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Thread: For the walkers- proprioception & balance?

  1. #1

    For the walkers- proprioception & balance?

    I'm 22 months post, and am able to walk with a walker. I am incredibly lucky and grateful for the return I have. I walk for exercise approx. 1,500+ feet each day. I have endurance and move at a pretty good pace. Outpatient therapy discharged me with 4-point small base cane and I am able to walk (baby steps) with close supervision. I have both left and right AFO's.

    I have incredible spasticity in my right leg and the knee doesn't bend. In short, if I fall (and I fall like a ton of bricks) I can't get up. I totally lack proprioception and balance. I somehow thought that with practice and exercise my balance and proprioception would improve. I was led to believe that in outpatient therapy.

    What have others done to improve balance and position sense? Will I see improvement in time? I want to make sure I am doing everything I can and should be doing. Thank you ever so much for your advice.

  2. #2
    Senior Member mr_coffee's Avatar
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    JW,

    congrats on your return. What improved my balance the most was to ditch the walker and try to walk with forearm crutches not quad canes. Quad canes are harder to walk than forearm crutches, unless your a lowever level injury and dont have diminished trunk control.

    For arm crutches force you to take proper steps as well, I'd recommend starting in a 4 point gait, then if you can a 2 point. Also i don't think you should be discharged from therapy, your only 22 months post, and still recoverying. Why did they discharge you?

    My favorite exercise that increased my trunk control was sitting on the side of a table/chair, and bending over like your picking somthing up by your feet then use your trunk to bring yourself back up. If you can't do this right away, go down alittle and back up, not all the way down. If you get good, then actually pick somthing up. Make sure your focusing on firing your trunk muscles and not your lower back. What helps me focus on the trunk muscles is to keep my arms close to my body.

    Also i highly recommend this website, it has so much stuff you'll never run out of exercsies. http://www.physiotherapyexercises.com/web2/index.php

    One last thing i liek to do is, stand up, inbetween the walker so if u fall u can grab onto the walker and not hte floor. While your standing try to do functional things, go out in the kitchen, try to put silverwear/dishes away, go get milk out of the fridge, etc. Once your standing move ur arms all around and see if u can stay up. Like bring them to the ceiling, bring htem out in front of you, to the side, etc. If its easy, hold somthing in your hands. This all will help your trunk balance, i was just like you in that sense, i had no balance at all. Goodluck!
    Injured:10-16-04
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  3. #3
    JW

    I'm almost 4 yrs post and I still fall got a broken right wrist with a cast on right now to prove it. I fall alot too, just part of it I guess. I still take very short steps, got no strength in the front portion of my feet, that's why the balancde thing comes in. Keep at it though!!!!!!! Good luck

  4. #4
    JW, you sound like a great candidate for body-weight-supported treadmill training. I've done a lot of it and it has improved my balance. Not so sure about my proprioception, though that's been ok for me.

    Here's a link to a thread about my experience at the U of Florida:

    http://sci.rutgers.edu/forum/showthread.php?t=47768

    I'm happy to answer any questions you may havel. I don't know where you might find this sort of training in Massachusetts, but maybe soneone else here does. I believe that the University of Florida is recruiting study subjects, if you want more info about that, let me know. There are other sites around the country that do this as well.

  5. #5
    Senior Member Broknwing's Avatar
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    Bruce-
    How do I find out info on the UofF study? I'd be interested in wether or not they're currently accepting study subjects and what the criteria are....

    Thanks
    'Chelle
    L-1 inc 11/24/03

    "My Give-a-Damn's Busted"......

  6. #6
    chelle check your PMs.
    Daniel

  7. #7
    Check this out:
    http://www.christopherreeve.org/site...asp?ct=1489719

    The CRF has launched the NeuroRecovery Network grant program to provide support for the translation of basic science and applied research into intensive activity-based rehabilitation treatments. This will also include the establishment of specialized centers that provide standardized care based on current scientific and clinical evidence. The program is funded by a joint agreement between the CRF and the Centers for Disease Control and Prevention.

    Members of the NeuroRecovery Network (as of January 2006):
    The NeuroRecovery Network at Frazier Rehab Neuroscience Institute and the University of Louisville, KY, Lead Center
    Director, Susan Harkema, Ph.D.

    The NeuroRecovery Network at Magee Rehabilitation Hospital
    Philadelphia, PA Director, Mary Schmidt, P.T., M.S.

    The Institute for Rehabilitation and Research (TIRR)
    Houston, TX
    Daniel E. Graves, PhD, Director

    Shepherd Center
    Atlanta, GA
    Deborah Backus, PT, PhD, Director

    Boston Medical Center
    Boston, MA
    Steve Williams, MD, Director


    Please note that Boston Medical was just added...check it out as a possibility.
    Every day I wake up is a good one

  8. #8
    Quote Originally Posted by Broknwing
    Bruce-
    How do I find out info on the UofF study? I'd be interested in wether or not they're currently accepting study subjects and what the criteria are....

    Thanks
    Broknwing, because I've had a fair amount of interest in this, I've started a new thread about the study here:

    http://sci.rutgers.edu/forum/showthread.php?t=65319

    There's a link to more info there. Your profile says you have an L1 injury, which may be out of their inclusion criteria as they say cervical and thoracic injuries only. This is most likely because the Central Pattern Generator is thought to lie at L1 and if that area of the cord is damaged it may affect the data you might provide. However, if you're interested it is still worth contacting them.

  9. #9
    Quote Originally Posted by cheesecake
    cheesecake, this is realy cool. I'm really happy to see this type of therapy getting more support, and getting established in more places around the country.

  10. #10
    Bruce~
    Thanks to CR, this theraphy has been spreading across the country and the CRF is working hard to show that it is effective. CRF was one of the funding sources at UoF, Gainsville. Now, Susie Harkama heads up the team of programs. A criteria of being a center is that you train therapist at other centers in the US. This ensures that the best methedology and data are being obtained.
    Every day I wake up is a good one

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