如何重建輪椅族的自主活動能力？讓輪椅變成短暫的陪伴 - 方格子

一般人需要運動，而靠輪椅活動的人其實也需要。

無論是先天因素還是後天因素（如受傷、生病、退化等等），輪椅族只是站在與常人不同的起跑點，擁有不同的短期目標，但同樣朝向健康邁進。

一般人的運動目標，通常是為了瘦身、線條、運動表現，也有一些人是為了「預防退化」。

從底層邏輯來看，無論你的目標為何，都是想透過運動來增強身體素質，延續/增加身體的健康。

科學對健康的定義

在科學上，我們又可以把健康加以區分成幾個不同的因素來看，例如：

1. 每個關節的活動範圍是否足夠？

2. 活動關節時是否會產生疼痛？

3. 在活動範圍中用力，是否可以感覺到肌肉有效率的用力？

4. 你的肌肉耐力及力量大小？

5. 有沒有什麼動作做不出來，或是動作中會產生疼痛？

一般人的訓練內容，會從這些重點進行評估、訓練，讓身體的運動能力跟著上升。

「那麼，回到輪椅族的身上，運動的內容會不一樣嗎？」

答案是：「基本上一樣，但細節不同。」

輪椅族的運動目標

大方向上，輪椅族可能喪失大部分站立、自主行走的能力，生活中也可能長期伴隨著慢性疼痛的問題。

因此在運動目標的建立上會是「先減緩疼痛，再改善運動能力」。

更具體的說，應該是透過運動來增加動作能力，並透過做動作，來改善慢性疼痛。

討論動作和慢性疼痛之間的關係，需要再花費有點篇幅，於是這邊就先把重點放在 「輪椅族應該具有怎樣能力？」

重建自主活動能力的5大階段

「重新訓練站立、自主行走的能力」就會是輪椅族很重要的目標，因為它影響了健康，以及社交的能力。

針對輪椅族的運動規劃，大致分成幾個不同的階段：

① 從彎腰駝背的坐姿，到自主挺直的坐姿。

② 從良好的坐姿，找回維持站立的基本耐力。

③反覆轉換坐姿和站姿的肌耐力、動作控制能力。

④維持站姿的單腳站的肌力、耐力、平衡感

⑤行走的動作訓練、協調、肌耐力、體力。

（每一個階段，都有許多訓練的重點和細節）

當輪椅族重新掌握自主行走能力以後，他們將重新站在另一個起跑點，與常人無異，在健康的道路上繼續前進。

身為健身教練的我，就會有另一串新的目標，希望可以和他們一起完成。

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教練的碎碎念

我是小賴，是一個健身教練，擅長一般人的運動規劃，同時也接觸過不少由復健診所轉介的案例。

在學員人生的不同階段，我都有許多想帶給他們的觀念，以及對應的專業知識。

無論你處於哪個階段，都可以來找我討論你的情況，讓我們能一起找到進步的方向。

People in general need exercise, and people who rely on wheelchairs for mobility actually need it too.

Whether it is congenital or acquired factors (e.g. injury, illness, degeneration, etc.), wheelchair users are just standing at a different starting point from the general public, with different short-term goals, but the same progress towards health.

The general publics exercise goals are usually for slimming, toning, and athletic performance, while some are for "preventing degeneration".

The underlying logic is that no matter what your goal is, you are trying to enhance your physical fitness and continue/increase your health through exercise.

Scientifically, we can categorize health into a number of different factors, such as:

1. is the range of motion of each joint adequate?

2. is there pain when moving the joints?

3. whether you can feel your muscles exerting themselves efficiently when exerting force in the range of motion?

4. what is your muscular endurance and strength?

5. are there any movements that you cannot perform or that cause pain during the movement?

In general, the training content of people will be assessed and trained from these key points, so that the bodys athletic ability can follow the increase.

"So, if we go back to the wheelchair users, will the content of the exercise be different?"

The answer is: "Basically the same, but the details are different."

Generally speaking, wheelchair users may lose most of their ability to stand up and walk on their own, and they may live with chronic pain for a long time.

Therefore, the goal of the exercise program is to "reduce pain first, and then improve the ability to exercise".

To be more specific, it should be to increase mobility through exercise and improve chronic pain by doing the movement.

It would take a bit more space to discuss the relationship between mobility and chronic pain, so lets focus on the question, "What should a wheelchair user be able to do?

"Retraining the ability to stand and walk on ones own is an important goal for wheelchair users because it affects health and socialization.

Exercise planning for wheelchair users is divided into several stages:

① From a hunched sitting posture to a straight sitting posture.

② From good sitting posture, find the basic endurance to maintain standing.

③ Muscle endurance and movement control for repeated changes in sitting and standing postures.

④Muscle strength, endurance, and sense of balance to maintain standing posture.

⑤Movement training, coordination, muscular endurance, and physical strength for walking.

(For each stage, there are many training points and details)

When wheelchair users regain the ability to walk on their own, they will be at the starting point again, no different from normal people, and continue to move forward on the road to health.

As a fitness trainer, I have a new set of goals that I hope to accomplish with them.

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My name is Lai, I am a fitness trainer who specializes in exercise planning for the general population, and I have also come across a number of cases referred to me by rehabilitation clinics.

I have a lot of ideas and expertise that I would like to bring to my clients at different stages of their lives.

No matter where you are in your life, you can come to me to discuss your situation, so that we can find a way forward together.