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Posts Tagged ‘Walking with FES’

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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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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