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Posts Tagged ‘Walking With A Spinal Cord Injury’

Five days after carpel tunnel surgery I have:

Walked along the waterfront using a gutter frame, twice

Transferred independently from the bed to to wheelchair and back

Transferred independently from the wheelchair to the gutter frame and back

Transferred from the chair to the floor for a bit of crawling

Stood up from the wheelchair to stand up at the bathroom vanity

Emptied the leg bag myself

Done standing exercise ….

Plus all the other things that anybody can do after carpel tunnel surgery:

Used a fork and spoon easily

Tied my shoelaces

Taken off my socks and shoes

Placed the Odstock electrodes after having retrieved them from their ziplock and zipped bag, then remove them and put them away

Squeezed and pinched my fingers and thumbs

Made a fist … And heaps of other things like cleaning my teeth, wiping my face, combing my hair, putting on moisturiser

Every day everything is stronger, but there are a few goals that will be a little way off, like being able to put my all weight down through my hands on to the crutch handles – that will likely be the final challenge!

Whew! So far, so much better than I had expected!

My surgeon didn’t refer me to a hand physiotherapist or give me exercise to do after the surgery so I found some good web sites to help me.

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OR: FINALLY, A MEDICAL EXPLANATION HOW THIS INCOMPLETE PARAPLAEGIC’S WALKING CONTINUES TO IMPROVE

I came across an article from the University of Washington that blew my mind. I am excited, delighted and vindicated.

Some highlights:

Spasm caused by spinal cord injury can prevent voluntary movement of weak muscles. Sounds pretty simple. Except it’s not. Spasm can be complex and the cause, other than the obvious one that it is caused by sci,can be difficult to identify. Pain that is not felt can cause spam, so pain killers can help reduce spasm. Stretching can help reduce spasm. Weight-bearing and walking can reduce spasm. Good postural alignment whether sitting or standing can replasma spasm.

I’ve already learnt this through experimention. I take a cocktail of prescription drugs from muscle relaxants, to pain killers, to anti-epileptics, to a neural enhancer. I exercise five days a week at the gym under the supervision of a personal trainer who creatively extends my range of movement and improves mobility through gentle exercises that target weak muscles, and finds ways of reconnecting neural pathways. I stretch at regular intervals during the day.

Here’s the eye-opener though.Spastic muscles not only inhibit weak voluntary opposing muscles, they also take up residence in synapses and axons and make them unavailable to voluntary muscles! So get rid of the spasm, and nerves can reconnect to voluntary muscles! That goes a long way to explaining rapid improvement in my walking over the last two years – since my spasm was finally under control.

It still doesn’t explain why muscles that had no movement, have gradually become enervated, suggesting that the central nervous system can repair itself!

So never, never, never give up!

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The iPad and exercise sounds more like an oxymoron than a marriage. Yet the iPad has freed me from the chains tying me to the pc, and everyday, while I’m using the iPad I’m exercising and stretching.

Most people spend their day in flexion, hunched over their computer, slouched on a couch or just sitting around. We didn’t evolve to spend our days sitting, we evolved to STAND STRAIGHT. Sitting shortens our hip flexors and weakens our hip extensors so that when we do stand up, our posture is terrible – our shoulders are rounded, and we  lean forward from the hips with our heads thrust forward. You might not notice this when you’re 25, but you sure will notice it when you’re 55. Look around. If that’s not enough to pursuade you to stop sitting so much, think about your internal organs. They’re designed to hang inside, not be squashed up so that end up with digestive and “other problems. If you have a spinal cord injury it’s even more important to get out of flexion.

When I was sitting at the pc I had a timer beside me (given to me by a daughter who cares) so that every 20 minutes it beeped at me til I stood up and went for a walk or did some stretches. Otherwise I’d soon end up with painful spasm and find it really difficult to walk. Ok, I’ve had an incomplete spinal cord injury since 1993 and spasm has always been a problem for me, and I’ve not been able to tolerate sitting for long, but getting down on the floor is just as useful for more able bodied people, you just don’t know it til you hit your fifties and you think being stiff and sore is part of growing older.  Nuh uh … Being stiff and sore is because you spend too much time sitting  and you’ve lost your flexibility.

Muscles get used to the range in which you use them. It’s not enough to occasionally stretch, it takes weeks of regular stretching to increase muscle flexibility. And if you stop, the muscles will likely tighten up again. You have to keep stretching. If you have a spinal cord injury you have to spend more time stretching and make sure that you are using the full range of movement. Otherwise, if you’re in a wheelchair you risk contractures, and if you walk you risk shortening muscles to the point where you can no longer use them. My right hamstring shortened to the point where I could not stand on it, let alone walk. My calf muscles shortened so that I only avoided surgery by doing lots of stretches. I need to keep stretching my calves, hamstrings, hip flexors and adductors every day, three times a day, to keep mobile. And I need to stretch other muscles too.

This is how my iPad and I became good friends*. We roll around on the floor together, we lie down together, we sit crossedlegged together, we do yoga together, we do pelvic tilts together, we extend and flex our internal obliques together, we rotate our hips around my spine together … I’m still discovering exercises we can do together, but pretty much any movement I can do on the floor I can do with my iPad.

I’m writing this while I’m lying prone on the floor.  I’ve rocked my pelvis, I’ve gripped my glutes.

I’ve pretty much had a work  out with my iPad this afternoon.

I’m an advocate of living on the floor, but if  you can’t bring yourself to moving the furniture out, at least get yourself an iPad and free yourself from the chains that bind you to a chair in front of a pc. (whether you’re able bodied or have mobility restrictions). Your body will love you for it.

*My son, the computer whizz, saw my predicament.  He saw how difficult it was for me to sit at the computer. He had the answer. Using the iPad, he said,would allow me to stand at the kitchen bench, lie on the floor , be virtually anywhere and able to do pretty much anything the pc would do. It took some persuading on his part to convince me, but a big, big thanks for his persistence!

Now that he’s seen how successfull the iPad has been, he ‘s suggested the next step. There are some things I still use the pc for, mostly design and publishing. He has suggested we reconfigure the physical set up of the pc so that I can use the keyboard on the floor with a flat screen that can also be use on the floor ….

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One year ago today, electrodes were applied to my lower left leg in an attempt to flex my ankle sufficiently to swing my left leg through in a normal gait pattern.

I had been using a dictus band to keep my left ankle flexed but I had to go up on tip toes on my right leg, and swing my left leg around, rather than through, to walk. I was causing damage to my lower spine and right hip, increasing spasm in my right leg, putting my entire body out of alignment – but it was better than being in a wheelchair.

The results from using the Odstock have been amazing! Initially, it was exciting just to be able to bring my left leg through straight rather than swinging it around and through. The Odstock electrically stimulated my muscles to flex at the hip, knee and ankle. The flow on effects from being able to walk like this have been profound. My spine is straightening, my posture has improved, I stand straight and I rarely experience pain in my right hip. Muscles on my left side from my core down are becoming enervated and are getting stronger.

(An earlier post, Wired To Walk, has a video showing how the Odstock works.)

With the help of a personal trainer who seizes every opportunity to reconnect muscles, I have developed lower abs, internal obliques, glutes, quads and knee control.

Over the last month I have been able to rotate my left hip. Now this may not sound like a big deal, but it has taken my walking to new level. My left hip flexor used to collapse, but now my hip extends, rotates, and my left leg is in a good position to take the next step. (Another plus is that as my internal obliques strengthen, I’m getting a waist!)

My balance is still awful, but the downward pressure I put on my crutches is much, much less as my legs take more and more of my weight … Fewer shoulder problems, twisting of joints, and maybe an easing of carpel tunnel syndrome, as well as walking faster and further. I still have to do lots of stretching – it’s like keeping the muscles oiled and moving smoothly.

So it’s been a good year …

Reach For The Stars

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Since I first tried walking by electronically stimulating dorsi-flexion and a little knee and hip flexion (see Bionic Woman)in my mostly paralysed left leg, I’ve made amazing progress. Particularly given that I have a spinal cord injury at T7/T8 and I was told I’d never walk …

I had been using a dictus to lift my drooping left foot off the ground (drop foot) – a dictus consists of a cuff around your ankle with a thick rubber band looped around hooks on the bottom eyelets of your shoe:

To walk I went up on the toes of my right foot, leaned over to the right and swung my left leg around. My spine was twisting and everything was out of alignment.

Now, using the Odstock to stimulate the muscles of my left foot, I walk with a normal gait, if a very slow normal gait. There is a switch in the heel of my right foot so that when that heel hits the ground, an electrical impulse travels up a wire to the small pocket sized computer on my belt, then down another wire to one electrode placed on my skin over a nerve that travels from the knee to the ankle, and a second electrode placed behind my knee. A micro second later my ankle, knee and hip bend and I am propelled forward. MAGIC!

Odstock Computer Unit


The image below provides an idea of how it works, except that it shows a male walking without sticks, with the heel switch on the same leg that’s being stimulated, and the second electrode on the calf rather than behind the knee. I’m a female, I walk with two elbow crutches, the switch is on my other heel, and I place the second electrode behind my knee (although I can place it on the calf but the response isn’t as good). But you get the idea.

Odstock stimulates walking

Even better is the U tube clip that shows <a href="http://“>how the Odstock works.

But here’s the catch. It’s not a sudden cure for spinal cord injury or stroke or multiple sclerosis. It’s a walking aid. And to get to this point of walking tall and straight I spend lots of time stretching and exercising the muscles that abused to be able to walk. I exercise weak muscles that I need to recruit to work with the Odstock. I spend hours repeating small movements that I need for endurance. I work hard to reconnect and reprogramme nerves that have learned a pattern that has to unlearned, corrected and relearned.

It’s intense. Determination, persistence, commitment is my mantra to which I’ve added creativity. Creative thinking. I discipline myself to follow precisely the instructions given to me by a clever personal trainer who thinks laterally and is always coming up with ways of tricking my brain so I can learn new, better patterns of movement.

Last week I walked two kilometres around a walking/running circuit at a local park. The expansiveness and wide open space encouraged me to stand tall. It took me 80 minutes, and apart from a few lapses of concentration I think my gait was fabulous.

Is it good enough? When will it be good enough? I’ve no idea, but this is good for the moment.

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My physio came to the gym today to film me walking. First I walked with a dictus and then with FES (yep, bionic woman) to compare the difference in gait pattern. The dictus lifts my foot at the ankle then I swing my leg through while I go up on the toes of my other foot. FES lifts my foot at the ankle, helps bend me bend at the knee, and I can swing my leg through while keeping the other foot flat on the ground. FES wins hands down! And it takes so much less energy to walk!

So, while I had my physio in the gym, I asked her to help me get on the treadmill to see if I could walk on it using FES. (Not possible with the dictus). Wow! Wow! Wow! Ok it was at 1km/hr, and after 10 metres my leg was scuffing, but i was walking normally! And after a half minute rest, I could do it again with a normal gait. Rest, walk, rest, walk, rest, walk. Get off. Do something else. Go back to the treadmill. Fantastic. What a life!

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This afternoon I was wired in every sense of the word!

This is a milestone, no doubt about it. With electrodes strategically placed on my left leg I was able to achieve a relatively normal gait … No hitching, no going up on my toes to lift my right leg up high to swing the other leg through, no heaving and pushing on my crutches to force my left leg through, no shoulder strain, no rotating, no leaning to one side …. And no dictus … Amazing!

Left leg bent at the ankle and knee, lifted at the hip, then took a step. I walked straighter, faster and with less effort. (Still with crutches of course.)

Awesome outcome.

I hope to trial it and see if the stimulus is maintained over time.

Big smiley face

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