Technology has been posing more barriers lately than not, and I had a huge win recently I thought I would share. I am going to ground this in a SWOT format because I think it will make the most sense.
Strengths: Happy, motivated teen with physical disability who can access an iPad with a stylus, when it is placed in her possession. Sits well in her power wheelchair. She can perform a variety of active trunk and arm range of motion activities independently.
Weaknesses: Dependent for transfers, needs iPad set up to access it, has limitations in hand strength and lower body strength
Opportunity: If the technology can be set up properly, could she independently participate in a home program?
Threat: iPad breaks, she becomes less motivated...
I had struggled with meeting this need for quite some time. The solution, as good solutions are, ended up being multifactorial. We started him on what I called Tabata exercises...because at the gym, I had found rounds of Tabata to be a really effective way to get myself to do just a bit more exercise.
Tabata is originally named for Dr. Izumi Tabata, a Japanese physician and researcher who suggested 20 seconds of exercise intensity followed by 10 seconds of rest for rounds. He conducted a study using an interval-based training model, and demonstrated that athletes had increased aerobic and anaerobic fitness levels with the Tabata approach. Embers (2013) demonstrated that a 20-minute Tabata session, which utilized multiple rounds of body-weight and plyometric exercises, improves cardiorespiratory endurance.
The solution: using an app, we devised a series of exercises for her to do...put photos of each on her iPad in case she forgot one: arm circles, nose punches (touch your nose), side bends (touching the ground), seated trunk rotation, single knee to chest, isometric chin tucks, isometric lats (pushing elbows into wheelchair)...to name a few. We taught her to use the app...and once the app was started, she could play the app which would time her for 20 seconds (with green light) and 10 seconds (with a red light), the app could be set for how many rounds she did.
The original intent of Tabata is for intense exercise...and while these exercises are not a high cardio demand for her, they are a high demand for her...I don't want to make Tabata and take away from his original intent, but I clearly think that his suggestion for timing is key...so perhaps Tabata style interval exercise??? I don't know...let me know your thoughts on this :)
References:
Emberts, T., Porcari, J., Dobers-tein, S., Steffen, J., & Foster, C. (2013). Exercise Intensity and Energy Expenditure of a Tabata Workout. Journal of Sports Science & Medicine, 12(3), 612–613.
Tabata I., Nischimura K., Kouzaki M., Hirai Y., Ogita F., Miyachi M., Yamamoto K. (1996) Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2 max. Medicine & Science in Sports & Exercise 28(10), 1327-1330