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Composition Myography Weight Management Program (CMWM) for Manual Wheelchair Users

Background

The study of measurement and description of physical activity in adult manual wheelchair users undertaken by the National Institute of Nursing Research and the National Centre for Minority Health and Health Disparities (NCMHD) gives us insight into the daily activity of manual wheelchair users.

The results show the following:

  • 9.1 mean daily hours spent in bed or asleep
  • 12.5 mean hours of light intensity activity
  • 1.3 mean hours of moderate intensity activity
  • 0.33 mean hours of strenuous activity

Thirty eight percent did not report any strenuous activity and 56% reported less than the 150 minutes per week of moderate or strenuous activity as suggested by public health guidelines.

This results in manual wheelchair users having poor cardio metabolic risk profiles (PCMRP) because of lack of physical activity, limiting their quality of life, characterised by low-self esteem, social isolation and depression. In addition, manual wheelchair users have a high body mass index, body fat percentage, serum lipid, cholesterol and blood sugar concentrations. Empirical investigations illustrate that exercise improves their PCMRP and cardio respiratory fitness levels.

When one starts talking weight management, and here we're only focusing on manual wheelchair users, it is normal that the following factors are used as the bench mark against which to gauge progress, namely actual weight and nutrition. This most often leads to the person who is undergoing a weight management program ending up feeling despondent and losing motivation to continue the program. The reason being is that initially the physical weight will reduce, however as the level of physical activity increases their muscle density increases. That’s why, one will see a decline in actual weight to a certain point and then the actual weight will for awhile stay constant or may even increase. This is often interpreted as either the weight management program being ineffective or the person in question is not putting in the required effort. It’s at this point that the person becomes demotivated and in the majority of cases ceases the program completely. In some cases this may affect the person mentally adding more complications into the mix.

In reality, what takes place is that when the person plateaus, the body continues to burn fat and even though the actual weight is constant (due to the increase in muscle density), the body fat percentage will be decreasing. In essence, weight management means the managing of the persons body composition as opposed to just actual weight. Experience has shown that manual wheelchair users are only assessed on their actual weight and not their body composition. The reason being, that up to now, the only affordable methods of ascertaining body composition involves the participant to be in an unaided standing position.

Methods of body composition currently available are as follows:

  • DEXA - requires a lab appointment, participant in supine position, 100% accuracy - 5 ⭐️  - £139 to £169 per scan
  • Bio-Impedance - personal device, participant in standing position, 90-95% accuracy - 2 ⭐️  - +/- £300 once off investment 
  • Skin-Fold Calipers - requires professional, participant in standing position, 96% accuracy - 3 ⭐️  - £50 to £175 per analysis
  • Composition Myography scanner - non invasive personal device, participant either standing or seated, 98-99% accuracy - 4 ⭐️ - Less than £50 per analysis

There are four components to take into account when looking at weight management-

  • Actual weight
  • Nutrition
  • Body fat percentage
  • Physical activity

Weight management is comprised of the above components; all of which work hand in hand to produce the end result.

Problem

Due to the above limiting factors, in reality this means that there is no effective weight management program utilising the above four components for manual wheelchairs users. This places manual wheelchair users at a disadvantage compared to able bodied persons. 
 

Solution

The Gym In Motion Composition Myography Weight Management (CMWM) program uses state of the art technology giving manual wheel chair users access to all the principles of weight management, namely physical activity, body composition, nutrition and actual weight. By combining the use of a composition myography scanner and a manual wheelchair treadmill, manual wheelchair users are able to undertake various cardio fitness programs and record such results as body fat %, muscle quality, speed, distance, calories and heart rate. By comparing these results to the individuals goals and initial benchmark, progress can be easily seen, motivating and ensuring long term compliance to their fitness and weight management program.

The CMWM program gives users accountability for their actions and results will be in easy to view graph form with achievable short terms goals leading up to their final goal.