Exercise Considerations

  • For those who experience spasticity, in the initial stages of your programme consider the duration more important than the intensity.
  • Longer periods of rest to prevent fatigue may help to avoid worsening of unwanted or abnormal movements.
  • Avoid high-intensity exercise that causes you to experience excessive and early fatigue. Such exercise will cause movement patterns to deteriorate and ultimately cause you to stop exercising early. Try exercising in blocks with rest in between (known as intervals).
  • Closely monitor the effect that exercise has on your impairment. If you see deterioration in your function consult a registered heath and exercise professional to help you evaluate and adjust your programme.
  • If you use relaxants or anticonvulsive medications, be aware that these can have an effect on your tolerance to exercise and on your overall exercise performance. Discuss this with your doctor where necessary.

Many individuals with CP suffer from stiff and/or weak muscles and so you should seek advice from an experienced exercise professional if you are new to this type of exercise prior to trying new techniques. Start gently before gradually building up. Trying to progress too quickly and lifting weights that are too heavy can cause damage so increase your training load gradually based on how quickly your body responds.

It is important to note that strength exercises should try to use the full range of motion/flexibility that you possess as this will enhance functionality. Increased range without increased strength will not produce much benefit and conversely, increased strength in a shortened range may exacerbate issues of function.

  • Prolonged stretching during the warm-up will help optimise range of motion and therefore help improve performance. For best results combine stretching techniques with core activation exercises and some body weight strength work for the affected muscle group(s).
  • Prolonged stretching in the cool-down might help prevent the spasticity which can occur following vigorous exercise.
  • Where possible limit stretches and exercises to one limb at a time.
  • When using static stretches try to use slow, deliberate movements to avoid causing a stretch reflex.
  • Incorporate relaxation exercises where possible.
  • Try stretching in a warm pool where the temperature may soothe and relax the muscle to allow a greater stretch.
  • Consider alternative positions or support to ensure your safety and to improve the effectiveness of a stretch or exercise (seated position, use seat belts/ wraps/stretch bands, use a wall or ask someone to help support you).
  • Some common standing stretches/exercises such as a quadriceps stretch can be performed whilst lying down.
  • In a gym environment most exercises can be performed on a fixed resistance machine, which will help stabilise your body and guide the direction of movement.
  • Consider more supportive exercise modes such as arm cranking, the cross trainer or the use of a tricycle.
  • If you find simultaneous bilateral movements (e.g. moving both arms at the same time during a bicep curl) hard then try exercising each side of your body separately.
  • Hemiplegia: consider using your unimpaired arm to help move your impaired side into the correct position and to guide movement. Exercise your unaffected side/limb first.
  • Stretch/exercise with a partner for support and take your time to assume the correct position.
  • To help prevent any injuries avoid using passive stretches where someone else moves your limbs.
  • If you find it hard to grip weights or cables you can use gripping aids such as flexion mitts or straps to help you perform these exercises safely and effectively.
  • If you find it hard to perform some exercises in the traditional way the use of therabands, suspension cables or towels can help you to perform strength and flexibility exercises because they complement any individuality in actions.
  • Flexibility: It is quite common to suffer from postural problems due to slumping and/or you may have a rounded posture caused by tightness in your chest and front shoulder muscles. Flexibility training that focuses on the shoulder region can help to prevent this. If you spend the majority of your day in a sitting position this can also cause tight and weakened hip flexors (the muscles that are designed to move your thigh towards your trunk). It is therefore good practise to stretch and exercise the muscles around your trunk, hips and knees on a regular basis.
  • Strength Training: To help prevent muscle imbalances ask a physiotherapist or qualified exercise professional to help you identify the areas that may require additional stretching and/or strengthening exercises. When planning a session ensure you include a combination of exercises for your chest and back muscles to prevent any imbalance occurring between the two. Remember to secure your chair prior to beginning any strength or flexibility exercises.
  • Aerobic Training: If you are able to exercise without your chair or simply without having to propel your chair, this may have additional benefits as you will be using different muscles. Try stretching in a warm pool where the temperature may soothe and relax the muscle to allow a greater stretch.
  • To get your heart rate going try using an arm crank (found in many fitness facilities across the country), doing some assisted Swimming or performing some standing frame exercises.
  • To improve your strength try using cable pulleys or an elastic/theraband to perform a set of exercises.
  • Remember that you don’t have to do it all at once; a few 5-10 minute sets throughout the day are just as good.
  • Try chair Yoga or Pilates to help improve your balance, coordination and flexibility.
  • Try Power Chair Sports such as Football, Wheelchair Dance or Boccia to add a competitive and social element.