Too often, people living with and beyond cancer are sidelined from fitness—not because they can’t exercise, but because programs aren’t designed with their unique needs in mind.
In this episode, Elise talks with Dr. Kaci and Dr. Reed Handlery, PTs, about building inclusive, sustainable community-based programs for people with mobility challenges—including those living with and beyond cancer.
From the CSM stage to real-world community impact, Kaci and Reed share how they’re creating inclusive, adaptable programs that meet patients where they are—and empower them to go further.
You’ll learn:
- The role of seated, high-intensity movement for oncology patients
- How to adapt exercise creatively for mobility impairments and other barriers
- What it takes to build and sustain inclusive fitness programs in your community
- How to identify and empower community champions to keep patients engaged
And most of all: you’ll be inspired to rethink what’s possible in your exercise prescription—inside and outside the clinic.
Listen now to discover how you can bring this innovative, adaptable approach to your oncology patients!
*LIMITED TIME: Watch the replay of GR-21049 – FIT and SIT: Ramping up Seated Exercise Intensity, Variety, and Inclusivity for Older Adults*
Please keep in mind this is only available to view through CSM On-Demand until April 14: https://apta.confex.com/apta/csm2025/meetingapp.cgi/Session/21049.
Read more from Dr. Kaci & Dr. Reed Handlery:
High intensity functional training for people with spinal cord injury & their care partners – https://doi.org/10.1038/s41393-024-00977-8
High Intensity Functional Training for People with Parkinson’s & Their Care Partners: A Feasibility Study – https://journals.sagepub.com/doi/10.1177/08901171241231085
Want to watch the episode instead?
Watch this week’s episode of TheOncoPT Podcast on our YouTube channel!
About Dr. Kaci Handlery, PT
Kaci Handlery, PT, DPT is an Assistant Professor in the School of Physical Therapy at the Arkansas Colleges of Health Education. She received her Doctor of Physical Therapy from the University of South Carolina in 2015 and became a Board-Certified Clinical Specialist in Neurologic Physical Therapy in 2018. She has over nine years of clinical experience, primarily treating individuals in the acute phase of recovery following traumatic injuries such as spinal cord injury, brain injury, and complex orthopedic injuries. Her research interests include utilizing qualitative methodology to investigate the impact and lived experiences of community-based physical activity and exercise interventions for people with neurologic diagnoses. She is the co-founder of SHIFT.AR, a community organization that aims to find, create, and sustain opportunities for those impacted by disability to be empowered physically, emotionally, socially, and mentally. In her spare time, she enjoys hiking throughout the United States, bungee jumping, searching for the best local doughnuts and coffee, and spending time with her dogs, cat, and husband.
About Dr. Reed Handlery, PT
Dr. Reed Handlery is an assistant professor in the ACHE School of Physical Therapy and is the Director of the Center for Rehabilitation Research (CRR). He completed his Doctorate in Physical Therapy and PhD at the University of South Carolina. He has worked clinically in outpatient orthopedics and neurology, as well as acute care. His research focuses on physical activity for individuals with disability, specifically those with neurological diagnoses such as stroke or Parkinson’s disease. He has presented his research nationally and internationally and plans to bring community-based physical activity interventions to Fort Smith and the surrounding areas. Outside of research and the classroom you can find Reed hiking or biking with his wife and two dogs.
Connect with SHIFT.AR
Transcript
Elise Cantu (00:19)
Hey, Onco PT and welcome back to this episode of the Onco PT podcast. Now y’all know I love CSM and every year before CSM we do these preview episodes, but nothing could have prepared me for the magic that actually happened at CSM this year. When I wandered into a session that was, dare I say, my favorite one of the entire conference. So if you haven’t heard of this session and you haven’t gone back,
Reed Handlery (00:21)
you
Elise Cantu (00:45)
to look at the recording of this session, I highly recommend it. So underneath the geriatric session, the session is called Fit and Sit, Ramping Up Seated Exercise Intensity, Variety, and Inclusivity for Older Adults. And this session, y’all, might be my all-time favorite CSM session ever, not just of 2025, but of ever at CSM because of how impactful and
immediately actionable the session was. As I was sitting in the audience, the pearls of wisdom that were coming out of these speakers’ mouths instantly translated into my brain of how can I do this in my own practice Monday morning with oncology patients. And one of the things that I loved already talking to these speakers before we started recording is that this is meant for all patients, all patient populations.
no matter your setting. And so I’m so excited to welcome two of the amazing speakers of that particular session to the Onco PT podcast. Reed and Kaci welcome to the Onco PT podcast.
Kaci Handlery (01:53)
Thank you. We’re happy to be here.
Reed Handlery (01:54)
Glad to be here.
Elise Cantu (01:56)
So Kaci, I’ll start with you. Would you mind introducing yourself to my listeners?
Kaci Handlery (02:01)
Absolutely. So my name is Kaci Handlery. I’m a physical therapist in Fort Smith, Arkansas, and I teach at the Arkansas Colleges of Health Education and am the co-founder of Shift Arkansas or Shift AR for short, which I think we’ll share a little bit more about later.
Reed Handlery (02:20)
And then I’m Reed Handler. It’s the exact same thing that she said, except my name is Reed, but everything else is the same.
Elise Cantu (02:28)
Okay, so I have to ask, first of all, what is Shift AR and what populations does Shift AR serve currently?
Reed Handlery (02:39)
Yeah, so shift AR it’s an acronym. It’s stood for several things throughout the years, but currently it’s support plus high intensity fitness training and recreation or AR is also an abbreviation for Arkansas. So we kind of double dip in that. But it’s a, it’s a fitness and recreational based program for people impacted broadly by neurological disability. That includes primarily we serve people with spinal cord injury, Parkinson’s stroke, brain injury and polio.
but it’s not specifically limited to those. And then a unique part, I think, is that we also incorporate care partners of individuals with those diagnoses. So basically, that’s why we say anyone impacted by those neurological diagnoses.
Elise Cantu (03:23)
obsessed with the the and caregivers part because I think so my patient population is oncology and I think there’s so much overlap between the caregiver burden that occurs with each of the conditions that we’re talking about today and how much they also need this this wellness this health and wellness especially this high intensity so what inspired shift AR
Kaci Handlery (03:51)
So I think a lot of this began with Reed’s journey throughout his PhD education. And so we had a similar program when he was going through his PhD in South Carolina called the NextGYM. So kind of that next step after physical therapy is over. And then our folks with neurological diagnoses kind of like now what? So this was an inclusive exercise experience where folks post physical therapy could still be with the physical therapist just in a different setting.
Elise Cantu (04:10)
Mm-hmm.
Kaci Handlery (04:20)
amongst other individuals and their care partners to kind of had shared experiences, but also the safe and inclusive exercise environment. And when we were interviewing for a job in Fort Smith, Arkansas, you know, we noticed, I mean, this is something we usually talk about in our presentations that we Googled exercise classes for X population and there was nothing here in a medically underserved region of Arkansas. So that’s what kind of inspired us to bring this with us as we moved here.
Elise Cantu (04:46)
Mm-hmm.
Kaci Handlery (04:50)
and it’s kind of just hitting the ground running from there.
Elise Cantu (04:56)
And where in Arkansas are y’all exactly?
Kaci Handlery (05:00)
We’re located in Fort Smith, Arkansas, so in the River Valley region, so kind of on the border of Oklahoma.
Elise Cantu (05:06)
Okay. And that’s just kind of south of like Fayetteville, Bentonville area. Okay. Okay. I’m picturing it in my head right now. So how does ShiftAR work? Like how are you working with this patient population to address those fitness and wellness goals?
Kaci Handlery (05:13)
Yes it is.
Reed Handlery (05:27)
And so it when it began, began as a research study. So looking at a six month, basically just fitness only program for people with spinal cord impact by spinal cord injury, and then also Parkinson’s. So essentially, two separate research studies going at the same time. That’s how it began. And then it shifted since then. And now it’s actually integrated into our physical therapies curriculum. And we also have OT School of Occupational Therapy involved as well.
Elise Cantu (05:45)
Mm-hmm.
Reed Handlery (05:53)
So it’s shifted from, while it still does research, involves research, it is now more of a community-based and then academic-based program.
Elise Cantu (06:04)
So I feel like, and I’m not sure if this is just an oncology or otherwise, research comes out and it’s like, this is the gold standard. This is what we know to be best for a designated patient population. But then the translation, like into actual practice, lacks. Or maybe it’s there for a while and it kind of fizzles out.
How are y’all able to maintain like, this is what we’ve been doing, this is what we found to be so helpful, and keep that going basically in this community setting?
Kaci Handlery (06:37)
That’s a great question. I think that’s speaking a little bit for Reed, that’s always been one of his goals is that we don’t bring this research project into a community. And then once the project’s over, we pull out and it’s over. And our folks have lost this opportunity. And it also just reduces trust in the community because we’ve had to establish a lot of community partnerships. And we never want to do that. So what we did to help make it sustainable.
Elise Cantu (06:58)
Mm-hmm.
Kaci Handlery (07:03)
is just what we discussed. integrated it into the physical therapy curriculum. And as we’ve expanded this program to another region of Arkansas, we’ve done the same thing there. So met with the physical therapy instructors. For us, it’s been those who teach neurological content. So here we, the students during their integrated clinical experiences, rather than being just in the pro bono clinic on campus, which is an amazing experience.
Now they have this opportunity to see almost like a wellness side of physical therapy and how to integrate that in the community. And they stay with us for a semester during their integrated clinical experience. So it gives them experience to see how to run the program, how to run a workout, how to provide inclusive exercise for individuals with a variety of impairments, but also their care partners too. So keeping it that appropriate intensity for everyone.
Elise Cantu (07:35)
Mm-hmm.
Kaci Handlery (07:56)
And then Reed does a good job of looking at foundational funding to keep the programs in check and to be able to keep this going. Reed, do you have anything to add on sustainability?
Reed Handlery (08:08)
Yes, we’ve been fortunate. usually, so the research funding ran out within, I guess, a year at that six month mark. And then we’ve been
pretty consistent about getting grants from other organizations. So Parkinson’s Foundation, Craig H. Nielsen Foundation, which is spinal cord injury, Christopher and Dana Reeves Foundation, which is people impacted by paralysis, but there is money and funds and programs out there looking to support this kind of stuff. It’s just finding it sometimes is the hard part. We’ve been fortunate to both find and then receive. And then also our institution is a service-based institution. So they are basically paying us to actually implement the program.
Elise Cantu (08:33)
Mm-hmm. Yeah.
Nice.
That’s spectacular. So as far as we talked around it, in your presentation, you talked a lot about like, this is what a class looks like. For those who maybe haven’t watched your presentation yet, haven’t seen the replay, can you walk us through like, I come to Shift AR and I’m like, I’m ready to start. What does that look like? What does a class or like a session look like with y’all?
Kaci Handlery (09:11)
That’s a great question. And I’ll start off with like the pre stuff. So, because we do have safety and I think that’s always something important to consider. before folks join, we do have a medical clearance form that they go through me to get. And that just ensures that there’s no underlying health conditions that we don’t know about. Because we’re not in a formal physical therapy setting where we would usually have access to a medical chart or get that patient referral. We still want to check our boxes and make sure that we’re safe.
Elise Cantu (09:17)
Mm-hmm.
Kaci Handlery (09:37)
So that’s step one is we have a medical clearance form signed by a physician or advanced practice provider. And then once the recruitment step is done and the medical clearance form is signed, we still meet for an assessment. That’s part of our research project, but I think we would do that anyway, just so they can meet us. Same thing in that typical physical therapy relationship. Do those baseline outcome measures to make sure that we’re assessing pre and post each semester, so to speak.
Elise Cantu (09:58)
Mm-hmm.
Kaci Handlery (10:07)
so that we have viable data, but also to provide the participants. So that’s kind of the pre and post introduction, and then I’ll let Reed speak to the actual sessions.
Reed Handlery (10:16)
So once they are green lighted to come into the program, it’s a rolling admission. there’s no, we do like 12 week blocks of interventions twice a week. People can come at any point in time during that, assuming they get cleared to do that. When they actually come into the program, you can really only describe it as chaos.
organized chaos. So sometimes our classes range from low attendance days, it’s eight people high attendance, it’s 30 people, probably in an 8,000 square foot space open floor gym, but you add the 30 plus the six students plus the two and two pts and it gets a lot a lot of bodies in there. And so as far as the actual fitness part of the program, it’s it’s highly variable.
Elise Cantu (10:42)
Holy cow.
Reed Handlery (11:01)
are constantly variable, guess is the term for that. So we never do the same thing on Tuesday as we do on Thursday. There’s very rarely does a workout or exercise routine repeat itself. If it does, it’s usually slightly, slightly different. So the participants are always expecting the unexpected or something new that they haven’t quite done. And it’s creative, it’s fun, it’s very loud. The our music changes depending on the group. our, our, our SCI group is a little bit more 80s rock and then our
Elise Cantu (11:10)
Mm-hmm.
Mm-hmm.
Reed Handlery (11:29)
Parkinson’s class is more like, I guess I would say 50s, kind of my mom’s music type of stuff. So the vibe is different, but it’s all positive. It’s optimism. People are socializing before, after the class. Most of them probably don’t even like to exercise, but they come because they know it’s good for them and they come for the socialization. But they get some good exercise in as well.
Elise Cantu (11:47)
Mm-hmm.
Okay, that was going to be my next question of some of these individuals may or may not have an exercise passed. So how do you get the buy-in from the community members to say, this is something that I am interested in and I want to be a part of?
Kaci Handlery (12:08)
That’s a great question. think we’ve kind of perfected this as we as we’ve gone because we’ve learned, especially in our Parkinson’s class with that older generation. They’re not as in tune to exercise, especially our older females where maybe exercise wasn’t something that was typically done. So now we’ve kind of perfected it where they come before they join the class. We were just like, hey, come by and check out a class. Come hang out for a little bit.
And that usually is what sells it. So everybody’s so friendly, they’re going to come up and say hi to the new individual or individuals. And I think what we’ve done to increase buy-in is we spend a lot of like, like Reed said, it’s chaotic. There’s a lot going on and we make sure that nobody gets lost in that momentum. So we may pair a student with a new member or one of the physical therapists or physical therapy assistants with a new member to make sure that they’re comfortable.
Elise Cantu (12:35)
Mm-hmm.
Kaci Handlery (13:02)
and or that they don’t go so heavy on a weight their first day that they’re so sore that they don’t want to come back. So we do provide a lot of that empowerment and education throughout, but also just make sure to give them a little bit more one-to-one attention. And now we’ve gotten better at, we pair them with one of the other individuals in the class. So rather than a therapist doing the orientation, so to speak,
Elise Cantu (13:08)
Mm-hmm.
Kaci Handlery (13:25)
we get one of our class members to do it, especially somebody who’s been there from the beginning, because that helps increase their buy-in in the program as well. So that’s been really helpful.
Elise Cantu (13:29)
Yeah.
Mm-hmm. When it comes to like the actual interventions that are happening in the class, this is not your great aunt Ruby’s like water aerobics class. This, I was so surprised in the presentation how high intensity, I mean like truly high intensity these exercises are. And my first kind of reservation was gosh, these participants like do that?
And the answer is yes, but the, just the equipment being used, these are like two questions in one because it was just so exciting and so eye opening to see all of it. So can we talk about just how truly high intensity these exercises are for these patient populations? Like this is tough stuff they’re doing.
Reed Handlery (14:26)
What’s funny, also, Kaci runs a Parkinson’s support group in our area. And a lot of our individuals in that support group are participants in the fitness program. And there was a couple of new folks that had never been in the fitness program, but they were in the support group.
Elise Cantu (14:36)
Mm-hmm.
Reed Handlery (14:40)
They were talking about, so we work outside of a CrossFit gym or it was a CrossFit gym. So people hear that term and sometimes there’s a connotation with that. they thought, they said, well, it’s not like we’re, the person who hasn’t been there, like, let’s, you know, I see CrossFit and it’s not like we’re going to be doing like tire flips or throwing balls into the wall. And then it was just kind of funny because we didn’t say anything. were like, no, that actually is what we do. But you’re right. It is an intimidating environment.
Elise Cantu (14:44)
Mm-hmm.
Absolutely.
Bye!
Reed Handlery (15:11)
It looks like there’s heavy weights around. do a good job of kind of de-emphasizing the whole like the masculinity macho vibe of what CrossFit might be. Basically, one, we don’t call it CrossFit anymore because there’s just such a negative connotation with it. Really, CrossFit is just branded exercise. So we just call it HIFT, High Intensity Functional Training. But most people probably don’t even know we call it that. We just call it exercise.
Elise Cantu (15:22)
Yeah.
Mm-hmm.
Mm-hmm.
Mm-hmm.
Reed Handlery (15:37)
So as far as reducing the intimidation factor, I think once people see it and after they do it, I think there’s a sense of empowerment. Like, wow, I didn’t think I could carry those heavy weights or throw that sandbag or do this. And once they do it, they go, no, I think we’re always more capable than what we think we are. Same for participants.
Elise Cantu (15:46)
Yeah.
Mm-hmm.
Kaci Handlery (15:56)
Yeah, I think the intensity piece is really fun for Reed and I to see that hoisting a kettlebell into the air that’s tied to a rope, you know, you feel like a sailor, you know, as, or some of our participants may feel like that as they’re hoisting the sails, so to speak. So it’s really empowering watching people exercise at this high intensity doing something that they’ve probably never done before in their life. or dragging a heavy sled across the gym or.
Elise Cantu (16:20)
Mm-hmm.
Kaci Handlery (16:25)
using a hammer to hit a tire for the one day that we did that, kind of like Reed said, just random things. But they really do enjoy the high intensity. We try to hit a specific RPE every day. That’s kind of our goal to make sure that we’re hitting that high intensity, but they do really enjoy it.
Elise Cantu (16:40)
Mm-hmm.
I was really, it was very eye opening to see the different videos and pictures that y’all had, but one in particular that stands out, you spoke of an older woman, I believe, who used a rollator. And so in the process of, how can we weight this? How can we add load to this? Adding weight to the rollator and she’s still doing her own version of the sled pushes. It was just like, this is genius. This is…
And I think sometimes we as physical therapists, maybe even especially in the oncology section where we historically under dose our patients, we tend to shy away from really loading up our patients, especially in the face of maybe some mobility challenges, such as what we’ve talked about. But y’all are doing the thing. Y’all are really loading these patients up with whatever they’re working with to still achieve that high intensity functional training that is the goal here. And that was really, really cool.
You know, I think conceptually we can be like, yeah, that makes sense. I’m a visual person and seeing that, was like, this opens up so, so much from my own patients that I see back here in Fort Worth. So, it was so exciting.
Kaci Handlery (17:56)
I’m glad you got to see those videos. The videos do they help you I think apply it and be like, I can do this.
Elise Cantu (18:01)
Yeah, yeah, and
just the inspiration. One of the things that I also really appreciated from the photo and video perspective, in that line of individuals who have different impairments or mobility challenges, like when it comes to grip. So some of my patients have neuropathy issues, or maybe they have strength impairments for one reason or another where they’re unable to grab stuff.
And so that might be kind of a barrier that a PT right now is listening and saying, well, I don’t know how to get around that, but there are some very, very achievable ways to still dose upper extremity exercise very intensively, even if we don’t have grip strength. Could you mind talking about some of those adaptations or tools that y’all use in these contexts?
Reed Handlery (18:30)
.
Kaci Handlery (18:50)
Absolutely, and that’s where I think we succeed.
particularly when working with people with spinal cord injury, that’s really opened our eyes as far as how to provide the most inclusive exercise. So just some of the items that we use frequently, the active hand general purpose grip aid is one that is almost like a mitt and it does help individuals with impaired grip for whatever reason that might be. Like you said, peripheral neuropathy all the way to a previous fracture or injury.
Elise Cantu (18:58)
Mm-hmm.
Kaci Handlery (19:19)
through a neurological injury. So it wraps around the patient’s hand like a mitt, and then you place the device within their palm, whatever it is, whether that’s a handle for a ski ergometer, whether it’s an arm ergometer or a dumbbell or a kettlebell or a rope or a sled, it can go around anything. And so that can help you, if they have distal weakness, that can help you still strengthen proximally or mid-joint.
while still accommodating and making sure that that hand is safe. So it does provide a lot of wrist support as well because it wraps around the wrist. So the Active Hand Series, there’s a variety of different grip aids they have. They have it for unilateral limb loss. They have it for individual finger loss. They have it for folks who like the D-rings where you can hook in bands where if let’s say they may not have a distal extremity.
Elise Cantu (19:52)
Mm-hmm.
Kaci Handlery (20:14)
or they have limited hand function or no fingers to be able to use the grip aid, you can use that as well. So they’re still getting the elbow and shoulder strengthening and you can just hook in bands to that. So active hands in particular has been really beneficial for shift in our folks.
Elise Cantu (20:14)
Mm-hmm.
Mm-hmm.
Mm-hmm.
As far as we’ve talked a little bit about upper extremity, those who maybe are in wheelchairs, or we’ve talked a little bit about rollators, for individuals who have more lower extremity impairments or differences, how are you still working to improve some of those fitness goals that y’all talked about? What are some of those maybe adaptations?
Reed Handlery (20:58)
I would say so we use weight vests both backpacks and then actual weight vests quite, quite often, especially if someone to try to level the playing field to so if someone’s just tearing through a workout, and they’re not having that much difficulty or challenge easily just throwing on a weight vest, and we have those all the way from five extra pounds to I think we have a 40 pound extra weight vest.
Elise Cantu (21:04)
Mm-hmm.
Reed Handlery (21:20)
So that’s one way to kind of level the playing field. And that’s also good for, we have a couple of people that they have severe upper extremity impairment and what may seem to one of their limbs might not be essentially functional. And so weighting them down and getting their legs involved more as a way to do that. As far as wheelchair users, manual wheelchair users specifically, we attach sleds to the actual chair, both pushing and then pulling. We try to balance both the push and the pulling since most of their day is pushing as far as mobility.
Elise Cantu (21:20)
Right.
Mm-hmm.
Mm-hmm.
Reed Handlery (21:50)
We do things that are more maybe rotational in nature. So that way they’re not just constantly working their, you know, their shoulder and elbow flexors and extensors. Try to really emphasize, especially for our people in wheelchair users, really emphasize the aerobic component. it’s not, yeah, so we try to, we try to mix that in when we do resistance training exercises. Cause if they don’t, if they’re only using their upper body, you can see how a circuit would get really, really tiring if you’re just alternating between pushing and pulling motions.
Elise Cantu (22:17)
Right.
Kaci Handlery (22:20)
I think I’ve watched Reed as the, I mean, he programs the exercise programs for our participants and watching him do it, I’m always quite amazed at the variety of exercises that he comes up with, but he does always come back to those foundational movements. And, you know, I kind of talked about this in the presentation, a deadlift for a person in a wheelchair is gonna look a little different than a person who is ambulatory, but it’s still that concept of picking something up from the ground and bringing it up to a higher level.
Elise Cantu (22:30)
Ha ha
Mm-hmm.
Mm-hmm.
Kaci Handlery (22:48)
or a squat is a transition. So maybe that looks like a dip for a person in a wheelchair where it’s a sit to stand for a person who’s ambulatory. So he does an incredible job of programming for the spinal cord injury class for individuals in manual chairs and then making it either more challenging or just a little different for both ambulatory individuals and individuals who use power chairs.
Elise Cantu (22:48)
Mm-hmm.
Reed Handlery (22:51)
So, thank
Elise Cantu (23:12)
Mm-hmm. How did, so we’re gonna take it like a step back here. How did y’all get involved
in this adaptive population exercise? Because I think, you know, a lot of PTs, we get really excited about, I’m gonna help people after surgery. And, you know, maybe there’s some personal experience, but I feel like unless you know somebody and you have somebody who gets you connected into this space,
A lot of us in PT don’t see this. How did y’all get started with this really, really cool concept?
Reed Handlery (23:47)
So we, as Kaci mentioned, we both lived in South Carolina prior to this. we, part of my dissertation was pre COVID, COVID, COVID messed it up, but we were going to do another group based intervention for people with stroke actually in South Carolina. And so group based has always just been, we just always loved the vibe of that. We feel like not that it’s more impactful, but you get to see the impact in more people, I guess, at one time versus the one-on-one model. And so when we moved to,
Elise Cantu (23:59)
Mm-hmm.
Yeah.
Yeah.
Reed Handlery (24:15)
Arkansas, essentially, we looked at place one, we looked at where we could get funding from. So there’s funding from again, Parkinson’s Foundation, Craig Wilson Foundation. So he said, Hey, other people across the country are doing things similar to that. Let’s there’s money out there. So let’s try to see if we can get that and then start something for those two populations there. So it was a matter of finding and applying for those. And then as far as using our finding space. So when we moved to Arkansas, I basically emailed every gym within,
Elise Cantu (24:21)
Mm-hmm.
Mm-hmm.
Reed Handlery (24:44)
10, 15 miles of our institution. And I said, hey, you we’re looking to do this adaptive fitness program. Would you be interested in maybe hosting or supporting something like that? Telling them that it’s not gonna make them rich or anything, but it is, it can provide additional income and reaching a target population that they wouldn’t have had otherwise. And there was one gym in particular that emailed me back within, I’m usually a late night person, so I emailed them at like midnight and I got an email back at like 4.30 a.m. saying like,
Elise Cantu (24:46)
Mm-hmm.
Ha!
Reed Handlery (25:14)
Yes, we would absolutely love to do this. Let’s talk, let’s call it a morrow. And so it just happened to work out that this gym that we use is probably 200 meters from our college. And so it’s been a match made in heaven and knowing that everyone will find that you just got to reach out because there are people out there who are interested in hosting that type of stuff. Finding the space and the people is the hardest part. And so that’s kind of the initial beginning of it all.
Elise Cantu (25:17)
my God.
Mm-hmm.
That’s cool.
Wow, that is so neat. I used to, way back, way back in college, I actually taught group exercise classes with MHMR here in my local area. And it was the same thing of like getting to work with a bunch of different people at one time was really, really fun. And seeing people who maybe didn’t exercise previously or maybe have like a very limited exercise experience getting, like, we would do a lot of dance because I was really into dance at that time. like,
just get on some music and whatever and being able to see that. But then those five extra steps that y’all have taken to really up the intensity and the, just like the transferability of what you’re working on and how that directly impacts people’s lives as a PT is just like the ultimate combination for me. Now we’ve talked about both in the interview and in your presentation, how inclusivity is such an important part of all of this. How can
the cancer rehab professional who’s listening to this right now, adopt this model into their own practice in their own community with their oncology patients.
Kaci Handlery (26:51)
That’s a great question. think Reed spoke to it a little bit. So if you’re looking to start a community organization, know, Reed and I started really small. Like I think our first class we had what, maybe eight people. So, and then now like Reed said, in the Parkinson’s class in particular, like we have usually about 30 folks. So it’s grown from that just in the short time. And so to get it started, I feel like it’s always intimidating. So finding your champion, that champion may be you.
Elise Cantu (27:10)
Wow.
Kaci Handlery (27:21)
but it’s also helpful to find a co-partner. like Reed and I have each other, but having somebody else that you can bounce ideas off of or finding somebody who’s done this before, because you’re going to hit barriers along the way. But I do think Reed highlighted an important piece of finding that community champion for us. That was the owner of Fort Smith Fitness who jumped at the opportunity. Despite again, this not being a money-making venture for them, it was a service to the community.
Elise Cantu (27:24)
Mm-hmm.
Mm-hmm.
Kaci Handlery (27:49)
So finding that community champion is key. And then funding of course is always challenging, but it’s not always the biggest piece. If we didn’t have the gym, for example, this program wouldn’t exist no matter how much money we had. So finding that community champion is key. And then the other part of being successful is recruitment, which surprisingly can be challenging.
Elise Cantu (28:02)
Mm-hmm. Mm-hmm.
Absolutely.
Kaci Handlery (28:13)
So getting
the buy-in with your state organizations. So for example, we have a strong relationship with the Arkansas Spinal Cord Commission through the case managers there. So thinking about that from an oncology perspective, getting in with the outpatient locations as well as inpatient, if the patients are receiving infusions or treatment inpatient that they have somewhere to go afterward. So I think a lot of it is
Elise Cantu (28:23)
Nice. Nice.
Reed Handlery (28:25)
you
Kaci Handlery (28:43)
getting the word out about your organization and what you have to offer. And again, you may start with two people. You know, we’re expanding to a second site and I think we do have two people at that second site right now. But I have three people on deck this week to call. So like it does happen, it does take time, but you just have to keep the faith so to speak. But I think definitely getting in touch with your local providers, whether that be, you know, outpatient physical therapists, but also your physicians and nurse practitioners.
Elise Cantu (28:52)
Mm-hmm.
Nice.
Kaci Handlery (29:11)
and your case managers who always help ensure to get the word out about you.
Elise Cantu (29:17)
Mm-hmm. Mm-hmm.
Reed Handlery (29:19)
I would add to that if the question’s about inclusivity.
One thing that we’ve done over time, so we actually start while we while it’s mostly exercise, we start with a question of the day, which could be something simple. What’s your favorite ice cream flavor? It can be more in depth. We try to stay away from what’s your favorite like memory or anything like that. Sometimes those take like this. Take it. It’s a good thing, but it takes longer than than you might want out of an hour exercise class. But we’ve added that component in because it’s meaningful. People get to share experiences and get to know each other.
Elise Cantu (29:42)
Yeah.
Reed Handlery (29:51)
Also, Kaci had mentioned partner, ex partner workouts where you and your partner have to tackle something that’s maybe heavier than you would do by yourself or just even working alongside someone. And it’s not always partner care partner. In fact, we usually split them up immediately as soon as they come in, just because they’re together all the time so they can go go meet other people. Shirts. We if you have a logo, you have a thing. People are proud to be part of a community. If you can name that community, we call our shift AR you know, having a name to it, people, people rock those shirts all the time.
Elise Cantu (29:54)
Mm-hmm
Yeah.
Absolutely.
Reed Handlery (30:21)
Kaci does a good job. If someone’s out for a little bit, they get a card, they get a call, hey, how’s it going? Because people are always coming up to her asking, hey, where’s so and so? And so I think building that community, it’s hard to measure, that’s the reason people keep coming back. It’s not the exercise, well, that’s maybe a small component of it. It’s the sense of belonging and community that they feel when they show up and do hard things together.
Elise Cantu (30:30)
Yeah.
Yeah.
Kaci Handlery (30:45)
I think that would be so great thinking about you applying this to the oncology population. They are going through the trials and tribulations similar to folks with neurological diagnoses. I think this would be an incredible journey for somebody to start.
Elise Cantu (30:53)
Yeah. Right.
You know, and that’s one of the things, those were all the thoughts going through my head, right? As I’m sitting in the back of your presentation, like, my God, how can I make this happen right now in Fort Worth? And, you know, in oncology, we know, gold standard is we get patients in immediately after they’re diagnosed that we can address the impairments that they have. We can watch for impairments as they come. And ultimately we try to instill
in our patients as they go through cancer treatment and after cancer treatment beyond that they are exercising because we know that exercise has so many health benefits including reducing
Reed Handlery (31:34)
So
Elise Cantu (31:36)
the risk of a cancer recurrence and reducing the risk of other cancers potentially occurring. But the actuality of that is very challenging. I’m very fortunate in my area, I have multiple programs that are like bridge programs.
where between PT and completely independent exercise, I have resources, I can get patients connected with programs that they can get into, where it’s a supervised exercise program. Because dear listener, you already know this, supervised exercise we know is superior when it comes to oncology stuff, probably elsewhere, et cetera. But the actual, the reality of that is not often how that works. And I’m very privileged. I’m in a very metropolitan area, I have access to those.
That is not the reality for probably most people listening to this. And so that’s why when I was in y’all’s session, I was like, my God, this is it. Like this is what a great model to put into practice what we know to be so beneficial for our oncology patients that maybe we’re having trouble doing so in our own community. So anyways, I could nerd out about how amazing your presentation was all day. It was so impactful and it was a packed house too.
Like the amount of people at your session, I got in and I was like, hot dang it. Like I need to find a seat before I get kicked out for being over capacity. So if people are listening to this and they’re inspired and they’re like, I need more of this. I need to know more. Where can they follow you and connect with you after today’s conversation?
Kaci Handlery (33:11)
think probably the easiest way is to reach out to our Instagram page. So it’s just shift.ar, which is really easy. And that’s where we post videos and highlight like the recreational events too, which we didn’t talk about much, but we just took the group bowling. You we do a lot of other community-based activities. We’re playing pickleball tomorrow. So again, just…
Elise Cantu (33:19)
Mm-hmm.
my God, I love
it.
Kaci Handlery (33:34)
Yeah, bringing again sociability and inclusivity to all aspects of fitness, exercise, recreation. But you’ll be able to see what we do there. You’re welcome to send us a message. And we have a Facebook page too, but I feel like Instagram is more popular these days. So shift.ar is where you can find us and reach out. We’d be happy to help share how to get started on this journey.
Elise Cantu (33:48)
Mm-hmm.
Reed Handlery (33:57)
I would say to so part of my job is Kaci’s more focused on teaching and more focused on research. I live to help people write grants to get money to do these types of things. So if that’s the daunting part,
Like, my gosh, I don’t know how to write a grant. Like, I am more than willing to help look at that. this, more we can spread this stuff across other places, the better, so.
Elise Cantu (34:20)
Oh my gosh, what a power team. Like, yes, please. Yes, please to both. Holy cow. And can confirm, I reached out on Instagram, so very responsive. So I really appreciate that. I will of course be linking to all of this information in the show notes. So where to get connected with shift.ar, that’s actually their Instagram handle, if I remember correctly. Is there anything else you’d like to leave my audience with before we wrap up today’s conversation?
Kaci Handlery (34:50)
I think, mean, I think Reed and I, our message is always just that anybody can do it. It is intimidating and it can be, but find the people that have paved the road before you and, you know, follow it, but also make your own path. It’s going to look slightly different. Like you said, where you are in Fort Worth, where we are in Fort Smith, and there’s probably somebody more rural or more urban than where we are and what we’ve discussed. It’s possible. It’s definitely doable and finding those people that can help you along.
Elise Cantu (35:10)
Mm-hmm.
Well, thank you both so much for coming on the podcast today. I could not wait to have you on to talk about this. And as I mentioned previously, their session is also available as a recording through CSM 2025. So if I find that, will definitely be linking to that. Would highly encourage you, even if you go and just look at the handout that they made. They talked through so much of the equipment that we talked about today in today’s conversation.
Also inspiration for different interventions and exercises that I’ve adopted into my own practice so far. And I don’t even have the setup yet that we’re talking about, but I’m working to that someday. So like that’s the goal. But even today, there are still things that you can be implementing with your own oncology patients, no matter where you’re at, to really get towards that high intensity exercise we know to be so beneficial for so many reasons. So Kaci Reed, thank you so much for coming on the podcast today.
Reed Handlery (35:55)
.
Elise Cantu (36:17)
really, really
appreciate your time and I really want to commend you all for the work that you are doing. is truly inspirational and we are seeing the benefits in our communities for it. So thank you very much.
Kaci Handlery (36:29)
Thank you for having us.
Reed Handlery (36:31)
And thank
you.