Transverse rotation of the trunk:

This is controlled by the internal and external oblique abdominals and the muscle of the erector spine group in the lower back. These muscles may be partly usable, if not completely unusable to people with spinal cord injuries. To provide support and trunk stability, those with spinal cord injuries may have metal rods surgically implanted in their spinal cords, which may make this movement difficult to perform.

Participants who have suffered from a stroke may have impaired balance, in which twisting movements could lead to them losing their balance in a chair. Twisting movements can also rub and lead to abrasion sores for anyone performing these movements in a chair. Also there may not be a large benefit or gain from using these muscles in adaptive aerobics because these muscles are relatively small and do not produce a big oxygen demand.

Asymmetrical full-extension arm movements:

These are shoulder exercises, that are performed with the arms extended and then moved through motions not in concert and not in direct opposition. Basically, one arm is pressed down while the other is pressed sideways. For participants with balance problems, this could lead to lose of balance. Participants with coordination difficulties or with cognition problems may become frustrated with the exercise. They may find it difficult to move their arms in opposing directions or in different motions, and a participant who is frustrated during an adaptive aerobic routine will have little or no benefit from the workout.

Moving just one arm singly is a good example of lowering the intensity level of an exercise. A participant may benefit from moving just one arm singly and using the other arm for balance and support.

Excessive arm movements above the shoulders:
The elevation of heart rate and blood pressure with extension of the upper extremities above the shoulder will vary with every adaptive aerobics participant. The changes can be immediate and dangerous for those with poor cardiovascular condition.

Trunk Extension and flexion:

Trunk flexion is controlled by the abdominal muscles and the trunk extension is controlled by the lower back muscles. Due to the absence of control of these muscles or due to implanted spinal stiffening rods, those participants with spinal cord injuries may be unable to perform this movement. This movement should be avoided by those in a seated adaptive aerobics class.

Movements to include:

Marches. The Kinesologic movement is shoulder/flexion/extension. The elbows should be bent and the arms moving in opposition. This is an effective warm-up, cool-down exercise, in which almost all participants in a seated class can master. For those seated participants that have some leg movement control, they can lift their legs in time with the march. Straighten out the elbows or lift the arms in front of the torso to increase intensity. Decrease the intensity by decreasing the range of motion. There is no twisting of the torso involved in this movement.

Presses:

Most seated participants can easily master presses. This exercise is very versatile due to the combination of location, intensity variations and speed variations. Using a full arm range of motion and by exercising one sequence at or above shoulder level will increase intensity and should only be performed by those who can do it safely. Decrease intensity by not pressing above the shoulder level or by not using arm muscles.