DO THIS DAILY....RISK POOR HEALTH....Dr. Mercola

Seated Aerobic and Strength Training Exercises for Those with Limited Mobility

December 04, 2015

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By Dr. Mercola 

Sitting for extended periods of time is an independent risk factor for poor health. Even if you are very fit, sitting all day can increase your risk for disease. I often recommend that seniors safely incorporate some high-intensity exercise and strength training into their weekly regimen. 

I also strongly urge everyone — regardless of age and fitness level — to stand up and walk as much as possible, to avoid the health hazards associated with chronic sitting.

However, many are simply too old, frail, or disabled to even consider a high intensity program. Some cannot even stand. So what are the wheelchair bound supposed to do? Don't resign yourself to doing nothing! This article is for you.

I believe it's never too late to start exercising. My mother didn't start working out until she was 74 years old, and while she was initially hesitant, she now loves her workouts and has gained significant benefits in the years since. 

One Caveat — Don't Limit Yourself to Seated Exercises Unless You Have No Other Choice

It's important to begin with exercises suited to your current level of fitness and physical ability. Regardless of your starting point, you CAN improve.

At the end of this article, you'll find one inspiring example of a disabled veteran who went from being unable to walk unaided, to regaining full mobility and even being able to run.

If you're disabled or paralyzed, you have no choice but to do seated exercises. But most people can stand, and if you can, then that's what you need to do — as much as possible.

Recent studies show that standing greater than six hours a day reduces your risk of obesity by 30 percent and if you stand more than 12 hours a day it is reduced by 60 percent.

So let's be clear that these exercises are not a substitute for standing, provided you can stand. Unless you're wheelchair bound, consider low-impact exercises to start, such as Tai Chi, yoga, walking (which can incrementally be turned into a higher intensity exercise), and water workouts, for example.

That said, let's take a look at how you can get more movement into your life even if you're confined to a wheelchair, or otherwise severely limited in your ability to stand.

What Types of Exercises Are Recommended If You Have Limited Mobility?

For starters, what types of exercises can a person with limited mobility actually do? As noted in an excellent article¹ by HelpGuide.org, even those with severe restrictions in their mobility should consider incorporating the following types of exercises.

• Cardiovascular exercises. This includes any movement that raises your heart rate and increases endurance. If you cannot stand, water exercises can be an option.
But even if you're confined to a wheelchair, there are ways to get a cardiovascular workout. The video featured at the very end of this article shows just how active a wheelchair-bound person can be, provided you're not further restricted by age and frailness.
• Strength training exercises. This involves strengthening your muscles and bones using weights or other resistance-type exercises. Strength training is important for improving balance and stability.
If you have limited lower body mobility, you can still perform exercises to strengthen your upper body, including your core, back, arms, and shoulders. Provided you're not paralyzed, you can also strengthen your lower extremities with seated exercises.
• Flexibility exercises are important for range of motion, and can help reduce pain and stiffness. These may include stretching exercises, either seated or on the floor, and chair yoga. Tai Chi can also be modified and adapted to be done while seated.

If your mobility is limited due to extreme fatigue or a painful condition such as rheumatoid arthritis, please know that both aerobic and strength training exercises can be very helpful for such conditions.²

As noted in A Woman's Health:³

"Though patients may be concerned that exercise will encourage joint deterioration or cause increased pain, the experience of participants in one study reveals that exercise programs designed specifically for RA patients do not increase disease activity ...

[T]he information gathered to date shows that 'there is a proven direct benefit from exercise to joint health and an indirect benefit to patients related to cardiovascular, weight, and overall mental and physical health.'"

Basic Tips and Tools to Get You Started

Here are some basic tips and tools you'll need to perform the seated exercises featured in this article:

• A stable armless chair to sit in. Make sure it doesn't have wheels or slide easily, unless the exercise actually calls for a chair with wheels
• A resistance band, two Frisbee rings or small (child sized) hula hoops, and hand weights of suitable weight based on your current strength
• Optional items you may want if and when you're ready to increase the difficulty of the exercise: an exercise ball, wrist, and/or ankle weights
• Remember to maintain good posture throughout each exercise, and engage your core by imagining your sternum moving back towards your spine
• If you are frail and/or have poor balance, be sure to perform any and all exercises with supervision and/or assistance

Three 'Seated Dance' Workouts for Those with Limited Mobility

If you're wheelchair bound, be it due to age, obesity, injury, or illness, the key is to get as much of your body moving as possible.⁴

In a previous article,⁵ Beth Donovan lists a few fun aerobics exercises that helped her get moving when her 460-pound frame kept her from participating in many regular exercise activities. Her novel choices include:

1. Roller chair workout: For this exercise, you need an open, non-carpeted area, and a chair with wheels or casters. If you're in a wheelchair, it will do the job. Adding some music will make it more enjoyable. Here, all you need to do is to propel yourself around the area using your arms, legs, or both. Start at one minute, and build up.
2. Seated dancing: Select your favorite music. Sit on your bed, on a chair, or on an exercise ball (if your balance is sufficient). Here, the focus is on moving to the music in whatever way you can. Bounce up and down, wave your arms in the air, gyrate your hips, and tap your feet. To make it slightly more challenging, you can add wrist and/or ankle weights.
3. Hula hands and hips: For this, you need two Frisbee rings, small hula hoops, or Pilates rings. Place one ring around each wrist, and rotate your arms to make them spin in circles. To up the challenge, do this while sitting on an exercise ball, and rotate your hips in a figure eight pattern. Music, while optional, can make it more enjoyable.

Other Cardiovascular Chair Exercises

The three seated "dancing" exercises are examples of cardiovascular exercises that will raise your heart rate and build stamina. The video above demonstrates an entire aerobics routine, working both the upper and lower body while seated. Here are two additional suggestions not covered in that video:

• Seated high intensity resistance training: Resistance training actually offers cardiovascular benefits, so the following exercise is an excellent way to reap the benefits of high-intensity exercise even if you cannot stand up. Start by wrapping a lightweight resistance band under the seat of your chair. Holding each end, do a quick series of chest presses — flexing your arms at the elbow, pulling the band toward your shoulders.
You can start with 10 repetitions, and work your way up to about 30.
Next, do a forward press by placing the band around the back of your chair. Make sure the band is under your armpits. Again, holding the ends in your hands, sit tall, and remember to engage your abs. Start with your elbows at 90 degrees, with palms facing down. Push your arms straight out in front of you while squeezing your chest muscles. Avoid locking your elbows. Bring your arms back to starting position.
To increase the resistance, simply wrap the band around your hands to shorten it, or grasp it further back.
• Air-punching, with or without hand weights, is another simple cardio exercise that can be done either seated or standing. This exercise is also a good warm-up. Jab forward, alternating arms.
You want some speed here, so snap your arm forward as fast as you can, without fully extending your elbow joint, and then pull it back in as fast as you can. Do anywhere from 10 to 30 reps. Then, jab toward the ceiling, or as high as you can get if your upward range of motion is limited, for another 10 to 30 reps.

Three Seated Strength Training Exercises

There are as many seated strength training exercises for those with limited mobility as there are for able-bodied people. In most cases, the exercise needs only slight modification. For a list of seated strength training exercises, take a look at About.com's Seated Upper Body Workout page.⁶ It contains far more suggestions than I have room for here.

A YouTube search will also yield a number of videos demonstrating exercises for seniors and the disabled, or those unable to stand up. Here are but a few examples.

For the bicep curl, make sure you're using a weight that is appropriate for your current level of strength. If you're just starting out, a five pound dumbbell in each hand may be appropriate. You want the weight to be heavy enough that by the time you complete 10 to 12 reps, you feel like you can't keep going.

1. Sit with good posture in a chair (remember to engage your core by imagining your sternum moving back towards your spine, to stabilize your posture); one dumbbell in each hand, palms facing forward, shoulders relaxed, and elbows close to your body
2. Focusing on your bicep muscle, bend your arm at the elbows and lift the weights about ¾ of the way toward your shoulders. Avoid rotating your shoulders forward, and keep your elbows fixed at your side
3. Breathe out as you lift the weight, and breathe in as you lower them
4. Do 10 to 12 repetitions

While the bicep curl above strengthens the muscle on the front of your arm, tricep exercises focus on the backside of your upper arm — an area that tends to get flabby with age and lack of use. If either of these exercises hurt your elbows, then don't do them. As the triceps tend to be weaker than the biceps, you may want to use a lighter weight to start; maybe as light as two pounds instead of five.

1. Sit with good posture in a chair, holding a dumbbell in your right hand
2. Raise the dumbbell above your head, and stabilize your right arm by placing your left hand on your right elbow
3. Slowly bend your right elbow, lowering the dumbbell down behind your head
4. From that starting position, raise the weight toward the ceiling, and then gently lower it back down behind your head
5. Repeat 10 times, then switch arms

By strengthening your shoulders, you will improve your ability to perform most other arm movements. It can also help relieve shoulder pain. To perform an overhead dumbbell press:

• Sit with good posture; one dumbbell in each hand, with your elbows bent so the dumbbells are up by your shoulders, and palms facing forward
• From this starting position, press the dumbbells toward the ceiling and then lower back down to shoulder height. Breathe out as you raise the weights, and in as you lower them
• Repeat 10 to 12 times

An Inspirational Success Story

If limited mobility has you feeling down in the dumps, I urge you to watch this video, featuring Arthur Boorman, a disabled veteran of the Gulf War. His injuries had put him on a downward spiral for 15 years, and his doctors had told him he'd never be able to walk unassisted again.

Due to his injuries, his choices were limited when it came to exercise. But one day, he came across an article about yoga, and the rest, as they say, is history.

Not only did he rapidly start losing weight, he also gained tremendous strength, balance, and flexibility — to the point he proved his doctors' prognosis wrong by walking unaided in less than a year! Not only that, now he can RUN again. Interestingly, research⁷ shows that yoga has a beneficial impact on leptin, a hormone that plays a key role in regulating energy intake and energy expenditure, which may account for his remarkable weight loss.

It's Never Too Late to Start Exercising

Barring coma or full-body paralysis, virtually everyone can do something in terms of physical movement. So no matter where you're starting off, do start, and keep at it. One goal, depending on your situation, could be to regain your ability to stand for periods of time, and later, to walk increasing distances, as chronic sitting is associated with worsened health outcomes all around; from an increased risk of diabetes to a shortened lifespan.

But even if you're confined for a wheelchair for the rest of your life, there are lots of ways to get physically active. If you don't believe me, take a look at the following video, featuring wheelchair bound athletes practicing CrossFit Redefined, a version of CrossFit specifically aimed at those in wheelchairs.

As you can see, some of these paralyzed individuals are fitter than most able-bodied people! The take-home message is that as long as you do what you can, and keep pushing your limits little by little, you'll be amazed at how much you can improve.

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