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Beyond physical for PWDs

"Giving support and opportunities to persons with disabilities"
By: Darleth Romana-Bantiles, MDBeyond physical for PWDs

In the Philippines, roughly 1.57% have a disability. According to NSO’s 2010 Census of Population and Housing, approximately 3% of the population has some form of difficulty in functioning like in seeing even when wearing eyeglasses, hearing even with hearing aid, walking or climbing steps, remembering or concentrating, and communicating. The trend in the number of PWDs is increasing in the country because of population aging, increasing incidence of acute and chronic illnesses, and traumatic injuries resulting in disabilities.
Despite the challenge in the functioning of PWDs, their condition should not hamper them from striving for fitness or well-being. A disability is said to be a function of the environment, where the barriers to participation are not addressed. For example, a visually impaired person may not have grills to hold on to or railings along a path to help in navigation. But with adaptations in place, the visually impaired person can do many things other people do like travel, play or even engage in sports.
The International Classification of Functioning, Disability and Health (ICF) further defined disability as an umbrella term covering impairments (problem in body function or structure), activity limitations (difficulty encountered by an individual in executing a task or action), and participation restrictions--problem experienced by an individual in involvement in life situations). All these considered, a comprehensive approach to help PWDs should be beyond the context of health, but more on helping them to overcome difficulties by removing environmental and social barriers.

Adjusting environments for active PWDs

Research has demonstrated that increase in physical activities, across disabilities, have provided significant benefit to PWDs, particularly in functional status and quality of life. The task of improving environments for PWDs to have increased participation in sports and other physical activities lies heavily on fitness instructors or wellness coordinators. First, a universally accessible program should be in place, with the program developed from consultations with PWDs themselves. Creativity may be employed to modify exercises. Sometimes, all it takes is to use an ordinary sports accessory as adjustment equipment (ex. an elastic wrap may be used to assist with gripping weights or to secure feet or hands to a bicycle or an arm ergometer). Financial considerations, although important, is not a priority as some equipment adjustments are inexpensive. Some helpful tips are as follows:
  • Work with or consult with a physician, who has PWD clients, before starting any physical activity or program. Medical professionals could have suggestions about specific activities or exercises.
  • Put safety measures in place always and match it to the person's functional level. Make spotters available for PWDs lifting weights, or offer flotation devices for those who are able to swim in pools.
  • Build extensive knowledge of your clients’ capabilities, health goals, special interests, strengths and even learning the style.
    When creating a program with your client, remember that people with the same disability can differ greatly in their levels of abilities. That's why it's important to be clear about the person's abilities, limitations and exercise preferences. (ex “Does he or she feel tired while exercising?”) Work together to identify a comfortable level. When certain movements cause pain or discomfort, stop, and try to perform the exercise differently
  • To keep the lines of communication open. This is to have clear expectation setting before program commencement. Explore the concerns of PWDs (ex. anxiety with the activity, fear of getting injured or hurt, etc). 

Therapy modalities beyond sports

Art therapy, utilizing different media, may also be helpful to build the confidence and boost the well-being of PWDs. Drawing or painting may become expressions to sublimate traumatic experiences, frustrations and other negative emotions that are experienced by PWDs. Performance in plays may also help PWDs vent unexpressed feelings or emotions constructively.
Lastly, who says play is just recreation? For PWDs aged 3 to 6 years old, play therapy may be helpful. It may also be adapted for young people in their late teens, and even for adults, including the elderly. This therapy is a developmentally sensitive intervention. The play therapist supports the child in revisiting early experiences through sensory play, symbolic play, and whatever other play opportunities the child chooses spontaneously in sessions. A child’s unique set of genes, life experiences, thoughts, fantasies, sensory and physical sensations, coping strategies, and ecological niche may be expressed in play.  In this therapy, there is a great dynamic relationship between the child and the adults surrounding him or her. Essentially, play therapy will also lead to positive and healthy changes in a young PWD’s way of responding to the world.
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