Stroke Connection - May/June 2011 - (Page 18)
E V E RY DAY S U R V I VA L | Connecting You to Helpful Ideas
Weight Management in a Wheelchair
Stacey Seifried, DPT
PT Practice Leader, Stroke Program Spaulding Rehabilitation Hospital, Boston
Kathryn Fuller, DPT
Physical Therapist, Advanced Clinician Spaulding Rehabilitation Hospital, Boston
he average American will gain approximately one pound every year starting at age 25. Thirty years later, that average American will have gained 30 pounds of weight and 45 pounds of fat. This is essentially a difference between calories in and calories out. Those sobering numbers are multiplied for people with disabilities because their high-yield cardiovascular activities are severely limited. This restriction in calories out places them at higher risk of becoming obese earlier in life and suffering from many complications, such as diabetes, stroke, heart disease and other cardiovascular issues. Researchers in the Boston area found that about 25 percent of adults with disabilities were obese, compared with 15.1 percent of those without disabilities. Approximately one in five Americans experiences disability, and of those 44 to 62 percent have impaired mobility. Severe mobility impairments typically require the use of a manual wheelchair. Wheelchair use often results in substantial physical changes that alter body composition by making fat cells larger and muscle fibers smaller. Some evidence suggests that the use of a manual standard wheelchair increases energy needs, heart rate, oxygen consumption and ventilation compared to ultralight wheelchairs and pushrim-activated, power-assisted wheelchairs. Fat accumulates in the stomach area, creating more weight to propel or transfer. Extra weight puts a major stress on your shoulders and wrists. Over time, this can lead to an inability to perform daily activities, changes in transfer status, skin breakdown, skin issues, the need for a power wheelchair and other issues. Losing the demands of a manual wheelchair increases the risk of obesity.
If you are in a wheelchair, follow this simple motto and you will feel better and be healthier: Move more. • Moving more improves circulation. This helps control swelling, which occurs in many stroke survivors.
18 S T R O K E C O N N E C T I O N May | June 2011
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