Disability Youth Overview ( Part 1 of 5 )
By Christina Lee Steele Chapan
Note:This series will continue each month until completed.                                                         

Inclusion is a term used quite frequently in our society.  It means that as trainers and teachers, we will have students with disabilities in our classrooms and fitness facilities, and we must learn how to meet their unique needs in daily activities and welcome them in our schools, churches, and recreation/gyms, while striving to serve the general public as well. This is a daunting task even for those people who specialize in special education. I believe that this article is essential for anyone who works with children with disabilities. This series  is divided into four categories addressing those students with physical, mental, learning and emotional/behavioral disabilities. Please read each of these sections since the persons you may be working with will have a variety of disabilities and perhaps a combination of multiple diagnoses.  This month we will explore physical disabilities. 

Physical Disabilities

A physically disabled person will have various ranges of coordination, mobility, balance, agility, strength, and endurance challenges. It is important to remember when working with these individuals that many of them have normal and gifted mental abilities. Some disabilities have been a part of an individual’s life since birth, others have developed over time, and still others are the result of injuries that occurred after birth. 

Arthritis and Rheumatism

Many people think that arthritis and rheumatism only occur in the elderly, but this is not always the case. Arthritis is the inflammation of the muscle joint line and pains in the body’s muscles, tendons, and ligaments are rheumatism. Individuals with arthritis and rheumatism may tire easy and activities such as walking, climbing, going flights of stairs, rising and standing may be challenging. It is recommended that physical exercise be mild yet challenging and done at the same time of day for those with these conditions. Many people with these conditions have reported improved health with exercise. 

Cerebral Palsy

Cerebral Palsy is caused by conditions that affect body movement and muscle coordination. It ranges from mild to severe. Some people with cerebral palsy are mobile and have hardly any physical characteristics whereas others cannot move at all. Cerebral palsy first appears during infancy. Some cases of cerebral palsy are caused by a blood-type incompatibility or an infection that happens before or just after birth. Cerebral palsy effects body movement and muscle coordination. Some individuals with cerebral palsy have either decreased muscle tone (hypotonic), increased muscle tone (hypertonic), or stiff and rigid muscles. Faulty development and damage to motor areas of the brain cause this disability. People with cerebral palsy have average and above average mental abilities and should be treated cognitively on that level. Physical abilities should be tested under the direction of a physical and occupational therapist. After assessment, assisted elastic tube body weight training and weight machines are great to include in your strength training program. Cardiovascular training will depend on the individual’s physical stamina. Stationary cycling or swimming are excellent options for someone with cerebral palsy. Modification of equipment is also a great way to include the child in fitness activities. Use balloons, beach balls, or soft balls for safe tossing and catching. Modifying the rules of games, using large scooters, or enlarging targets gives students success. 

Tourette's Syndrome

Tourette's syndrome is a neurological or neuromechanical disorder characterized by tics of involuntary, rapid movements and repeated vocalization. This person frequently displays eye rolling, blinking, twitches, sniffing, and throat clearing. Speech disorders may include echolalia, the urge to repeat words spoken by someone else; palatial, repeating one’s own words; lexilalia, the urge to repeat read words, and coprolalia, using swear words or inappropriate words uncontrollably during speaking. Teachers and trainers can minimize embarrassment by educating the rest of the class about this condition and having activities where the individual’s strange behavior is ignored or minimized by redirection or by allowing that child an opportunity to display their behavior in a private space such as an extra classroom or gym.

Spinal Bifida

Spinal bifida is a birth defect that happens when the vertebral canal fails to close normally around the spinal cord. Disabilities with this disorder include paralysis or lack of feeling to the legs and feet and lack of bladder and bowel control.  Programs should be conducted in conjunction with a physical or occupational therapist.   Next month we will focus on part two on visual, hearing, and speech and language  impairments.

Stay tuned for part two next month.

Changes to Lose Those Last Few Pounds

Today we are going to address a fairly common question I get from a very typical (maybe even average) sort of person that is having trouble with those last couple of pounds.

Here is the set up. She is 45 years old, five foot three and weighs about 123 pounds. She is fairly lean but seems to carry that last bit of weight on her lower body. She is a little scared to hit her leg training hard because she doesn’t want bulky legs. She knows if she can just lose those last couple of pounds that her lower body will look the way she wants.

She is within 5lbs of her desired body weight and would still like to burn more fat particularly off her legs as they are not nearly as defined as she would like! She has the basics covered and is currently doing a split routine that allows her to do a lower body workout 2x per week and an upper body workout 2x per week.

So what is the problem? She doesn’t know how many or what type of cardio workouts she should be doing to drop the last bit of weight but to compliment fat loss off the legs. She has extremely strong cardio. She has a workout resting heart rate of around 46 or so. Her endurance allows her to do a cardio workout with incline training at 12/14 incline for an hour at 80 to 90% heart rate. That's pretty fit! Should she bring her heart rate down to 70 or 75% because of all the info she has been hearing about fat burning cardio workouts at lower heart rate levels?

This is a pretty common question and it has a multi-part answer.

It's important to note before going any further that your body burns fat as a whole and you can try all you want but you will not notice significant fat loss off a single area by doing focused exercise for it. All you can do is work the muscle and then remove fat off the whole body to reveal what is underneath. For women, those thighs seem to be the last to go.

Onto the changes she needs to make for those last few pounds.

This first thing you want to do is recheck your calorie intake and break down between carbohydrates, fats and proteins. It's different for everyone but for myself if I make a slight switch to more complex carbs in the early part of the day and transfer into more fat based fuels like nuts at night, this makes a big difference.

For the cardio workouts, when I need that last bit off, I go into heavy interval training workouts and change my regular form of cardio to something new that I am NOT efficient at. Either in the form of wind sprints or sparring. Bag work and grappling work well as a substitute. You can also use jump rope, which I am a big fan off. With this sort of training, it's an all out effort for 1-2 minutes followed by a minutes rest. I will do this 3-4 times a week whenever I feel like fitting it around my resistance training and if I start to get really tired during the day, I will throw in a rest day as my body tells me.

I've never been a fan of long slow cardio workouts that take more than 30 minutes. All that happens is I lose a lot of my daily schedule and my body gets flat and I feel week. The same thing happens to my clients that do slow cardio workouts. The only times I do this is in cases where the client is very over weight and it's more about pounds than composition. The other is when they are training for an event or simply really enjoy getting outside for a long run.

It's also very important that you keep up the progression of weight increases in your training. This is what will keep you hard even though you are doing increased cardio workouts.

If you see a little of yourself in the sample client above, give these changes a try. They'll work for you too!

Raisin-Date Cookies

Makes:
35 servings

Ingredients:

• 1 cup plus 2 tablespoons whole wheat flour

• 3/4 cup sugar

• 1 teaspoon baking soda

• 1/4 cup plus 2 tablespoons Prune Puree

• 1 tablespoon honey

• 1 teaspoon vanilla extract

• 2 cups bran cereal flakes

• 1/3 cup raisins

• 1/3 cup chopped dates

• 1/4 cup toasted wheat germ

Directions:

• Combine the flour, sugar, and baking soda in a large bowl, and stir well. Add the Prune Puree, honey, and vanilla extract, and stir to mix well. Mix in the cereal, raisins, dates, and wheat germ.

• Coat a baking sheet with nonstick cooking spray (nonfat). Drop rounded spoonfuls of dough onto the cookie sheet. Flatten each cookie with the back of a spoon.

• Bake at 350 degrees F for 8-10 minutes. Allow cookies to cool for 10-20 minutes. Then transfer the cookies to wire racks, and cool completely.

Nutritional Information:

• Serving size: 1 cookie

• Calories: 50

• Fat: 0.5 g

• Cholesterol: 0 mg

• Protein: 2 g

• Carbs: 9 g

• Fiber: 2 g

• Sodium: 50 mg

Q: Dear Tom: I know approximately what my protein needs are by bodyweight and activity level (about 180 grams), but the question I have always had is: how much protein can I eat/drink at one time? I have heard that only 30 grams can be digested at a time. I eat 5 times a day like you recommend, but supposing I only ate 3 times a day; that would be 60 grams of protein per meal. Would half of the protein be wasted?

A: Thirty grams of protein per meal seems to have become one of those "nutrition rules of thumb" that has been passed around so long that it has become accepted as an "unbreakable nutrition law." Some people claim that the human body can only digest 30 grams of protein per sitting (others claim the limit is 40 grams).

There has been a lot of research done on protein needs, although not much of it has focused specifically on the maximum amount digestible per meal. There have been studies where a large bolus of protein was eaten at one time rather than in small, frequent meals, and yet positive nitrogen balance was achieved. This would suggest that the 30 grams per meal limit does not exist and that 60 grams over three meals would allow your body to utilize the majority of that 180 grams.

30-40 grams per meal may be a pretty good rule of thumb for bodybuilding diets with an eating frequency of 5-6 small meals per day (slightly less for females). However, I have never found any research which says that the body has a "30 grams at a time" absolute limit and it doesn't seem likely that one fixed amount could apply to every person in every situation, with no accounting for body weight and activity level.

Nutritional needs - including protein - are highly variable depending on the individual. For example, are the protein needs for a 250-pound bodybuilder the same as a 105-pound ballerina? Are they the same for a 17-year-old football player and a sedentary 70-year-old? The obvious answer is no, and this is why you should look at dietary recommendations made as "absolutes" with caution. Instead, it's optimal to think in terms of customization for each individual.

The best way to figure out how much protein you need in one sitting is to first calculate your total daily protein needs. One gram per pound of bodyweight is a common recommendation (for active, strength-trained individuals), although total protein needs should be customized according to age, gender, body size, lean body mass, activity levels, energy status (deficit or surplus) and personal goals. Then take your daily needs and divide that amount by the number of meals you eat each day; usually five or six in a bodybuilding-style nutrition program.

As a bodybuilder or someone participating in regular strength training, the one gram per pound of bodyweight guideline is a pretty good estimate for daily protein needs (although some competitive bodybuilders go as high as 1.25 to 1.5 grams per pound on reduced carb pre-contest diets). If you weigh 180 pounds and you’re eating six times per day, then bingo – there’s your 30 grams. (180 grams divided by 6 meals). If you’re a 240-pound male bodybuilder, and you eat six times per day, now you’re up to 40 grams per meal.

If you’re a 125 pound female athlete, then 125 grams a day would suffice; spread over 5 meals a day, that’s 25 grams per meal. On a pre contest fitness or figure competition diet, many women eat up to 150-175 grams of protein per day, which, over five meals, is 30-35 grams per meal.

Some people think that the 30 grams of protein "rule" was started by protein supplement company marketing because thats the amount of protein they put into each serving of their product. However, looking at these examples, you can see that 30-35 grams of protein per meal is pretty close to the average amount that's consumed on a typical bodybuilding diet. My belief is that this is where the 30-gram "rule" came from - it's simply an average figure. But just because the "average" comes out to around 30 grams per meal, doesn’t mean that 30 grams is the most that you can digest.

The digestibility rate of high quality protein sources is 94 to 97% and even the protein in grains and beans is 78-85% digestible. Generally what happens with a large meal, including a large protein intake, is that the meal will simply take longer to digest, but the body will increase the rate of gastric emptying and nutrient absorption in response to the larger food intake. So while the 5 or 6 small meals a day is an accepted practice among bodybuilders, there doesn't seem to be any proof that you couldn't utilize the protein if you took it across only 3 meals instead.

On the other hand, if the total amount of protein exceeds what your body requires and if you are in a caloric surplus, you can convert the excess into body fat. Although protein is the least likely of the macronutrients to be converted to fat (due to an energy inefficient conversion process), a caloric surplus will always lead to fat deposition, even if the surplus comes from protein. In a caloric deficit, protein consumed beyond the body's needs for skeletal muscle and body tissue protein synthesis can be converted to glucose through a process called gluconeogensis.

Bottom line: Even large protein servings can be digested and absorbed, and it appears there is no 30 gram absolute limit. On the other hand, huge servings of protein at one time are not necessary for muscle growth. Beyond what is needed for growth, repair and energy, an excess of protein can get "wasted" if you are referring to being stored as fat or burned for energy.

References
1. Plant proteins in relation to human protein and amino acid nutrition. Young V. and Pellet P., American Journal of clinical Nutrition. 59. pp 1203S-1202S. 1994

2. Protein pulse feeding improves protein retention in elderly women. Arnal, M, et al. American Journal of clinical Nutrition. 69. 1202-1208. 1999