Work That Body...But HOW?

- By Robert P. Bennett

Exercise. We live in a society that is exercise crazy. Wherever you look, you see people trying to shape up and slim down. Gyms are cropping up all over the place. On the surface they all look the same and offer the same services. However, when you peel back the glitz there are differences that people should be aware of.

No two gyms are exactly alike. Each has its own problems and strengths. Of all the things a prospective consumer should look at the principle item is the staff. Do the trainers and assistants have any experience with working with disabled individuals? The answer is usually no, and this shouldn't come as any surprise. Part of the problem is that fitness is still an evolving industry. Part of it is fear and lack of education.

"The biggest problem," says fitness expert Maria Serrao, "is the lack of knowledge and education. There are very few gyms that have staff who know how do deal with someone with a disability. They'll go ahead and sign you up but don't know how to help you."

"I don't think the ownership of gyms or fitness centers have the background to work with this population," says Robert Romano, Chief Operating Officer of the Powerhouse Gym in Farmington Hills, Michigan. "I think it makes them uncomfortable. If you don't know something you fear it. In a sense you can't blame them. They just don't know."

Romano does know. His bachelor's degree, from Brooklyn College in New York, was in adaptive physical education. He started the first sports program for people with disabilities on that campus. He was also the director of the United Cerebral Palsy aquatics program.

A representative of The Sports Club Company (Los Angeles), which operates 13 fitness centers nationally, sums up one of the chief rationales for lack of proper staffing.. "Some of our trainers have rehab or physical therapy training. But it's important to realize that the clubs aren't specifically for disabled people."

While it is true that most gyms are not for the sole use of people with disabilities, those that do include the disabled community should have some background knowledge in how to handle the issues that come up around disabilities. Part of that knowledge should be in the area of sensitivity training. People with disabilities have to become comfortable with the staff members of gyms. They have to feel as if the staff understands their specific needs.

“Attitude of the staff is important,” says Jen Feltz, Special Program Director at the Southwest Family YMCA (Milwaukee, Wis). “It doesn't help if we have a staffmember who is in a panic when he sees someone with a disability. You can make the most accessible facility but if the staff has a bad attitude you may as well not have done anything. We do a disability awareness program. We talk about language. We stress the need to direct questions about capabilities directly toward the person with the disability. Staffmembers have to learn from the individuals how to help them. People with disabilities may not know how to use a specific piece of equipment but they are probably used to adapting things to their needs.”

“The most important thing for a trainer, whether they are working with someone who is disabled or able-bodied is personal fitness training and certification,” says Mike Haynes, a fitness specialist at St. David’s Wheelchair Fitness Program (Austin,Texas). But Haynes says there is more to working with a disabled population than is taught to the basic trainer. “You need to go through some sensitivity training on how to deal with someone with a disability. Gym personnel have to be made aware that people with disabilities are going to progress more slowly and they aren't going to feel comfortable right away. People with disabilities need to develop their comfort zone. Gym personnel have to help them. Also, when working with someone with a disability you need to know the physiology of weight training but you also need the pathology of disability. You need to know the contra-indications of weight training because normal weight training will often hurt someone with a disability. Usually you stress a muscle and your body adapts, that's not the case with people with neuromuscular disabilities.”

“There are two options in hiring staff members” says Feltz. “You can have someone who knows how to work with someone with a disability and train them to use the equipment or you can have someone who knows how to use the equipment and then have them work with someone with a disability. I think the second way works better. I think its mostly a matter of getting past their fears and feelings that they lack the knowledge to work with someone with a disability.”

“Staff members should have knowledge about disabilities in general and the individual specifically, says Thomas Dodd, a wheelchair user who works out at the Gold’s Gym in Attleboro, Mass. “The person’s file needs to be close at hand. Staffmembers need to know when the individual is in trouble while s/he’s working out. They need to watch for perfuse sweating or loss of breath. They need to have the proper emergency equipment around, like sweets and juice for a diabetic. They need to have an emergency plan in place.”

It is all well and good to have gyms that are physically accessible and staffmembers who are trained to know the physiology and pathology of disability, but staffmembers also have to know what exercises can best serve the needs of people with different disabilities.

“For paraplegics and quadriplegics,” says Haynes, “you need to work on the musculature of the back to help them straighten up. Someone with cerebral palsy may have speech impediments. Working on their trunk strength and their diaphragm is good. Upper body ergometers are great for spinal cord injuries. Often quads can’t get the benefits of cardio-vascular training because their heart rates don’t go up very high. For weight training we use Paragym, which is a company like cybex but they build for disabled people. Also the Versatrainer, by Bowflex, is an adapted version of their main machine. The equalizer is also like a Universal system but a wheelchair user can roll right into it.

“You don’t want to do forward or backward rolls with someone who has Down Syndrome,” says Mike Boyle, Director of Special Programs at the YMCA in Missoula, Montana. “They have a strange neck anatomy. The vertebra are not stable. A lot of people with developmental disabilities, such as MS, don’t sweat properly. Water exercises work well for them because it keeps them cool.”

One of the largely, and final, unaddressed challenges in making gym and fitness center programs well-rounded and inclusive is exercise classes. While many gyms do offer aerobics and other kinds of classes to the elderly and other special groups few offer such programs to the disabled.

“We’ve always had classes for adults with disabilities,” says Boyle. “Right now we’re working on setting up classes for the under 18 people with disabilities. We have work-out buddies in the fitness centers. A lot of them are therapists. We have a kind of physical education class for people with disabilities. They play softball or basketball. We also try to teach them some basic cardio and stretching exercises. We don’t have an aerobics class specifically for people with disabilities, though we have classes for seniors who can’t get out of their chairs. Our aerobics room is kind of difficult for someone with a disability to get into.”

The concept of aerobics classes for people with disabilities is catching on though. Nine years ago Mike Fink began a seated aerobics class at the Virginia Wadsworth Wirtz Sports Program at the Rehabilitation Institute of Chicago. He is now the facility’s Aerobics Coordinator. “We provide Seated Aerobics Classes four times weekly, with instructors whom I have trained.” But Fink did not stop there. “I have a training class that I have put together and I train instructors in other locations on Adaptive Aerobics. The training is registered for Continuing Education credits that Group Exercise Leaders are required to attain to maintain their certifications.”

When you visit a gym the first thing you see is the physical layout. This first impression answers many of the questions that should be on the minds of prospective consumers with disabilities. Is the gym multi level? Is there an elevator? Is the locker room accessible?

The ADA groups gyms and fitness centers under the umbrella of places of public accommodation. They must follow the same rules and guidelines as hotels and restaurants. For example, their bathrooms must be wheelchair accessible. Many gyms follow these rules, but some don't. Like many other establishments, they either plead poverty or claim that they are in fact reasonably accessible as defined by the ADA. Now here's a problem. The ADA says that buildings with only two floors don't need an elevator. Unfortunately, many gyms are housed in two story buildings. Without an elevator someone who uses a wheelchair can't access whatever is on the top floor. Try getting a cardio workout in a wheelchair if the equipment is on the second floor.

The Powerhouse Gyms try to alleviate this problem. "Some of our facilities," says Romano, "are two levels but whatever equipment we have on one level there's usually a compliment on the other level. No one really has to go to the second level to get to a piece of equipment."

The Sport Club Company, on the other hand, goes beyond the simple requirements of the ADA. "We have elevators in all of our buildings that are more than one floor," says a company representative.

It is difficult at best to hold the privately owned gyms to any kind of standard in terms of physical layout. They're smaller and, like many mom and pop stores, tend to fall through the cracks. Chain gyms are somewhat easier to control, but here too they have to use the space available to them. Most gyms are housed in already existing buildings. They stick to the letter of the law and the rather flimsy definition of 'reasonable accommodation.'

"The trouble is in the definition of 'reasonable accommodation.'" says Helen Durkin, Legal Council for the International Health Racquet and Sports Association, an organization that represent 4000 health clubs around the world. "It's hard to say what is reasonable in an existing structure. We don't have an easy checklist to determine compliance. It's hard to say what's reasonable for any particular facility."

"Members of the clubs themselves are often the most helpful in getting the club to be accessible. We often recommend that the clubs put together an audit committee made of people who can look at the club and help it adapt. One club in Boston has a member who is also on the Commission for the Blind. She was very helpful in helping the club adapt.."

"A lot of times navigating a chair in a fitness center or gym is difficult," says Romano. "We try to put in as much equipment as we can to service as many people as we can so no one has to wait. Unfortunately that's a double-edged sword. It means navigating around is often difficult. What we do in extenuating circumstances, like with a wheelchair user, is help people get around. People with disabilities however, might not need to access every part of a gym. Wheelchair users, for example, need a cardio-vascular workout, and that's usually using an upper body ergonometer. That piece of equipment is usually in a very accessible part of the facility. With weight training equipment it really depends on the body part worked on, but in general I think we do a pretty decent job in terms of access."

"We get quite a few people with disabilities, at least at this gym," says Rich Minzer, manager of the Gold's Gym in Venice, California. "The disabilities we see range from amputees to wheelchair users to people with cerebral palsy, and everything in between. Working out in the gym is important for our clients. It makes their day. I have no idea if the facility is fully accessible as far as the ADA goes, but since we do have people come in it must be accessible enough. They wouldn't train there otherwise. It might be more difficult for someone in a wheelchair to get around inside the gym. It may not be easy but it's not hard. The company doesn't set standards because we don't know where a gym will be located. But, every Gold's I've visited has access in terms of the bathrooms and locker rooms, things like that."

Standard gyms aside, sometimes people with disabilities prefer to exercise in a place where they know that the staff is knowledgeable of their needs. This is why a few specialty gyms are opening up around the country.

In Austin, Texas, the St. David’s Wheelchair Fitness Program was created in 1990. Designed for people with disabilities, it discriminates against able bodied people. At the center, which is to the public, people from St. David’s Rehabilitation Center work side by side with community members and none of the machines have to be transferred onto. “When we opened we thought we would get wheelchair athletes but we ended up getting people looking for independence.”

In New York City, the United Cerebral Palsy center has recently opened a fitness center for its regular clients.

"The suggestion to open a fitness center came from our participants," says Kristzi Afzali. "They wanted to find a place to work out and exercise. They'd been trying to make use of city facilities but had found them inaccessible. We took the idea to some people who we thought might be interested in funding the project, including some long term board members."

"Some of our participants did do other forms of exercise before we opened, but they said that in terms of a private gym or health club those places were just not right. They had no one who knew how to train someone with a disability and their facilities were not very accessible, they weren't designed to be."

Gym equipment is another area where attention must be paid to client needs. The equipment found in most gyms is not overly user friendly if you have any sort of physical disability. The manufacturers of this equipment, even those like Cybex who started out in the rehabilitation industry, don't build with disabilities in mind. The common belief, again, being that the people who work out are able bodied.

“The way that some equipment is built makes it inaccessible,” says Dodd. “The Pyramid machines tend to be the best. As long as you can transfer onto them it’s easy to use them. However, sometimes its difficult to change the weight on a piece of equipment. I can’t bend easily because of my balance so leaning over to change weight is difficult.”

"We don't buy equipment for any specific population," says Romano. We concentrate on cardio-vascular, strength training equipment. We look at the best and safest equipment in the industry. We want to service as wide a population as we can. Some of the equipment out there is not very accessible for anyone. It's designed very poorly. We try to look from an intellectual standpoint."

"None of our equipment was special ordered for people with disabilities," says the director of World Gym's, Venice, California branch, Mike Ureec. "But a lot of it is very adaptable. It's easy to transfer from a wheelchair to the seat of most of the equipment because the seats are low."

"We've tried to keep a focus on equipment that was not only appropriate but beneficial to people with disabilities," says Kristi Afzala, manager of the United Cerebral Palsy Center's new fitness center in NYC. "Most of the equipment is geared toward upper body strength."

Finding appropriate equipment is not an easy task. Labels are often insufficient for those with visual problems. Access is limited due to awkward construction, making it difficult for people with mobility impairments to transfer onto many pieces of equipment that might otherwise provide them with a good workout. While there are manufacturers who do build their equipment specifically with disabled users in mind, this equipment isn't standard in most gyms.

There's no transferring needed onto our equipment," says Norman Stein, President of No Boundaries (Garden Grove, Ca.). The company has been in business for the past five years because "trying to work out on machines that isn't designed for people with disabilities is intimidating."

Unfortunately Stein says that he's had a lot of difficulty trying to sell his equipment to gyms and fitness centers across the country. "There's a lot of red tape to go through to sell to gyms. They aren't really interested in having this kind of equipment. They'd rather have their employees help disabled clients. They disregard the whole issue because they don't have many members or potential members with disabilities."

On the supply side of the business, Stein believes that money is a major part of the problem. A lot of the cashflow of manufacturers like Cybex comes from the general market. There's risk involved in putting money into specialized markets like disabilities. The VersaTrainer is a good example. It was a wheelchair accessible Bowflex. But, after a short time, the company dropped out of the market because, as Stein puts it, "there isn't a tremendous amount of money to be made and you have to be in it for more than the money."

Fortunately times are changing and people with disabilities are working out in the gym. The market for special populations like people with disabilities is growing. The younger people with disabilities aren't willing to just sit at home and the newer club administrators are starting to understand their needs. Out of necessity clubs are becoming more aware of how to deal with special populations like disabilities. Its part of a shift of from the 70s/80s stereotypical of a club as a meat market.

"What needs to be done," says Minzer, "is to educate the public and those who are working in gyms. We need more understanding of the needs of this group. They don't have to stay away from the clubs. They don't have to stand out."

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