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The water provides an excellent environment for individuals with disabilities to improve physical fitness for two reasons. First, the physiological effects that occur when one is just submerged in the water are often beneficial to those with disabilities. For example, the warmth and pressure of the water on the body increases circulation, aids in relaxation, and promotes deeper breathing. Second, the density of the water requires more effort to move through it than air. This may facilitate movements that are often difficult to perform on land. For instance, the water resistance increases the workload on the body making dynamic movement much more challenging. In addition, the decreased gravitational pull and buoyancy cushions joints and reduces impact which makes movement less painful.  The extra support the water provides allows for greater freedom of movement.

Station/Activity #1 Stair Stepping/Ladder Climbing

·         Using pool stairs or ladder walk/climb to top and walk/climb back down. If using ladder, individual may get out, jump/sit in off edge to allow several students to use the stairs.

·         Equipment Pool stairs/ladder

·         Training Benefits balance, lower body strength and endurance, coordination, (upper body strength if using ladder)

Station/Activity #2 Cone Obstacle Course

·         Place markers on bottom of the pool for form pattern. Participants move throughout course using a variety of locomotor movements.

·         Equipmentheavy plastic cones or markers, sand filled jugs

·         Training Benefitsbalance, agility, gait training, cardio-respiratory endurance

Station/Activity #3 Balance Beams

·         Using lines on the bottom of the pool walk balance while walking across.

·         Equipmentnone

·         Training Benefitsbalance, gait training

Station/Activity #4 Pole Challenges

·         Place a pole at an angle so students can choose to step over it at low, medium, or high levels. They can also move in different directions over it, jump over it, or swim under it.

·         Equipmentpool extension pole anchored to the pool wall and weighted down in the water provides a sloping angle.

·         Training Benefits lower body strength and endurance, gait training, agility, coordination, breath control, (cardio-respiratory endurance if continuous)

Station/Activity #5 Hula Hoop Challenge

·         Lift hoop up overhead using one or two hands…bring down to feet and step out of the hoop. Repeat and/or go from feet to head.

·         Equipmenthula hoops

·         Training Benefitsupper body flexibility, balance, coordination

Station/Activity #6 Water Chair Challenges

·         While sitting and holding onto chair kick legs using scissors (up, down), straddles (in, out), or knee bends (bend, straighten). Legs can be moved together or one at a time, to increase resistance add flippers or flotation devices (water wings).

·         Equipmentchairs that sink or are weighted down

·         Training Benefitstrunk, abdominal, and lower extremity strength and endurance, cardio-respiratory endurance, flexibility

Station/Activity #7 Water Jugs/Buckets

·         Using laundry jugs and buckets, students pour and fill jugs in an area of the pool where they can sit and stand.

·         Equipmentlaundry jugs and buckets

·         Training Benefitsupper body strength and endurance, hand-eye coordination

Station/Activity #8 Monkey Walks

·         Using sliding or overhand technique, participants monkey walk along the pool gutter.

·         Equipmentpool gutter that is water level or just a little above

·         Training Benefitsupper body strength and endurance

Station/Activity #9Sponge/Toy Challenge

·         Float sponges/toys in water, on signal students pick up one sponge/toy and place it in designated bucket, repeat. Vary locomotor movements. Focus on competition with self, not others.

·         Equipmentsponges/toys and containers to put them in

·         Training Benefitscardio-respiratory endurance, balance, coordination, hand-eye coordination

Station/Activity #10 Noodle Tag

·         Using swim noodles as taggers, participants avoid being tagged while staying in designated area. If tagged, must do 3 bobs or bubbles and back in the game.

·         Equipmentswim noodles

·         Training Benefitscardio-respiratory endurance, breath control, balance, coordination

Station/Activity #11 Keep It Up

·         Individuals/partners/small groups try to keep balloon from touching the water.

·         Equipmentballoons

·         Training Benefitsupper body strength and endurance, hand-eye coordination

Station/Activity #12 Push Downs

·         While standing on bottom,  push a ball, kickboard or other floating object down under water and slowly bring back to surface. Repeat. (Be sure to use soft objects in case it gets out of control and comes to the surface quickly.)

·         Equipmentballs, kickboards or other soft floating objects

·         Training Benefitsupper body strength

Station/Activity #13 Horses

·         Using swim noodle as a horse/pony try to balance as long as possible w/o feet touching bottom, challenge others or go for individual high score counting 1,2, 3….

·         Equipmentswim noodles

·         Training Benefitsbalance, abdominal/trunk strength and endurance

Station/Activity #14 Water writing

·         While standing or sitting and wearing swim paddles on hands write letters, shapes, words, numbers w/ hand under the water, be sure to practice with both hands.

·         Equipmentswim paddles

·         Training Benefitsupper body strength and endurance, flexibility

Station/Activity #15 Whirlpool

·         In small group walk in circle creating current, then quickly reverse direction and walk against the current.

·         Equipmentnone

·         Training Benefitslower body and trunk strength, balance

Station/Activity #16 Mat Challenges

·         While team supports mat one student tries to crawl or roll across, sit, kneel or stand on mat.

·         Equipmentgymnastics mat that is free of holes in the outer covering

·         Training Benefitsbalance

Station/Activity #17 Wall Push Ups

·         Using arms only, lift body up out of water at wall and lower slowly and carefully back into the water. Repeat. Care should be taken not to lift past point of comfort because the reentry into water must be slow or injury to chin could result.

·         Equipmentnone

·         Training Benefitsupper body strength and endurance

Station/Activity #18 Sharks and Minnows

·         Shark is the tagger in middle of designated space, on command minnows try to cross "shark tank" w/o getting caught. If caught minnow becomes a shark helper and is able to tag others. Participants can cross "shark tank" using a variety of locomotor and swimming movements.

·         Equipmentnone

·         Training Benefitscardio-respiratory endurance, balance, coordination

Station/Activity #19 Giant Kickboard

·         Using the mat as a big kickboard the entire group hangs on with hands and moves it across pool using the kick of choice.

·         Equipmentgymnastics that is free of holes in outer covering

·         Training Benefits cardio-respiratory endurance

Station/Activity #20 Submarines

·         Swim through hula hoops anchored to bottom or closer to water surface

·         Equipmenthula hoops

·         Training Benefitscardio-respiratory endurance, breath control

Station/Activity #21 Poison

·         Place floating objects in designated area, students must move around using a variety of locomotor or swimming skills w/o touching the "poison," change skills to target fitness areas.

·         Equipmentfloating toys or objects

·         Training Benefitscardio-respiratory endurance, lower body strength and endurance, balance

Some considerations/recommendations when planning physical fitness stations/activities:

Cerebral Palsy

·         Water temperature of 85-95 degrees is ideal for those with contractures. Air temperature should be 10 degrees higher.

·         Provide "calm/relaxing" environment.

·         Encourage normal postural.

·         Preferred strokes are those in supine position such as the elementary backstroke. Strokes/skills that are performed the same bilaterally  (homologous) are best.

·         Maintain the head in a neutral position and avoid extension because extending the head will increase extensor tone and eliminate the possibility of relaxation.

·         Swimming in the prone position should be avoided until individual feels comfortable with face in the water because swimming with the head out of the water will increase extensor tone throughout the back and prevent relaxation.

·         The flutter kick is contraindicated because it increases muscle tonus.

Spinal Cord Injuries/Paraplegia

·         Any stroke can be successfully learned.

·         Placing floats around the knees can reduce the "drag" effect caused by nonfunctional lower extremities and allow the swimmer to move in a more streamlined position.

·         Regular socks or Aqua socks are recommended to prevent possible scrapes /scratches to feet from pool bottom, sides and steps.

Spinal Cord Injuries/Quadriplegia

·         Accommodate and encourage as much movement as possible.

·         Use flotation devices that support yet allow maximum levels  movement of the extremities.

·         Homologous strokes such as the elementary backstroke provide the best method of movement.

·         Supine strokes are recommended because breathing is sometimes a problem.

·         Provide short periods of intense work with longer periods of rest.

Muscular Dystrophy

·         Use moderate levels of activity and do not over fatigue. Build in frequent rest periods.

·         Water temperature should be 85-95 degrees.

·         Make sure the individual does not get "chilled" because they are very susceptible to pulmonary infections. Once finished dry him/her off quickly in warm air and put on warm clothing.

·         The elementary backstroke w/ flutter kick is most preferred.

·         The objective of swimming is to maintain strength to prolong independent movement skills.


·         Kyphosis

  • Because the goal is to stretch and strengthen upper back/shoulder muscles the back crawl, elementary backstroke and breaststroke are most recommended.

·         Lordosis

  • Because the goal is to stretch the hip flexors and lumbar extensors the scissors kick on both sides is recommended.

·         Diving is contraindicated because of the high impact it has on the spine.


·         Partial amputees should use affected limbs as much as possible.

·         Watch for initial balance problems due to the effects of water buoyancy.

·         Upper extremity/complete bilateral focus on kick, scissors or whip.

·         Upper extremity/complete unilateral side stroke recommended w/ nonfunctional arm down.

·         Lower extremity/complete bilateral focus on arm action and glide portions of strokes.

·         Lower extremity/complete unilateral requires stronger pull w/ opposite arm, flutter kick will assist with directional control.

Visual Impairments

·         Use sighted guides or electronic auditory cueing aides.

·         Allow individual to "survey" the entire aquatic environment including locker room, pool deck, and pool to assure familiarity with environment.

·         Use large print station/activity cards.

Seizure Disorders

·         All aquatic personnel should be notified prior to participant entering the pool.

·         Do not over fatigue or over work.

·         Diving is often contraindicated.

·         Avoid deep-water swimming.

·         Supervise closely after swim since seizures are likely to occur during "cool down."

·         If seizure occurs in the water, maintain head above water and allow seizure to continue. It may be necessary to have 2 people support the individual’s body under water. After the seizure, allow participant to rest in a warm, dry area and provide proper emergency procedures.


·         Work within limitations of range of motion.

·         Avoid exercising to fatigue, provide frequent rest periods.

·         Water temperature should be 85-95 degrees.

Down’s Syndrome

·         Consider developmental and motor delays when planning.

·         Use short, simple statements to aide understanding, demonstrations.

·         Vary activities


·         Eliminate unnecessary external stimuli.

·         Use short, simple statements, demonstrations and physical prompts.

·         Use vigorous aerobic exercise to limit self-stimulatory and off task behaviors.


·         If attack occurs prior to swimming activity get medical clearance before individual enters water.

·         If an attack occurs in the water, maintain an open airway and get participant out of the water.

·         The sudden change in body temperature caused by contact with the water may trigger an attack, but should not prohibit individuals from participating in aquatics.

Behavior Disorders

·         The use of floatable objects will interest the participant.

·         Because the individual may disregard safety practices, constant reinforcement of safety rules is necessary.

·         Situations that might cause fear or stress should be avoided.

Spina Bifida

·         Since the goal is the prevention of contractures, stretching and strengthening aquatic activities such as floating and kicking are recommended.

Multiple Sclerosis

·         Water temperature should be 80-84 degrees. Water that is too warm will increase circulation too much.

·         Activity may be contraindicated at times, be careful to not to over fatigue. Provide rest periods.

·         Sensory input may be slow; care should be taken to avoid abrasions.

·         Focus on strengthening muscles around affected areas.

·         Provide ambulation activities.


American Red Cross. (1977). Adapted Aquatics. Garden City, NY: Doubleday.

Grosse, S. (1998, March). Water exercise for teens: Motivation, Movement and Music. Action Monographs, 1(1), 1-19.

Schilling, M. (1993, June). Aquatics and persons with disabilities. PAM Repeater, (80), 2-14.

Thome, K. (1980, August). Adapting circuit training for special populations. Practical Pointers, 4(3), 2-19.

Lepore, M., Gayle G.W., & Stevens S. (1998) Adapted Aquatics Programming: A Professional Guide. Champaign, IL: Human Kinetics.

Aquatics for Children with Disabilities, Courage St. Croix and Stillwater School District #834 Courage St. Croix, 1460 Curve Crest Blvd., Stillwater, MN. 55082

This content was created by Sandra Cravens,
Physical Educator in the Irving ISD,
Doctoral student in Adapted Physical Education,
Texas Woman's University.

page last updated 1/3/2017 1:00 PM