Rethinking one-size-fits-all exercise prescriptions.

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Date: Mar. 21, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 11)
Publisher: CMA Impact Inc.
Document Type: Article
Length: 1,320 words
Lexile Measure: 1340L

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Posted on cmajnews.com on March 7, 2022

Most Canadians struggle to get the recommended 150 minutes of moderate physical activity a week, and people with disabilities say one-size-fits-all advice is part of the problem.

One in five people in Canada and roughly half of those older than 60 have at least one disability. Yet, until recently, research and guidelines have rarely acknowledged that physical activity needs may differ depending on a person's abilities.

Although the Canadian Society for Exercise Physiology has released some specific guidance for people with multiple sclerosis and spinal cord injury, people with varying abilities interviewed by CMAJ say clinicians seldom offer advice tailored to their realities.

Alison Purdy has spina bifida, uses a wheelchair, and is a regular member of her local YMCA's Abilities in Motion program in Dartmouth, Nova Scotia. She enjoys Tai Chi, lifting weights, balloon badminton, and exercising with resistance bands.

But when it comes to discussing exercise with doctors, Purdy says it sometimes feels like they "simply don't understand or have the knowledge or enough research on our disabilities" to give meaningful advice.

Joana Valamootoo of Regina, Saskatchewan, says she felt misunderstood by her doctor when she started experiencing intense fatigue and pain after delivering a child in 2015.

Previously, Valamootoo went to the gym every day, but after her pregnancy, her energy levels dropped and the pain she experienced during activity became so overwhelming that even caring for her baby felt impossible.

Valamootoo says her doctor dismissed the pain as being related to postpartum depression. She eventually stopped seeing him because it felt like she was bothering him. "The way he was talking to me, it was as if everything I was going through was in my head," she says.

Years later, Valamootoo was diagnosed with fibromyalgia, endometriosis and adenomyosis. She now manages her pain with restorative yoga and is back in the gym a few days a week.

Able-bodied clinicians can be quick to dismiss patients' limitations, or assume they...

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