Table 1 Staying UpRight exercises and progression principles
STRENGTH EXERCISES | |
Progression principles | |
Increase duration of static hold; increase repetition; increase number of sets; alter speed, distance moved, reduce hand support, move from sit to stand, decrease base of support (BoS) | |
Lower limb | Description |
Hip extension; abduction, flexion | - Stand up straight, engage core. Lower leg to floor after each movement |
Lunges | - Step forwards or sideways. Bend both knees and sink towards floor. Push up with both legs to return. Repeat with alternate leg initiating step |
Squats | - Standing behind chair, feet shoulder width apart, bend both knees and sink to the floor. Push up into standing. Progress by reducing hand support, increasing depth of squat, increasing speed |
Sit to stand | - Standing up from chair. Progress by reducing hand support, increasing speed |
Heel raises and toe raises | - Standing behind chair, lifting heels off the floor. Lifting toes off the floor. |
Upper limb | |
 Breaststroke | - Hands together in front of chest. Push arms forward, pull to side & back as if doing breaststroke |
 Shoulder press | - Hands at shoulder level, elevating arms to ceiling through flexion. Progress from seated to standing, increase speed |
 Biceps curl | - Elbow flexion |
 Triceps chair press up | - Hands on seat of chair, back straight. Push down through arms to lift bottom off seat. Slowly bend elbows and lower |
 Wall press | - Stand with hands on wall at shoulder height. Keep back & legs straight, bend elbows and lower body towards the wall. Straighten elbows and return to standing |
 Boxing | - Jabs: make a fist punch forward alternating left & right. Hooks: make a fist and punch across your body |
- Uppercuts: Make a fist and punch upwards from waist to chin. Progress from seated to standing, increase speed | |
Trunk | |
 Trunk flexion, extension, side flexion, rotation | - Progress from seated to standing |
BALANCE EXERCISES | |
Progression principles: static exercises | |
- Increase duration of static hold | |
Progression principles: dynamic exercises | |
- Increase or vary speed; require stop, start or change direction on command | |
Progression principles: all exercises | |
- Reduce hand support, BoS, visual input; add a cognitive task; combine exercises & progressions | |
Centre of gravity | Description |
Low level | - Stand with chair support both hands, one hand |
- Stand unsupported, arms by side | |
- Stand arms crossed | |
- Feet together; semi-tandem stance; tandem | |
- Arms to side; arms crossed | |
Medium level I | - Reduce BoS: feet together, move to semi-tandem stand |
- Reduce sensory input: eyes closed | |
- Add cognitive task: count backwards out loud | |
High level II | - Reduce BoS and add arm movements: unilateral to bilateral |
- Standing + throw & catch: reduce BoS + throw & catch | |
Weight transfer within limits of stability | |
 Low level | - Standing shift weight foot to foot |
- Standing move hips in circular figure of 8 patterns | |
- Marching | |
 Medium level II | - Nudge object on ground in different directions with foot; pass between feet and to neighbour |
 High level I | - Reduce BoS (feet together, semi-tandem, tandem) reach: turn & reach |
- Pass ball/object between group members; vary height & distance of reach | |
- Alternating top taps forwards, backwards, sideways, diagonally | |
Postural strategy: challenging limits of stability | |
 Low level | - Standing sway: forwards & return to midpoint. Repeat backwards/lateral directions |
- Standing pass object (newspaper, scarf) around body | |
 Medium level | - Standing sway forwards, backwards, sideways, diagonal without stopping at midpoint. Increase sway speed/distance |
- Squat and pass object between legs in figure of 8 pattern | |
 High level | - Standing sway eyes closed |
- Step forwards, backwards, sideways, lean & step; increase speed and step length | |
GAIT TRAINING | |
 Low level | - Step forwards, backwards, sideways, diagonally |
- Walk on spot/on toes/heels | |
- Turn clockwise/anticlockwise around chair | |
 High level II | - Tandem walk forwards/backwards |
- Step over obstacles | |
MULTISENSORY TRAINING | |
 Low level (sitting) | - Fix eyes on finger: follow moving finger keep head still |
- Fix eyes on point ahead, move head slowly side to side, up & down, diagonally | |
- Fix eyes on point ahead, move head slowly side to side, up & down, diagonally | |
- Sit unsupported with eyes closed | |
 Medium level II (standing) | - Stand still, eyes closed |
- Turn trunk in same direction as turning head & pass object to neighbour turning trunk in same direction as head. Swing arms/scarf with trunk & head whilst watching arms/scarf | |
 High level | - Reduced BoS. Fix eyes on finger & track moving finger, head still |
- Reduced BoS. Fix eyes on point & move head slowly side to side, up & down, diagonally keeping eyes fixed | |
- Reduced BoS, eyes closed | |