Exercise Time

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June 2005

By Dawn T. Gulick, PhD, PT, ATC, CSCS

Home fitness equipment can help patients continue their exercise regimens after therapy ends

Imagine this scenario. A client undergoes physical therapy for an injury. After a few sessions, a few weeks, or a few months, the client is eventually discharged. You may elect to provide this client with a home exercise program, and hopefully you have positively increased this individual's understanding of the value of physical activity. You may be asked about a fitness program at the YMCA or a local health club. You may also be asked about the use of certain pieces of weight-lifting or cardiovascular equipment at these facilities. As physical therapists, we have the skills to advise our clients about the appropriateness of each piece of equipment for specific functional limitations.

However, many of us are not thoroughly versed in the plethora of exercise equipment on the market. What if your client asks you about purchasing one or more pieces of equipment for his home? Could you recommend a good treadmill, multi-station unit, or free-weight setup? Should the client buy new or used equipment? Should the client purchase something they have seen on an infomercial? Sure, the movements look easy when performed by Olympic athletes, but are they reasonable for your client? Just because a piece of equipment is endorsed by a celebrity does not mean it is right for your client.

It is impossible to provide the answers to all of these questions for every client we may treat. Likewise, generic statements about fitness equipment are not very helpful. Instead of trying to address every situation, it is better to provide a framework you can use to guide your client through the decision-making process to determine if home exercise equipment is appropriate for him. Begin by asking your client to complete a checklist similar to the following:

The answers to the below questions should help you see the direction that may be appropriate for your client. Although convenience and privacy may be strong factors for purchasing home equipment, it may be wise to advise your client to not overspend on equipment with the notion that this will "guilt" them into exercising. A client could spend a considerable amount of money on a piece of equipment that may eventually become nothing more than a clothes hanger.

QUESTIONS:	ANSWERS:
Do you prefer exercising alone?	YES	NO
Do you need the company of others to motivate you?	YES	NO
Is the location of the gym or fitness center convenient enough to ensure compliance with an exercise program?	YES	NO
Are the hours of the gym or fitness center consistent with your schedule?	YES	NO
What are your exercise goals? Are you looking to lose weight, improve your conditioning, get stronger, etc?	YES	NO
Do you have a well-ventilated space in your home to put the equipment?	YES	NO
How much money are you willing to spend?	YES	NO
Does the equipment needed to achieve your goals fit into your price range?	YES	NO
Would you know how, or have access to the resources, to modify your exercise program if it is too hard or too easy?	YES	NO
Are you familiar with the use of the equipment you plan to purchase?	YES	NO
Will you be the only person using the equipment?	YES	NO
Are there small children in the home that could present a safety concern?	YES	NO

TAKING THE PLUNGE
If your client does decide to purchase home equipment, encourage him to become an educated consumer. First, have your client determine how much space he has available in his home. Next, have him go to a large gym or fitness equipment store and try out a variety of equipment.

Make sure that your client is comfortable with the machines' movements and resistance methods. Does the treadmill, bike, stepper, or rower move at a velocity that is comfortable yet challenging? Can the weight stack be progressed at reasonable increments (less than five pounds), or are the weights too large to provide safe levels of progression? Is the range of the weight stack/resistance within your client's abilities?

Also, make sure that he experiments with the sizing adjustments, since equipment does not always accommodate every body size. Most equipment is geared toward the "average" individual. Thus, if your client is a 5-foot, 1-inch, 110-pound woman or a 6-foot, 5-inch, 275-pound man, they may have difficulty finding machines that align properly to their size.

Other important things that your client should consider about the equipment are delivery, setup, warranty, and maintenance. What should your client do if the equipment malfunctions? Also, he should beware of the presence of excessive bells and whistles on a piece of equipment. There may be some very helpful components on some pieces of equipment, but if they are not going to be used, they simply mean extra maintenance.

With that in mind, encourage your client to not overlook the smaller, more creative approaches to fitness. Elastic bands/tubing, fitness balls, and exercise videos can also provide a safe and enjoyable way to improve both strength and endurance. Likewise, martial arts or yoga are alternatives to conventional exercise programs.

A QUESTION OF MOTIVATION

Sometimes, it is not a bad idea for your client to join a fitness facility for 1 month or so. Two very important things can be gleaned from a short-term membership. First, your client will have multiple opportunities to try out numerous pieces of equipment during a series of workout sessions. This will allow him to determine exactly what pieces of equipment he likes and/or dislikes. Comfort and stability are extremely important components of a workout. If he does not like the "feel" of a machine, or if he experiences excessive joint stresses, the client may be prone to pain or injury. Clearly, that would defeat the point of exercising.

Second, your client can prove to himself that he has the drive to commit to an ongoing fitness program prior to making a significant financial decision. Your client may even find that he enjoys participating in an aquatics program, for example, and may opt not to buy any equipment at all.

Once your client has secured a piece of equipment, it is often helpful to establish an inviting environment to maximize the likelihood of workout compliance. Setting up a small sound system or television can provide an entertaining diversion. Establishing a fitness routine is a change in lifestyle. Remind your client to be skeptical about an exercise program or piece of equipment if endorsers claim that results are easy to obtain or require only 5 to 10 minutes of exercise per day. Getting fit takes work, and committing to a weekly routine is the first step to achieving that goal. N

Dawn T. Gulick, PhD, PT, ATC, CSCS, is an associate professor at The Institute for Physical Therapy Education at Widener University, Wilmington, Del.

RESOURCES

Avoiding the muscle hustle: tips for buying exercise equipment. 2004. Available at: www.ftc.gov/bcp/conline/edcams/exercise. Accessed January 22, 2005.

Choosing exercise equipment. 2004. Available at: http://www.fitfaq.com/choosing-exercise-equipment.html. Accessed January 20, 2005.

Neporent L. Buying exercise equipment for your home. 2001. Available at: http://www.ivillage.com/diet/expects/fitfriday/articles/0,,165563_49624-1,00html. Accessed January 22, 2005.

Selecting home exercise equipment. February 2002. Available at: orthoinfo.aaos.org. Accessed January 20, 2005.

Simple fitness solutions. Buying home exercise equipment. 1999. Available at: http://www.simplefitnesssolutions.com/articles/home_equipment.htm. Accessed January 22, 2005.

Snelling HT. How to select exercise equipment for your home gym. December 2002. Available at: http://www.delawarewoman.com/200212/howtoselec.html. Accessed January 20, 2005.

Tips for buying exercise equipment. 2000. Available at: www.stopgettingsick.com/templates/news. Accessed January 22, 2005.

Wescott WL. Selecting exercise equipment. 1998. Available at: www.healthy.net/scr/column.asp?ColumnId=12&ID=226. Accessed January 20, 2005.

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