Q: I've had well-elderly clients ask me about easy-to-use, home exercise equipment that fits into seniors' budgets. Do you have any suggestions?

A: I've had people asking the same thing! Especially now that so many people want to stay fit and active as they grow older.

I have found, used and recommend several small, affordable pieces of equipment that focus on necks, hands and knees. These areas often weaken in the aging process, and need attention to avoid future problems. People who have used these pieces of equipment have remarked on both their positive effects and ease of use. And, they fit into the TV baskets I have written about before.

Inflatable neck traction devices can help with necks that have weakened and compressed due to age, gravity or osteoporosis. The devices are comfortable and adjustable, and there are a number on the market. The client puts the uninflated plastic collar around her neck and fastens it with Velcro straps. Then the client inflates it with the rubber-bulb inflator until she achieves a comfortable stretch. After a few minutes it can be inflated a bit more.

I suggest the client do neck presses to the front, back and each side, holding against the inflated collar for a few seconds. One woman said this enabled her to hold her head up high for the first time in years.

You may have seen the Neckline Slimmer on TV. It is a collapsible tube angled to rest between the upper chest and beneath the chin that has a spring inside (it comes with three varying strengths). One exercise uses a head bend and another uses the jaw to close the spring. It is advertised to reduce double chins, but the exercises improve neck flexion, jaw strength and range. One woman said it made her dentures more comfortable because chewing was easier. It may help with pain from temporomandibular joint disorder, although none of the people who I've seen use this device had TMJ.

I have not followed these items long enough to know if dowagers humps and general weakening might be avoided with their regular use if started in middle age. I think they might!

Chinese hand balls (Bao Ding or Qi Gong balls) are great for strong, flexible hands and wrists. They are a pair of same-size balls that you hold in a hand and rotate clockwise completely, then counter clockwise. This takes a bit of practice and sometimes in the beginning you may need

some help from your other hand to keep from dropping them. For at least 30 years I've recommended these to clients of all ages, and I have three different-sized sets of my own.

The balls come in different sizes, ranging from about ¾ inches to 2 inches in diameter. The larger they are, the harder they are to control. The most common are about golf-ball size. They are usually made of metal or jade stone and come in a small box. Sometimes the metal ones contain chimes which make a soothing sound when you achieve a smooth rhythm.

Floor bicycle pedals help knee and hip range. I agree that stationary bikes are more comprehensive an exercise, but they often stay parked in a back room unused. A sturdy set of floor pedals is easy to use, and they are at least a dozen times cheaper than stationary bikes. I tell people to use them with the pedals centered at first and then move them farther or closer together on different days. I suggest people just keep them nearby and use them when watching TV or talking on the phone. This seems to get good compliance. People say they use them for an hour or two at a time.

Politically it looks like Medicare will undergo some big budget cuts. With the current economy people may need to monitor expenses, including exercise and activity budgets. Hopefully these will encourage more health self-reliance and initiative in people over 65. And hopefully OTs will meet them in their communities to teach and show them how to do it.

Jane Sorensen, PhD, OTR, ND, practiced in all traditional OT areas over 32 years and wellness for 25 years in private practice. She currently has a supervisory and consulting practice. She has written A Therapist's Tales (www.lulu.com/drjane) and was ADVANCE editor E.J. Brown's co-author for An Overview of Early Intervention (www.proedinc.com). You can reach her at 212-744-5836, drjane@hvc.rr.com or www.drjanesorensen.com.