1. Instructors need to prepare the room for participants before starting an adaptive aerobics class. If some of the participants will be standing and some seated, arrange those seated in wheelchairs so that their view is not obstructed by a standing participant, but do not separate the class into "seated" and "not seated" sections.
2. Make sure there is plenty of room for participants to move, especially if part of your choreography involves the class moving. It is a good idea to have your seated participants at the sides, but as close to the front as possible.
3. You should check seated participants wheelchairs to make sure the brakes are locked. If the chair is powered, it should be turned off. If the wheelchair has no brakes, you should chock the wheels with sand weights or some other type of wedge to prevent the chair from moving.
4. Make sure those participants needing to wear seat belts are properly secured. Take a few minutes to check that seat belts are tight across participants lap, but still comfortable.
5. Wheelchair participants that have impaired tactile function or no tactile function should be given special care to see that the wheelchair arms or other parts of the chair do not rub against his or her body. You may want to remove the wheelchair arm rests if the participant has sufficient trunk support, but make sure to reinstall them when the class over.
6. During the winter months, participants may need help removing coats and jackets. This may not be a problem for some because thermoregulation is not an automatic response with some disabilities, so it is best to wait to be asked for help before helping.
7. You will need to find a polite way to remind participants who are cauterized to empty their leg bags before exercising.

Types of exercises:

• -Stretching and range of motion exercise:
  Stretching muscles with help maximize participants abilities. Stretching and range of motion exercises will help keep muscles flexible and prevent tightness. Arm circles, wrist circles, shoulder shrugs, calf stretching, bending and extending the knee, lifting the knee up towards the chest, back stretch and ankle circles are all great range of motion exercises to include.


• Cardiovascular exercise:
  Cardiovascular exercise increases the heart rate and blood flow. This type of exercise is also known as aerobic exercise. The intensity level of aerobic exercise will vary depending on the individual. The participants medical condition is a main factor. Lower blood pressure level and lower cholesterol levels are just a few benefits of cardiovascular exercise.


• Strength (resistance) training:
  Strength training will help to improve muscle strength. Using hand-held weights, weight machines, stretch bands or even exercise balls is usually a strength exercise. Stretching exercises can involve any muscle in the body.

Movements to include:

1. Marches: Elbows should be bent and the arms should move in opposition. If there are seated participants that have some leg movement control, they can lift their legs as they "march". To increase the intensity of this exercise, participants should straighten out their elbow joint or lift their arms in front of their torso. Decrease the range of motion to decrease intensity.
2. Shoulder roll and lifts (shrugs):
   The shoulders should be worked through the full range of motion. Using one shoulder at a time, participants should roll or shrug their shoulder, then both together. Those participants with balance problems should move just one shoulder at a time. This type of exercise is mainly used as a warm-up and cool down, but is appropriate for participants that have a limited amount of arm movement.