The Five Foundations of Adaptive Functional Fitness - Erik Kondo

Adaptive Functional Fitness (AFF) goals are different from able-bodied functional fitness goals because people with disabilities (PWDs) have to be able to perform demanding physical tasks just to be able to participate in many of life’s activities. In comparison, these same tasks are relatively easy for the able-bodied (ABs) to accomplish because the activities have been designed with them in mind. Therefore, ABs are primary concerned with using functional fitness training to increase their level of performance.

The average abled-bodied person’s primary limiting factor for participation in most of life’s activities is his or her motivation to participate. On the other hand, a PWD must have the physical capability to participate, which many times requires having a relatively higher level of residual functionality in order to successfully adapt to the activity.

For example, in order for a handcyclist to participate in a bicycle ride with able-bodied riders, he (or she) must be in relatively better condition in order to keep up since he is using his arms as opposed to legs (assuming no power-assist). The same goes for going out for a walk, jog, or a run, a wheelchair user or amputee must have relatively better conditioning and technique to stay up with the able-bodied pack.

When it comes to using certain gym exercise equipment, a person with a disability needs to first have the ability to transfer onto the equipment. Transfers are not a consideration for ABs. When a wheelchair user rock climbs, she (or he) will likely be using only her arms. Therefore, she must have a much stronger upper body than what is required by an AB. In these examples, some level of Adaptive Functional Fitness training is required to be able to fully participate.

In a nutshell, able-bodied functional fitness training is about enabling ABs to perform at a higher performance level then their current level. Whereas Adaptive Functional Fitness Training is about enabling PWDs to engage in the activity in the first place (AFFT gets you in the door). Once this initial goal has been achieved, then AFFT becomes about increasing the person’s relative level of performance. 

The Five Foundations of Adaptive Functional Fitness (FFAFF) are the main components that make up AFF. In order for a person with a disability to engage in many activities of daily living and recreation, he or she must have some degree of capability in each of the Five Foundations. The greater the degree of capability, the higher his or her overall level of functional performance and the wider variety of activities available for his or her participation.

The Five Foundations are Personal Mobility, Transfer Capability, Carrying Capacity, Resilience-to-Injury, Adaptive Performance Quotient:

1.     Personal Mobility is the ability of the person to get from one location to another. It can be evaluated by using the following metrics.

a.     Range of travel: The distance the person can travel.

b.     Speed of travel: How fast the person can travel.

c.      Maneuverability: Agility, Turning Radius, Backwards Movement, Sideways    Movement, Stopping Distance, Speed Control.

d.     The variability of environments the person is able to deal with.

e.     The person’s independence from outside assistance.

2.     Transfer Capability is the ability of the person to move his or her body from one surface to another. The metrics are:

a.     Variability of surfaces

b.     Independence from outside assistance

3.     Carrying Capacity is the ability of the person to transport items from one location to another.

a.     The variability of objects able to transport.

b.     The variability of environments the person is able to deal with.

4.     Resilience-to-Injury is the ability of the person to handle situations and events with a reasonably low risk of bodily and psychological injury.

a.     The variability of environment

b.     and the extent of situations able to be handled without injury.

5.     APQ (Adaptive Performance Quotient) is a combination of human development based physiological, psychological, and neurological abilities (soft skills) that affect the person’s capability to perform. It is made up of the person’s

a.     Level of confidence in his/her capability.

b.     Ability to accurately assess situations and personal capabilities.

c.      Rapid decision-making ability.

d.     Coordination, balance, timing, and speed.

e.     Complex skill acquisition and execution capability.

The APQ has five classifications (scores):

1.     Very low APQ

2.     Low APQ

3.     Moderate APQ

4.     High APQ

5.     Very High APQ

The purpose of the APQ classification is to acknowledge the effect that having a disability has on the development of the person’s physiological, psychological, and neurological abilities due to lack of opportunity for development and training as a direct result of having a disability. The deficit in these areas is not the result of physical disability itself. It is the result of how having a disability in a society geared towards serving able-bodied people leads to exclusion from opportunities to develop these areas.

Therefore, the APQ score for PWDs is typically moderate or low due to the fact that most people with physical disabilities have significantly less opportunity in their lives to develop aspects of APQ through engaging in complex activities and high level training. Hence, they are underdeveloped and untrained as compared to the typical AB from lack of opportunities.

The Five Foundations provides a framework for adaptive functional fitness training. It is a list of the main areas that must be successfully addressed in order for a person with a disability to be able to function at a baseline level in many physical activities and recreations.