chair master-exercise-instructor-manual-with-pictures.pdf

7/27/2019 Chair Master-Exercise-Instructor-Manual-with-pictures.pdf

1/64

17280 Woodinville Redmond RD NE STE 800 Woodinville WA98072

Phone: (425) 402-4062 Fax: (425) 402-4063

www.ChairMaster.com

Exercise Instructor Manual

By Sabrena Merrill, M.S.

Produced for Cascade Health and Fitness


2/64

2


3/64

3

Table of Contents

Section I: State of the Nation Page 3

Overweight/Obese Population Page 4

Aging Population Page 6

Section II: The Importance of Physical Activity for Improved Healthin Older Adults

Page 8

Functional Training for Activities of Daily Living Page 8

Balance Training Page 10

Muscular Strength and Power Page 11

Cardiorespiratory Endurance Page 12

Flexibility Page 13

Biomechanical Considerations for the Older Adult Page 14

Section III: The ChairMaster Approach to Improving Health Page 16

ChairMaster Apparatus Page 16

Summary of Benefits of ChairMaster Exercise Page 17

Section IV: ChairMaster Exercise Program Design Page 19

Pre-exercise Precautions Page 19

Warm-up Techniques Page 20

Balance-training Guidelines Page 21

Functional Movement and Strength Training Page 25

Cardiorespiratory Exercise Page 30

Mobility/Flexibility Exercise Page 34

Putting It All Together Page 35

Section V: Sample ChairMaster Exercise Routines Page 37

Mobility Exercises Seated Without Using Bands Page 37

Strength Exercises Seated Without Using Bands Page 38Strength Exercise Seated With Bands Attached to Front, Low Rings Page 40

Strength Exercises Seated With Bands Attached to Back, High Rings Page 42

Strength Exercises Standing Behind Chair With Bands Attached to Back,High Rings

Page 43

Strength Exercises Standing Behind Chair With Bands Attached to Back,Low Rings

Page 45

Strength Exercises Standing Behind Chair Without Using Bands Page 48

Static Stretches Standing Behind Chair Page 49

Aerobic Exercises Page 52

Summary Page 52

References Page 54


4/64

4


5/64

5

SECTION I

STATE OF THE NATION

As advances in technology continue to eliminate the need for manual labor and promote

sedentary leisure-time activities, and as convenient food choices increasingly become

laden with higher calorie counts, the stage is set for a growing number of health

problems. These so called lifestyle-related diseases are typically chronic in nature and

tend to develop over many decades of associated lifestyle choices, such as physical

inactivity and diets high in empty, non-nutritious calories. Thus, many lifestyle-related

diseases can be addressed successfully by a combination of a sensible diet and a regular

exercise program.

The major diseases that plague modern productivity include cardiovascular disease

(CVD), diabetes, and overuse- and obesity-related musculoskeletal disorders such as

osteoarthritis and low-back pain. While genetic predisposition can lead to increased risk

of developing these diseases, it is obvious that lifestyle remains the single most

influential factor in the incidence of these diseases.

The ChairMaster, from Cascade Health and Fitness, is an effective tool in promoting a

healthy, physically active lifestyle. The design and ease of use of the ChairMaster

eliminates two common barriers for individuals who have struggled to start or maintain a

regular exercise program in the past: (1) inconvenience and (2) inappropriate intensity.


6/64

6

The ChairMasters unique design meets the specialty fitness needs of sedentary

individuals and older adults by combining a low-impact aerobic workout with resistance

training in a user-friendly seated workout. The ChairMaster includes a recumbent cycle

for aerobic conditioning, which folds out of site when not in use, and resistance bands for

muscular-fitness training. In addition, the ChairMaster is designed for functional

aesthetics in that it serves as a chair that can be used anywhere.

The ChairMaster is a convenient facility or home workout solution, as its design takes up

a small footprint (versus larger fitness equipment such as a treadmill) and it offers

exercise options for the following important components of fitness: muscular strength

and endurance, cardiorespiratory endurance, flexibility, and balance. The ChairMaster

ensures appropriate intensity by providing seated exercise that imparts low-impact

aerobic training along with smooth resistance without the use of heavy weights. These

options make the ChairMaster optimal for older individuals or those with health concerns

to achieve their fitness goals.

Overweight/Obese Population

One of the most pernicious conditions that impacts the development of chronic disease is

obesity. As such, the prevention and treatment of obesity are public health concerns that,

if successful, could reduce the risk for developing many chronic diseases that result in

reduced quality of life and disability. Due to the prevalence of inactive lifestyles and

increased caloric consumption in modern society, as well as genetic factors that may lead

to the excess accumulation of body fat, the incidence of overweight and obesity continues


7/64

7

to grow at an alarming rate. Obesity is defined as a body mass index (BMI) 30 kg/m2,

whereas overweight is classified as a BMI between 25 and 29.9 kg/m2. Together,

overweight and obesity affect more than 66% of the adult population in the United States,

which is a trend that has been rising for more than a century, with a substantial increase

noted in the past several decades (Ogden et al., 2006; Helmchen & Henderson, 2004).

Obesity is associated with many other adverse health conditions, including CVD, type 2

diabetes, and the metabolic syndrome(i.e., a cluster of factors associated with increased

risk for coronary heart disease and diabetesabdominal obesity, dyslipidemia, and

elevated levels of triglycerides, blood pressure, and fasting blood glucose) [National

Heart, Lung, and Blood Institute (NHLBI), 1998]. In addition, chronic obesity may lead

to functional impairment (Jensen, 2005)and reduced quality of life (Fontaine &

Barofsky, 2001), as well as to greater mortality (Fontaine et al., 2003). Fortunately, when

treatment is successful at producing small amounts of weight loss (even as little as 10

pounds), obese individuals experience many health benefits, including prevention of

disease (especially type 2 diabetes) (Knowler et al., 2002) and reduced mortality rate

(Bray, 2007). These factors, in combination with the estimated direct and indirect costs of

obesity-related conditions that exceed $117 billion in the United States annually, make

treating obesity a national healthcare concern (Stewart, 2001).

The basis for managing body weight is founded upon energy balance, which is influenced

by energy intake (i.e., caloric consumption) and energy expenditure. Physical activity and

structured exercise programs play an important role in weight management because they


8/64

8

contribute to long-term weight loss by facilitating energy expenditure. Overweight and

obese individuals can exhibit weight loss when they expend more daily calories on

average than they consume. When used regularly, the ChairMaster provides an effective,

low-impact, whole-body workout that offers a means to directly increase energy

expenditure through aerobic activity and promote enhanced muscle mass through

resistance training, which can help to increase calorie burning indirectly by enhancing

resting metabolic rate.

Aging Population

In the Centers for Disease Control and Prevention (CDC) report, The State of Aging and

Health in America 2007, the authors state that the combination of longer life spans and

aging baby boomers will result in the doubling of the population of Americans aged 65

years and older during the next 25 years. Consequently, by 2030, there will be 71 million

American older adults accounting for roughly 20% of the U.S. population (CDC, 2007).

Among older adults, chronic diseases and their associated health limitations are a major

problem that can reduce seniors health-related quality of life. These conditions can cause

years of pain, disability, and loss of function and independence. It has been reported that

approximately 80% of older Americans are living with at least one chronic condition, and

50% have at least two (CDC, 2003). Since life expectancy in the United States has risen

dramatically in the twentieth century, from about 47 years in 1900 to about 75 years for

males and 80 years for females in 2003, older adults are living for an extended period

with chronic ailments that tend to appear in the fourth decade of life (Arias, 2006).


9/64

9

Conditions such as CVD, cancer, diabetes, arthritis, and cognitive impairment are

challenges that many seniors must manage as they advance in age. Fortunately,

regardless of age and health limitations, older adults can expect to experience significant

physiological and psychological benefits from regular physical activity, such as the kind

of activity promoted by the ChairMaster exercise chair.

One of the most significant factors of quality of life for older adults is the ability to live

independently. The mobility and functioning of frail and very old adults can be improved

by regular physical activity. For midlife and older adults of all ages and abilities,

adopting regular physical activity as part of a healthy lifestyle may extend years of active

independent life, reduce or prevent chronic disease and disability, and improve overall

quality of life. Clearly, few factors contribute as much to successful aging as having a

physically active lifestyle.


10/64

10


11/64

11

SECTION II

THE IMPORTANCE OF PHYSICAL ACTIVITY FOR IMPROVED HEALTH IN

OLDER ADULTS

A wide variety of age-related changes occur simultaneously in different systems

throughout the body. Overall, the nervous, musculoskeletal, cardiovascular, and

respiratory systems experience decreased functioning as aging advances. The cumulative

effect of these changes, which include decreased balance, muscle strength, flexibility,

and cardiorespiratory endurance, results in a reduced ability to respond appropriately to

the stresses of everyday life. These declines in function highlight the importance of

adopting and maintaining a physically active lifestyle throughout the lifespan in order to

offset some of the known reductions in functional ability due to the natural aging process.

The ChairMaster is ideal in assisting older individuals maintain healthy, independent, and

active lifestyles through convenient, intensity-appropriate exercise.

Functional Training for Activities of Daily Living

Functional training may be described as exercise with a purpose. Purposeful exercise

entails any training movement performed with the intention of enhancing ones function,

whether it is in the area of sports performance, fitness development, occupational

performance, or activities of daily living (ADL). Through effective functional training,

older adults may be able to avoid, postpone, reduce, or even reverse the declines in

physical function associated with aging.


12/64

12

Optimal performance of movement requires that the bodys muscles work together to

produce force while simultaneously stabilizing the joints. Typically, individuals who

have weak stabilizer muscles (e.g., deep abdominals, hip stabilizers, and scapula

retractors) exhibit problems performing proper, efficient movement, which may lead to

pain and/or injury. Because individuals with pain or injury frequently have stabilizer

weakness, functional training is often incorporated into a rehabilitation and post-

rehabilitation training program, but this does not mean that functional training always

focuses on the bodys stabilizing musculature. Instead, functional training provides a

solid foundation that the participant can draw from when performing movements that

require the muscles and joints to move in a coordinated, efficient manner.

An example of a program that develops functional strength and flexibility is a

conditioning routine that incorporates squats, lunges, multidirectional reaches, and

overhead presses to enhance the performance of an older adults everyday activities.

Squatting and lunging are essential to human movement, as these tasks are required to

stand up from a chair or stoop down to pick up a pair of shoes. Multidirectional reaches

(i.e., reaching one or both arms in front of, to the side of, or behind the body) are

important for training balance and postural control during dynamic activities that may

place a persons center of gravity (COG) outside the typical position between the feet

during standing. Unilateral or bilateral overhead shoulder presses are tied closely to

function in older adults because age-associated declines in upper-body strength often

make the simplest tasks, such as putting away groceries on a top shelf, a substantial


13/64

13

effort. The ChairMaster allows an individual to practice all of these functional

movements, and more, as part of a comprehensive physical-activity program.

To improve function and help counteract the diminished function of body systems that

coincide with aging, a program of regular physical activity that includes modes of

training that challenge the various systems is appropriate. In the sections that follow,

information is provided that supports the concept of functional training in which exercise

is performed with the intent of improving daily function.

Balance Training

As adults mature and advance into old age, the constant pull of gravity on their upright

postures begins to take its toll. Balance becomes more difficult, the chance of falling

increases, and the quick, youthful actions of jogging, running, and jumping are replaced

with walking. Maintaining an adequate sense of balance into old age is crucial for

preventing trips and falls in the last decades of life. The goal of a balance-training

program is to increase an older adults capacity to perform ADL (e.g., reaching for,

picking up, and carrying objects; performing household tasks; and reacting to obstacles in

the environment).

Appropriate balance-training progressions include starting in a seated position, then

transitioning to a standing posture with different foot placements, followed by standing

on a compliant surface (such as a foam balance pad). The ChairMaster allows all of these

progressions to be performed in a safe and effective manner.


14/64

14

Muscular Strength and Power

Similar to maintaining balance capabilities, maintaining a minimum amount of muscular

strength and endurance is essential for the performance of a variety of ADL. Carrying

groceries, lifting boxes, climbing stairs, and rising from a chair all require a certain level

of muscular function. Both muscular strength and endurance tend to decrease with age.

Loss in muscle function is likely due to the muscle atrophy that accounts for a significant

decrease in lean mass with aging. In sedentary individuals, it is estimated that muscle

mass declines 22% for women and 23% for men between the ages of 30 and 70 [National

Institutes of Health (NIH), 2006]. Muscle atrophy that occurs as a natural part of the

aging process is called sarcopenia and reflects a decrease in both the average fiber size

and the number of muscle fibers. Since the amount of force an individual can produce

depends, in part, on the amount of working muscle mass, sarcopenia has a dramatic

negative effect on strength.

Age-related decreases in muscular strength, particularly in the lower body, are associated

with a decreased ability to maintain balance, walk, prevent falls, and move quickly (i.e.,

produce muscular power). In addition, muscle strength of the lower body declines more

quickly with age than does muscle strength of the upper body. Furthermore, isometric

strength appears to be maintained better than dynamic strength, and strength during

eccentric, lengthening contractions is better maintained in the elderly than strength during

concentric, shortening contractions. As a result, many older adults find it easier to lower


15/64

15

themselves into a chair, which requires a lengthening contraction of the quadriceps, than

to rise from a chair, which requires a shortening contraction of these same muscles.

The ChairMaster provides opportunities to increase muscular fitness through the use of

elastic resistance bands that easily attach to specific rigging points on the frame. The

resistance bands offer various intensities and come equipped with handles and strap-on

cuffs appropriate for working the upper and lower extremities. Furthermore, the frame of

the ChairMaster acts as a safe, sturdy prop for assisting exercisers during the

performance of body-weight resistance movements (e.g., sit-to-stand squats, one-legged

squats, lunges, and incline push-ups).

Cardiorespiratory Endurance

Maximal oxygen consumption (VO2max) declines, on average, by about 1% each year of

a sedentary adults life. It also declines in masters athletes and individuals who have been

physically active throughout their lives, but to a lesser extent. Typically, by the age of 65,

aerobic power is 30 to 40% less than that of a young adult (Shepard, 1987). Possible

reasons for age-related decreases in VO2max include a reduction in maximum heart rate

with advancing age, decreases in muscle tissue and its ability to use oxygen, and a

diminished ability to redirect blood flow from organs to working muscles (Spirduso,

Francis, & MacRae, 2005).

The decline in aerobic capacity that occurs with aging tends to accelerate from ages 65 to

75 and again from 75 to 85. Very low aerobic capacity leads to constant fatigue in older


16/64

16

adults, especially the frail elderly. The functioning of the structures responsible for

oxygen delivery and utilization in many low-fit older adults falls below the minimum

necessary to maintain an independent lifestyle. Thus, many 65-year-old sedentary people

are dangerously close to becoming disabled (Shepard, 1987). Fortunately, regular

physical activity can increase functional capacity and stamina and prevent or correct

many of the fatigue-related problems of the elderly. Similar to young adults, older adults

can elicit 10 to 30% increases in VO2max with prolonged endurance exercise training.

Flexibility

Decreased flexibility is another important issue for older adults. The elasticity and

compliance of connective tissue is altered with aging. As muscle fibers atrophy, they are

replaced by fatty and fibrous (collagen) tissue. Collagen is a primary component of

connective tissue that exhibits a low compliance, which contributes to the stiffening and

decreased mobility of aging muscle. Additionally, a significant loss (up to 15%) of body

water between the ages of 30 and 80 contributes to increased stiffness in soft tissues

[American Council on Exercise (ACE), 2005]. Collectively, these changes appear to be

partly responsible for flexibility loss due to aging. However, it is possible that the

reduction in range of motion (ROM) is due, in part, to lack of physical activity, since not

all older adults lose flexibility at the same rate.

With advancing age, any loss of ROM impairs most functions needed for good mobility.

Maintaining lower-body flexibility is vital for preventing low-back pain, musculoskeletal

injury, and gait abnormalities, and in reducing the risk of falling. Limited ROM in the


17/64

17

shoulder girdle has been associated with pain and postural instability. Both upper- and

lower-body flexibility decrease with age, but can be improved through stretching.

The ChairMaster is ideal for individuals with limited mobility as a tool to develop

healthy ROM in joints with limited flexibility. Performing muscle-conditioning exercises

using the resistance bands on the ChairMaster, as well as practicing specific stretches

while seated on or standing near the ChairMaster, will serve to enhance flexibility at all

the major joints throughout the body.

Biomechanical Considerations for the Older Adult

The prevalence of musculoskeletal pain and joint alterations in the aging population is

remarkably high. About half of persons age 65 and older are affected by osteoarthritis

(American Geriatrics Society, 2001), approximately half of adults age 80 and older

experience sarcopenia (Baumgartner et al., 1998), and 55% of Americans age 50 and

older have osteopenia or osteoporosis (National Osteoporosis Foundation, 2008).

Decreased range of motion and loss of spinal flexibility in many older adults results in a

stooped posture that is associated with a vertical displacement of the COG backward

toward the heels. This change in postural alignment can lead to lowered self-confidence,

faulty balance, and an increased risk for falls. These and other musculoskeletal conditions

impart varying levels of discomfort and disability to older adults. Thus, an important

exercise consideration for this population is to ensure that physical activity is as

comfortable as possible for the older person. The ChairMaster accomplishes this goal by

providing an ergonomically designed seat and reclining backrest that accommodates


18/64

18

exercisers of all shapes and sizes. In addition, the resistance bands are equipped with

comfortable handles and cushioned cuffs to allow for various handgrips and attachment

sites on the limbs.

Chair-seated Exercise

Older individuals who have issues related to endurance, mobility, and self-efficacy may

find that a chair-seated exercise routine is one of the only types of physical activity that is

tolerable and even enjoyable. For the frailest older-adult populations, seated exercise may

be the only practical method.

During chair exercise, participants who have challenges with stability and proper posture

should sit with their backs supported by the backrest of the chair. If, due to his or her

body proportions, an individuals back does not contact the backrest of the ChairMaster,

the ChairMaster support pad can be placed between the exerciser and the backrest to

ensure adequate lumbar support during exercise. Additionally, the participants feet

should be in full contact with the floor (when not using the pedals), which, if necessary,

can also be facilitated by using the ChairMaster support pad between the exerciser and

backrest to effectively shorten the distance between the edge of the seat and the backrest,

allowing the users knees to line up properly with the edge of the seat. Another option for

individuals who have good functional strength while standing, but who have balance and

stability problems and/or a fear of falling, is to include standing work behind the chair,

using the back of the chair for support.


19/64

19

SECTION III

THE CHAIRMASTER APPROACH TO IMPROVING HEALTH

The ChairMaster is an excellent mode of exercise for overweight or deconditioned

individuals in that it provides for light resistance training, low-intensity aerobic exercise,

and simple stretching. The ChairMaster is designed to conveniently fit in any setting and

built to deliver a rewarding workout. Attractive and cordless, it can be positioned

anywhere for maximum enjoyment. The ChairMaster is a comfortable chair, recumbent

bike, strength-training device, and stretching station, all built into one compact unit.

ChairMaster Apparatus

The ChairMaster was designed to be an unobtrusive and attractive addition to any facility

or home. Its small profile and quiet drive mechanism allows the chair to be situated and

used in almost any location with a minimum of disruption. The chosen location for the

ChairMaster should provide adequate room for the equipment while it is in use and

should be in an appealing setting that will encourage its use (e.g., a main living area or

nearby a regularly watched television). The physical dimensions of the assembled chair

are listed below:

Length: 27 inches (68.6 cm) Width: 28.5 inches (72.4 cm) Height: 40 inches (101.6 cm)


20/64

20

Some of the unique features of the ChairMaster include:

Recumbent pedaling unit that stows under the seat. When the recumbent unit isout, there is no step-over height, which makes it easy to use

Contour-fitting backrest for maximum support Small footprint (see the chair dimensions listed above) Reclining backrest that allows for a variety of positions Five levels of pedaling resistance Ratchet-style pedal straps for a more secure and comfortable positioning of the

foot

Three sets of elastic resistance bands, with each set varying in length for optimalfunction

Sturdiness and stability: The chair can be held onto during standing strengtheningand stretching exercises without fear of tipping over

Summary of Benefits of ChairMaster Exercise

The following list outlines the many benefits of using the ChairMaster as a primary form

of exercise:

The ChairMasters unique design meets the specialty fitness needs of sedentaryindividuals and older adults by combining a low-impact aerobic workout with

resistance training in a user-friendly seated workout.

When used regularly, the ChairMaster provides an effective mode of exercise thatdirectly and indirectly increases energy expenditure.


21/64

21

Older, overweight/obese, and/or deconditioned individuals can experiencephysiological and psychological benefits from consistently performing

ChairMaster exercise, regardless of age and health limitations.

The ChairMaster allows an exerciser to practice several functional movementpatterns as part of a comprehensive physical-activity program, which is ideal in

helping older individuals maintain healthy, independent, and active lifestyles.

The ChairMaster provides opportunities to increase muscular fitness through theuse of resistance bands that easily attach to specific rigging points on the frame.

The ChairMaster offers non-impact aerobic exercise through seated pedaling, andlow-impact, weightbearing exercise via step-ups while standing behind and

holding onto the chair.

The ChairMaster is ideal for individuals with mobility restrictions to use as a toolfor developing healthy ROM in joints with limited flexibility.

The ChairMaster is designed for comfort by providing an ergonomically designedseat and reclining backrest that accommodates exercisers of all shapes and sizes.

In addition, the resistance bands are equipped with comfortable handles and

cushioned cuffs to allow for various handgrips and attachment sites on the limbs.


22/64

22


23/64

23

SECTION IV

CHAIRMASTER EXERCISE PROGRAM DESIGN

Safe and effective exercise programming for older, overweight/obese, and/or

deconditioned adults is based on addressing their specific health and fitness needs

without exposing them to unnecessary risks. This can be accomplished by providing a

conservative exercise stimulus initially, and then progressing to more challenging

exercise bouts as participants become more conditioned. Exercisers using the

ChairMaster should be encouraged to develop cardiorespiratory endurance, muscular

strength and endurance, and flexibility, along with a special emphasis on balance. The

following sections present guidelines for safe and effective exercise programming using

the ChairMaster.

Pre-exercise Precautions

To ensure that older and deconditioned individuals are medically safe to exercise, they

should first see a physician and undergo a physical examination and evaluation before a

physical-activity program is initiated. The extent of the evaluation depends on an

individuals age, health status, and the strenuousness of the anticipated exercise regimen.

Men over age 45, women over age 55, and all individuals at moderate-to-high risk (i.e.,

individuals with two or more coronary risk factors, one or more signs/symptoms listed in

Table 1, or with known cardiovascular, pulmonary, or metabolic diseases) are strongly

encouraged to undergo a medically supervised, graded exercise test, especially if

vigorous exercise is contemplated [American College of Sports Medicine (ACSM),

2010].


24/64

24

Table 1: Major Signs or Symptoms Suggestive of Cardiovascular and Pulmonary

Disease*

Pain, discomfort (or other anginal equivalents) in the chest, neck, jaw, arms, andother areas that may be due to myocardial ischemia

Shortness of breath at rest or with mild exertion Dizziness or syncope (fainting) Orthopnea or paroxysmal nocturnal dyspnea (difficult or labored breathing) Ankle edema (swelling) Palpitations or tachycardia (elevated heart rate) Intermittent, severe leg pain (claudication) Known heart murmur Unusual fatigue or shortness of breath with usual activities

*Adapted from American College of Sports Medicine (2010).ACSMs Guidelines forExercise Testing and Prescription (8th ed.). Philadelphia, Pa.: Wolters Kluwer/LippincottWilliams & Wilkins.

Warm-up Techniques

For older or deconditioned participants, transitioning from a resting state to moderate or

vigorous physical activity requires more time than it does for a younger or more fit

person. Similarly, the time it takes to return to the resting state after exercise is longer.

Accordingly, warm-up periods of approximately 10 to 15 minutes are recommended for

this population.

The warm-up should gradually prepare the body for movements that will be required

during the workout. Each of the major joints and muscle groups should be gently

engaged using continuous rhythmic movements that mimic the more intense exercises

that will be performed. For example, if an overhead shoulder press with the ChairMaster

bands is part of the exercise routine, the warm-up can include overhead shoulder presses

without using any resistance. Furthermore, proper body alignment and ideal posture


25/64

25

should be emphasized. Table 2 lists some practical ChairMaster warm-up techniques that

are safe and effective for older or deconditioned exercisers.

Table 2: ChairMaster Warm-up Techniques

Seated

Slow, non-strenuous pedaling

Rhythmic, limbering exercises working through a full, pain-free range ofmotion

Neck rotation Shoulder rolls backward and forward Multidirectional arm reaches Arm circles backward and forward Spine rotation Side bend Marching

Standing

Easy-paced marching behind the chair, holding onto the back of the chair forbalance

Easy-paced walking around the chair in one direction and then the oppositedirectionEasy-paced step-ups standing behind the chair, holding onto the back of thechair for support

Balance-training Guidelines

The ultimate goal of a balance-training program is to increase a persons capacity to

perform ADL. Older adults and deconditioned individuals can incorporate balance-

training activities at the beginning of their exercise sessions or they may choose to

perform a series of balance exercises on separate days apart from other types of training.

A frequency of two to three nonconsecutive days per week is adequate for enhancing

balance through training. However, fundamental balance principles can be applied on a


26/64

26

daily basis as individuals transfer what they learn from their balance-training exercises to

the functions of daily living.

Center of gravity (COG), or the area of the body wherein all the forces acting upon it are

balanced and equal, is an important concept in balance training. While the location of

COG varies from one person to the next, it is typically found just above the pelvis in a

standing posture. When participants develop an increased awareness of COG, they are

able to maintain a better upright position during sitting and standing, lean away from and

return to the midline with more postural control, and move through space more quickly

and confidently. Activities that enhance COG awareness are performed seated, standing,

or while moving. Different levels of balance challenge can be added by manipulating the

type of support surface used during exercise and reducing or eliminating visual feedback.

Balance-training Progressions

An introductory seated balance exercise involves having the exerciser sit in the

ChairMaster with back support while keeping the feet flat on the floor. The participant

should practice sitting with the back against the chair and maintaining correct posture

(Table 3). Have the participant hold the position for 15 seconds while breathing normally

and relaxing the rest of the body. Individuals who are unable to achieve correct sitting

posture while seated on a stable surface are not ready to progress to a more difficult

seated balance challenge.


27/64

27

If a participant successfully completes the introductory seated posture exercise, he or she

is ready to try the same exercise in an unsupported sitting position. The individual should

attempt to hold correct posture for 30 seconds with the eyes focused forward on a visual

target. Next, the exercise can be repeated with the eyes closed. Finally, for added balance

challenges, the exerciser can add arm and leg movements while focusing on maintaining

a correct seated posture.

Introductory-level standing-balance activities teach participants how to maintain correct

standing posture while performing various tasks. To begin, exercisers should check their

standing postures (Table 3). Have the participant hold the position for 15 seconds while

breathing normally and relaxing the rest of the body.

Table 3: Characteristics of Ideal Seated and Standing Postures

Ideal Seated Posture

Eyes focused forward on a target

Chin gently pulled back Ears directly above the shoulders Shoulders placed slightly back and down Abdominal muscles gently pulled up and in Feet resting flat on the floor

Ideal Standing Posture

Eyes focused forward on a target Chin gently pulled back Ears directly above the shoulders Shoulders placed slightly back and down Abdominal muscles gently pulled up and in Hips level Kneecaps facing forward Ankles and feet in neutral alignment (facing forward) Weight evenly distributed on both feet


28/64

28

Next, the participant should attempt to close his or her eyes for 15 seconds and

concentrate on the feeling of standing correctly. To progress the standing-balance

activities, the base of support can be altered so that subtle shifts of COG are required to

maintain an upright posture. A typical altered base-of-support challenge starts with the

individual standing with the feet together, holding the position for 15 to 30 seconds. The

same exercise is repeated with the eyes closed. Next, the exerciser moves the feet to a

tandem position (front foot ahead of the rear foot with a small space between the feet)

and holds for 15 to 30 seconds. The same exercise is repeated with the eyes closed.

Finally, the participant adopts a single-leg stance and holds the position for 15 to 30

seconds. The same exercise is repeated with the eyes closed. Other ways to manipulate

the balance challenge during standing exercises are to alter the position of the arms or

change the support surface beneath the feet (e.g., ChairMaster foam pad). Table 4

presents a summary of guidelines for balance training.

Table 4: Summary of Guidelines for Balance Training

Training Variables

23 times per week

Perform exercises toward the beginning of workouts beforethe onset of fatigue (which decreases concentration)

Perform 1 set of 24 repetitions, each for 1530 seconds

Training Progressions

Base of support progresses from wide to narrow (e.g.,standing with the feet shoulder-width apart to standing with

the feet together)Small movements of the limbs progress to large movements(e.g., small arm reaches to large arm reaches with a bodylean)

Movement of the body progress from static to dynamic (e.g.,standing to squatting or lunging)


29/64

29

Functional Movement and Strength Training

Optimal performance of movement requires that the bodys muscles work together to

produce force while simultaneously stabilizing the joints. Typically, people who have

weak stabilizer muscles (e.g., deep abdominals, hip stabilizers, and scapula retractors)

exhibit problems performing proper, efficient movement, which may lead to pain and/or

injury. Because individuals with pain or injury frequently have stabilizer weakness,

functional training is often incorporated into a rehabilitation and post-rehabilitation

training program, but this does not mean that functional training always focuses on the

bodys stabilizing musculature. Instead, functional training provides a solid foundation

that the exerciser can draw from when performing movements that require the muscles

and joints to move in a coordinated, efficient manner.

Kinetic Chain

A biomechanical concept that is used commonly in functional training is the idea that the

bodys joints make up a kinetic chain, where each joint represents a link in the chain.

Drawing on this principle, exercises may be described as either open- or closed-chain

movements. In a closed-chain movement, the end of the chain furthest from the body is

fixed, such as in the performance of a squat where the feet are fixed on the ground and

the rest of the leg chain (i.e., ankles, knees, and hips) moves. In an open-chain exercise,

the end of the chain furthest from the body is free, such as in the performance of a seated

leg extension.


30/64

30

Closed-chain exercises tend to emphasize compression of joints, which helps stabilize the

joint, whereas open-chain exercises tend to involve more shearing forces at the joints.

Furthermore, closed-chain exercises involve more muscles and joints than open-chain

exercises, which results in better neuromuscular coordination and overall stability at the

joints. Because both open- and closed-chain activities are required for typical ADL,

incorporating both types of activities is an integral part of the ChairMaster exercise

program.

An example of a program that develops functional strength through both open- and

closed-chain activities is a conditioning routine that incorporates squats, lunges,

multidirectional reaches, and overhead presses. Squatting and lunging are essential to

human movement, as these tasks are required to stand up from a chair or stoop down to

pick up a pair of shoes. Multidirectional reaches (i.e., reaching one or both arms in front

of, to the side of, or behind the body) are important for training balance and postural

control during dynamic activities that may place a persons COG outside the typical

position between the feet during standing. Unilateral or bilateral overhead shoulder

presses are tied closely to function in older adults because age-associated declines in

upper-body strength often make the simplest tasks, such as putting away groceries on a

top shelf, a substantial effort.

Primary Movement Patterns

Human movement can essentially be broken down into five primary movement patterns

that encompass all ADL. Movements can be as simple as one primary movement or as


31/64

31

complex as the integration of several of them into a single motion. The five primary

patterns are as follows:

Bend-and-lift movements (e.g., squatting) Single-leg movements (e.g., single-leg stance and lunging) Pushing movements (primarily in the vertical/horizontal planes) Pulling movements (primarily in the vertical/horizontal planes) Rotational (spiral) movements

In essence, if a person can perform these five primary movements effectively, it improves

his or her potential for efficient movement and decreases the likelihood for

compensation, pain, or injury. When the five primary movements can be performed with

proper form, external resistance may be applied for progressive strength development. It

is essential that the external loads are increased gradually so that correct movement

patterns are not altered during the exercise performance. The ChairMaster exercise

program promotes the practice of the five primary movement patterns and allows for

progression to develop strength via the ChairMaster bands and body-weight exercises

(Table 5).

Table 5: Sample ChairMaster Exercises Based on Primary Movements

Primary Movement Exercise Examples

Bend-and-lift pattern Sit-to-stand squatBody-weight squat standing behind chair

Single-leg pattern Single-leg squat behind the chair

Single-leg abduction behind the chair with ChairMaster bandPushing pattern Seated overhead press with ChairMaster bands

Seated chest press with ChairMaster bands

Pulling pattern Seated biceps curl with ChairMaster bandsBack row standing behind chair with ChairMaster bands

Rotation pattern Seated spine rotationSpine rotation standing behind chair with ChairMaster band


32/64

32

Strength Training

The acronym FIRST may be used to designate the five key components of strength-

training program design: frequency, intensity, repetitions, sets, and type of exercise

(Table 6). During the initial weeks of resistance training, motor learning plays a major

role in the desired physical development and movement patterns. Consequently, during

this training period, exercise repetition should be emphasized over exercise intensity.

Frequency: Beginning exercisers experience excellent results by strength trainingtwo to three days per week.

Intensity: Due to the emphasis on proper movement patterns, the training intensity

is lower during the initial phase. Start with the light ChairMaster bands that allow

participants to learn proper movement techniques and then progress to the more

challenging ChairMaster bands.

Repetitions: The number of repetitions performed varies inversely with theintensity of the exercise set. That is, fewer repetitions can be performed with a

higher resistance and more repetitions can be completed with a lower resistance.

Beginners should focus on lower training intensity to permit more repetitions in

each exercise set. Furthermore, light resistance allows for proper movement

patterns to be learned. Generally, if the resistance does not permit at least 12

repetitions, it should be reduced. In the case of the ChairMaster bands, if the

lightest band resistance prohibits the completion of 12 repetitions, the exercise

movement can be performed without any external resistance until the exerciser

becomes strong enough to tolerate the light bands. When 16 repetitions can be


33/64

33

properly performed, the exerciser should consider increasing the resistance to the

next level of resistance of the ChairMaster bands.

Sets: One set of resistance exercise can be as effective as multiple training sets,especially for beginning exercisers. For initial workouts, one set of each exercise

is certainly a good starting point. As training progresses, more sets of each

exercise may be performed as determined by the participants desire to do so.

When the participant demonstrates consistent adherence and initial adaptations to

a single-set program, the volume of sets can increase.

Type: The type of exercise should be selected to help the exerciser learn and

improve movement patterns with respect to his or her muscular fitness and

strength-training experience. Participants with less muscle strength and training

experience should begin with basic exercises performed with light or no external

resistance and relatively stable conditions. Once a participant demonstrates

progress with motor control and muscular strength, he or she can begin

performing ground-based standing exercises that emphasize muscle integration.

Table 6: Summary of ChairMaster Resistance-training Guidelines

Frequency Intensity Repetitions Sets Type

23 daysper week

Light ChairMasterbands, graduallyincreasing to

moderate bands astolerated

1215 Minimum of 1,progressing to 2or 3 as desired

ChairMasterbands and body-weight exercises


34/64

34

Cardiorespiratory Exercise

Cardiorespiratory, or aerobic, exercise for older individuals should focus on a variety of

non-impact modalities (such as pedaling while seated on the ChairMaster) and low-

impact weightbearing formats (such as step-ups performed standing behind the

ChairMaster). For inactive individuals, 30 minutes of these types of activities most days

of the week is sufficient for enhancing health and well-being. For deconditioned

individuals, 30 minutes of exercise may be accumulated in shorter bouts throughout the

day (e.g., 10-minute sessions, three times a day). Gradually increasing aerobic exercise

intensity and duration is an appropriate goal for those who want increased body-fat

reduction and improved cardiovascular fitness. Table 7 summarizes general aerobic-

activity guidelines for use with the ChairMaster.

Table 7: Summary of ChairMaster Aerobic-activity Guidelines

Frequency Intensity Time Type

57 days per week Light to moderate 30 minutes or more,which can beaccumulated in short,10-minute bouts

ChairMasterpedaling or step-upsbehind chair

Aerobic Exercise for Weight Loss

For overweight or obese individuals, experts recommend a weekly energy expenditure of

2,000 calories per week, which equates to approximately 6090 minutes per day of

moderate-intensity physical activity, for long-term weight loss [U.S. Department of

Agriculture, 2010; ACSM, 2009; Sarris et al., 2003]. The basis for these

recommendations is also supported by the National Weight Control Registry (NWCR), a

cohort of approximately 10,000 successful losers who have lost an average of 66


35/64

35

pounds and maintained this loss for approximately 5.5 years. The NWCR found that

while dietary control was an important factor in the maintenance of weight loss, one of

the most significant findings was that successful losers maintained consistently high daily

physical-activity levels. In fact, 90% of the NCWR subjects exercise, on average, about 1

hour per day and 62% report watching fewer than 10 hours of television per week

(NCWR, 2012).

The amount of physical activity suggested for weight loss and prevention of weight

regain in overweight and obese individuals is clearly greater than that recommended for

public health improvement for the average person. For improved health, a minimum of

150 minutes of physical activity per week, or 30 minutes of physical activity on most

days of the week is advised (U.S. Department of Health & Human Services, 2008;

Haskell et al., 2007). However, for obese individuals, a progression to approximately 250

to 300 minutes of physical activity per week, or 50 to 60 minutes five days each week,

may be necessary for long-term weight loss success. In some cases, 60 to 90 minutes of

daily exercise may be required (Zoeller, 2007).

The primary mode of initial activity to facilitate weight loss is aerobic exercise. Aerobic

conditioning maximizes caloric expenditure in individuals who have obesity or are new

to exercise, and reduces the risk of chronic disease associated with obesity (e.g., CVD,

type 2 diabetes, and the metabolic syndrome). Because the intensity of aerobic exercise is

an important variable related to its effectiveness in improving health and promoting


36/64

36

weight loss, individuals using the ChairMaster cycling option should have a basic

understanding of how hard they should be working.

Monitoring Aerobic Exercise Intensity

An intensity-monitoring technique called the talk test takes into account an exercisers

ability to breathe and talk during a workout. If a person can comfortably answer a

question during exercise while still feeling like he or she is getting a good workout, it is

likely that the activity being performed is appropriate for cardiorespiratory conditioning.

The talk test is especially useful for beginners who are learning to pace themselves by

monitoring their bodily responses to exercise.

An exerciser on the ChairMaster can take the talk test by simply answering questions

while exercising. Ideally, the responses of the participants should be in the form of

sentences, rather than one-word statements, such as fine or okay. For example, a

participant could be asked to describe how he or she is feeling and the participant could

respond by saying, I feel like Im working pretty hard. If the exerciser can string those

words together in a sentence without stopping and gasping for air, he or she is probably

working at an appropriate intensity. On the other hand, if the participant has a hard time

talking or breathing, it is an indication that the exercise intensity is too difficult and he or

she should be coached to slow down and resume at an intensity that is light to

somewhat hard. This level of intensity corresponds well with light- to moderate-

intensity aerobic exercise as recommended for improvements in health and weight loss.


37/64

37

Benefits of the ChairMaster on Aerobic-exercise Adherence

Regardless of the reasons people have for engaging in physical activity, a ubiquitous

barrier to committing to a regular program of exercise is lack of time. Add to this the

inconvenience and cost of going to a fitness facility, and it is easy to see why many

people shy away from physical activity. The ChairMaster eliminates these obstacles and

provides a simple method for engaging in regular exercise. In fact, the ChairMaster

allows the exerciser to sit in a comfortable chair and watch television or read, all while

pedaling for aerobic exercise. ChairMaster users can do a leisure activity, such as watch

their favorite program, while simultaneously getting fit. In other words, they can sit and

get fit. Since the ChairMaster doubles as a functional piece of furniture, it can be left out

in the open as a regular chair when not in use, which eliminates the need to move a piece

of exercise equipment before and after working out.

As described above, the added convenience and ease of use of the ChairMaster

effectively removes common barriers to exercise, which enhances the likelihood of

sticking with a physical-activity program. These adherence-promoting benefits of the

ChairMaster could make the difference between a workout program that is tried and

quickly dropped and one that is performed regularly and improves the health of the

exerciser.


38/64

38

Mobility/Flexibility Exercise

Physical inactivity is a major contributor to decreases in flexibility, such that physically

inactive individuals tend to be less flexible than active individuals. Furthermore, regular

exercise improves flexibility. Disuse as a result of physical inactivity or immobilization

leads to contraction and shortening of the connective tissues, restricting joint mobility.

Similarly, using the joints and muscles in repetitive activity patterns or maintaining

habitual poor body postures can inhibit ROM because of the shortening and tightening of

the muscle tissue. A physical-activity program using the ChairMaster offers the

participant methods to improve mobility and ROM through dynamic and static flexibility

exercises.

Dynamic mobility exercises that gently take the joints through their appropriate ROM

can be performed in the warm-up segment of any workout. As discussed previously in

the Warm-up Techniques section, continuous rhythmic movements that mimic the more

intense exercises that will be performed during the workout can be used not only to warm

up the muscles, but also to improve ROM in the joints. At the conclusion of an exercise

session, static stretching techniques (e.g., holding a stretch position for 15 to 60 seconds)

can be used to develop lasting increases in flexibility. It is important to stretch the muscle

groups that have been used in the exercise activity as well as muscles that are commonly

tight. It is also important that stretching be comfortable for the participant. Proper form

can be encouraged by using cues such as move to the position where you can feel gentle

tension, then hold; your muscles should notfeel like a rubber band ready to snap; find a


39/64

39

comfortable stretch and hold; if you are shaking, then back off the intensity of the

stretch.

A flexibility program for older adults and deconditioned individuals should include a

consistent routine of stretches for the important postural muscles of the chest, trunk, hips,

and thighs. At minimum, stretching is recommended two to three days per week, but can

be performed up to seven days per week (ACSM, 2010). A daily flexibility program

performed after an appropriate warm-up or at the conclusion of a training session

consisting of static stretches for the whole body can go a long way toward enhancing

flexibility. Table 8 presents a summary of stretching guidelines for use with the

ChairMaster.

Table 8: Summary of ChairMaster Stretching Guidelines

Frequency Intensity Time Type

57 days per week Light to moderate;feels like a goodstretch, but does notprovoke pain

Minimum of 510minutes; holdingstatic stretches for 1560 seconds for 24sets

Mobility work in thewarm-up and staticstretching after theworkout;Seated in theChairMaster orstanding behind oralongside the chair

Putting It All Together

Once an exercisers goals are determined, an exercise session format can be developed.

For example, if the primary goal is to improve cardiorespiratory endurance, an aerobic-

only workout can be implemented. On the other hand, if a person wants to increase both

strength and cardiorespiratory performance, the workout format should focus on both of


40/64

40

those variables of fitness within the session. Table 9 presents examples of various

workout formats.

Table 9: Examples of Various Workout Formats

Aerobic-only Workout

Warm-up: at least 1015 minutes Aerobic work: approximately 30 minutes or longer Stretching/relaxation: at least five to 10 minutes, longer if time permits

Muscle Strengtheningonly Workout

Warm-up: at least 1015 minutes Strength training: approximately 3040 minutes Stretching/relaxation: at least five to 10 minutes, longer if time permits

Stretch-only Workout

Warm-up: at least 1015 minutes Stretching/relaxation: approximately 3040 minutes, longer if desired

Total-body Workout With Strength Work Preceding Aerobic Work

Warm-up: at least 1015 minutes Strength training: approximately 15 minutes Brief stretching: approximately two to five minutes Repeat active rhythmic warm-up activities: approximately five minutes Aerobic work: approximately 1520 minutes Final stretching/relaxation: at least five to 10 minutes, longer if time permits

Total-body Workout With Aerobic Work Preceding Strength Work Warm-up: at least 1015 minutes Aerobic work: approximately 1520 minutes Brief stretching: approximately two to five minutes Strength training: approximately 15 minutes Final stretching/relaxation: at least five to 10 minutes, longer if time permits

Note: The outlines presented above represent examples of workable exercise formats, butare not intended to cover all viable training options. To keep workout durationmanageable, choose numbers from each range of minutes that will combine to produce aworkout lasting approximately one hour (or up to 30 minutes for novice and/ordeconditioned exercisers). Keep in mind that balance-training techniques can beincorporated into all workout formats.


41/64

41

SECTION V

SAMPLE CHAIRMASTER EXERCISE ROUTINES

When performing any exercise in the ChairMaster routine, always avoid painful ROMand only move within tolerable limits.


42/64

42


43/64

43

Mobility Exercises Seated Without

Using BandsFor all of the exercises in this section, sit

upright in the chairusing the backrest or

the ChairMaster foam pad for support as

neededwith the feet flat on the floor.

1) Neck rotation

Rest the hands on the armrests or in thelap.

Rotate the neck so that the head turnsto the right and then to the left.

2) Shoulder rolls backward and forward*

Roll the shoulders up, forward, anddown and then roll the shoulders up,

backward, and down.

3) Multidirectional arm reaches*

Reach the arms above the head, out tothe sides of the body, in front of the

body, and across the body. For progression, add a weight shift

(i.e., lean with the body) as the arms

reach in each direction.

4) Arm circles backward and forward*

Extend the arms to the sides andperform small arm circles forward and

then backward.

For progression, perform larger circles.


44/64

44

5) Spine rotation

Rest the hands on the armrests or in the lap.

Rotate the spine so that the torso turns to the

right and then to the left.

For progression, reach across the body with onearm or hold both arms out to the sides while

rotating.

6) Side bend


Flex the spine to each side so that the torsobends to the right and then to the left.

For progression, reach overhead with one orboth arms while bending.

7) Marching


Alternate lifting each knee upward toward thetorso.

For progression, reach overhead with one or

both arms while marching.*These exercises can be performed with one limb at a

time or with both limbs simultaneously. It is typically

more challenging to use both extremities at the same time

versus one at a time.

Strength Exercises Seated Without Using

Bands

1) Sit-to-stand squat

Sit at the edge of the chair with the feetshoulder-width apart and both arms reaching

out in front of the body.

Stand up, fully straightening the knees and hips.

Return to the seated position, concentrating onthe gluteal and thigh muscles to lower the bodydownward.


45/64

45

2) Alternating straight-leg lift

Sit at the edge of the chair with the hands

resting on the armrests or in the lap. Straighten one knee and lift the leg as high

as possible without changing the position of

the spine in good sitting posture.

Lower the foot to the floor and repeat withthe other leg.

3) Alternating bicycle crunch

Sit in the chair in the reclined position usingthe backrest or foam pad for back support as

needed. Hold on to the arm rests for increased

stability.

Lightly contract the abdominals, lean back

with the torso, and lift one knee toward thechest while the opposite foot remains on the

floor.

Switch the knee and the foot so that theopposite knee lifts toward the chest and the

opposite foot touches down to the floor (i.e.,

in a bicycling motion).

4) Ab/knee tuck holding onto armrests*

Sit in the chair using the backrest or foampad for back support as needed.

Hold on to the arm rests for increasedstability.

Lightly contract the abdominals, lean intothe backrest or foam pad with the back, andlift (tuck) both knees toward the chest.

Lower the feet down to the floor.

*This exercise can be performed with the chair in the

reclined position.


46/64

46

Strength Exercise Seated With Bands Attached to

Front, Low Rings*

1) Biceps curl

Grasp the tube handles with the palms facing forwardand sit at the edge of the chair so that the backs of the

hands touch the seat.

Lift the handles toward the shoulders and then lowerthem to the starting position, moving only at the

elbows (i.e., keep the shoulders still during the

movement).

2) Upright row

Grasp the tube handles with the palms facingbackward and sit at the edge of the chair so that the

palms touch the seat.

Keeping the elbows bent, lift the arms so that theelbows lead the movement and at the end position the

elbows are slightly higher than the shoulders (i.e.,

creating a V position with the elbows).Lower the

handles, returning the arms to the starting position.

3) Overhead press

Grasp the tube handles, keep the elbows bent and closeto the body, and position the hands in front of

shoulders with the palms facing forward. Lift the arms overhead, trying to achieve full elbow

extension at the top of the movement.

Lower the handles, returning the arms to the startingposition.

4) Front-arm raise

Grasp the tube handles with the palms facing towardthe floor, keeping the arms straight and in front of the

body.

Lift the arms upward to shoulder height and then lower

them, returning to the starting position. Avoid elevating the shoulders toward the ears during

the movement; only lift the arms, keeping the space

between the ears and the shoulders fixed.


47/64

47

5) Side-arm raise

Grasp the tube handles with the palmsfacing toward the floor, keeping the armsstraight and toward the sides of the body.

Lift the arms upward to shoulder height andthen lower them, returning to the startingposition.

Avoid elevating the shoulders toward theears during the movement; only lift the

arms, keeping the space between the earsand the shoulders fixed.

6) Knee extension

Attach the cuffed tubes just above theankles.

Sit upright in the chairusing the backrestor the ChairMaster foam

pad for support as neededwith the feet flaton the floor.

Lift one foot off of the floor bystraightening the knee and then return the

foot to the floor by bending the knee.

Repeat with the opposite leg.

*All of these exercises can be performed

with one limb at a time or with both limbs

simultaneously. It is typically morechallenging to use both extremities at the

same time versus one at a time.


48/64

48

Strength Exercises Seated With Bands

Attached to Back, High Rings*For all of the exercises in this section, sit upright in

the chairusing the backrest or the ChairMaster

foam pad for support as neededwith the feet flaton the floor.

1) Chest press

Grasp the tube handles with the palmsfacing downward toward the floor, elbows

fully flexed, and the wrists, elbows, and

shoulders aligned in the same plane(shoulder height).

Push the handles forward so that the armsextend in front of the body.

Return the arms to the starting position.

Be sure to keep the back positioned againstthe backrest or foam pad and avoid

rounding the shoulders forward during the

pushing movement.

2) Chest fly

Grasp the tube handles with the palmsfacing toward each other, elbows fully

flexed, and the wrists, elbows, andshoulders aligned in the same plane

(shoulder height).

Push the handles forward in front of the

body in an arc (as if they are

hugging a barrel), keeping a slight bend inthe elbow, even in the fully extended

position.


Be sure to keep the back positioned againstthe backrest or foam pad and avoid

rounding the shoulders forward during thepushing movement.


49/64

49

3) Overhead triceps press

Grasp the tube handles with the backs of thehands on top of the shoulders and the palms

facing upward toward the ceiling (the

elbows will be fully flexed in this position).

Prepare to begin by lifting the elbowsupward toward the ceiling and keeping the

arms as close as possible to the sides of the

head.

Push the handles upward above the head byextending only the elbows (the shoulders

should remain fixed).


*All of these exercises can also be performed with

the chair in the reclined position. They also can be

performed with one limb at a time or with both limbs

simultaneously. It is typically more challenging to

use both extremities at the same time versus one at a

time.

Strength Exercises Standing Behind

Chair With Bands Attached to Back,

High Rings

1) Mid-back row*

Stand facing the back of the chair with thefeet shoulder-width apart, keeping a slight

bend in the knees.

Grasp the tube handles so that the palms arefacing each other with the arms extendedstraight out in front of the body.

Pull the handles toward the ribs by flexingthe elbows while squeezing the muscles of

the upper/mid back, being sure that theelbows move behind the body in the end

position.



50/64

50

2) Chest scoop

Stand facing away from the back of thechair with the feet shoulder-width apart,

keeping a slight bend in the knees.

Grasp the tube handles so that the palms are

facing forward with the arms extendeddown along the sides of the body.

Pull (scoop) the handles upward toward theceiling to shoulder height at the point where

the handles almost touch each other,keeping a slight bend in the elbows

throughout the motion.


3) Horizontal spine rotations with both hands

grasping the same band (twisting motion)

Stand alongside the back of the chair withthe right side of the body with the feet in a

split-stance (tandem) position (right foot

behind the left foot), keeping a slight bendin the knees.

With both hands, grasp one tube handle sothat the palms are facing each other with the

arms extended forward in front of the body.

Pull the handles away from the chair usinga twisting motion with the torso, keeping a

slight bend in the elbows throughout the

motion, and focusing on squeezing theabdominal muscles during the movement.


Repeat on the other side with the feet in the

opposite tandem position.

*These exercises can be performed with one limb at

a time or with both limbs simultaneously. It is

typically more challenging to use both extremities atthe same time versus one at a time.


51/64

51

Strength Exercises Standing Behind Chair

With Bands Attached to Back, Low Rings

1) Bent-over row*

Stand facing the back of the chair with thefeet shoulder-width apart, keeping a slight

bend in the knees.

Lean slightly forward at the hips, keeping theback straight and maintaining a slight bend inthe knees.

Grasp the tube handles so that the palms arefacing each other with the

arms extended straight out in front of thebody.

Pull the handles toward the ribs by flexingthe elbows while squeezing the muscles of

the upper/mid back, being sure that theelbows move behind the body in the end

position.


2) Single-arm bent-over row with opposite hand

leaning on back of chair

Stand facing the back of the chair with the

feet in a split-stance (tandem) position (rightfoot behind the left foot), keeping a slight

bend in the knees.

Lean slightly forward at the hips, keeping theback straight, maintaining a slight bend in the

knees and placing the left hand on the back of

the chair.

With the right hand, grasp the tube handle so

that the palm faces the midline of the body

with the arm extended downward in front ofthe body.

Pull the handle toward the ribs by flexing theelbow while squeezing the muscles of the

upper/mid back, being sure that the elbowmoves behind the body in the end position.

Return the arm to the starting position.

Repeat on the other side with the feet in theopposite tandem position.


52/64

52

3) Diagonal spine rotations with both handsgrasping the same band (opposite of wood-chop

motion)

Stand alongside the back of the chair with theright side of the body facing the chair holding

the feet in a split-stance (tandem) position (right

foot behind the left foot*), keeping a slight bendin the knees. (*reverse foot plant than shown

in photo)

With both hands, grasp one tube handle so thatthe palms are facing each other with the armsextended downward in front of the body.

Pull the handles upward away from the chairusing a twisting motion with the torso, keeping a

slight bendin the elbows throughout the motion, and

focusing on squeezing the abdominal muscles

during the movement.


Repeat on the other side with the feet in theopposite tandem position.

4) Single-leg hamstrings curl

Place a cuffed tube slightly above one ankle and

stand facing the back of the chair with the feethip-width apart.

Lean slightly forward at the hips, keeping theback straight and maintaining a slight bend in

the knees.

Lift the cuffed ankle upward toward the back ofthe thigh by flexing at the knee.

Return the ankle to the starting position byextending the knee.

Repeat on the opposite side.


53/64

53

5) Single, straight-leg hip extension

Place a cuffed tube slightly above one ankle and standfacing the back of the chair with the feet hip-width

apart.

Lean slightly forward at the hips, keeping the backstraight and maintaining a slight bend in the knees.

Keeping the knee completely straight, lift the cuffedankle upward toward the ceiling (however, avoid lifting

the leg so high that the pelvis/hips start to shift).

Return the ankle to the starting position.


6) Single, straight-leg hip abduction

Place a cuffed tube slightly above the right ankle and

stand facing the back of the chair with the feet hip-width apart.

Keep the back straight and maintain a slight bend in theknee of the non-cuffed leg.

Keeping the right knee completely straight, lift thecuffed ankle (in this case the right ankle) outward tothe side of the body (however, avoid lifting the leg so

high that the pelvis/hips start to shift).

Return the ankle to the starting position.


7) Single, straight-leg hip adduction

Place a cuffed tube slightly above the right ankle andstand facing the back of the chair with the feet hip-width apart.

Keep the back straight and maintain a slight bend in the

knee of the non-cuffed leg.

Keeping the right knee completely straight, lift thecuffed ankle (in this case the right ankle) inward

toward the midline of the body, crossing slightly in

front of the other leg (however, avoid lifting the leg so

high that the pelvis/hips start to shift). Return the ankle to the starting position.


*This exercise can be performed with one limb at a time or with

both limbs simultaneously. It is typically more challenging to use

both extremities at the same time versus one at a time.These exercises require the cuff attachment instead of the handle

attachment.


54/64

54

Strength Exercises Standing Behind Chair

Without Using Bands

1) Body-weight squat holding onto back of chair

Stand facing the back of the chair with the feetshoulder-width apart, while reaching out both arms infront of the body to lightly grasp the back of the chair.

Concentrating on the gluteal and thigh muscles, lowerthe hips downward into a squat position as far as is

comfortable/tolerable for the knees.

Stand up, fully straightening the knees and hips, andreturn to the starting position.

2) Single-leg squat holding onto back of chair

Stand facing the back of the chair with one knee bent,holding the foot off of the floor while reaching outboth arms in front of the body to lightly grasp the

back of the chair.

Concentrating on the gluteal and thigh muscles, lowerthe hips downward into a squat position as far as iscomfortable/tolerable for the supporting knee.

Stand up, fully straightening the supporting knee and

hip, and return to the starting position.

3) Lateral lunge holding onto back of chair

Stand facing the back of the chair with the feettogether, while reaching out both arms in front of thebody to lightly grasp the back of the chair.

Concentrating on the gluteal and thigh muscles, take alarge step out

to the right side with the right leg, and lower the hipsdownward into a lateral lunge position as far as is

comfortable/tolerable for the right knee (the left knee

should remain straight).

Return to the starting position. Repeat on the opposite side [i.e., take a large step out

to the left side with the left leg, lower the hips

downward into a lateral lunge position as far as iscomfortable/tolerable for the left knee (the right knee

should remain straight)].


55/64

55

4) Push-up holding onto back of chair

Stand facing the back of the chair with the feet hip-

width apart, while reaching out both arms in front of

the body to lightly grasp the back of the chair. Place most of the body weight onto the hands and

rise up on the balls of the feet, keeping the back and

knees straight and in good alignment.

Lower the torso downward toward the back of thechair by flexing the elbows and allowing them to

move behind the body.

Return to the starting position by extending theelbows.

Be sure to keep the abdominal muscles slightlycontracted and the back in proper alignment

throughout the movement.

Static Stretches Standing Behind ChairEach of these stretches should be held in position for 15 to 60

seconds.

1) Downward-facing dog holding onto back of chair

Stand facing the back of the chair with the feetshoulder-width apart, while reaching out both arms

in front of the body to lightly grasp the back of thechair.

Keeping the arms straight, hinge at the hips andlower the torso so that the chest is facing the floor.

Keep the back straight and maintain a slight bend inthe knees.

The stretch should be felt in the backs of the legs,front of the torso, chest, shoulders, and arms.


56/64

56

2) Calf stretch holding onto back of chair

Stand facing the back of the chair with the feet in

a split-stance (tandem) position (right foot behindthe left foot), while reaching out both arms in

front of the body to lightly grasp the back of thechair.

Lean forward with the whole body, bending theleft knee, keeping the right knee straight, and

keeping the back straight, until a stretch in theright calf area is felt (be sure to keep the right heel

down in contact with the floor throughout the

stretch).


3) Leaning side bend holding onto back of chair

Stand with the right side of the body alongside the

back of the chair with the feet together.

Lightly grasp onto the back of the chair with theright hand.

Reach the left arm up overhead and bend to thetorso to the right side, leaning toward the chair.

The stretch should be felt in the left side of thebody.


4) Straight-arm chest/shoulder stretch with one hand

holding onto back of chair

Stand with the right side of the body alongside theback of the chair with the feet together.

Lightly grasp onto the back of the chair with theright hand and take a step or two to the side awayfrom the chair so that the right arm is straight.

Gently rotate the torso away from the right arm.

The stretch should be felt in the chest, shoulder,and upper arm of the right side.



57/64

57

Aerobic Exercises

1) Seated pedaling

Sit upright in the chairusing the backrest or

the ChairMaster foam pad for support asneeded.

Place the feet in the pedal straps and check toensure that the knees are slightly bent at the

down position of the pedal stroke.

Place the hands on the armrests or on the lap.

Start pedaling using smooth, continuous pedalstrokes at a resistance that is tolerable.

2) Step-ups standing behind the chair holding ontoback of chair

Place the step on the floor up against the backof the chair.

Stand facing the back of the chair with the feethip-width apart, while reaching out both arms in

front of the body to lightly grasp the back of the

chair.

Step up onto the step and then down onto the

floor leading with the right foot. Switch to the opposite side.

Eventually, progress to stepping withoutholding onto the back of the chair, if possible.


58/64

58


59/64

59

Summary

The ChairMaster is an effective tool in promoting a healthy, physically active lifestyle

with a unique design that meets the needs of sedentary individuals and older adults by

combining a low-impact aerobic workout with resistance training in a user friendly seated

workout. The ChairMaster includes a recumbent cycle for aerobic conditioning, which

folds out of site when not in use, and resistance bands for muscular-fitness training. In

addition, the ChairMaster is designed for functional aesthetics in that it serves as a chair

that can be used anywhere.

The exercise programming provided in this manual addresses the specific health and

fitness needs of older, overweight/obese, and/or deconditioned adults without exposing

them to unnecessary risks. Adherence to the ChairMaster exercise system following the

guidelines described on the previous pages is a practice that will benefit the functional

capabilities of the user in important areas of health, including aerobic endurance, muscle

strength and endurance, flexibility, body composition, and balance.


60/64

60


61/64

61

References

American College of Sports Medicine (2010).ACSMs Guidelines for Exercise Testingand Prescription (8th ed.). Philadelphia, Pa.: Wolters Kluwer/Lippincott Williams &Wilkins.

American Council on Exercise (2005).ACEs Exercise for Older Adults (2nd ed.). SanDiego, Calif.: American Council on Exercise.

American Geriatrics Society (2001). Exercise prescription for older adults withosteoarthritis pain: Consensus practice recommendations.Journal of the AmericanGeriatrics Society, 49, 808823.

Arias, E. (2006). United States life tables, 2003.National Vital Statistics Reports, 54, 14.

Baumgartner, R.N. et al. (1998). Epidemiology of sarcopenia among the older persons in

New Mexico.American Journal of Epidemiology, 147, 755763.

Bray, G.A. (2007). The missing linklose weight, live longer.New England Journal ofMedicine, 357, 818820.

Centers for Disease Control and Prevention (2007). The State of Aging and Health inAmerica 2007. Centers for Disease Control and Prevention and the Merck CompanyFoundation. www.cdc.gov/aging.

Centers for Disease Control and Prevention (2003). Public health and aging: Trends inagingUnited States and worldwide.Morbidity and Mortality Weekly Report, 52, 6,101106.

Fontaine, K.R. & Barofsky, I. (2001). Obesity and health-related quality of life. ObesityReviews, 2, 173182.

Fontaine, K.R. et al. (2003). Years of life lost due to obesity. Journal of the AmericanMedical Association, 289, 187193.

Haskell, W.L. et al. (2007). Physical activity and public health updated recommendationsfrom the American College of Sports Medicine and the American Heart Association.Medicine & Science in Sports & Exercise, 39, 14231434.

Helmchen, L.A. & Henderson, R.M. (2004). Changes in the distribution of body massindex of white US men, 18902000.Annals of Human Biology, 31, 174181.

Jensen, G.L. (2005). Obesity and functional decline: Epidemiology and geriatricconsequences. Clinics in Geriatric Medicine, 21, 677687.


62/64

62

Knowler, W.C. et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyleintervention or metformin.New England Journal of Medicine, 346, 393403.

National Heart, Lung and Blood Institute (1998). Obesity Education Initiative ExpertPanel. Clinical Guidelines on the Identification, Evaluation, and Treatment of

Overweight and Obesity in Adults: The Evidence Report. Bethesda, Md.: NationalInstitutes of Health. NIH publication No. 98-4083.

National Institutes of Health (2006).National Institute on Aging:Aging Under theMic

chair master-exercise-instructor-manual-with-pictures.pdf

Documents