D–E

disability and exercise Regular exercise is
important for health and well-being for everyone,
and most people are able to participate in physical
activities to some degree. Though chronic or debil-
itating health conditions may limit a person’s
physical abilities, it is possible to adapt many phys-
ical activities to accommodate individual needs.
For example, 30 minutes of pushing oneself in a
wheelchair is comparable to 30 minutes of walk-
ing. In other circumstances health conditions such
as moderate to severe CARDIOVASCULAR DISEASE
(CVD) may limit AEROBIC CAPACITY; conditions such
as CEREBRAL PALSYand OSTEOARTHRITISmay restrict
FLEXIBILITYand mobility.

Anyone who has a physical disability

should consult with his or her doctor

before beginning a new physical activity

or exercise plan.

Physical therapists and exercise physiologists,
particularly those who specialize in sports medi-
cine, can help people who have disabilities
develop effective CONDITIONING or TRAININGplans
and modify physical activities to meet their fitness
goals and interests. Such modifications may take
the form of adaptations in technique or alterations
in intensity or duration of activity. Individual cir-
cumstances also may require adaptive clothing,
shoes, and equipment. Many communities and fit-
ness facilities have special physical fitness pro-
grams, including team and competitive events, for
people who have disabilities; such programs allow
participation at levels that match individual capa-
bilities and interests.
Strengthening and flexibility activities are
important for maintaining as much function as
possible. Such activities improve BLOODflow, par-

ticularly to the extremities and the SKIN. They also

maintain BONE DENSITYand JOINTrange of motion,

permitting the best mobility possible. Passive exer-

cise (in which a therapist or caregiver guides the

person’s body gently through structured move-

ments) benefits people who have severely

restricted mobility or PARALYSIS such as due to

STROKEor SPINAL CORD INJURY.

See also AEROBIC EXERCISE; FITNESS LEVEL; PHYSICAL

ACTIVITY RECOMMENDATIONS; RESISTANCE EXERCISE;

STRENGTH.

endurance The ability to persist in performing a

physical activity. Endurance may refer to AEROBIC

CAPACITY(the fitness of the cardiovascular system),

the ability to sustain a position over time (such as

in YOGA), or the ability to repeatedly and consis-

tently perform a set of movements (such as lifting

weights). Endurance is an important element of

overall physical fitness that requires an integration

of aerobic capacity with STRENGTHand FLEXIBILITY.

Endurance improves with exercise that chal-

lenges the body’s capabilities at a moderate level,

encouraging the muscles to draw energy from

glycogen stores and the LUNGS to function at

higher efficiency in the amount of air, and conse-

quently oxygen, they take in with each breath.

Endurance training emphasizes activities that

extend the duration of performance. For aerobic

activities this means extending the length of time

for TRAININGsessions in incremental fashion, for

example increasing distance for running or the

duration of holding a yoga pose. RESISTANCE EXER-

CISEalso can improve endurance by increasing the

number of repetitions of a resistance activity such

as lifting weights or working with resistance

bands.

See also CONDITIONING; FITNESS LEVEL.

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