Disability and limited mobility

How can you exercise with limited mobility?

You can start small, and you can start seated. The WHO recommends that if you aren't yet meeting activity recommendations, you begin with small amounts and gradually increase how often, how hard and how long you're active. Building up gradually also helps manage risk¹.

Adults living with a disability or a long-term condition should aim for the same amounts of activity as other adults where they can. If you can't, any activity you're able to do brings benefits.

If you use a wheelchair and aren't used to exercise or haven't exercised for some time, the NHS suggests starting with 10-minute sessions and gradually building up towards 20 minutes. It also says not to worry about hitting targets straight away: it's more important to do something active that you enjoy³.

Activity that doesn't use your legs counts. Wheelchair users and people with low mobility can reduce sedentary time with light or higher-intensity activity that doesn't involve the legs, including while seated¹. The UK Chief Medical Officers advise disabled adults not to be still for too long, and say even a little movement is better than nothing⁴.

Options include sitting exercises, wheelchair workouts, swimming, adapted rowing machines and wheelchair sports. Some wheelchair users also do muscle-strengthening exercises at home with resistance bands³.

What does adaptive exercise look like?

Adaptive exercise means shaping activity around what your body can do now, rather than following a standard routine. One size doesn't fit all: people with disabilities have different needs, preferences and barriers, so a good program is flexible and offers activities you prefer². It also takes account of how your condition affects your exercise capacity, the energy activities take and how easily you tire².

That can mean shorter sessions. Many people with disabilities find long, sustained effort at moderate-to-vigorous intensity arduous or even impossible, so shorter bouts may suit better. Sessions of about 20–30 minutes, 2–3 times a week, can bring significant benefits, and for many people a suitable amount is well below 150 minutes a week of moderate-to-vigorous activity².

Examples include:

• Seated classes that work on strength and balance from a chair⁵.
• Online sessions that can be done seated or standing⁵.
• Adapted gym equipment, such as a handcycle, a low recumbent bike, or a rowing machine with a chair and backrest⁵.
• Adapted bikes, including handcycles, tandems, trikes and wheelchair cycles⁵.

Physical activity is considered safe and beneficial for people with a disability when it suits their current activity level, health and physical functioning. Some people may need a doctor, physio or disability specialist to help work out the right type and amount¹.

Where can you find inclusive activity programs?

Start with your local council or leisure centre's disability sport and activity pages, and ask local disability or carers' charities what is on. Not knowing what's available or how to get started is a commonly reported barrier, and adapted equipment can be hard to find and expensive².

In the UK, for example, a council disability sport network supports deaf and disabled residents to join adapted, tailored and inclusive sport and activity. Local charities run free seated gentle exercise classes for strength and balance. A disability sport organisation offers free online classes three times a week, led by wheelchair users. One leisure centre has accessible gym equipment, and an all-ability cycling project offers adapted bikes⁵. Places like these are worth looking for where you live.

Before you commit:

• Ask what adapted equipment is on offer and what experience the instructors have with your needs.
• Ask your doctor or physio whether a program suits you. A listing doesn't guarantee a program is good quality or right for your condition.
• If you're wary of online classes, ask someone you trust to look at the provider with you first.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio. Some people with a disability need a healthcare professional or disability specialist to help work out the right type and amount of activity¹.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

If you feel unwell, sick or sweaty, have unexplained discomfort, or have breathlessness or dizziness that doesn't settle during or after activity, don't just ease off. Use the emergency advice above, or see a doctor soon if it has settled. For a sore muscle or joint, stop or ease off, and see a doctor or other health professional if it persists or gets worse. If you notice unusual tiredness, get it checked by a doctor.

If you have a spinal cord injury, ask a specialist about activity that puts weight through weak or numb legs. Injuries linked to walking-based programs, including electrical stimulation walking, are the main concern, and protection for weak or numb legs may prevent them. Lightheadedness or low blood pressure on standing is the most commonly reported problem with electrical stimulation⁶.