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Stage I: Beginning To Move Exercises
Ernest H. Rosenbaum, MD, Francine Manuel, RPT, Isadora R. Rosenbaum, MA, Arthur F. Cerf, MD, and Jack LaLanne
Demonstrations by Jack LaLanne
Shoulders And Chest
Elbows And Wrists

Hips, Knees And Ankles
Trunk 		Stage I Medi-Gym® Exercises
Clothespin and Rubber Band
Exercise Putty

Sponge Ball
Elastic Sheet

Shoulders And Chest
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The following exercises increase the mobility of your shoulder joints and strengthen the chest muscles. Begin by taking ten deep breaths. Remember, do not hold your breath while you do any exercise. Breathe rhythmically in and out.

Straight Arm Lifts
1. Lying on your back, place your arms down by your sides.
2. Keeping your elbows straight, lift your arms up and as far back over your head as you can.
3. Keeping your elbows straight, lower your arms to your sides.
Lying on back with arms by side Lying flat with Arms over head
 
Side Arm Lifts
1. Lying on your back, place your arms down by your sides.
2. Keeping your elbows straight, bring your arms out to the sides and on up over your head until your hands touch.
3. Keeping your elbows straight, lower your arms back to your sides again.
arms out to the side with elbows straight Lying flat with Arms over head
 
Elbow Touches
1. Lying on your back, place your hands behind your head, elbows flat on the bed.
2. Bring your elbows together in front of your body.
3. Lower your elbows back down to the bed.
elbows bent with hands behind the head
elbows together in front of body
 
Straight Arm Crosses
1. Lying on your back, put your right arm out straight to the side at a right angle to your body.
2. Keeping your elbow straight, bring your arm across your chest to your left side.
3. Keeping your elbow straight, return your arm to its original position.
4. Repeat with your left arm
5. Try to use both arms at once, crisscrossing them in front of you.
lying on back with arm straight out arm crossing the chest both arms crossing each other

Elbows And Wrists
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The following exercises help preserve the mobility of your elbow and wrist.

Elbow Bends
1. Lying on your back, place your arms down by your sides and make a fist with each hand.
2. Bring your fists up to your shoulders, bending your elbows.
3. Lower your fists to their original position.
arms by the side with hands forming fists arms up with hands made into fists
 
Wrist Rotation
1. Lying on your back, make a fist with each hand.
2. Make small inward circles with your fists.
3. Reverse directions and make small outward circles.

Now is a good time to stop and rest. If you are tired, pause and take ten to twenty deep, relaxing breaths! Try to relax your neck and shoulders. Don't let tension build up, and you won't tire so easily. Place your hand on your stomach and try to make it rise when you inhale. Blow out as long as you can.

Hips, Knees And Ankles
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The following exercises mobilize and strengthen your walking mechanisms.

 
Knee To Chest Lifts
1. Lying on your back, place your legs together flat on the bed.
2. Bend your left leg and bring your knee up toward your chest.
3. Straighten your knee while lowering your leg slowly to the bed.
4. Repeat with your right leg.
legs flat on the bed bending knee to chest while lying on bend
 
Straight Leg Lifts
1. Lying on your back, place your legs together flat on the bed.
2. Keeping your knee straight, lift your left leg as high as you can.
3. Keeping your knee straight, lower your leg slowly in the bed.
4. Repeat with your right leg.
lying flat on back raising the leg
 
Knee Touches
1. Lying on your back, bend both knees, keeping your feet flat on the bed.
2. Relax and let your knees fall slowly outward as far as they will comfortably go.
3. Bring your knees back up together.
knees raised while lying flat on bed knees outward while lying on bed
 
Ankle Rotation
1. Lying on your back, lift your right heel a little off the bed and make small inward circles with your foot.
2. Reverse direction and make small outward circles.
3. Repeat with left foot.
leg lifted and foot rotating

Trunk
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The following exercises strengthen your trunk.

Side-to-Side Rolls
This exercise helps prevent bedsores.

Caution: If you are in a hospital bed, do this exercise with the bedrails raised. If there are no bedrails, have someone stand beside the bed, to make sure you do not roll out of bed.
1. Lying on your back, slightly bend your knees and elbows.
2. Lift your left shoulder and roll to the right reaching with your left arm for the bedrail or the side of the mattress.
3. Roll back and repeat the exercise on your other side.
lying on back arms by side lying on side
 
Trapeze Bar Pull-Ups
1. Lying on your back, put both hands up on the trapeze.
2. Lift your buttocks up off the bed.
3. Try to get your nose or chin up to the bar.
arms holding onto trapeze
pulling body up using the trapeze
 
Partial Sit-Ups
1. Lying on your back, clasp your hands behind your head.
2. First, try to lift your head off the pillow.
3. Next, try to lift your head and shoulders up.
arms behind the head knees bent arms clasping behind the head lifting head and shoulders knees bent

Stage I Medi-Gym® Exercises The next set of exercises uses the Medi-Gym® equipment for added resistance in your exercise routine. If you are tired, take a rest before proceeding. Breathe deeply ten to twenty times.

In the following exercises you will use the clothespin, rubber band, exercise putty, sponge ball, elastic sheet and breathing bag from your Medi-Gym®

Clothespin and Rubber Band
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The following exercises use a clothespin and rubber band to strengthen your hands and fingers. These exercises can be done even if you have an intravenous feeding tube in your arm.

Finger Squeeze
1. Squeeze the clothespin between your thumbs and first two fingers. If this is too difficult, squeeze the clothespin between your thumb and four fingers.
2. For added resistance, wrap a rubber band around the tip of the clothespin and repeat the exercise.


Advanced Finger Squeeze
1. Hold the clothespin between your thumb and first finger, trying to keep your thumb and finger in a circle.
2. Open the clothespin to its fullest and hold it open for a few seconds.
3. Repeat with your thumb and each of your other fingers.
4. For added resistance, wrap a rubber band around the tip of the clothespin and repeat the exercise.
hand with fingers squeezing the clothespin
 
Finger Spread
1. Place a rubber band over the fingers of one hand, stretching the rubber band.
2. Spread your fingers apart.
3. Repeat with your other hand.
fingers spreading rubber band

Exercise Putty
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The following exercises use exercise putty to give coordination control and to strengthen your hands. The putty can be pulled, worked in a ball, or bounced. Use your imagination to devise your own exercises in addition to the ones below.

First and Second Finger Pinch
1. Place a ball of putty between your thumb and first finger.
2. Squeeze through the ball until your thumb and finger meet.
3. Repeat with your thumb and each of your fingers.
pinching the putty beween thumb and finger
 
Wrist Pull-Ups
1. Place your left forearm on a table and hold a piece of putty in your left hand.
2. Hold the other end of the putty in your right hand.
3. Pull the putty up with your right hand, bending your right wrist back.
Repeat with your other hand.
pulling the putty to strengthen wrists
 
Finger Spread
1. Make a loop out of the putty.
2. Place the loop around the fingers of one hand between the two top joints.
3. Spread your fingers apart against the loop.
4. Repeat with your other hand.
cirlcle of putty with fingers spreading out
 
Finger Opening
1. Smash the putty flat with the palm of your hand.
2. Stick your thumb and first finger into the putty close together.
3. Push your thumb and first finger apart.
4. Repeat with your thumb and each of your other fingers.
fingers inserted in putty pushing apart
 
Hand Squeeze
Squeeze the putty in your hand like a ball, moving it about at the same time.
sqeezing the ball of putty

Sponge Ball
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The sponge ball is lightweight, easy to handle and safe -- it won't bruise your skin if hits you. Some of the following exercises are done lying down others sitting up.

Knee Squeeze
Lying down or sitting up, put the ball between your knees and try to hold it there.
 ball between knees while lying flat
 
Leg Lift
Lying down, put the ball between your feet and try to lift it off the bed. (Blow out as you lower the ball back to the bed).
lifting the legs with the ball between the feet
 
Hand Squeeze
Squeeze the ball in your hand, moving it around at the same time.
 hand squeezing the ball
 
Up and Down Toss
Sit up (make sure your bed rails are up), throw ball up and catch it.
 tossing ball up
 
Side-to-Side Toss
Toss the ball from one hand to another, leaning from side to side to catch it.
 tossing the ball side to side
 
Clap and Catch
Toss the ball back and forth with a friend. For more coordination, try clapping your hands just before catching the ball.
 tossing ball clapping hands before catching it

Elastic Sheet
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The following exercises use an elastic sheet for resistance. The sheet is very thin and easy to stretch. All exercises may be done lying in bed or sitting up.

Caution Never use the elastic sheet close to your face. If you lose your grip on it, it could injure your face or eyes. Do not do these exercises if you have any weakness or tremor or if your grip has been injured.

Arm and Chest Stretch
Grab hold of both ends of the elastic sheet and stretch it sideways.
arms apart stretching the elastic sheet
 
Chest and Shoulder Stretch
Stretch the elastic sheet apart behind your head or back.
stretching the elastic sheet in front of chest arms apart stretching the elastic behind the head
 
Wrist Stretch
1. Hold both ends of the elastic sheet in your left hand.
2. Loop the sheet around your right wrist.
3. Try to push your right wrist up against the elastic sheet.
4. Repeat with your left wrist.
elastic sheet wrapped around wrist pulling with other hand elastic sheet on wrist being pulled by other hand
 
Calf Stretch
1. Hold one end of the elastic sheet in each hand.
2. Bend your knees and loop the sheet over the bottom of your feet.
3. Push down on the sheet with your feet while pulling the sheet up with your hands.
knees bent sheet looped over the feet feet pushing against the elastic sheet while hands pulling the sheet
 
Leg and Thigh Stretch
1. Hold one end of the elastic sheet in each hand.
2. Loop the sheet over the bottom of your left foot.
3. Bend your left knee toward your chest.
4. Push your left leg straight out against the elastic sheet while pulling the sheet up with your hands.
5. Repeat with your right foot.
knee bent toward chest with elastic sheet looped over foot holding the elastic sheet looped over the feet with both hands straighten the legs
 
Thigh Stretch
1. Hold one end of the elastic sheet in each hand.
2. Loop the sheet over the bottom of your feet.
3. Try to spread your legs apart against it.
hands holding elastic sheet looped over bottom of feet legs spreading apart



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