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Thread: KAFO's vs. Treadmill Therapy

  1. #1

    KAFO's vs. Treadmill Therapy

    I have been doing a lot thinking since the latest news release regarding Chistopher Reeve's improvement. I am T12/L1 (lower motor neuron), 17 months post, so am unable to benefit from the FES bike. There is a PT program nearby with a supported treadmill therapy program but they will not accept me because I can't lock my knees. (I don't have control of my quads). I can ambulate using 2 KAFO's and a walker. I was never advanced to crutches because my PT felt I would not use the braces often enough and also my insurance was running out and she wanted to maximize my PT time. My question is: Could I somehow replicate the treadmill therapy at home? I have been wondering if just walking on the KAFO's more would help any? Could that possibly stimulate new nerve connections? Or would it be possible to walk on a treadmill with my KAFO's? I know it wouldn't be the same since all of my body weight would be on my legs and my knees would be locked. I am feeling so frustrated and powerless since I can't use the FES bike and PT won't take me into the program. What can I do at home (by myself)? Sorry for rambling on like this but I am really frustrated. I have the discipline and determination to exercise but I just don't know what to do! Any suggestions would be appreciated.

  2. #2
    Join Date
    Jan 2002
    Phoenixville, PA, US
    just out of curiosity, why can't a person with your level of injury use a a fes bike?

  3. #3
    My level is T12/L1 which means I damaged my peripheral nervous system which means I have a lower motor neuron injury. What that means is that the peripheral nerves to my leg muscles have been injured and therefore will not respond to any form of electrical stimulation including, obviously, the FES bike. Hope that answers your question!

  4. #4
    Phillis, I should think you would benefit from supported ambulation. I am C6 ASIA D, 18 months post. I used a LiteGait for a while, and also a KAFO on my right leg. Today I can walk with forearm crutches and no braces. I did not use my KAFO on the LiteGait because the idea of supported ambulation is to train the locomotor patterns in your spinal cord and nervous system, as well as to work to create new pathways to your brain. Early on, I would sometimes use an AFO to keep my right toe from dragging. Using the KAFO makes you advance your leg with hip circumduction, which is obviously not a natural gait pattern.

    You can build your own supported ambulation system. I believe that Debbie7's husband built her one using a large bolt in a ceiling beam, a pulley system, and a climbing harness along with a regular treadmill. You will want a treadmill that runs as slow as 0.1 mph .. many of them don't go that slow. Debbie7 is a regular poster here and you can contact her for more info on what she did.

    When you start, you will have to recruit two friends or family members, one per leg, to advance your foot and to make your leg follow a "normal" gait pattern. It will take you all some practice to make it work. You also should have a third person running the treadmill .. controlling the speed and ready to hit the stop button if necessary.

    In my experience, you don't need the quad strength to lock your knees to get benefits from supported ambulation. In addition to the supported ambulation, you may want to try electrical stimulation of your quads and hamstrings to help strengthen things up, along with exercises for your legs, hip flexors, and your hip extensor system (the low back muscles, the gluets, and the hamstrings).

    Whatever you do, keep at it .. keep working what you've got because, in my experience, you can build on it and get more. Good luck!

    - Bruce

  5. #5
    Phillis, you posted your reply as I was composing mine. If you have motor neuron damage, shouldn't those eventually regenerate since they are not part of the spinal cord?

    - Bruce

  6. #6

    My fiance did build me a hoist for supported gait training. I bought a safety harness and a pro forma ellipitical trainer. With the pro forma I use my arms to pull levers that make my legs mimic walking. I also already had a treadmill. Anyway the whole system cost around $800. Email me and I'll give you all the info on where to buy stuff and good luck.


  7. #7
    Bruce--Thanks for all of your information. You asked about my motor neurons regenerating...I was told that my injury was a "cauda equina" type injury and therefore there was a possibility of the nerves growing back. It all depends on the severity of the injury and in my case I have been told by numerous doctors that I couldn't have had a worse injury if I had tried. They had never seen anything like it. Complicating matters, it took almost 5 hours for me to get to a hospital so I was told the blood supply to those nerves was effectively cut off and they probably died. So I don't hold out a lot of hope for them to regenerate. But you never know!! I've recently gotten bladder sensation back and this is 17 months post! Thanks again for your info.

    Debbie--I just sent you an email so you can write me with the details of your system at home. Thanks!

    "A journey of a thousand miles begins with a single step".-Confucius

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