Introduction
The purpose of this fact sheet is to provide guidance for people with visual disabilities, as well as those who are interested in establishing a fitness program for people with visual impairments at a public or private fitness facility. Constructing a facility for people with visual disabilities is neither difficult nor costly; it simply involves some planning and forethought. This fact sheet offers some helpful ideas and suggestions to assist everyone from the manager of a fitness facility, to the fitness trainers working with the visually impaired client, to the persons with the visual impairments themselves.
The History of Assistance Dogs
Many people with disabilities use assistance dogs to help them with their mobility needs and daily activities. These dogs can be easily identified by the harnesses that they wear while they are working. Others may have a sign that says, “Working Dog – Please Do Not Pet”. When you come into contact with an assistance dog, never try to pet the dog; you may distract the dog from doing its job. You may ask the owner if you may pet the dog at an appropriate time.
German soldiers who were blinded in combat used the first assistance dogs during WWI in Germany. The concept of training dogs to assist soldiers eventually came to the United States a few years later, thanks to an American woman named Dorothy Eustis. In 1929, the first Seeing Eye Guide Dog organization was created in the United States.
There are three types of assistance dogs; guide dogs for people who are blind/visually impaired, hearing dogs for the persons who are deaf/hard of hearing, and service dogs for people with other mobility-related disabilities. Common dog breeds that are often trained to become assistance dogs include Labradors, Golden Retrievers, and German Shepherds. All assistance dogs are legally welcome in any place that accommodates the public.
Process and Costs
A person must be legally blind in order to apply for a guide dog. An application is the first step of the process, and it needs to be completed so that it demonstrates the daily physical activity level of the visually impaired person. It is also important that the person applying for the guide dog is able to demonstrate how he/she is presently able to travel to various destinations independently (i.e., grocery store, meeting a friend for lunch, work, etc.). Once that is completed, an in-home interview is conducted to verify that the individual with the visual impairment is able to physically work with a guide dog (the applicant must be able to walk 1 mile) and that his/her home environment is suitable for a guide dog.
Medical verification of the visual disability must be obtained in one of the final steps of applying for a guide dog. If the applicant is approved after all these steps, he/she can then travel to a guide dog training center to be taught how to work with his/her new canine friend. This training can last anywhere from 2 to 3 weeks. Once training is complete, the guide dog can go home with his/her new owner free of charge. Most guide dogs begin their careers at age 2 and can be in service for 6 to 8 years.
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Types of Assistance Dogs
People who are blind or have a severe visual impairment use guide dogs. The individual must be deemed legally blind in order to qualify and obtain a guide dog. Guide dogs are mobility aides that assist people in navigating through their daily activities. Guide dogs know when to stop for traffic, crosswalks, steps, or curbs. These dogs can be trained to navigate the layout of a facility (such as a fitness center) and will stop when an obstacle (such as a person or object) is blocking the path of their owner.
Hearing dogs can be useful in many ways to a person who is deaf. Hearing dogs can alert their owners when someone is knocking or ringing a doorbell, when the telephone rings, when an alarm is sounding off, or when a specific name is being called. It is the duty of these dogs to get their owner’s attention by using physical touch with their nose or paw, and then leading the owner to the cause of the noise or sound.
Service dogs offer the greatest range of abilities, in that they are trained to perform a multitude of physical tasks such as; pulling a wheelchair, retrieving objects like a newspaper, a remote control, or plastic bottle of water from the refrigerator, opening doors, or turning on light switches.
All assistance dogs, regardless of type, must be able to do three things successfully: relieve themselves on command, ignore unattended food (whether on the ground or on a table), and ignore other people when they are working. Section 36.302(c) of the Americans with Disabilities Act requires public accommodations generally to modify policies, practices, and procedures to permit people who are blind or disabled to be accompanied by working dogs anywhere.
Having playtime is just as important as working for assistance dogs. When the dog is not wearing its harness, it is free to play and just be a dog. Because these dogs play such a large role in the lives of their owners, many become a member of the family unit.
Navigating a Fitness Facility
When people with visual disabilities come to a fitness center, they typically must first arrange some form of transportation to get there. Some people choose public transportation (which can be costly depending on the distance traveled), while others will use a taxi or get a ride from a friend/family member. The added cost of transportation to get to and from the fitness center is something to be considered when setting membership rates for people with visual impairments. Many people who do have to pay for transportation realize they do not have the added cost of a car or car insurance in their personal budget; and therefore do not mind paying for a taxi or other means of transportation to get to a fitness center.
In order to learn how to navigate through a new environment, a person with a visual disability must rely on familiar environmental sounds or audible verbal cues to travel successfully around the gym. Examples of environmental sounds might include the opening of automatic sliding doors, being greeted by employees when entering or exiting the fitness center, working gym equipment, a water fountain, the humming noise of a treadmill, music, people talking, etc.
When people with a visual disability first come to a new facility, they learn how to visualize/or map the area in their mind’s eye with verbal cuing or with a tactile map. After people are confident in their internal map, they will give verbal commands to their dogs to follow and find. Sometimes, food rewards (such as a piece of kibble) are given to the guide dog when training them to find objects, such as treadmills, bicycles, classrooms, and lockers. Teaching a guide dog the map of a facility is also important to identify any potential barriers such as a scale, a towel bin, or weight benches that may be an obstacle or danger to the person with a visual impairment.
Guide Dogs in Fitness Facilities
Typically, during a workout, guide dogs need to be near their owners and have them in their field of vision at all times. Some facilities have “holding areas,” which are specific areas that members can tie down their dogs while working out. Other facilities allow members to move their dogs with them from machine to machine. It is important that members with service dogs are aware of the space that their dogs require, as well as the placement of the dogs in relationship to the other members trying to work out in the facility. In a class setting, such as a yoga class, a member would have his/her dog lay down next to his/her yoga mat so as not to be in the way of the other members.
In addition to having an assistance dog, many members with visual impairments may bring a helper or assistant with them to aid in their workout program. Some facilities may offer a discounted membership rate for members who bring their own assistants, as this alleviates the strain on the facility of hiring more staff.
To encourage more independence on the part of members with visual impairments, some facilities will employ the use of bump dots (plastic dots with adhesive on the back that can be applied to anything in need of marking) on the start and stop, up/down, and faster/slower buttons of specific pieces of cardiovascular equipment. With a guide dog and bump dots, many members can navigate their way to a specific piece of equipment and proceed with their cardiovascular exercise.
When a person with a visual impairment wants to use the strength-training machines in a facility, they may need the help of a trainer or friend. Braille labels can be used to identify the name and function of each piece of equipment; however, to adjust the weight stacks and modify the moving parts of the particular machine, another person is generally needed. It is important to realize that many people who are visually impaired do not read Braille – especially those with acquired visual disabilities that were diagnosed in adulthood.
Choosing a slower time of day at the fitness facility can also be helpful for members with visual impairments. When the facility is less busy, fewer people will be trying to utilize the machines and equipment. This can be a beneficial environment for a member who is learning to navigate through the facility.
It is important for a fitness facility to coach their fitness instructors on how to teach classes to individuals with visual impairments. Fitness instructors will need to learn how to use “verbal cuing,” describing in detail to the class, instead of simply demonstrating with their own bodies. This can be especially challenging in a class such as yoga, where many of the participants rely so heavily on visual cuing to be successful.
Member Retention
A high level of member retention is something that all fitness facilities work to achieve. Retaining a member with a visual impairment is no different. Various factors can contribute to how much or how little people decide to participate in exercise programs. Some of these factors might include weather, available free time, work demands, health status, changes in finances, holidays, etc. Building personal relationships and reaching out to members who have been absent for some time are great ways to keep people engaged in their fitness programs.
Fitness Levels of People with Visual Impairments
Pursuing a fitness program is critical for the health and wellbeing of all individuals. Although research on the physical activity levels of people with visual impairments has been limited, studies have reported that there are lower levels of physical activity and a greater occurrence of obesity among individuals who are visually impaired compared to the general U.S. population (Campbell, Crews, Moriarty, Zack, & Blackman, 1999; Crews & Campbell, 2001). When people with visual impairments do engage in exercise, it is often not at an intensity level that will achieve health-producing benefits (Holbrook, Caputo, Fuller & Morgan, 2009). It is also known that visually impaired individuals who use a cane are often less fit than those using a guide dog. Part of the eligibility process for becoming a guide dog user is to be able to walk for 1 mile.
The current recommendation from the American Heart Association (AHA) is “to perform any moderate-to-vigorous-intensity aerobic activity for at least 30 minutes on most days of the week at 50-85 percent of your maximum heart rate” http://www.americanheart.org . It is a challenge to meet that exercise prescription from the AHA. However, the life-enhancing benefits that a person with a visual impairment will experience can make it all worthwhile.
Case Studies
Patrice:
Patrice is a 60 year old female who has progressively has been losing her eyesight over the past 30 years due to Retinitis Pigmentosa. Today she is legally blind. Patrice relies on a county wide transit system (called Access) to get to and from the places she goes on a daily basis; like her job, the gym, the grocery store etc. Patrice has to pay $2.70 each time that she uses this transportation system, which is reasonable compared to the alternative of paying for a taxi (which she also does at times). Patrice has a guide dog that goes with her everywhere including the gym. The guide dog has learned how to navigate from the lockers, to the treadmills, to the yoga room where Patrice takes a weekly yoga class.
William:
William is a 19 year old male who has Bilateral Retinoblastoma and resulting blindness. William uses a cane as well as Access to get to the gym everyday of the week. William uses both the cardiovascular equipment and well as free weights when he comes to the gym. The cardio machines at the gym have bump dots on them so that William can easily find the start and stop buttons as well as the buttons to make the machines go faster and slower. William also enjoys doing various exercises with a bench press bar and plate weights. William often trains at the gym with a friend of his who is also blind. In order to train safely with the free weights, William and his friend ‘spot’ each other to prevent any accidents from happening. William and his friend are able to spot each other in the following way; one of the guys will put his hands on the bar while the other guy does his repetitions. If either guy should fumble or struggle while lifting the weights, the other person is there to assist with the lifting
References:
Campbell, V. A., Crews, J. E., Moriarty, D. G., Zack, M. M., & Blackman, D. K. (1999). Surveillance for sensory impairment, activity limitation, and health-related quality of life among older adults; United States, 1993-1997. Morbidity and Mortality Weekly Report, 48(SS08), 131-156.
Capella-McDonnall, M. (2007). The need for health promotion for adults who are visually impaired. Journal of Visual Impairment & Blindness, 101, 133-145.
Crews, J. E., & Campbell, V. A. (2001). Health conditions, activity limitations, and participation restrictions among older people with visual impairments. Journal of Visual Impairment & Blindness, 95, 453-467.
Harrison, T. (2006). Health promotion for persons with disabilities: What does the literature reveal? Family and Community Health, 29(1S), 12S-19S.
Holbrook, E., Caputo, J. L., Perry, T. L., Fuller, D. K., Morgan, D. (January 2009). Physical activity, body composition and perceived quality of life of adults with visual impairments. Journal of Visual Impairments & Blindness, 17-29.
U.S. Department of Health and Human Services. (2000). Healthy people 2010 (2nd ed.). Washington, DC: Author.
Whitmarsh, L. (2005). The benefits of guide dog ownership. Guide Dogs, 7(1) 27-42.