Devon Palermo, Author at MedFitNetwork

What is This Thing Called Adaptive Fitness?

Devon Palermo/12 July 2023/ All MFN blog/

Her insurance benefits had just run dry, we were at a critical point in her rehabilitation and recovery following a Spinal Cord Injury (SCI) from an automobile accident. “What should I do?” she asked me as we neared the end of a therapy session. “Why don’t we meet up and just keep exercising.” I replied and the rest was history.

There are countless other stories with other patients at the time that could have easily pointed me in the same direction. “I am being discharged with a home exercise program, but I want to keep working on my Stroke recovery.” or “I have been using a wheelchair for the past 20 years and I want to maintain my health and function as I continue to age but every time I go to a gym it just does not work out.” or “I wish there were a way I can be active besides adaptive sports.”

In my case, it was the former, a patient of mine with so much potential for continued outcomes was being prematurely discharged from physical therapy due to insurance limitations — the start of my personal journey into adaptive fitness began.

Up until the start of this journey in 2005, the majority of activities for individuals living with or recovering from disability was limited to adaptive sports… Wheelchair Basketball, Quad Rugby, Wheelchair racing, etc. The availability of fitness programs, group fitness, and even accessible gyms were very limited.

The idea that there was a trainer that was performing one-on-one fitness training with an SCI client and that the individual was excelling to the point that once therapy resumed, newer goals could be addressed by the therapists leading to better outcomes, spread throughout the rehabilitation halls and soon more folks wanted this type of training in addition to therapy.

What initially started as a temporary fix to aid a patient in need, has led to redefining my own career and sharing through experience and education what adaptive fitness is and how adaptive fitness trainers can bridge a huge gap.

Adaptive Fitness has really blossomed and now (thanks to social media) Adaptive Fitness Trainers, clients, and facilities are able to share training experiences to the public.

Wheelchair users can highlight their fitness workouts, PRs, and other fitness trends and challenges. Facilities can highlight client success stories, and brands can and have sponsored wheelchair athletes.

For the purpose of this article, I would like to highlight education and standards as I identify what adaptive fitness means to me.

Group Exercise, Virtual Group exercise, Seated Exercise, Adaptive Crossfit, one-on-one personal training can all be identified as Adaptive Fitness and really anyone can lead a group exercise class for any and all abilities… but should they?

Understanding the needs of a participant who is living with Multiple Sclerosis, Transverse Myelitis, Cerebral Palsy, Stroke and SCI in the same group class is extremely important for the safety of all individuals and should not be taken lightly.

Adaptive options presented to one participant may not work for another. Some folks may need specific cueing to maintain safety while others may be able to accept any challenge without adaptive needs.

Understanding risks, precautions and limitations to maintain safety in the group class setting but still make it an effective class is vitally important, and is why having the proper education to lead such classes is a must.

Working one-on-one with an adaptive fitness client who is focused on neuro recovery following a neurological impairment is not a cookie cutter type workout. You can use exercises you may know of, but the set and rep schemes differ entirely and blow traditional routines with 4 sets of 10 reps out of the water. There are specific strategies that can be utilized to effectively challenge someone working on improving neuroplasticity, but how you implement those strategies is dependent upon the individual, the diagnoses, and the strategy being utilized. Having an understanding of all of the above is imperative to your success as an adaptive trainer and their success for their outcomes

The same can be said for an adaptive client working on functional mobility. If floor transfers or stair climbing is a challenge then working on movements and exercises to improve those abilities is a must, but it’s important to have an understanding of how to guard, how to support, how to transfer, how to use your adaptive trainer body to aid your adaptive client in successful progressions toward achieving the movement they are working towards.

An understanding of adaptive training, adaptive accessories that can be used, equipment that can be modified, and strategies that can be used to make an adaptive client successful in the pursuit of their goals should be your goal as a Medical Fitness Professional. So that you become that trainer that should be leading adaptive fitness classes/session and not the trainer that is leading the classes/sessions but shouldn’t be.

Become an Adaptive Fitness Specialist

The Adaptive Fitness Specialist online course is designed to provide the knowledge needed to safely and effectively design and implement adaptive exercise programs for individuals living with or recovering from a physical disability or disease.

Devon Palermo is a leading authority on Adaptive Fitness for those living with or recovering from a disability. He is the Founder and Principal director of DPI Adaptive Fitness, A company focused on safe and effective adaptive fitness for individuals living with disabilities. With over 15 years of experience in both fitness and rehab, He is the go-to resource for clients, therapists, and doctors in the DC, Maryland and Virginia area looking to maximize the benefits of adaptive exercise to improve strength, balance, function and abilities. dpiadaptivefitness.co

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Bridging Rehab with Fitness: Become the Trusted Referral for Rehabilitation Therapists

Devon Palermo/30 March 2022/ All MFN blog/

There are special and unique bonds that are made between clinician and patient in a rehabilitation setting. Many times, rehab patients are at a very difficult time in their lives and through months of daily expert guidance, hard work, education, and often even fun, alongside their rehab team, they make considerable gains back towards independence.

Because of this daily interaction, the rehab team develops a vested interest in the continued progress of their patient. Over the course of many months of the blood, sweat and tears of intensive therapy sessions, a friendship has been formed and considerable progress made together. It’s no wonder that rehab professionals are very selective with the fitness referrals they make once their patients are ready for the post-rehab world.

They are selective because they want the absolute best for their patient; they want someone with an understanding of their patient’s diagnosis; someone who understands medical precautions and contraindications; and someone who can safely continue to progress their patient without putting them at risk for a secondary issue. Though they may be selective with referrals, a trusted source for continuing their patients’ goals is needed.

Here are some ways to bridge the gap and gain the trust of your local rehabilitation professionals:

Require a medical or physical therapy release

Having medical releases before beginning ongoing sessions is an excellent way to open dialog with your client’s doctor or physical therapist and further, ensures that you are programming their fitness plan accordingly. Send your assessment with your client to share in their next appointment along with a simple inquiry form about restrictions or suggestions to use in your program design. This will go a long way in establishing a great level of trust and building a rapport with the clinic.

Volunteer at a rehab clinic

One of the best ways to build a rapport with local rehab professionals and patients is to spend time shadowing/observing or volunteering in a rehab inpatient and/or outpatient clinic. This can be a time-consuming start-up as many rehab clinics will have an orientation process and procedures to allow you to be present in a clinic, but it is definitely worth the time investment. Just being in this environment you can learn a lot about how therapists progress their rehab patients, guard their rehab patients during activity, interact with and educate their patients as they progress them to discharge (the point where you would continue their work). You may also get some valuable opportunities to learn from and build relationships with many therapists in one setting.

Lead warm-ups for local 5K races

There are 3.2-mile run-walk-and-wheels events that take place all over the country. Donating your time to your community Spina Bifida Walk ‘n Roll or Parkinson’s walk is a great way to become visible in your community and demonstrate what you have to offer for all abilities.

Speak at local support groups

Same as with the 5Ks, there are support groups that take place monthly or quarterly for stroke survivors, caregivers, individuals living with Multiple Sclerosis and more. Contacting the organizer of these groups and offering to donate time to speak about the benefits of continued exercise or even providing a no-cost group class during the scheduled talk time is a really good way to connect with both the organizers and their peers and those in attendance who would benefit from a continued exercise program.

Educate yourself on adaptive/medical exercise equipment

Understanding the different options there are for accessories and actual exercise equipment for stroke survivors or those living with spinal cord injury is another great way to demonstrate an understanding of working with a rehab population and continuing to bridge the gap between rehab and fitness. Not all equipment is accessible nor safe, so while thinking outside the box is great, ensuring safety is optimal. Take the time to learn about all the great adaptive equipment that can benefit the population you work with.

Host an open house at your gym

Host regular open house events at your facility and invite any and all rehab professionals, patients, and people from your community. Offer instructional sessions during the open house to demonstrate your adaptive programming/equipment. This is a great way give a sneak peek into what you’re doing to provide a safe environment for patients to continue their progress.

Offer to provide a lunch in-service to rehab staff

Meeting with a clinic full of therapists is an excellent way to educate those therapists that you have done your research, understand your population, and really want to bridge the gap between rehab and fitness. A presentation focused on the population you’re most comfortable working with (Parkinson’s, stroke survivors, etc.), the programs you offer, and pictures or videos of some of the work done in your gym. Bringing food is always a great incentive!

Bridging the gap between rehab and fitness is a process that is long overdue and much needed. By focusing on the points above you will be working towards and moving one step closer to improving the therapist-trainer model, adding a valuable resource to your community and providing a safe environment and safe programming to continue progressing your post-rehab clients.

This article was featured in MedFit Professional Magazine.