Staying healthy is not as hard as one might think; by simply being informed about good suggestions, big changes can happen.

In the first part of this article we discuss equipment, available at little to no cost, suitable for all varieties of disabilities. Often, having the money and resources to purchase equipment is not an option. In addition, modifying or adapting equipment is sometimes necessary to meet the individual and unique needs of students.

Presented are 10 easy ways to create inexpensive equipment that could help you provide a more appropriate, successful, and fun exercise program. Secondly, we present 5 simple nutrition suggestions that are sure to have a positive impact on diet and feelings of well-being. An ideal diet, paired with proper physical activity, is a key factor in overall health for any individual.

Finally, very important suggestions and tips are given to improve medical care and services. Remember, anyone (teachers, health providers, co-workers, friends, neighbors, etc.) can be an advocate for people with disabilities. Many times individuals with disabilities do not know how to adapt equipment, prepare food, and fight for proper medical care. As a result, they need help from you and me!

You will also find links to: 1) great supportive websites, 2) a story about "Johnny," a boy who made a difference in his community, 3) information about a court ruling that mandates teaching adapted aquatic classes, 4) on-line classes in adapted physical activity, 5) ACSM & NCPAD specialty certification in adapted physical activity for health and fitness professionals, and 6) an article on physical fitness for children with cerebral palsy.

Phillip Conatser
Contributing: Chris Ledingham and Jo Conatser
Adapted PE Editor

Simple Equipment, Nutrition, and Medical Care Ideas for People with Disabilities

NYLON SOCKS

Discarded panty hose and nylon socks can be made into:

• rings for ring toss
• frisbees
• geodesic type balls
• compact balls
• hacky-sack balls
• jump or tug-of-war ropes
• "May Day" streamers

To make a ring or ball, begin by rolling a nylon sock into itself, or place several socks inside another nylon sock. To make a jump rope or tug-of-war rope, panty hose legs are rolled to the toe with a hole torn in the toe and then rolled completely up. Hook two circles together by inserting one circle into another. Continue connecting the rings until you make the desired length.

INNER-TUBES

Your local bike riding club, automotive shop and/or gas station can become an equipment supply store. Inner-tubes from bikes or car tires can be cut up and used for support straps, or in physical fitness and conditioning activities. Bike or car inner-tubes can also be made into harnesses that are excellent for resistance training during running or walking, and for the wheelchair population.

Bike inner-tubes can be used for Frisbees, dyna/therapy bands, tunnels, bridges and jump-ropes, as well as for stabilizing the upper body during throwing and catching activities for those in a wheelchair. Car inner-tubes can be used for bounce, balancing, roll, targets, or barricades in obstacle courses.

GARDEN HOSES

Discarded garden hoses can be used for many purposes, such as enlarging the grip of golf clubs, weight bars, ping-pong paddles, badminton racquets, and bike grips. Garden hoses can also be used for tug-of-war, limbo, high-up, jump the river, tether line, and to mark boundaries for games. Splitting the garden hose and attaching it to the sharp edges of equipment can help protect students against a scrape or cut.

VELCRO

In many rehabilitation centers, velcro straps are only used a few times before being replaced. Ask a local rehabilitation center to save these pieces of velcro for your use. Velcro has many uses in modifying equipment. You can attach golf club grips and golf gloves with velcro, or attach tennis/badminton racquets and baseball bats to gloves.

Basically, you can use this technique with any type of athletic equipment grip so hands can remain firm to the racquet. Another idea is to place velcro at the end of the racquet shaft, or on the head of the racquet, to help pickup or catch balls and birdies. Lastly, velcro placed on shoes and bicycle/tricycle pedals will help prevent slipping and improve pedaling efficiency.

CARDBOARD BOXES

Cardboard boxes are easily obtained at grocery stores or even from the school custodian. Cardboard boxes are very useful in teaching the concepts of over, under, around, and through. They are also excellent for creating obstacle courses. In addition, cardboard boxes can be made into hands, feet, shapes, colors, numbers, alphabet letters, stop and go signs, rest room signs, and various types of bean bag or ball targets.

PLASTIC BOTTLES

Plastic bottles can be used as bowling pins, pool floats, projectiles for throwing activities, and containers. A pair of plastic bottles filled with sand, and connected with a dowel rod or broom handle, can be transformed into a weight bar. Cut a hole in the side of a plastic milk carton and use it as a target for golf putting. You also can cut a hole in the bottom of plastic milk cartons and use them to throw or catch objects.

PLASTIC GROCERY BAGS

Stuff one plastic bag full of other plastic bags, and tape it closed to form a ball. For more elaborate equipment, make balls, beanbags, and bats out of fabric, and then stuff them with plastic bags. These projects require many plastic bags, so have all of your students collect bags. It's a great way to reuse them, and keep them out of our landfills.

SCARVES

Cut scarves into four sections and use them for juggling, blindfolds, or to limit movement of a body part, like an "anatomical splint." Brightly colored scarves can be designated as starting or finishing areas during retrieving games. Also, large scarves can be used for parachute activities. (continued)

COFFEE CANS

Many types of objects can be thrown into containers made from coffee cans. Another idea is to make stilts (with the addition of rope) and drums by using coffee cans. Small cans can be used for a kicking game. Also, connecting a can and ball together with a short rope makes for a fun fine motor game.

BROOMS

Old brooms, push brooms, and mops can be used to teach galloping, or to play field hockey and shuffle board games. A flip stick game can be played after connecting (with a rope) a stick and plastic milk carton (with the bottom cut out). Furthermore, a stick can be used to increase shoulder flexibility, assist in walking, and to play stick ball.

CUT THE JUNK

Many of the junk foods we consume contain high levels of refined sugars and so are pretty much empty calories; that is, they don't provide any of the key nutrients our bodies need. By simply scaling back on the sodas and sweets we can impact our overall health. Try substituting junk food snacks with a piece of fresh fruit and cheese, or exchange a glass of water or milk for your usual soda.

WHOLE GRAIN GOODNESS

The website MyPyramid.gov suggests that we increase our consumption of whole grains to about 50% of our bread and grain intake. This can be done by selecting whole grain breads and rolls at the grocery store, or by substituting whole grain cereals for your usual morning breakfast routine. Another suggestion is to hit the granola bar isle at the store. Just be careful to select those without added sweeteners and other processed ingredients.

PROTEIN VARIETY

Protein is a critical substance in our lives, and many of us get a large majority of our protein from animal sources. To add some variety to your protein intake, increase your consumption of nuts and seeds. Just a handful (about ¼ cup) of nuts as an afternoon snack, or as an addition to your breakfast routine, will both ward off those hunger pains and serve as one of your three daily servings of protein.

SIZE MATTERS

Not only does variety in our diet have an impact on our health, but so does the amount of food we consume. Depending on age, gender, and activity level, a person's daily calorie needs can vary greatly. We all know it is important to consume only what your body requires. For advice on how many calories you need, visit your health care provider or a registered dietitian.

PLAN FOR BALANCE

Eating a balanced diet, with a little planning, is a very achievable goal. Many of us have our days and our children's days planned down to the hour, maybe even the minute. Our busy lifestyles make pre-planning healthy meals very important. At the beginning of the week sit down and plan the who, what, when, and where of eating. This doesn't have to be a super detailed plan, but just make sure you plan to get what you and your family needs for a balanced diet.

Although most people would not consider themselves competent to give advice on good medical care, it is very important to have a basic understanding of age appropriate exams, gender and/or ethnic health issues, as well as common side effects of medications. This is true not only for people with disabilities, but for the general population.

While there are many caring health professionals, people with disabilities sometimes can be relegated to second class medical care for a number of reasons. In our society, there is still a stigma attached to having a disability. (The word handicapped evolved from a beggar having a "cap in hand"). Advocates must have the available knowledge, and be ready to speak up when it is necessary. See Disability Is Natural.

Recently, for example, the medical chart for a 45 year old woman with mental retardation was reviewed. Even though she was taking medication that could cause osteoporosis and had a diagnosis of osteoporosis in her chart, there was no evidence of a bone density exam or other commonly used medications to treat her condition. There was no follow up on a condition that has serious long term side effects, not to mention she was prescribed medication that could worsen osteoporosis.

Ethnicity, as well as gender, often can signal potential medical problems. Men and women need to be aware of common health issues for themselves, as well as their family members and people who have disabilities. A checklist for age appropriate exams for men and women can be found here.

The side effects of medications can turn a fun afternoon in the hot sun into a medical crisis. Some anti-convulsion medications cause photosensitivity. Other drugs can increase susceptibility to heat stroke or dehydration. It is always important to ask for a list of participant's medications prior to indoor or outdoor activities. See the Food & Drug Administration for more information.

Promoting wellness is important. Because medical care is expensive, providing information about health fairs and/or free clinics in your community may make a big difference. Along with information, encouragement can change attitudes about healthy living options.

Recognizing health issues regarding abuse and/or neglect are extremely important. Professionals must be ready to make the appropriate referrals if they suspect that a person with disabilities is being mistreated. Some common signs are: wariness, unexplained fractures, lacerations or bruises, changes in attitude, behavioral extremes (withdrawal or aggression), and unexplained absences. Knowing what to report is crucial when you suspect that the health and/or safety of a person with a disabled is at stake.

In conclusion, basic information regarding healthcare is a necessity for everyone. As professionals who work with persons who have disabilities, making that information available is very important. Remember, if you don't do it, who will?

To Be Like Johnny? - A great story about an individual with Down Syndrome who made a really big difference in his community! This may at first appear to be an advertisement, but wait it out a few seconds. The story of Johnny will begin.

Distance Education in Adapted Physical Activity - New Mexico State University offers APENS study courses, and the University of Florida offers classes in adapted physical activity, medical and health aspects for individual with disabilities, and evaluation of leisure services. You do not have to enroll at the University to take these classes. Upon completion of the class, you can receive continuing education credits and/or be prepared to take the national certification test to become a Certified Adapted Physical Educator (CAPE). Check it out.

ACSM & NCPAD Specialty Certification - ACSM and NCPAD are offering a specialty certification for ACSM professionals in health and fitness that want to become more effective working with individuals who have disabilities. If you want to take the test contact ACSM by calling 317-637-9200, send an email to certification@acsm.org, or go to NCPAD.

Promotion of Physical Fitness for Children with Cerebral Palsy - The American Physical Therapy Association's Section on Pediatrics Research examined the current literature on physical fitness and secondary condition prevention in children with cerebral palsy. Read this article.

ACCESSories - This video features high-tech inventions and low-tech equipment solutions to inclusion in a wide variety of physical education activities and units. The high tech inventions were designed in collaboration with retired engineers from Rockwell Collins in Cedar Rapids, Iowa. You will see switch activated arrow launchers, bowling ramps and fishing machines. Also featured are "no" and "low-tech" equipment modifications and adaptations that facilitate participation by students with diverse abilities.

Adapting Equipment for Special Needs: author Sue Tarr - All students benefit from physical education, but equipment used in mainstream programs often is not appropriate for students with special needs. Equipment adaptation is necessary to improve students' opportunities for successful participation in class. The article describes how to create and finance adapted equipment and offers a resource list.

Click the 'find in a library' to access this article in a library close to you.

Purposeful Play: Early Childhood Movement Activities on a Budget - Using this book you can create an exciting, easy-to-use movement program for minimal cost. The book features 36 energizing activities and 104 classroom-tested variations that use commonly available materials and require minimal space. The activities will help preschool through early elementary age children learn movement, fitness, and nutrition skills and concepts, and have lots of fun doing it! (more...)

RAISING THE BAR - An Oregon Professor Helps Bring PE Into the Standards Movement. Terry Wood of Oregon State University is one of eight PE experts nationwide who crafted the national PE standards, released in 1995 by the National Association for Sport and Physical Education. Widely published in the area of psychomotor measurement and evaluation, Professor Wood was a keynote speaker at the 1998 International Sports Teaching Symposium in Taiwan. In this article Northwest Education Editor, Lee Sherman, talks with him about the standards and about PE's ongoing evolution.

ADAPTED PHYSICAL EDUCATION FOR THE BLIND AND VISUALLY IMPAIRED - By Kathy Letcher

Physical Education is important for the health and well being of people of all ages. It is enjoyable, builds self-confidence, and improves ones health and fitness. Specific sports skills are developed in individual as well as team sports. Students experience a variety of lifetime and recreational activities. Students who are blind or visually impaired also need to experience physical activity.

The visually impaired student with additional disabilities should experience a program designed to improve their fitness levels by participating in various games, activities and exercises. Some students may have developed poor circulation, limited lung capacity, poor muscle tone, poor posture, and a tendency to become overweight. A regular physical activity program will improve fitness and give the student confidence to move through space without instructions. It can also develop motor skills needed for daily living and mobility.

The New Jersey Commission for the Blind and Visually Impaired lists specific strategies for students with visual impairments in physical education programs. Find out what they are.

Secondary Physical Education Teachers' Beliefs and Practices in Teaching Students with Severe Disabilities - A Descriptive Analysis

Increasingly students with disabilities are being educated in general physical education (GPE) classes. To date, however, the extant literature on the efficacy of inclusion practice in GPE is sparse. Of note, Vogler, Koranda, and Romance (2000) evaluated the efficacy of a GPE program in which a people resource model (i.e., an adapted physical education [APE] specialist) was used to provide instruction for a child with severe cerebral palsy. They reported that this model was highly effective in time engagement and management. Moreover, the qualitative nature of inclusion was one of widespread social acceptance and successful motor participation.

Still today, there is limited research on the efficacy of inclusive practices. In contrast, the extant literature abounds in information on teacher effectiveness. For instance, scholars assert that effective GPE teachers: (a) demonstrate target skills and strategies for students, (b) provide multiple exemplars, (c) use guided and independent practice and (d) reflect to inform their practice. It is reasonable to expect GPE teachers' teaching behaviors would be similar when teaching students with and without disabilities.

But for teaching students with severe disabilities there would be more emphasis on adaptations, modifications, and supports (e.g., APE specialist, peer tutors). Read this article. There is also a PDF version available.