditions and reported having an average of 13 secondary conditions within a year. • A descriptive study • Examining how secondary conditions and how they affected or were related to women’s overall well being • Results showed • Women were impacted emotionally, physically, and socially because of their secondary conditions • Further research • Needs to address which specific secondary conditions cause the most stress and harm • The impact of secondary conditions on overall well being, life satisfaction, and quality of life needs further research

9. Literature Review: Charlifue Study • A prospective longitudinal study • Addressing the health status in individuals with spinal cord injury across duration of injury, type of injury, and age • Results: • Common secondary conditions associated with length of injury are: joint pain, fractures, motor or sensory changes, and total cholesterol level increased. • Pneumonia, pressure sores, and an increased serum creatinine level are common symptoms that are associated with the age of the individual. • Symptoms that are prevalent regardless of duration of injury or age are heart conditions, rectal bleeding, and renal stones. • In addition to psychological symptoms, depressive symptoms are common in individuals with a SCI, which may be due to a lack of participation and poor health

10. Purpose • The purpose of my research is to measure how health and wellness programs with exercise components affects the prevalence of secondary conditions and the impact on participation in the community • Similar models • Program Shake-It-Up • PAD model, Physical Activity for People with Disabilities Model

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

12. Variables • Independent variables • Exercise program • Secondary conditions handbook • Dependent Variables • Duration, frequency, and severity of secondary condition • Participation

13. Measurements • Participation • Community Participation and Receptivity Survey (CPRS) • Possible evaluation of secondary condition variables: • Doctor visits • Emergency room visits • Personal log books