I'm going to keep checking back here to see if anybody has suggestions for the wrists, because I generally grasp weights as my modification, which won't work very well for some of these moves. I thought I'd let you know what I do for standing up too quickly though. I have neurally mediated syncope, which basically means I pass out whenever my body feels it's under duress. There's meds for it, but I can't take them, because the meds caused my blood pressure to drop, which caused me to - yep, you guessed it - pass out. So, I've learned to modify my whole life in order for my body to handle temperature, elevation, etc. changes in order to keep from looking like one of those fainting goats. So, when I have to go down and then come back up, I do every other movement (only half of what Cathe and Crew do), but when I get to the standing portion, I kind of punch my arms above my head while doing a calf pump (raise up onto toes) before going back down. The 1/2 time pace gives my body time to adjust (no dizzies or passing out) while I'm rising, but the extra movement (arms and calf pump) at the top keep me from losing the cardio benefits.