Components of Fitness

Flexibility is simply the range of motion you have around a joint.

Take a gymnast for example, they are clearly very flexible because they are able to put their bodies into positions that many of us would not even attempt.

The American College of Sports Medicine (ACSM, the largest sports medicine and exercise science organisation in the world, www.acsm.org) guidelines state that adults should try to do flexibility exercises at least two to three days per week to improve their range of motion.

Remember that the full range of motion at affected joints may not be possible so it is important to work within your own capability.

• Stretching is most effective when the muscle is warm so always do some light to moderate aerobic activity beforehand.
• You should move into a stretch to the point of tightness or slight discomfort and then hold.
• Hold static stretches (once you are in the stretch position you do not move) for 10-30 seconds during the warm up, or use dynamic stretches (stretching as you are moving, without bouncing) that mimic the movements of the subsequent activity.
• During the cool-down stretch all of the major muscle groups that you used in your workout and any smaller muscles that you may have targeted (20-30 seconds per stretch). Static stretches can be useful for this.
• Regular stretching should also be performed on days you are not exercising to maintain a normal range of motion around your joints.
• To develop flexibility further it is worth holding stretches for at least 60 seconds or alternatively, repeat the stretch to accumulate this time.

Completing a flexibility routine is particularly good practise for individuals with Cerebral Palsy. For those who have spastic CP, where contractures may occur (shortening of muscles and connective tissue), gentle stretching and flexibility sessions are recommended.

Strength training in the initial stages of a programme is defined as anything that challenges your body above its norm in terms of lifting or moving weight. Strength training does not have to take place in a gym; lifting a bag of sugar, tins, bottles or simply your own body weight can be classed as strength training and can be quite difficult depending on the weight, number of repetitions, and exercise selection.

Out of the gym, strength training can be done using a number of training alternatives:

• You can do some exercises using simply your own body weight such as press-ups, dips, squats or chin-ups.
• Small wrist and ankle weights with Velcro straps can also be useful to increase the resistance during any type of exercise.
• Partner resisted strength exercises. You can still do the same movements as you would on gym machines but with a partner resisting these movements rather than a weight. These can be done at home, at work, in the park, almost anywhere!
• Elastic tubing (often called dyna bands, therabands or clini bands) are simply pieces of elastic which offer more resistance the greater you stretch them. Again, these give you the freedom to mimic many of the movements that can be done in the gym.

If you choose to go to a gym perform exercises without any or with minimal weight when learning new techniques. Once you have mastered the technique (ideally under supervision) choose a weight that will produce a moderate amount of muscular fatigue during the number of repetitions you have planned. Your chosen weight should allow you to complete a full set without stopping and you should be able to maintain good technique throughout.

Aerobic training is any activity that raises your heart rate and gets you out of breath for a sustained period of time. It trains the cardiovascular (heart, blood and blood vessels) and respiratory (lungs) systems to help reduce fatigue and improve endurance. It may take you a little longer to master movement patterns so keep movements simple, large and repetitive, especially during activities such as aerobics classes.

During any type of exercise but especially aerobic sessions, it is important that you avoid exercises that cause you to experience excessive and early fatigue, and that you learn when to stop. If you do get tired very quickly or your muscles become fatigued you should rest and recover and consider starting at a lower intensity next time you do the same type of exercise.

Specifically, individuals with athetoid CP will benefit from intervals or movement patterns that include stop-start repetitions.