On a Friday evening, a little before 5:30, Brian Pollack, 20, changes into a black tank top and white athletic shorts and waits patiently for Suzanne Welsh to arrive at his home in Merrick, N.Y. At 5:33 p.m., she arrives and greets him with a smile.

After some small talk, the two venture off to Pollack’s fully finished basement. A flat-screen TV, a coffee-colored couch adorned with a New York Yankees pillow and a pool table are all fixtures of the room, but Pollack and Welsh turn their attention to the other side of the basement – the side stocked with an array of colored dumbbell weights, an exercise bike and a Bowflex machine.

Pollack hops on the cardio bike and places his feet on the pedals.

“All right, let’s start at five, we won’t go all the way up yet,” Welsh says, taping on the bike’s speedometer. “Ready?”

Pollack nods and exhales vigorously.

Welsh is a personal trainer. Once a week, she comes to train Pollack, who has high-functioning autism and suffers from learning disabilities and attention deficit disorder. Welsh is one of nine personal trainers who work for HOPEFitness, a gym that claims to be the first and only stand-alone commercial fitness facility in New York that focuses on people with mental and physical disabilities and is also open to the public. HOPEFitness trainers also travel to homes like Pollack’s, day habilitation facilities, camps and group homes to work with clients.

Suzanne Welsh, a certified personal trainer at HOPEFitness, and Brian Pollack, 20, who has high-functioning autism and attention deficit disorder, at Pollack's home in Merrick, N.Y. on March 18, 2011. Welsh travels to Pollack's home once a week to help him exercise. "She’s just a great person to workout with because she helped me through a lot of the workouts that I thought that I couldn’t get done," Pollack said.

“We tried a local gym and it didn’t fit Brian because of his special needs,” said Pollack’s father, Harvey. “They didn’t know how to cater to him in a way that we are now getting with HOPEFitness. In a regular gym, they’re not going to understand all the giving positive reinforcement that a person like Brian needs to keep going forward and getting better.”

Pollack, who sought a gym to lose weight he had gained from his behavioral medications, a common side effect, has thinned out, improved his upper-body strength and gained muscle definition from his nearly three years of training with HOPEFitness. But he is one of the lucky ones. Pollack is one of 50 million Americans – or one in five – who suffer from some sort of mental, emotional or physical disability, according to the Centers for Disease Control and Prevention. But data suggest that 56 percent of adults with a disability reported no leisure-time physical activity, compared to 36 percent of people without a disability, according to Healthy People 2010, a document released by the U.S. Department of Health and Human Services.

While much of the population has the luxury of choosing whichever fitness facility they want, options are more limited for people with disabilities. Finding the right gym and a trainer who suits their needs takes research and trial and error. And though national efforts have been made to bring awareness to the importance of physical fitness for people with disabilities, and some gyms are making attempts to foster a more inclusive atmosphere, many still have a long way to go — despite the passage of the Americans with Disabilities Act more than 20 years ago.

Exercise is just as important, if not more important, for people with disabilities as this group is more likely to lead a sedentary lifestyle. Lack of exercise can spur secondary conditions such as pain, fatigue, obesity and depression. And the strength that exercise develops can help people with disabilities maintain a higher level of independence, according to the Inclusive Fitness Coalition, an organization geared towards facilitating the participation of people with disabilities in physical activity, fitness, sports and recreation.

“Exercise increases your joy, decreases depression, increases energy, and reduces the risk of developing disease associated with living a sedentary lifestyle,” said Joanne Duncan-Carnesciali, a registered clinical exercise physiologist and president of Focused Wellness, a New York City-based business that provides wellness and fitness plans for people at home, online, in gyms or in the open-air. She has worked with people with multiple sclerosis, fibromyalgia, rheumatoid arthritis, and those undergoing cardiac rehabilitation.

Pollack’s father found out about HOPEFitness through the gym’s owner, H.L. Greenberg, whom he works with as a Special Olympics coach. Greenberg, a former financial services executive, incorporated HOPEFitness in 2004 as a part-time endeavor and traveled to homes to provide fitness training. In 2006, Greenberg said he “basically mortgaged his house” to open HOPEFitness in North Bellmore. Two years later, he opened a second place in Bohemia. As a longtime Special Olympics coach and the father of a developmentally disabled son, Greenberg said he felt there weren’t many options for this group to exercise.

“I wanted to give them a place to call their own, a safe, comfortable atmosphere, because they’re not comfortable in the local gyms,” he said. “Most commercial facilities cannot accommodate the disabled; they don’t want to.”

Sal DelGenio, a certified personal trainer, tosses a ball to Lorraine Murphy of Stewart Manor, N.Y. while she pedals a bicycle with others at HOPEFitness in North Bellmore, N.Y. during a class for people with multiple sclerosis on Friday, April 1, 2011.

Greenberg, who owned a home mortgage company for 20 years, originally asked several large gyms to rent space, but they weren’t receptive, he said. So, without government funding, he opened HOPEFitness on his own and now services several hundred clients with developmental and physical disabilities from all over Long Island with a staff of personal trainers, adaptive physical education teachers, behavioral specialists and psychologists. Clients get bused from schools, camps and day habilitations, which teach independent living skills to people with developmental disabilities.

One HOPEFitness client, Anastasia Papadopoulos, who has multiple sclerosis and scoliosis and uses an electric scooter, goes to HOPEFitness for the experienced staff.

“I need a little more attention,” she said. “If you just go to a physical therapist, they’ll give you exercise on the bench and just leave you there, and you do your exercises, and they’ll go somewhere else.”

This was a problem because Papadopoulos needs supervision transferring from her scooter to gym equipment and needs assistance walking.

Papadopoulos, 47, who said she went to 10 different physical therapists before joining HOPEFitness, now has trainers who stay with her throughout her workout and strap her feet down to the exercise bicycle so she can pedal effectively. She has tried other gyms near her hometown, North Bellmore, but, she said, they weren’t accessible.

“The ones that I’ve gone to, they know me, because I complain all the time about how hard it is,” she said. “I complain that the doors are not accessible, and then a lot of the time the rooms are not wide enough to accommodate the electric scooters.”

Papadopoulos, who takes a one-hour class every Friday afternoon in the North Bellmore location with eight to 12 other clients who have multiple sclerosis, said she appreciates the social aspect of being with others who understand the disease.

“Mentally, it’s good because I get to be with all MS people,” she said. “So it’s not others that are fine who are walking around in physical therapy looking at me.”

While many HOPEFitness clients share Papadopoulos’ assessment, Dr. Garth Tymeson, an adaptive physical education teacher and professor at the University of Wisconsin La Crosse, says a better option would be for fitness facilities to be inclusive.

“You don’t want to isolate the persons with disabilities in their own segregated gym,” said Dr. Tymeson. “What you want to do is inclusion, where, in any YMCA or fitness program, you hope what you can do is include persons with disabilities into the programs.”

But one of the major challenges to this, he says, is hiring the proper staff with the knowledge, skills, experiences and attitude to work with people with disabilities.

“You need the right people doing the right things to create active and healthy lifestyles for persons with disabilities,” he said. “You need to hire people with the proper background – same as any profession.”

U.S. federal and state governments have not yet regulated fitness training, so there are no laws to specify whether fitness professionals should have certain credentials. There is a broad range of qualifications among staff members at any given fitness facility. Most of the time, it’s up to the person with a disability, or the family member of someone with a disability, to question these fitness centers and employees and to do their research before trusting anyone, Duncan-Carnesciali said.

“You have to question: ‘Is there someone here who I know is not going to put me in a position that my wheelchair tips?’” Duncan-Carnesciali said. “’Is there someone here who is sensitive, who knows how to communicate effectively with someone who has a traumatic brain injury, or who is deaf or blind?’”

Anastasia Papadopoulos, 47, of Levittown, N.Y., who has multiple sclerosis and scoliosis, exercises her arms on a machine at HOPEFitness in North Bellmore, N.Y. during a class for people with multiple sclerosis on Friday, April 1, 2011.

Duncan-Carnesciali is one of 21 registered clinical exercise physiologists in New York, and with this credential, she can prescribe specific exercises to people with conditions that make exercising on their own potentially unsafe. Clinical exercise physiologists help people with cardiovascular, pulmonary, metabolic, orthopedic, neuromuscular and immunological disease. It is the most prestigious credential given by the American College of Sports Medicine and is only for those who hold a master’s degree in exercise science, movement science, exercise physiology or kinesiology, according to Richard Cotton, the national director of certification programs at the American College of Sports Medicine.

So far, almost 700 registered clinical exercise physiology credentials have been given by the American College of Sports Medicine since they became available in the early 2000s, according to Traci Sue Rush, the assistant director of certification programs at the American College of Sports Medicine.

Duncan-Carnesciali is part of a legislative subcommittee under the American College of Sports Medicine to make clinical exercise physiology a licensed profession on a state-by-state basis. If this happens, it will increase the chances that people who have clinical conditions could get the services that they need and use insurance or Medicaid to pay for it, Duncan-Carnesciali said.

Another effort by the American College of Sports Medicine is the Certified Inclusive Fitness Credential. This credential, which does not require a master’s degree, was developed in 2007 in collaboration with the National Center for Physical Abilities and Disabilities, an information center focused on physical activity and disability. This credential is given to fitness trainers and qualifies them to assist in including people with disabilities in exercise facilities and developing, adapting and implementing individualized exercise programs for those with a physical, sensory or cognitive disability, as well as for healthy people. Approximately 80 of these credentials have been given out by the American College of Sports Medicine since they became available in 2007, Rush said.

While these efforts get off the ground, uncertainty remains for people with disabilities who require assistance. It’s difficult for this population to go into any given gym and expect to find a trainer qualified to suit their specific needs.

But sometimes, they will go to gyms solely because they are low-priced. Despite the well-trained staff at HOPEFitness, Greenberg has had clients leave and go to other gyms, like Planet Fitness, which charges just $10 per month. HOPEFitness charges $60 for one-on-one personal training and $15 for a one-hour group training, which is miniscule compared to the $50 per one-hour session insurance co-payment Papadopoulos used to pay to get exercise in a physical therapy office where, she said, she was one of many and didn’t get the attention and assistance she needed. Papadopoulos now pays $15 per session for her multiple sclerosis group class each Friday.

HOPEFitness does not lock clients into contracts where membership fees are taken out automatically through a credit card or checking account each month as many gyms do. And Greenberg allows family members of clients with disabilities to work out for free.

But even with these perks, it isn’t easy for Greenberg, who said country’s recession has taken a toll on his business and forced him to lay off staff in the past year and consider downsizing. Greenberg said he often wrangles for payments from group homes and day-habilitation centers – two places that allot recreation money for people, which may be used for a class at HOPEFitness. Greenberg said some homes and independent living centers owe him months worth of pay for clients even after he has sent several bills.

Often, people with special needs who live in group homes get to choose how they would like to spend their recreation money and aren’t urged by staff or family members to partake in exercise, which discourages potential clients, Greenberg said.

“When the disabled have the choice of spending on HOPEFitness or movies and the food court,they inevitably will choose the latter,” Greenberg said. “If exercise was part of their treatment plan as outlined by professionals, things would probably be different.”

Still, some former HOPEFitness clients, who do recognize the importance of exercise, opted to transfer to gyms that are cheaper than HOPEFitness. Greenberg said this worries him.

“I don’t know who is going to help them when they get there,” he said. “And I don’t know how the other patrons are going to react to seeing a group home with five guys walking in there and basically just walking around and not knowing what to do. Someone ultimately going to get hurt, that’s what I think.”

Bicycles at HOPEFitness in North Bellmore, N.Y. A typical one-hour group training session consists of 30 minutes of cardio, 20 minutes of step aerobics and weightlifting and a five minute cool-down stretch, according to Robert Kagen, an adaptive physical education teacher and trainer at HOPEFitness in North Bellmore, N.Y.

Some mainstream fitness facilities are making small steps in the right direction. Gold’s Gym offers what its employees call kranking, an upper-body cycle that allows users to sit on a seat or remain in a wheelchair. The kranking class for the Gold’s Gyms in Islip, Deer Park and Smithtown were all approved by the director of Suffolk County’s Office of Handicapped Services. Gold’s Gym in Islip also has a fully accessible pool with a lift for individuals in a wheelchair.

“Now the disabled can integrate with the rest of the students, too, and not just be on their own,” said Sue Slack, group fitness manager for Gold’s Gym in Islip. “It’s something they could do which they never could before. They would just go off and do their own thing, so now they can be part of a group. They can be participating right next to somebody that’s on a spin cycle.”

The Suffolk Y Jewish Community Center in Commack, N.Y., offers scholarship programs and sliding scales based on income. It also has an aquatics program for people with arthritis and multiple sclerosis. The pool has a ramp and an aquatic wheel chair, said Nancy Briel, the aquatics director at the center.

The Huntington YMCA offers a fully accessible pool and provides pool space for Special Olympics athletes on most Sundays, according to its executive director, Eileen Knauer. This YMCA has also worked with the Helen Keller Foundation to develop guidelines for visually impaired participants and to provide training and instruction to the staff. At the Brookhaven-Roe YMCA in Holtsville, there is a half-price guest fee of $6 per visit for members who come from group homes, and they are eligible to bring an aide to assist them for free, according to Debbie Santoro, the associate executive director.

Issues remain, though. For instance, Gold’s Gym in Smithtown has a meandering entrance to its locker rooms, which could be difficult for someone in a motorized scooter to navigate, and two floors with no elevator in sight. Slack says it’s because all the equipment that is upstairs is also downstairs.

According to the Americans with Disabilities Act, buildings with fewer than three stories or less than 3,000 square feet per story are exempt from having an elevator, unless they are owned or run by municipalities. Such regulations leave many two-story gyms in the clear. And then there are individuals like Papadopoulos who say that many gyms have inadequate space for her scooter.

“The American with Disabilities Act is self-enforcing,” said June Isaacson Kailes, a disability policy consultant. “So unless somebody files a complaint, they’re going to get away with it. But a lot of people don’t really understand what accessibility is. Most gym managers or workers say ‘Well, I saw someone in here with a wheelchair once, so we must be okay,’ and then they never really go any deeper than that.”

Duncan-Carnesciali said another problem area is the design of fitness equipment, which often can’t be adapted to people with special needs.

“You don’t have to be a rocket scientist to figure out that most of the major chain gyms, when they came into business, their market wasn’t people with disabilities,” she said. “And we know, for the most part, the manufacturers of gym equipment don’t manufacture with the disabled in mind.”

With the help of some organizations, adaptive machinery is seeping into gyms across America. Last February, the Newman YMCA in Seekonk, Mass., received a $17,000 grant from the Christopher and Dana Reeve Foundation to assist in purchasing exercise equipment designed for people with physical disabilities. One of the machines purchased was a bike designed to help people with paralysis from stroke and other injuries as well as those living with multiple sclerosis.

In 2008, a task group called Committee F08 was formed through the American Society for Testing and Materials to ease access to mainstream fitness equipment for a wider population, across all abilities. Currently, the committee is drafting regulations that will provide guidelines for fitness product designers for things like the size of handles and seat adjustments, and legibility of warnings and instructions, said Harvey Voris, the F08 chairman and vice president of engineering at Paramount Fitness Corporation.

Though the American with Disabilities Act became law in 1990, recreation and fitness facilities were something of an afterthought. The U.S. Access Board first published accessibility guidelines for playground design in 2000, and guidelines for other recreation facilities such as swimming pools, fitness centers, sports fields, golf courses, boating areas and fishing in 2002.

“For years, the fitness centers were low on the list,” said Kailes. “It was more important to be able to get on the bus, or get into a mall, or get into a grocery store. It was kind of a hierarchy of needs.”

Robert Kagen, an adaptive physical education teacher and fitness trainer, sings "Happy Birthday" with others to Mary Noon, left, from Bellmore, N.Y., who turned 30, at HOPEFitness in North Bellmore, N.Y. on March 28, 2011. "The trainers are great, patient and really nice," Noon said.

In July 2010, on the 20^th anniversary of the Americans with Disabilities Act, President Barack Obama and the U.S. Department of Justice issued the “2010 Standards for Accessible Design,” which affect elements of public recreation facilities, including fitness centers, pools and playgrounds. Compliance with the 2010 standards is not required until March 15, 2012.

The new standards address policy or operational issues related to service animals, a person’s mobility and automated telephone systems. One revision, for instance, is to include a “safe harbor,” or suitable path of travel, in recreation facilities. But facilities that were built or altered in compliance with the 1991 standards would not have to be brought into compliance with the 2010 standards until the elements were subject to a planned alteration.

On the state level, the New York State Inclusive Recreation Resource Center has developed a tool that gathers information about the physical and social inclusiveness of recreation spaces and places. The goal of the assessment is not to seek compliance with the Americans with Disabilities Act but merely to describe facilities so that people with disabilities can determine whether they would be able to use a particular recreation site, according to the project coordinator, Laurie Penney McGee.

To date, more than 500 assessments have been conducted across the state in places like Planet Fitness, Gold’s Gym and various YMCAs, and the highly detailed information is available in an online database. Available information includes things like how high the registration counter is or how spacious locker rooms are.

“The problem is that when you say something is accessible, that means different things to different people,” McGee said. “So, if somebody uses a wheelchair, they might need a higher level of accessibility to someone who might use a cane, for example.”

The center runs an eight-hour course called Inclusive U that has so far has trained more than 1,000 students, recreation programmers and park and recreation professionals in New York and around the country. The students learn to assess places for inclusion and accessibility by gathering information about the physical environment and interviewing an administrator about the agency’s policies and procedures, McGee said.

“A lot of time places become more accessible because they just weren’t aware of all the things that they could do,” McGee said.

She added that places have incorporated simple changes after being assessed, such as changing the weight of a door or changing hinges on bathroom stalls so that doors swing outward instead of inward.

Another fitness facility following a mission similar to HOPEFitness is the Goodwill Fitness Center in Orange County, Calif. This 12,000-square-foot gym, for which the community raised $7 million, is stocked with completely adaptive equipment to service people with a broad range of disabilities. Many of the machines are built with seats that swing away so people who use a wheelchair can remain in their chair to do exercises. Members must have a medically diagnosable disability to work out at the Goodwill Fitness Center, and it is not open to the public.

Though HOPEFitness doesn’t have the funds for specialized equipment, it makes do with innovative staff members who develop exercise routines to suit all their clients’ needs. For instance, resistance elastic bands are used for upper-body workouts.

And there’s a certain charm about the grassroots effort behind HOPEFitness where birthdays are celebrated with 100-calorie snack packs, “Karaoke Night” is once a month, and the only two rules are to clean your hands (with the Purell hand sanitizer dispenser in the entranceway) and to have fun, according to Greenberg, who said he has gotten calls from people in all five boroughs, from New Jersey and one call from Kentucky asking when HOPEFitness will open up in their area.

“It’s all about the passion and the enthusiasm,” Greenberg said. “And all of our staff has the same passion, and I have fun with them. They leave with a smile on their face.”