Treadmill Training...UCLA

[TEION]

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Just wanted to get some opinions on what you all think about treadmill training. My wife, who is paraplegic, has recently been in contact with doctors at UCLA. They are currently looking for participants for treadmill training. I have read that others here have done this, is it worth persuing. Sounds like it might be very beneficial, especially now. Your opinions would be much appreciated.

Thank You

[Jim]

TEION,

I participated in treadmill training at the Miami Project for a few months. It was a great experience. The more she's on her feet, the better!

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[Schmeky]

JLB,

What if any improvement did you see after the treadmill training, and how many hours per day did you you use the treadmill?

[jb]

i was treated at thomas jefferson and magee rehabilitation in philly. a kid from penn state was there maybe 2yrs ago and the first game of the football season, he ran out on the field. DO IT!!!!!!!!!!

[TEION]

http://sci.rutgers.edu/forum/images/smilies/cool.gif
Just wanted to thank everyone that responded for your help. Just out of curiosity, do your think an FES bike is worth getting. Of course we are hoping to get it covered by insurance. How likely is that? Again thank you all.

[foster]

jb my son was at both places from sept 15 to nov 20 2001 when were you there. did you do the treadmill

[This message was edited by foster on 01-19-03 at 23:22.]

[cpaul]

Treion

I spent 7 months, most of 2001 as part of their human trial for locomotor/ body weight support treadmill training. I spent 3 to 5 hours a day, 5 days a week working with Dr. Harkema and her team. What happens in this lab is the SCI patient is suspended from an elaborate Body Weight Support System over a treadmill as the team manually moves your legs in a stepping motion. All the while and as much as possible the load of your full body weight is increased as well as the speed of the machine. The science here is that within your spinal cord there are locomotor Processors take over the mundane chores of moving you from point A to point B. For example, When you decide to get up and go for a drink of water, once the process is mentally initiated you don't have to think of putting one foot in front of the other to get there. Also that with repetitious movement the spinal cord can be retrained and learn. They were able to prove this point with myself and others participating in 2001. I was also their freshest kill so to speak being only 4 months post injury when I participated. The hardest part for me being a T4 was balance and trunk control. It was pretty grueling for me but I was always pushing myself as hard as I could and the team complied to see how heavy, far and fast I could go. There were times when once the stepping pattern was established, they would let go of my legs and I would continue walking. I think it was a very positive endeavor in that it got me up out of my chair, weight baring and using my lower extremities. Also part of my protocol was to free stand with a walker, which I continue to do to this day. I will say however that you must understand this is a research program, and like all research programs there are specific goals in mind. The main goal is their goalwhich may or may not be yours. And i'm sure they may be different now than when I was there. I don't know where you live but in my case I moved to LA from Colorado. There was no cost to participate in the program but living in Westwood village was not cheap. You do however have Hollywood and the movie industry literally right under your nose for whatever that's worth. The long and short of it is that your wife like the rest of us SCI victims wants to have her life back. The current thinking is that you have to get SCI people up and moving ASAP. I agree with this model. Now 28 Months post I have had a lot of improvement in my recovery. I have done UCLA as well as many other therapies outside the box, but I am still living with this mobile prison cell called a wheelchair. I do get up and walk around now with braces and a walker each day and I think this program influenced my gains to date. The folks @ UCLA are a great bunch of dedicated people and I still stay in touch with them from time to time. I do however think Project Walk might be a bigger bang for the buck! I have done a visit there and they have a similar approach in many ways to UCLA. The big difference in the two is that PW's agenda is to get you walking and functioning again. They aren't a research environment and their only agenda is to fulfill your goals. But PW is not free. A good value but not free. Since they are coloring outside the lines of conventional medicine, insurance will probably not help much either. I have not gone to PW yet as I am considering the removal of my rods in the near future while I still have good insurance coverage. In any event, I hope this helps some. Either way, if you don't use it, you loose it and UCLA can provide a modality to get your wife up and moving. In the same time helping to provide research data that could be beneficial to all SCI patients as well as herself.


Good luck!

Chris

[skier]

Are any of you who have done the treadmil training quads?

[Wise Young]

cpaulm, thanks very much for sharing your experience. Wise.

[Jeff]

Teion - I find my FES bike is incredibly valuable. It has dramatically improved my overall health. Christopher Reeve stopped doing the treadmill training but continues riding his FES bike. It's doing great things for him.

I'm sure treadmill training is better for incompletes who want to improve their walking ability. If I were incomplete and able to take a few steps I'd probably prefer treadmill training.

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[TEION]

Thanks Jeff. Let me ask you this, did you pay for your FES bike or did manage to have insurance pay for it? If it was through insurance, how did you do it? Thanks for the info. it seems that FES may be the way to go since my wife is complete. Sounds like treadmill would benefit incompletes more.

Dion

[Jeff]

Teion - I bought my bike used for $7K. I got a year's worth of supplies with it, too. The guy who bought it never used it. It had been in storage for two years but has worked fine since I bought it.

I think insurance is opening up to the benefits of FES. I hear the majority of purchases are funded by insurance now.

When a cure comes along having healthy muscles and bones will be a big advantage. Plus, it's a big benefit in the meantime. I feel 100% better than I used to. I'd pursue it for your wife with vigor. It's a great thing. http://sci.rutgers.edu/forum/images/smilies/smile.gif

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[This message was edited by Jeff on 01-20-03 at 21:21.]

[cpaul]

Teion,
I will share a couple other things with you as well with regard to treadmill training and FES. I didn't mention earlier but I too have an FES bike that I still use 3 to 4 times a week. Got insurance to pay for it by using the rehab portion of the other guys insurance to pay for it. The whole deal was close to 15k but there are certainly benefits to using it the others have pointed out. I got the FES bike and started training with it about 2 1/2 to 3 mo. post injury. Please know that I was a T4 ASIA "A" complete. As complete as you can be by ASIA standards. I say, "was" because recently I was tested and now they have labeled me a T4- ASIA "C" incomplete. I didn't have my FES bike to ride the whole time I was @ UCLA. When I returned home to Colorado 7 months later and tried to ride, the main thing I noticed was that I could not tolerate the amount of stim I used prior to treadmill training. I have to ride now with much less current going to my legs because if I were to ramp it up to where it was, it would hurt like hell and I would know it! I defiantly feel FES has a place for SCI. Cardiovascularly as well as the fact that your legs are actually doing the work. But the benefits of weight baring and being upright with treadmill training has benefits that FES won't cover. C Reeve may not be doing Treadmill now because of his high point of injury. He also did some work @ UCLA for a session or two and broke his leg in the process. That may have certainly impacted his consideration of using treadmill training in his daily routine. Your wife being a Para could and if possible should try to do both things if she can in my opinion. Both compliment each other in different ways. This in addition to stretching and strength training. Challenging each muscle group in any way possible to get things reconnected. I have done a great deal of things over the past 28 months that are outside the box of conventional thinking. All of which have contributed to the gains I've made. FES as well as treadmill have been part of that program. As I said, I still use my FES bike. I still do treadmill training. Big difference for me is that when I use the treadmill now, I use no body weight support and start each step on my own. I stand up from my chair and walk very slowly. I still have 2 people guide my legs after I initiate the step but when I started all this I needed a lot of Body weight support and 4 to 5 people to help me. The bottom line here is that I started out a "complete" and feel that by busting A__ I have made solid gains towards recovery. Do any and all that you can. Getting up and moving ( even if assisted at first) will have positive effects.


Chris

[Jim]

Schmeky,

My training was one hour, three days a week.
In the beginning I could only walk for about 10 minutes. After about a month, I was able to walk for the whole hour.

Great experience!

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[Jeff]

One other thing about treadmill training....while I view it a better option for incompletes than completes, I think the exception to that is for recent injuries. cpaulm described moving from ASIA A to ASIA C. I often wonder if I'd be an ASIA C had I had access to advanced rehab shortly after injury. The first few years are critical. There are no rules. I agree that doing whatever one can get their hands on is absolutely beneficial. There's no telling what gains can be made. Only by aggressively pursuing recovery will you know.

The other aspect of treadmill training to me is its use post cure therapy. You can bet I'll be using it then.

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[TEION]

http://sci.rutgers.edu/forum/images/smilies/cool.gif
Another question. We have also seen leg machines that offer passive/active therapy. No FES involved. One in particular can be seen at www.exnflex.com (http://www.exnflex.com). This machine cost a lot less then an FES machine, but I don't know if insurance will cover it. What do you think of these type of machines. Should we focus on getting an FES bike. Thanks for you thoughts.

[Jeff]

Teion - I've been told that those type of passive pedaling devices can be really good for your joints but, of course, the benefits to your muscles stop short of adding any bulk. I don't think it will help bone density much, either, as little stress is being applied to the bones. If the pedaling is accomplished with the hands then it could be a fairly good workout....but probably not like pedaling with your legs. If it's motor driven then here wouldn't be any cardiovascular benefit. I'm trying to preserve my arms and shoulders for the long run. I really like using my legs for cardiovascular fitness.

~See you at the SCIWire-used-to-be-paralyzed Reunion http://www.stopstart.fsnet.co.uk/smilie/wavey.gif ~

[BMOC]

I (C5/6Inc.) participated in the BWS Treadmill Training at the Miami Project a few years ago. I've been looking for the published study but can't find it in my office. I did however come across some of my other related publications:

"Supported Treadmill Ambulation Training..."
Arch Phys Med Rehab Vol 82, June 2001

"FES-Assisted Walking for Persons with Incomplete Spinal Injuries"
Scand J Rehab Med 2000; 32: 28-36

"Partial Body Weight Support w/ Treadmill Locomotion to Improve Gait After Inc. SCI"
Physical Therapy, Vol 78. Number 4 April 1998

"Spinal Cord Control of Movement: Implications for Locomotor Rehab Following SCI"
Physical Therapy, Vol 80. Number 5 May 2000

"FES Cycling may promote recovery of leg function after incomplete SCI."
Spinal COrd 2000 Nov; 38(11):680-2

I'll post my study when I find it. The results were very positive, showing an increase in overall time and speed AND a noted improvement in over ground walking. Remember, I am a true incomplete.

I recently purchased a SCI Fit Pro II for my non-prof organization. I've only used it once thus far (just came in yesterday) but it's fantastic for upper/lower body work. Obviously the lower extremity workout increases tenfold with some degree of voluntary movement...for completes it should still provide some significant advantages.

Good Luck!

NEW WEBSITE FOR ADAPTIVE SPORTS!! www.misportsunlimited.com (http://www.misportsunlimited.com)

[krajaxa]

I wondered: Which therapy would be better w/harness suspension:
1. treadmill training or
2. ecliptical training to improve walking?