Ask the Expert: Wheelchair Exercise — Yes You Can

Exercise is a vital part of our overall health and well-being. Research shows that exercise can offer many positive benefits for those living with cancer. Memory, cognitive skills and recovery post-treatment can be positively impacted through exercise. Furthermore, exercise has been shown to boost appetite, decrease fatigue, anxiety and cancer-related treatment symptoms. 

Regardless of your current functional level, there are exercises you can do to help keep your body strong. As an individual diagnosed with a brain cancer, it is important to discuss exercise with your physician and to ensure you listen to your body during exercise. Fatigue is a symptom commonly reported by patients going through brain cancer treatment; pay close attention to how you are feeling and pace your activities appropriately. 

Note: Prior to engaging in any physical activity program it is important that you speak to your health care team. They can address your specific needs and provide guidance regarding any restrictions, contraindications and modifications required. To complete a well-rounded program, it is important to incorporate all types of exercise to provide balance and ensure you are addressing all of your fitness needs. 

Types of Exercise

Cardiovascular

Cardiovascular exercise is any type of exercise that increases your heart rate. This helps to improve your heart health and oxygen consumption, which can help decrease fatigue. 
 
  • In sitting, a cycle ergometer can be used with your hands or feet to increase your heart rate. 
  • Aquatic exercise programs offer classes for those with decreased mobility.
 

Strengthening

Strengthening exercises work to increase specific muscle strength. This is particularly important if you use a wheelchair for mobility, as the muscles in your legs will not get used as often. Lower extremity exercises can help improve your ability to transfer and move in bed with increased ease. Some examples for sitting strengthening exercises are:
 
  • Kick your leg out straight so the muscles on the top of your leg tighten. 
  • Lift your knee up towards the ceiling. 
  • Complete foot taps and heel raises with your feet on the floor. 
 

Flexibility / Stretching

These types of exercises maintain the length and range of motion of your joints.  When sitting in your wheelchair for long periods, it is common for muscles to get tight and stiff, especially those of the legs.
 
  • As part of your daily routine, stretch your arms and legs to their full range of motion.
  • Before you get out of bed, stretch your legs as straight as you can, ensuring your hips go as straight as is comfortable. You want to feel the muscles come to their end range and hold each stretch for 15-20 seconds. While you are stretching, ensure you are breathing fully and deeply. You should not feel pain, just a comfortable stretch.
  • When sitting, reach your arms up over your head and out to the side. Feel the stretch in your arms and in the core of your body. 
 

Balance

Balance exercises are very important even if you aren’t walking. Though you may not be walking, the muscles usually used still help maintain your ability to sit up independently, transfer positions and reach for objects while sitting.
 
  • Sitting in your wheelchair, use your stomach and back muscles to help you sit up not using the backrest. Take deep breaths while holding yourself in this position. Don’t rely on the wheelchair for support; instead use your muscles to maintain your body in the sitting position. 
  • Once you master this exercise, have someone hold objects out to the side/above/below and reach for them ensuring you continue to breathe, always ensuring your safety. 
 
This information discusses general principles for exercise in a wheelchair and is not meant to be a personalized program. Depending on your level of ability, you can increase or decrease the intensity by omitting exercises/repetitions or by adding resistance. A physiotherapist is a health care professional that has been trained to assess and recommend exercises that are specific to your needs. Talk to your health care team about meeting with a physiotherapist before starting any physical fitness program.

DOWNLOAD THIS INFORMATION SHEET AS A PDF
 
Thank you to physiotherapist Deirdre Igoe for providing this Ask the Expert information sheet.

Deirdre is a registered physiotherapist who works as a Rehabilitation Consultant within The Pencer Brain Tumor Centre at Princess Margaret Hospital. Her role requires her to address the rehabilitation needs of the brain tumour population to help increase their independence and maximize function. Deirdre also works at Sickkids Hospital, where she has had extensive experience with the pediatric brain tumour population. Her areas of practice also include relaxation therapy, support group facilitation and sports injury, as well as involvement in research looking at the benefits of exercise for brain tumour survivors. Deirdre is also a member of the Professional Advisory Group providing expert advice to Brain Tumour Foundation of Canada. 
 
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