< < Physical Therapy, Flexibility, Fitness and Fun

A slalom game helps build underwater courage and skill.

"Swimming is probably the most important thing responsible for the condition I'm in," says Chad O'Connell, who's 26 and has Duchenne muscular dystrophy.

Unlike many people of his age with DMD, says O'Connell, he doesn't need a ventilator, has fairly good cardiac function, and has kept his weight down despite using prednisone, a drug that almost always causes significant weight gain. He attributes all this to his time in the water.

"I'm probably one of the strongest people with DMD that I know. I'm stronger than people that are 18 years old," he says.

O'Connell remembers taking a bus to a pool near his elementary school in Fairport, N.Y., as part of the school day. Then, starting in ninth grade, he attended schools that had pools.

The swimming was considered adapted physical education, something that's required by the Individuals with Disabilities in Education Act. O'Connell also had some physical therapy through his school system.

The buoyancy of the water can aid in exercise.

"I still think swimming is the best," he says of the various physical education and physical therapy activities he's done. "I pace myself. I don't try to overdo it."

Shree Pandya, a physical therapist at the University of Rochester (N.Y.) Medical Center who has evaluated O'Connell as part of a drug study, couldn't agree more with O'Connell's assessment of his swimming program. "What we have always recommended here as one of the best exercises is swimming," Pandya says.

Flotation aides like this collar (above) and swim disks can help children feel secure enough to exercise in the water.

"That's because it's fun for the kids and they can exercise all the muscles in the body at the same time. They can even throw in some pulmonary work, like holding the breath and blowing bubbles in the water. "Water is a medium in which they can function even in the late stages of a neuromuscular disease. I've had kids who can't walk who still can go in the water and swim or walk in the pool. While they're losing other activities, this is an activity they can stay with.

"Even a child who doesn't have the strength to function on land will be able to function in the water, because the buoyancy of the water can be used to minimize weight and the effect of gravity," she says. "You can use water as a medium of assistance or resistance, depending on what movement you're doing and how you do it."

Family Fun

Cheri Gunvalson and her family live in Gonvick, Minn., where it's too cold to swim outside most of the year. Her son Jacob, 8, has Becker muscular dystrophy.

Devices like this spa lift can help with getting in and out of the pool safely.

"I think swimming is one of the best activities for Jacob," Gunvalson says. "We swim at a local pool at a motel. It has a warm whirlpool, too, and he's thin and gets cold fast, so then he can go in the whirlpool. The cost is usually $2 to $3 per time. I bring all three of my kids and they play together. Our local pool is an outdoor one that's only available three months a year, so the motel pool works well."

Pandya, located in upstate New York, says they, too, are "talking indoor pools." She says, "We really push for swimming in community pools. We have two or three pools that are available, with nominal charges."

Safety First

Of course, take sensible precautions. Make sure an able-bodied person is at the pool at all times in case something goes wrong, and make sure there are no heart problems that would rule out swimming.

Special problems occur in cold temperatures (including cold water) in some disorders. In periodic paralysis, cold can bring on an attack of paralysis, while in myotonic dystrophy (MMD) and paramyotonia congenita (PC), cold water can cause muscles to stiffen and interfere with swimming. People with these conditions should swim in warm water.