Autism: The usefulness of exercise

Being healthy is not only a matter of what you eat but of your level of activity during the day. Diet and exercise go together. Many problems in autism can be prevented by following good dietary and exercise habits. Healthy habits such as exercise can increase muscle power and extend your life by reducing the risk of cardiovascular disease, stroke, osteoporosis, and diabetes. In the case of autism, exercise has the added advantage of increasing skill-related components of movement like coordination, agility, reaction speed and balance.

Lack of balance (falls) may be considered a common disorder in the elderly causing thousands of accidents per year within the United States. According to the CDC, each year one in three adults over the age of 65 will fall causing some type of moderate to severe injury (e.g. hip fracture, head trauma). Strength and balance training may improve this dismal statistic. Balance is the result of integrating the activity of multiple systems of the body including, the vestibular (located in the inner ear and accounting for the position of the head in space), visual, and the somatosensory (stimuli coming from the skin and muscles) systems. In autism there seems to be a lack of coordination among these systems. According to an ongoing theory of autism, albeit applied primarily to attention (i.e., monotropism), autistic individuals seem to process information from only one sense at a time. Thus in autism we do not have a restriction of vision or a comorbid medical condition such as Parkinsonism, but they do appear to be clumsy and have difficulties participating in sports. Exercise can help in strengthening the integration of these multiple systems.

According to the Autism Research Institute (ARI) exercise is one of the most effective therapies for autistic individuals: “Studies have shown that vigorous or strenuous exercise is associated with decreases in stereotypic (self-stimulatory) behaviors, hyperactivity, aggression, self-injury, and destructiveness” (see http://www.autism.com/treating_exercise).

Before you start to exercise make sure that you do not have any pre-existing medical conditions. Plan on exercising 5 days a week for some 30 minutes each session. It is not necessary to go to a gym, but vigorous exercise could reduce the training schedule to 3 days per week. However any amount of exercise, even 15 minutes per day, is better than no exercise. Try to combine repetitions with weight training. Consume adequate amounts of water and fiber. Get a pedometer and a partner to exercise with you. Pick something that you like and be consistent. Look for types of exercise that can be squeezed into your lifestyle. Don’t exercise when you are sick.

Start by warming up and work out all of your joints. The workout phase maintains the intensity of exercise as measured by your heart rate. Recommended heart rates depend on your age (for criteria according to the American Heart Association see http://www.heart.org/HEARTORG/GettingHealthy/PhysicalActivity/Target-Heart-Rates_UCM_434341_Article.jsp). Finally finish exercising by instituting a cool down phase where you steadily decrease the intensity of the exercise and end with some stretching exercises.

For autistic individuals try to emphasize exercises that are meant to increase balance and coordination. It may be helpful to keep a journal showing the benefits of training. Test the balance of an individual by having them walk in a straight line while placing one foot in front of the other (just as a policeman tests a drunk person). When testing in this manner observe any difficulties in how they turn around and come back walking towards you.

Some exercises for balance can be made into games, e.g. standing or hoping on one foot (e.g., playing hopscotch) or trying to balance while sitting on a big ball. If the surface is slippery consider placing the ball on top of a large towel or rug piece.

swissball

Figure: You can use a Swiss ball as a playful activity that also helps in sensory therapy.

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Figure: The possibility of using games to enhance the balance and coordination of children is only limited by your imagination.

The Wii board is being used in rehabilitation by different institutions. This is a balance board or an unstable surface that engages many of your muscles used to maintain balance. It is a good body workout. Just go frontwards and backwards or side to side using the board while trying to control the balance. You can also use the Wii boar while playing video games designed for this task. Other possibilities to enhance your balance include Tai Chi and aqua/hydro exercises. Exercising in water usually elicits good childhood memories and is often preferred to exercise in land. It has been recommended for rheumatoid arthritis and obese individuals as the water (its buoyancy) takes the weight off from the joints. Hydro exercises decrease body contact with the floor (the impact) and cushions body movements thus reducing the possibility of injury.

Exercising in a swimming pool increases blood circulations and prevents the pooling of blood in the lower extremities which may cause fainting in some individuals. This squeezing action increases venous return, stroke volume and cardiac output. You also do a lot more exercise involving the respiratory muscles (caution for those suffering from a respiratory condition). It keeps you cool and more enjoyable, more comfortable. It promotes social interaction as most hydrotherapeutic sessions are done in-group sessions. Use floats or paddles to increase resistance and noodles for flexibility exercise.

aquatic-therapy

Figure: Aquatic therapy for a group of autistic children in the Philippines. It is therapy for the whole family!

References

Oriel KN, George CL, Peckus R, Semon A.The effects of aerobic exercise on academic engagement in young children with autism spectrum disorder. Pediatr Phys Ther. 2011 Summer;23(2):187-93.

Elliott RO Jr., Dobbin AR, Rose GD, Soper HV. Vigorous, aerobic exercise versus general motor training activities: effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation. J Autism Dev Disord. 1994 Oct;24(5): 565-76.

García-Villamisar DA, Dattilo J.Effects of a leisure programme on quality of life and stress of individuals with ASD. J Intellect Disabil Res. 2010 Jul;54(7):611-9.

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