The impaired balance may be due to amputation, or stroke; regardless of the cause of impaired balance, you should assess the athlete's ability to maintain balance. If the athlete's focus on maintaining balance outweighs his ability to exercise vigorously, he may be more appropriate to be seated in the class. Primarily, when you select movements for your class of standing athletes, keep in mind that the movements and sequences should prevent or minimize the possibility of falls.
Generally, the athlete's balance increases in standing position with a wider stance and a lower center of gravity. The feet should be wider than the shoulders, with the knees slightly flexed throughout the workout. This may not be appropriate for some lower extremity prosthetics, which may be more stable with a staggered (front-to-back) foot position. Work with each of your athletes to find the most appropriate position.
Complex and highly coordinated dance steps are more likely to compromise balance, but this does not mean that you can't use these moves in the class programming. Just demonstrate an alternative step sequence in the same musical stanza for those unable to maintain balance in the cross-over or grapevine steps.
Steps that require support to be shifted to one leg (pendulum rocks, side-kick repeaters, etc.) bring the center of balance to the outer part of the support. If your leg and arm movements are coordinated to maintain the center of gravity over the base of support, balance can be maintained in a wide variety of combinations.
In your programming, try to minimize sudden directional changes. Instead of moving directly from one travel sequence (forward/back, for instance) to another (side-to-side), insert an eight-count march-in-place or side-shuffle kick.
Impaired balance athletes may need support; chairs have been recommended, but does your studio have chairs? Use a step bench , on end, during standing aerobics. The athletes could also position themselves along the side of the studio, if your studio has a ballet barre.
Athletes with impaired coordination who are able to exercise standing up should be encouraged to do so, but these guidelines are applicable to both standing and seated aerobics classes for these athletes. Coordinating movement patterns is generally related to motor control of the muscles due to brain injury or brain or neurological disease (CP, MS, head injury, stroke). Spasticity of the muscles can complicate the coordination impairment. The two primary considerations in programming your aerobics class that includes athletes with impaired coordination are to simplify the movements and to avoid eliciting undesirable movement patterns. Except for the spasticity possibility, many of these tips are the same as you would use for programming a class for older athletes.
Keep the movements slow and simple. Impaired coordination athletes feel more success with large, fluid movements, rather than small, rapid, stylized tense movements. Not only will the faster movements frustrate your class, they may increase spasticity in the muscles.Simplifying body movements does not mean simplifying verbal instructions; unless your participants have a cognitive impairment, cue the class or the specifically impaired athletes as you would any other athlete.
Don't use unilateral movements; a coordination-impaired athlete will get frustrated in trying to follow a routine in which one arm is performing a different movement or a different direction than the other, while the legs are performing a third movement. When you move from one movement to another, do it for one set of extremities at a time; in other words, when you introduce the next arm movement sequence, keep the legs moving in the old (familiar) sequence. If you introduce complex arm movements, restrict the leg movements to simple and repetitive marches, back-and-forth rocks, etc.
Limit the number of routines if the majority of the class has coordination impairment. Stretch the routines from the normal eight-count sequence to sixteen to decrease the amount of concentration needed to master that movement. The typical sequence of increasing or decreasing the number of repetitions in a sequence that aerobics instructors use in programming is inappropriate for this population (Now, do four counts,...now the same sequence in two counts, etc.).