Being active members of our local gym, as well as tech geeks from the AFB TECH product evaluation lab, we have a great personal interest in the barriers faced by people who are blind or have low vision who want to be physically fit. Hoping that AccessWorld readers share the same interest, we decided to discuss some of the issues involved in working out at your local gym or fitness center, with an emphasis on the accessibility of various types of exercise equipment.

In addition to our own personal interest, we have been reading some alarming things about exercise and people with disabilities. For example, AFB's Active Living Research reported that recent research has suggested that "people with disabilities are more likely to be sedentary, have greater health problems, and have more barriers to participating in physical activity than the general population." In an excellent, comprehensive article in the Journal of Visual Impairment & Blindness, entitled "Building Inclusive Physical Activity Communities for People with Vision Loss", James H. Rimmer stated, "One of the major barriers to access for people with vision loss is inaccessible exercise equipment." Rimmer detailed the barriers to access that are found at most fitness centers and presented solutions for removing the barriers.

A February 9, 2006, New York Times article, "Fitness: Disabled and Shut Out at the Gym," noted that only 36% of Americans with disabilities engage in any leisure-time physical activity, compared with 56% of the general population, according to Healthy People 2010, a report by the U.S. Department of Health and Human Services. That article illustrates many of the barriers to accessing fitness centers. It also referred to another study by Rimmer in the American Journal of Public Health that concluded that the 16 for-profit and 19 nonprofit health clubs in the study all had significant problems. Some had obstacles, such as stairs preventing disabled members from reaching parts of the club, and others lacked equipment that could be used by people with disabilities or staff members who were willing to help such members.

What Are the Barriers We Encounter at Fitness Centers?

In this section, we discuss some of the specific access barriers that we have encountered in our own efforts to stay in shape and build our six-pack abs. We also talk about some of the techniques we have used to work around the barriers and still get a good workout.

Cardiovascular Machines

Treadmills are popular machines for getting a good cardiovascular workout, and most treadmills use a flat control panel with no tactile markings or speech output. They also feature display screens and control labels that people with low vision cannot read. The display screens often have poor contrast or reflective plastic coverings that cause a significant amount of glare. The flat panel controls are also often labeled in small fonts and poorly contrasting colors and, like the visual displays, are covered in highly reflective plastic. A green Start button and a red Stop button are common on many exercise machines; although color indicators such as these are helpful to people with low vision, the ability to start and stop the machines does not create accessibility. Because of their interface design, it is difficult and most likely impossible to use all of the machines' features independently if you are blind or have low vision.

Although a handheld magnifier is cumbersome to use in an exercise setting, some may find it helpful for reading control labels and visual displays, whereas others may find that the best technique for getting around access barriers is to place braille or other tactile markings on the various controls on the flat panel. We put braille labels on the control panels of treadmills at our local gym, placing the words Start and Stop in braille over their corresponding spots on the flat control panels. We also placed braille markings on the Up and Down arrow controls for adjusting the treadmills' speed and for adjusting the incline angle of the tread. We used the braille letter "o" sideways to represent the arrow controls, with the dot 5 of the letter on top to represent an Up arrow and on the bottom to represent a Down arrow. We are also fortunate that most treadmills in our gym emit a beep to indicate a successful press of an arrow, so we can count the beeps and know how much we are increasing or decreasing the treadmills' speed or tread angle.

This braille technique allows us to start and stop a treadmill independently and to adjust its speed and incline, but there are many more features that we cannot access, such as programming a route with various speeds and inclines as we go. There is also a great deal of inaccessible visual display information, such as the current speed, heart rate, and duration of the workout, that could be displayed in numbers or graphs, depending on a particular machine. Unfortunately, some of our less thoughtful gym members insist on picking off the tactile markings, so it is necessary to replace them periodically.

Stationary bikes are another popular type of cardio machine, and many of them also have inaccessible flat panel controls and difficult-to-read control labels and visual display screens. We always thought it strange that you would need a computerized control panel to ride a bike, but gyms are becoming increasingly high-tech these days. Fortunately, a few of the bikes in our local gym have mechanical knobs that are twisted to increase or decrease the resistance of the bikes' pedals, so we do not have to use flat panel controls. Some of the bikes we have used during our work-related travels actually use tactile buttons to increase and decrease the pedals' resistance. For bikes that rely on flat panel controls alone, similar marking techniques to those mentioned for treadmills can be used. However, like treadmills, many of today's bikes can be set up to vary the resistance as you ride to represent going up and down hills, but marking techniques do not provide access to these features or the other visual display information.

The stationary bike user interface consists of five flat panel touch pads, four small screen displays, and flashing indicator lights.

Caption: The stationary bike user interface.

Another popular cardio machine is the "elliptical" trainer, on which you stand up and put your feet into pedals and move them in an elliptical motion. Most of these machines have tactile buttons for adjusting the resistance or the angle of the motion. However, they also have difficult-to-read control labels and visual display screens that are not supported by speech output. We are left counting button presses to ascertain our resistance level and the angle of the motion. Again, as with the other cardio machines, we do not have access to the visual display information and the feature that is used to set up a program that varies the angle and resistance throughout the workout.

Weightlifting Machines

The most prevalent type of weightlifting machines are the "pin and plate" type, popularized by Nautilus, a leading company in the fitness world. These machines have a stack of flat rectangular plates that are the weights, and each plate has a hole near the center. You place a pin in the hole of the plate that corresponds to the amount of weight you want to lift. As long as you know the weight of each plate, you can count down the stack by touch and place your pin in the proper hole. For example, if you want to lift 100 pounds and the weight plates weigh 25 pounds each, you count down to the fourth plate and insert the pin in that plate. Marking the plates with braille is another option. Although these machines can be accessible if you learn their design and the weight of the plates, they often do not use good ergonomic design techniques. You have to do a lot of bending and turning to reach the pin and plates, risking possible muscle strain.

Trading off good accessibility for good ergonomic design and ease of use, machines that are manufactured by the Keiser Corporation use a pneumatic system for adjusting the weight, or resistance, of the machine. You simply press and hold a button or step on a pedal, and the pneumatic system automatically adjusts the weight. Some machines have buttons at the end of their handles, and others have pedals on the floor. The right button or pedal increases the resistance, and the left one decreases it. This feature is certainly easy to use, but the lack of accessibility comes into play when you want to determine exactly how much weight you are lifting.

These systems use a gauge similar to an old-fashioned car speedometer, with a needle pointing to the amount of weight currently set, and the gauge is under a clear plastic cover. This is not a huge problem for someone like Darren, who is just there for a light workout, because he can simply adjust the weight until it feels right. However, it would not be good for an athlete like Lee, who is on a strict weight-training program and needs to know precisely the amount of weight being lifted.

Free weights usually do not pose a problem with regard to accessibility. The weights are often stored in fitness centers according to their weight, and as long as you learn the way they are organized, you can put the proper amount of weight on the bar. However, the weights are not always put back in their proper place, so braille or another tactile marking system may be required. Because of the greater risks involved in using free weights, you should always work out with another person, so you can spot each other, helping out if the weights get too heavy. In addition, it is advisable to use proper travel techniques and to be careful when moving around in a fitness center, but the free-weight area can be a particular problem, since weights can often be strewn about on the floor.

Are Equipment Manufacturers Doing Anything to Improve Access?

Knowing the barriers to accessing fitness machines, we decided to do a little poking around to see if the manufacturers were doing anything to increase accessibility. We looked at the web sites of the top equipment manufactures, and, unfortunately, we found nothing regarding accessibility for our community. We found a few things on wheelchair access and arthritis, but nothing about visual impairment. The New York Times article cited earlier mentioned efforts by the manufacturers Cybex International and Life Fitness to develop more accessible machines. According to the article:

In May 2006, Cybex International introduced a line of disabled-friendly machines, and the company says it has sold hundreds of models, mostly to universities. The line includes seven pieces of cardiofitness equipment with bright yellow pedals, straps and handgrips that are easier for people with poor sight to see, as well as raised icons on control buttons for the blind. Strength-training machines have swing-away seats and long, low grips reachable from a wheelchair. (Each piece costs about $200 more than standard equipment.)

Life Fitness, another exercise machine maker, has been working with the Center on Physical Activity and Disability to outfit its equipment with Braille instructions, brightly colored handles and adjustable seats. "It's a significant 2006 agenda for us," said Christine Cunningham, a manager at the education arm of the company, in Franklin Park, Illinois.

The Concept 2 rowing machine offers the most intriguing news about a company working to create an accessible piece of exercise equipment. The Concept 2 was demonstrated at this past summer's National Federation of the Blind convention in Atlanta, and it requires no buttons to push or flat screens to mark. The company is also developing software that you will eventually be able to download onto a BrailleNote or other Pocket PC device with speech software to provide feedback on elapsed time, stroke rate, and power produced while rowing. For more information about the Concept 2 rowing machine visit <www.concept2.com>.

On the negative side, we have come across a new inaccessible exercise program monitoring system. FitLinxx is a computerized system that attaches to existing fitness equipment, adding an "intelligent" dimension to a workout. FitLinxx "learns" users' exercise programs, "coaches" them individually through their workout for better form and safety during the exercise, and "tracks" their progress over time.

This touch screen interface is networked to fitness equipment to help monitor and record your workout.

Caption: The FitLinxx interface attaches fitness equipment to computers for monitoring.

On strength-building equipment, FitLinxx appears as a touch-screen display interface that is attached to the machine. For cardiovascular equipment, each machine's console is networked to FitLinxx. Users tap in their PIN on the touch screen pad to log in and pull up the information on their personal exercise programs. FitLinxx then coaches them on speed, form, heart rate, and so forth and tracks their workout sessions—each rep, set, and step. All this is conveyed via the visual display screen with no speech output.

The main Fitlinxx kiosk also has a touch screen interface with no tactile indicators or speech output.

Caption: The FitLinxx kiosk touch screen interface.

Behind the scenes, all the exercise machines are networked into a central database, giving exercisers and fitness center staff access to information on individual progress and a set of motivational tools. The system can be accessed on workout-floor touch screen kiosks, at the staff computer station, or on the Web from your computer.

By adding this computerized feature to exercise equipment, FitLinxx's goal is to provide better results for exercisers and staff and higher attraction and retention rates for fitness centers. This is a great concept; the problem is that it involves an inaccessible touch screen interface with no speech output, rendering it useless to people who are blind or who have low vision. FitLinxx is a growing company and is installing its system in fitness centers in several countries. According to its web site, it is working with manufacturers of exercise equipment to become compatible with their various pieces of equipment. We hope it will also work to make its product accessible to people with vision loss, so they can benefit from its service as well.

Advice for the Beginner

Although there are certainly access barriers in today's fitness centers, these barriers are not insurmountable, and proper strategies and techniques can get even the biggest couch potato on the way to physical fitness. Here are some tips and advice for those who want to begin a healthier lifestyle.

  1. Most facilities will allow you one or two free visits to get a feel for the place and how things work, so you may want to check out a few fitness centers before you join one. Once you choose a gym, you will want to learn its layout with a friend or gym employee until you are confident enough to be able to go it alone. You should also learn how to use the various machines and how to move safely around the various handles, levers, and moving parts of the exercise equipment. It is easy to bump your head or get poked if you do not know the design of the various machines.
  2. It is also a good idea to talk with your fitness center's managers about using the gym. They may have had other customers who were blind or had low vision and can provide some advice on the basis of past experience. You can also talk to them about adding some braille or other markers to the machines, instead of simply barging in and labeling things. That way, you can convince them that you will not be ruining their machines with a little braille. Most gym managers will be accommodating, but be sure to stand up for your rights if they have no knowledge of the abilities of blind people and try to insist that you hire a personal trainer for all your workouts. Do not let them tell you that you cannot go independently, but be willing to work with them by explaining the type of assistance you may need or how you can independently and safely use the equipment. Be proactive about your rights.

If you show them, once you learn the system, that you can do most things independently, they should come around to your way of thinking. Of course, if a fitness center is too difficult to learn to navigate and use independently, there is nothing wrong with working out with a friend or another gym member. Nothing should get in your way if you want a good workout.

Resources for Learning More

As we investigated the issues around physical activity and accessibility, James H. Rimmer, the researcher mentioned in the New York Times article and author of the article in the Journal of Visual Impairment & Blindness, kept coming to our attention. Rimmer, a professor in the Department of Disability and Human Development, College of Applied Health Sciences, at the University of Illinois at Chicago, has been developing and directing health promotion programs for people with disabilities. Over the past 25 years, he has published more than 70 articles in peer-reviewed journals and book chapters on various topics in health promotion, physical activity, and disability. He is also the director of two federally funded centers, the National Center on Physical Activity and Disability (NCPAD) <www.ncpad.org> and the Rehabilitation Engineering Research Center on Recreational Technology and Exercise Physiology <www.rercrectech.org>.

Rimmer gave a presentation at a September 13, 2007, conference sponsored by the Centers for Disease Control and the NCPAD, among others. The presentation covered information on several resources from the NCPAD related to fitness and disability, many of which can be found on its web site, including:

Rimmer's entire PowerPoint presentation can be found at <www.astphnd.org/resource_files/54/54_resource_file1.ppt#2>.

One striking statement in Rimmer's presentation is that youths with disabilities are 4.5 times more likely to be physically inactive than are youths who are not disabled. This statement reminds us of a conversation one of our AFB colleagues had with a concerned parent of a blind child. When the parent said, "I'm afraid my son will get hurt if he goes out and plays with the other kids," my colleague responded, "I'm afraid that he won't get hurt." My colleague was, of course, implying that a child who is kept inside and shielded from the bumps and bruises that are part of growing up will eventually miss out on life itself.

We hope that more manufacturers of fitness equipment will consider using more universal design principles in designing their equipment. A perfectly accessible machine with tactile controls and speech output for display information and compatibility with wireless braille displays may be far in the future, but we hope that manufacturers strive to meet this lofty goal.

In the meantime, it would be easy to design more tactilely discernable controls and tone feedback to provide at least some partial accessibility. Larger labels on controls and higher-contrast, larger-font, easier-to-read visual displays would also be welcome. A simple solution for the displays on the Keiser weight machines described earlier may be to put a hinge on the glass covering the gauge, allowing the cover to open like the braille watches that many of us own, along with some tactile markings around the gauge. This would allow us to feel the needle pointer and determine the machine's weight setting.

We at AccessWorld are interested in getting feedback from readers who are interested in the fitness and exercise topics that we have discussed in this article. We would especially like to hear about other techniques that you may use for getting around the access barriers of health clubs and fitness equipment. You can e-mail us at accessworld@afb.net.

This article was funded by the Teubert Foundation, Huntington, West Virginia.

Additional Resources on Physical Fitness for People Who Are Bind or Visually Impaired

Author
Darren Burton
Lee Huffman
Article Topic
Access Issues