If you use a wheelchair—or can't get out of bed because you are recuperating from an injury or long illness—it's important to exercise to maintain fitness, control your weight and prevent stiffness and muscle atrophy.

Good news: It's easy to get the exercise you need. All you need are an inexpensive set of light dumbbells (two to five pounds)...and a little determination. It doesn't take long to strengthen key muscle groups and increase your range of motion.

Important: Talk to your doctor before starting an exercise program. Then, schedule a session with a certified personal trainer or physical therapist who has experience working with people with limited mobility.

Be sure to talk with him/her about shoulder and neck protection. Exercise-related injuries caused by improper form-or by overdoing it can be particularly troublesome for those who depend on fewer muscle groups to get around and those who are stuck in bed.

Most people do best when they exercise for about 30 minutes, five or six days a week. If you need assistance to exercise and can schedule only two or three weekly sessions, extend your workouts to 45 to 60 minutes after you become fit enough to handle a session that long.

Warm-Ups And Stretches

Always start your workout with light cardiovascular movements—such as arm circles or shoulder shrugs Gif you don't have serious arm or shoulder issues)—for at least three to five minutes as a warm-up.

Stretching is important, too: Do it throughout your workout. I stretch at the beginning and end of exercise sessions, as well as in the middle. People in wheelchairs, or those who are limited to a bed, need to stretch a lot.

For example, focus on the major muscle groups in the…

  • Neck—lower your left ear toward your left shoulder and hold for 10 seconds...repeat on the other side. Do 10 times total.
  • Chest—lift both arms (to shoulder height if you can) and extend them out to your sides with palms facing forward. Then move your arms back, pressing your shoulder blades together as much as you comfortably can. Do five times.
  • Hands and fingers—flex your hand so that your fingers are spread out. Hold a few seconds, then make a fist for a few seconds. Extend your fingers again and use the other hand to gently pull each finger. Do this about six times, then repeat with your other hand.

Exercise Sessions

Whether you're in a wheelchair or in bed, do each exercise slowly. Unless otherwise indicated, count from one to six from the beginning to the end of each movement. Never hold your breath while exercising, Exhale when you're tightening muscles, and inhale when the muscles are relaxing. To work the neck, back and abdominals, do…

1. Side reaches. While sitting in a chair, with your arms relaxed at your sides, twist your torso to the right, letting your arms follow the motion of your shoulders.

If you can, keep going until you feel tension in the abdominal and torso side muscles on the side of the body opposite the direction you're moving in. So, when you're twisting to the right, you'll feel tension on the left side of your body.

Slowly repeat a right-center-left movement—stopping in the center before twisting to the other side—10 to 15 times.

If you're in bed, you can work some of the same muscles with an exercise known as a minimal crunch. While lying on your back with your arms at your sides, tighten your stomach muscles and very slightly raise your head and shoulders-don't raise them more than about an inch. Hold the stretch for a few seconds, then relax. Repeat 10 to 15 times or as many times as you can.

2. Neck extension. You can do this exercise while sitting in a chair or lying down. Keeping your back and shoulders relaxed, gently thrust your neck forward, like a turtle. Go as far as you comfortably can, then ease your neck back. Repeat 10 times.

3. Cardiovascular exercises. Perform simple cardiovascular exercises, such as moving your arms in circles or shrugging your shoulders, for three to five minutes. You can do these movements while sitting up or lying down. Try to do the movements quickly enough to increase your breathing/heart rate.

Even better: If you go to a gym and it has an upper-body bike (powered by your arms instead of your legs), you can use it to perform similar movements, but at a higher intensity.

To work your shoulders, biceps, wrists and abdominals, start with...

  • Dumbbell raise.

What to do: Hold the dumbbell vertically. Lay your right hand over your left, and wrap your fingers around the top of the dumbbell. Rest it on your right thigh. Keeping your elbow close to your side, raise the dumbbell until it's almost touching the front of your right shoulder. Repeat 10 to 15 times. Switch sides.

  • Biceps curl.

What to do: Hold a dumbbell horizontally in your right hand, with your palm up, just above your right thigh. Keeping your elbow close to your side, curl your arm upward until the weight is close to shoulder height. Then relax and lower the weight to the starting position. Repeat 10 to 15 times. Switch sides. For variety, try…

  • Dumbbell chop. Hold the dumbbell vertically. Lay your right hand over your left and wrap your fingers around the top of the dumbbell. Lift the weight at your midline to chest height. Slowly lower the weight at an angle toward your left hip, as though you were chopping wood. Then raise it to the starting position. Repeat 10 to 15 times. Then do the exercise at an angle toward your right hip. Repeat 10 to 15 times.
  • Ab finder. The goal of this exercise is to work only the abdominal muscles. First, place the fingers of one hand in the area around your belly button. Keeping your shoulders and neck relaxed, tighten the muscles in the abdomen by pulling your belly button back toward your spine. Keep contracting when you feel the muscles tighten-hold the tension for about 10 seconds, then relax. Repeat 10 to 15 times.

A Little Exercise Helps a Lot

As little as one minute of standing and walking around can make a difference in waist circumference over time.

Example: People who get up regularly and switch TV channels by hand, instead of using the remote, have, on average, a waist circumference of 2.4 inches 6 cm) less than those who stay seated. People who do these small amounts of activity also have lower body mass indexes and lower glucose and triglyceride levels. Stand up to answer the phone...take a long route back to your desk...do some stretches before reading a new e-mail.

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