Wednesday, December 18, 2013

Why YOU should understand what Neuroplasticity is and how it can help you

Hey Team,

I hope that all of you are doing well, staying active, and prepping for Christmas next week. I can't believe we're so close to Christmas and the end of another year, It seems to just go by quicker and quicker every year.

It's been a little while since my last post and I apologize for that, things have been a little crazy since the release of the book... I also recently have transitioned from part time in the PT clinic and part time Adaptive Fitness Training to just full time Adaptive Fitness Training.  While I do love the Physical Therapy profession, the need is just too great for Adaptive Fitness Trainers, so I have dedicated myself to providing my services as an Adaptive Fitness Trainer full time and to reach as many people as possible.

It's been really cool to be able to help so many people locally and out of state, this has been the reason for my recent hiatus in my posting.

I come back though, with a great post! I think you all will benefit from this post and really think it will make you think about your fitness activity a bit differently after reading it. If you like it please comment below, Enjoy!

Why YOU should understand what Neuroplasticity is and how it can help you

Let's get past the terminology for a second, we'll come back to that.... the majority of my post stroke and spinal cord injury clients are usually coming to me because they want to walk better, get stronger, or improve their function.

They want to continue the benefits of their PT program, just one problem......

Physical Therapy is complete, and they have been discharged!

Some people will just wait until they are able to resume PT, others will do some exercise here and there, and some will hire a trainer.

Hiring a trainer is great, but...

Going to a trainer who does not have a background working with people who have disabilities is like driving in circles, they mean well but ultimately cannot design a program to benefit you to improve function.

They most likely will focus on things that you can do very well, while neglecting the more challenging activities that you cannot do or are too weak to perform efficiently.

This is where an Adaptive Fitness Trainer shines, as an Adaptive Fitness Trainer we are looking to maximize everything you;ve got. Communicating closely with your medical team (PT, OT, MD) We will do whatever we can in the safest manner possible to maximize your strength and improve your function by attacking your weakest points, attacking your nervous system, getting you to try to use as many muscles all at once as much as you can and doing this over and over and over again.

Now....lets go back to the term: Neuroplasticity. What is Neuroplasticity and how can it help you....

Check out the following per www.Medicine.Net

 Neuroplasticity: The brain's ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.
Brain reorganization takes place by mechanisms such as "axonal sprouting" in which undamaged axons grow new nerve endings to reconnect neurons whose links were injured or severed. Undamaged axons can also sprout nerve endings and connect with other undamaged nerve cells, forming new neural pathways to accomplish a needed function.
For example, if one hemisphere of the brain is damaged, the intact hemisphere may take over some of its functions. The brain compensates for damage in effect by reorganizing and forming new connections between intact neurons. In order to reconnect, the neurons need to be stimulated through activity.
"Forming new neural pathways to accomplish a needed function"  This is done through repeated compound activities that require communication throughout your nervous system to many muscles all in a preferred weightbearing position.

This is the reason why the FES bike, the Locomat, and other rehab tools have become so popular.
Research proved that locomotor assisted walking over a period of time improved neuroplasticity in patients, as well as regular consistent walking for periods of 20 minutes a day. See here and here.
The point of this post is to stress to you that consistent activity will yield positive results. If you can safely walk the hallways with your walker or cane, then bring a stopwatch and do it for twenty minutes or more daily (with rest breaks as needed), if you have access to an Adaptive Fitness Trainer, then be bold, be fearless, have your trainer challenge you beyond what you think you can do. If you don't have a trainer do whatever exercise or movement or activity that you can safely attempt to do on your own and be consistent and do it often.
If improving Neuroplasticity is done by consistent repeated movements, than just sitting at home isn't going to help. Start moving!

If you don't know where to start check out my book disabilityfitnesshandbook.com for some info to get you started on an adapted fitness program, talk to your therapist, or contact an Adaptive Fitness Trainer in your area.

Feel free to contact me if you have any questions! 
As always......
Keep Pushing, Never Give Up!
-Devon

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Wednesday, November 13, 2013

The Disability Fitness Handbook is finally here!

Hey Team,

I'm so excited to present this to you guys.... www.disabilityfitnesshandbook.com

I feel like I've been working on this book for forever, there have been so many speed bumps that I have encountered that prevented or delayed my working on the book, but I persevered, held strong, and Never gave up because I really feel that this can be an extremely helpful tool for all of you and I wanted it to be just right so that you will love it as much I loved putting it together.

As an Adaptive Fitness Trainer, I really see the benefit in a book like this for people living with a disability that just aren't sure....Not sure about nutrition, not sure about adaptive sports, not sure about fitness or specifically what exercises to do.

My hope is that this book will fill some gaps and present some "A ha" moments so that you all will begin to or increase your current level of fitness and become more sure of your Abilities.

I really hope you enjoy it.....

Check out some more info on the book at the following website: www.disabilityfitnesshandbook.com

on this site you will be able to download a free chapter, take a look at some of the downloadable forms that are in the book and learn a little more about the book.

You will be able to purchase a PDF copy, Amazon Kindle download or a Barnes and Noble download for just $5.95

Also you can check out and leave comments on the Disability Fitness Handbook Facebook page, like us and friend us spread the word about this awesome resource.

As always....

Keep Fighting and Never Give Up!

-Devon







Saturday, November 9, 2013

Inspiring blind bodybuilder caught my attention....

Hey Team,

The other day I caught a story on television that really grabbed my attention.

The story was about Pat Leahy, a man who was born with a rare genetic disease that left him with only 4% of his vision and whose parents were told he would never live a normal life.

This story is amazing....It is everything that the Never Give Up attitude, lifestyle, and mantra is all about.

This guy is truly an inspiration, his dedication and perseverance are definitely a motivating factor in everything that I do.

Full time job on capital hill....no problem,

vision impaired....so what,

Not only does he give it his all during his workout sessions, he also competes in bodybuilding competitions.

Great stuff.....

Check out the story here: http://www.today.com/klgandhoda/inspiring-blind-bodybuilder-defies-odds-8C11553827

Let it motivate you too!

-Devon


Thursday, October 31, 2013

Happy Halloween!!!!

Hey Team,

I received an awesome email from www.spinalpedia.com today and wanted to share it.

Not many people dress up for Halloween.... I love Halloween (other than the fact it's my birthday) it's such an awesome day to just be young and have fun.  I think all of us could benefit from slowing things down a bit and just enjoying something small and silly like dressing up in costume.

I'm sure all of you have numerous great memories of your past Halloween adventures, anyway Check it out here http://us7.campaign-archive1.com/?u=e91567037e4b5ed54a0dee386&id=8fdddcabd0&e=af83f95cb9

Bonus....They touch on Wheelchair boxing which for  those of you who know me know that I am a huge fan of Boxing Fitness at any level and implement with almost every client of mine, the benefits. are. endless.

Check it out here http://www.spinalpedia.com/blog/2013/10/brits-women-quads-take-wheelchair-boxing/

If you haven't checked out www.spinalpedia.com yet please do so, a great online community and a great resource for everyone who is living with a spinal cord injury.

Lastly, an update on the Disability Fitness Handbook.....Editing has been completed and formatting for Amazon Kindle and Barnes and Noble is currently in process. 

I am so proud of this work, and can't wait to share my insight as an Adaptive Fitness Specialist with you.

I'm hoping It will be ready for release by mid November, please stay posted....

Happy Halloween!!!!
Me in my full Super Trainer costume for Halloween!!!

Thursday, October 24, 2013

Update on the book....Disability Fitness (A Fitness Handbook for those living with Stroke, Spinal Cord Injury, Amputee or as Seniors)

Hey Team,

Things have been a little hectic.....I'm in the process of taking on more Adaptive Fitness Clients and cutting back hours in the PT clinic.

I'm looking to keep my Therapy License active, but there is such a need for Adaptive Fitness Trainers, that I decided to go out full time and make myself more available to help those interested in continued fitness after injury or illness.

Exciting times....

I  also
wanted to give a quick update on the book.

Editing pictures took much longer than expected, but it was definitely worth it.

The next step is to send off for Formatting so that it can be viewed on Kindle, Nook, or on any other electronic device.

I'm also in the process of obtaining copyright status, and building a website (www.disabilityfitnesshandbook.com) where you will be able to view a sample chapter of the book, take a look at the book cover and description and table of contents.

The site is not live yet, but once it is I will let you all know.

I've also contacted a company about possible having a printed copy of the book made, depending on how the electronic version does.

I really am excited about presenting this book and sharing my knowledge on adaptive fitness to the public.

Stay tuned for continued updates and an official release date.

Thanks for the support!


-Devon

Monday, October 14, 2013

I want you to be prepared.....What to expect during your fitness assessment

Hey Team,

I want you to be prepared.....

I've recently been completing a lot of fitness assessments for adaptive training as well as personal training and thought it be a good idea to list what you should expect out of your initial visits with your personal trainer/adaptive trainer so that you can make the most out of your first visit and make an informed decision on committing to sessions with your new trainer.

So you've found a trainer and have set up an initial visit, here are some things to expect out of your first visit.

  • This is an information gathering meeting: Be prepared to have information ready to provide to your trainer, this includes: Emergency contact info, your medication lists, recent injuries or ailments, etc...

  • You will be presented with release forms to be signed before any physical activity begins: Consent forms, confidentiality forms, and medical release forms are the norm.

  • The trainer will conduct a question/answer period including your past exercise history, medical history, current nutrition habits and will discuss realistic short term and long term goals that as a team you will strive to meet.

  • You may have your baseline body fat, heart rate, blood pressure, and body measurements checked.

Once you have completed the above, you will now move onto the physical assessment portion of the visit.

This will include an assessment of your current strength and endurance (ie, push up test/sit-up test) form and function (squat test) Balance and cardio endurance (Step test)

If your living with a disability an adaptive training assessment will be performed. This will include an assessment of your abilities to perform tasks such as sitting balance, transitioning from sit to stand, your ability to get down to and up from the floor, and your upper body strength and endurance

(Adaptive training assessments will really vary per the individual and the disability)

Now that all of the above have been completed, your trainer will schedule some follow up visits with you and will implement a program based off of your assessment designed to meet your goals and your trainers goals for you.

As mentioned in previous posts, consistency is key and is instrumental in achieving progression towards goals.


If your completing an assessment in your home try to do the following in preparation for your assessment:

  • Have an open space dedicated to the assessment

  • Wear workout clothing (your going to be moving around aren't you)

  • Bring your water ahead of time

What to look for in an adaptive fitness trainer:

  • Many of the accredited certifying agencies are offering certifications for exercise therapy or adaptive fitness. This is a specialty certification, usually in addition to a Personal Training Certification.

  • Ask to make sure your trainer is insured (just in case)

  • Ask about your trainers background working with similar clients.

Keep an eye out for my book coming out the end of this month, in it I will touch on fitness that can be completed at home with supervision for those recovering from Stroke, SCI, Amputation, or who are Seniors, it will also cover self assessments, nutrition, and adaptive sports

The book is a real comprehensive guide and I'm excited to share it with everyone.


That's all for now Team,

Keep Fighting and Never Give Up!

-Devon






Thursday, September 26, 2013

Adaptive Fitness Resource Guide soon to be released

Hey Team,

I'm excited to announce that I am nearing the final preparations and expect to release an Adaptive Fitness resource guide (e-book) by mid-late October.

This guide will cover Assessment, Nutrition, and most importantly exercise to improve functional tasks for individuals living with Stroke, Spinal cord injury, Amputation, or as Seniors.

I'm really excited to put all of this information together into a comprehensive resource guide for people living with disabilities to refer to that may not have access to accessible fitness centers or adaptive trainers.

As an Adaptive Fitness Specialist myself, I feel that there are not enough accessible gyms, or trainers to really push someone to their full potential.

I put this guide together in hope that more individuals living with disabilities will become motivated to live a healthier lifestyle to the best of their ability.

This resource guide is based on research and my own personal experience working with people living with disabilities.

If interested, Keep checking back or subscribe to my blog for updates on when the release will be you can also follow me on twitter @fitdp23.

Take care for now!

Keep Fighting, Never Give Up!

-Devon

Monday, September 23, 2013

2013 Super H Run Walk Wheel to benefit adaptive sports programs


 
Yesterday was such a great day for such a great event!
 
Early Sunday morning my daughter and I attended the annual Super H 5 K Run Walk Wheel to benefit adaptive sports programs in the DMV area.
 
It has been a couple of years since I last attended, I'm so glad I made it out this year.
 
It was really great to see some of the Therapists and patients that I used to work with at the rehab hospital.
 
This event really personifies the "Never Give Up" attitude that I so often express, people of all abilities going out and competing a 5K race with the benefit going to programs that will further instill the "Never Give Up" lifestyle.
 
It was awesome to see people wheeling the race in quad rugby chairs, hand cycles, crutches, walking, running...what a great collaboration of athletes
 
If you would like more info on the Super H race here is a link to check it out: http://medstarnrh.org/Ways+to+Give/Events/Super+H/default.aspx
 
 
Keep Fighting, Never Give Up
 
-Devon
 

Thursday, September 12, 2013

6 Best commercials that bring awareness to disabilities

Hey Team,
 
Saw a great commercial the other day so I thought I would put together a list of my top ones.
 
I wish there were more television ads that bring awareness to disabilities and that demonstrate the capabilities of all of those living with a disability as these do.
 
Here are my top Six disability awareness commercials, enjoy and be motivated!
 
6.
 
 
5.
 
 
4.
 
3.
 
 
2.
 
1.
 
 
 
Am I missing one? Comment and let me know.
 
 
Keep Fighting, Never Give Up!
 
-Devon


Saturday, September 7, 2013

Why Sleep is so very important for your health and recovery

Do you get the recommended 8 hours of sleep every night?

The majority of you I'm sure will answer no to this question, sleep tends to take a backseat nowadays and has become less of a priority.

I know that as we get older time is something we need more of, but seem to have less of due to work, family, and other obligations.

If your work, family, and obligations are important to you than so too should your health be. Maintaining proper health including the recomended amount of sleep will ensure that you can not only continue with your daily activities of living, but also live your life to the fullest.

In the fitness world sleep is just as important as diet and exercise.  

Muscle growth and repair does not happen during  training sessions, it happens during sleep.

When you fall into a REM cycle your body begins the repair process.

So...Sleep is instrumental in any gains made in the gym.

Read more on sleep to improve performance here:

http://www.sleepfoundation.org/alert/sleep-athletic-performance-and-recovery

The benefits of sleep go beyond just muscle tissue repair though....

The Huffington Post lists 11 health benefits of sleep including - lower stress levels, ability to maintain healthy weight, and improved performance to name a few.

A consistent sleep schedule of 8 hours will yield improvements in mental acuity and performance, it will assist in decreasing inflammation linked to heart disease, stroke, and diabetes.

For those recovering from  stroke or spinal cord injury, research suggests that regular sleeping habits has been shown to boost production of brain support cells, and specifically for post stroke persons to enhance motor skill learning.

In a recent post, I discussed the importance of consistency not just for exercise and diet but also in life.  I feel that this is especially true for good sleeping habits as well.

Better your health today by planning for improved sleep tonight.










Keep Fighting, Never Give Up

-Devon











Wednesday, August 28, 2013

Why consistency is so important, the truth behind the reason your not seeing improvements

As a trainer and a therapist it is not uncommon to provide "homework" to  patients or clients, part of what we do as trainers or therapists is to educate the trainee on exercise, diet, form and technique of movement, etc.... Our goal is to initially have the trainee adopt our program to maintain when not being supervised.

The reason for this is so that the client develops consistent diet, exercise or movement patterns with the instruction that was provided. The repeated performance of an exercise or an activity reinforces it in your brain so eventually it becomes more of a natural movement or activity.

Once that has been accomplished the progression can be implemented during training or treatment sessions.

Despite popular belief, there is no quick fix to improve health or recover from injury, there is no safe magic pill to drop 30lbs in 2 weeks or build 30lbs of muscle in the same time period.

What there is though, is tried and true and has been performed for years by many. It's consistent hard work.

Think about it... Michael Phelps did not become one of the greatest Olympians ever by practicing inconsistently did he? No, he practiced consistently to achieve his goals.

As babies when learning to walk many falls take place, probably 10 or more a day, does that stop them from trying? No, they are consistent in practicing their walking until they achieve it.

The same can be said for your exercise routine, are you getting the most out of your current exercise program? Are you exercising consistently 2-3 times a week or are you going hard and then fizzling out?

The majority of people will work really hard for 2 weeks, expect to see major differences in strength, weight, performance and when they don't they get frustrated, become inconsistent, or quit altogether.

I want to stress how important consistency is, not just for exercise and diet, but in life. Some of the most successful people in this world failed at some point in something, yet they still managed to find success.

The reason for this is that they were consistent in their performance, they did not let in or give up.

So I encourage you to do the same, if it's a diet or an exercise program to lose weight, improve function, or just to overall improve your health.

Stay consistent and I promise you will see the rewards of your efforts.

Keep Fighting and Never give up!

-Devon

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Thursday, August 22, 2013

3 Easy and effective exercises to improve your posture

Hey Team,

I thought I would touch on something that I feel I talk about on the daily with clients and patients...Posture.

In this day and age of computers and smart phones, more and more everywhere you look you are bound to see someone with rounded shoulders and forward head like this





or like this







So much of our daily activities require us to work with our arms out in front of us like typing, driving, or writing. Over time we begin to slump which rounds our shoulders and places our head in a forward position, the longer we stay in this position our postural muscles become weaker and chest muscles become tighter rounding our shoulders more.

Over time we may begin to develop shoulder pain, neck pain, or even headaches as a direct result of this muscle imbalance.

Well I have a cure for you.....it's not in a pill or magic potion though, it's actually good ol consistent work on your part to correct the issue.

3 easy and effective exercises that you can do anywhere to begin to correct this muscle imbalance and start improving your postural awareness.


1. Doorway Stretch- This is a very effective stretch to decrease the tightness in your pecs, do it daily.





















Position yourself in a doorway from a wheelchair position or standing, put your hands on the frame of the door as pictured and lean into the doorway until a comfortable stretch is felt.

Hold for 30 seconds and repeat 3 times.

2.  Scapular Retractions

From a seated or standing position, position your arms 90 degrees at your side. Squeeze your shoulder blades together, sticking your chest out and return to start position.
Perform 3 sets of 10 repetitions each with a 2-3 second hold on the squeeze.
3. Scapular Wall Slides



This one is definitely not as easy as it looks.....
Position yourself against a wall, pull your wheelchair so that it is completely against the wall.
Place your head, shoulders, and bottom against the wall. Now position your arms in a W position as pictured.
Keeping all of the above points of contact (head, shoulders, and bottom) as well as the back of your hands on the wall as you slide from a W position to a Y position.
Perform3-5 sets of 10 repetitions.


As mentioned earlier, the above exercises are extremely effective in decreasing tightness and improving postural awareness, it won't happen with just 2 times or even 5 times of performance. This is something that you have to be consistent with in order to begin to see the effects shine through.
Think about it, your at your work desk for 8 hours of the day on the computer...that's 8 hours of forward rounded posture, just 4 times of completing the above exercises is not going to cut it.
Be consistent, do it daily. They are quick and easy and can be done anywhere, start improving your posture today.
Try them out right now and tell me what you think, and yes that handsome devil in the first pic is me doing my doorway stretch in case you were wondering.
That's all for now,
Keep Fighting, Never Give Up!
-Devon
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Sunday, August 18, 2013

Benefits of health and fitness for the disabled

Hey Team,

Doing some reading today and gathering some research and other articles that focus on positive outcomes following activity or exercise performance.

It is common knowledge that there is a benefit to regular exercise for everyone, which is why any morning of the week you will see people running, riding bikes, or walking.

The benefits of a consistent exercise program are countless, but overall help to improve mind, body, and soul.

Following a disability there is an even greater reason to exercise, yes it is still important for mind, body, and soul, but there is plenty of consistent research that is proving that regular exercise can also improve function.


  • Activity based rehab- is a term that has become popular in the spinal cord injury, and while more research is needed to prove its effectiveness for all spinal cord injuries, there is some research that finds benefit for some.












I recently did a post on The first fully functional quadriplegic- check it out here---> http://fitdp23-nevergiveup.blogspot.com/2013/08/relentless-training-first-fully.html

and

Take a look at this research article on Activity based therapies-
http://www.bu.edu/drrk/research-syntheses/spinal-cord-injuries/activity-based-interventions/-


  • Walking program-I have stressed walking to many of my clients who are recovering from a stroke. There are countless studies on the benefits of a regular walking program for strength, muscle and cardiovascular endurance, as well as improving movement patterns, balance, and control.
Here are two articles that prove the benefits of walking for those recovering from a stroke and for seniors to improve or maintain strength and independence.


http://patients.aan.com/resources/neurologynow/?event=home.showArticle&id=ovid.com:/bib/ovftdb/01222928-201006030-00010- Walking for Stroke

and

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661455/- Walking for older people



  • Group Fitness for kids with disabilities-Regular consistent exercise is just as important for children and may even be more beneficial

http://ptjournal.apta.org/content/85/11/1182.long- Research article on fitness program for kids with disabilities









As more research is conducted and gathered, the same result will be proven over and over again for anyone with or without a disability....Consistent exercise will improve and benefit your Mind, Body, Soul, and Function.

So keep fighting and Never give up!

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-Devon



Sunday, August 11, 2013

The Dedicated-True story of an adapive fitness clients progress with aggressive training

 
 
 
Hey Team,

I came across a progress report that I wrote for an adaptive fitness client who was recovering from multiple strokes that I worked with for over 6 years and thought I would share it for those that are interested.

This clients name has been switched to The Dedicated, it is a real account of our progress made together.

Take a look at our journey together, and see how an aggressive adaptive fitness program  and consistent hard work took The Dedicated from dependence in a tilt in space wheelchair, to walking with hand held support.


Devon Palermo Adaptive Exercise Progress Report


Client: The Dedicated



Disability: Multiple strokes, gait/coordination disturbance
 


Initial assessment for Adaptive exercise: March/2006


To whom it may concern;


The Dedicated was initially evaluated for an adaptive exercise program in March of 2006, at that time The Dedicated presented in a tilt in space wheelchair dependent for propulsion. The Dedicated was non-ambulatory, and required maximum assistance if not completely dependent for all transfers. In the home The Dedicated utilized the following: Hospital bed, standing frame, Wheelchair, and portable ramps for negotiation of steps in the home, as well as necessary aids for self grooming, The Dedicated also utilized the care and assist of a caregiver. The Dedicated was able to communicate with me verbally, but often required assistance from a caregiver when unable to express verbally what was wanting to be said.


Standing was assessed which required max assist-dependent effort with max assist for verbal cues. Sporadic volitional control of the lower extremities was demonstrated when weight bearing and The Dedicated could only stand for seconds at a time. The Dedicated expressed an intense fear of falling when standing supported. we tried weight bearing through the knees with upper extremity support through the elbows on a bed. Positioning required max assist-dependent with max assist verbal cueing. Just as with standing The Dedicated demonstrated sporadic volitional control with glute and lower extremity activation which prompted me to focus solely on weight bearing exercises to improve muscle control by overloading the central nervous system.


The Dedicated agreed to begin in home training 3x a week to work on strengthening the lower extremities and improving standing tolerance.


An exercise program was demonstrated to the caregiver to perform on days we could not meet for training. Exercise program consisted of Leg strengthening exercises that could be performed in the bed. These exercises required max assist for verbal cues to be performed properly secondary to The Dedicated having much difficulty with awareness of left versus right/ right versus left and the sporadic volitional control of the leg muscles.


After several months of working on weight bearing exercises in standing and on the knees and with the exercises performed while laying in bed, I began to note improvement in volitional control of the lower extremities. The Dedicated was now able to respond with muscle activation consistently with verbal cueing, though at times The Dedicated would confuse which lower extremity The Dedicated was attempting to control.
I decided to start implementing core balance and proprioception through the use of a physio ball. The Dedicated required max assist for set up, but was able to maintain balance while sitting on a physioball with moderate assist and moderate assist verbal cueing. I decided to continue with weight bearing exercises while including the newer core stability exercises.


As strength improved in the lower extremities, we were able to work on standing with close supervision after min to moderate assist going from sit-stand and with verbal cues for upright posture.Standing had exhibited tremendous improvement going from seconds to minutes. Soon we began to implement dynamic balance exercises, reaching across midline, standing with eyes closed, etc...


With the improvements noted in standing, I decided to attempt walking with The Dedicated. This proved to be a VERY difficult task. Secondary to fear and lack of coordination with movement, walking ended up being a very maximum assist of 1, almost dependent. Verbal cues were expressed for upright standing, activation of muscles for standing, breathing, and lower extremity  advancement.


As we continued to push with the very difficult task of walking, slowly The Dedicated’ walking began to improve. Requiring less physical assist going from max/dependent to mod/max, and the verbal cues for advancement of the lower extremities decreased, though cues were still required for breathing, balance, and posture. Due to the improvements noted, The Dedicated requested to increase our visits. We would shift from 3x a week to 5 x a week sometimes with sessions lasting two hours depending on the day.


Through the first two years of working with The Dedicated privately, The Dedicated continued to attend physical therapy. The physical therapist and I conversed regularly on the improvements that were made in the home and would apply them to treatments in PT. The Dedicated was able to benefit from the use of the Lite gait and Lokomat while in PT. It is my belief that of all the tools presented for trial with treatment, the Lokomat made the most significant improvements by increasing confidence, decreasing fear of falling, and forcing an upright position in standing.
 


The Dedicated would go to PT for Lokomat training 3x a week for 20- 50 min ambulation sessions in addition to the home training. Lokomat use improved  coordination of the lower extremities with ambulation while not in the lokomat, it also improved endurance for walking while training. Another benefit of the use of Lokomat is that it positioned The Dedicated in an upright proper walking alignment by use of the exoskeleton, The Dedicated was unable to lean . Lokomat training continued well over the normal recommended amount of 12 sessions secondary to improvements.


Once discharged from physical therapy the focus at home became solely walking. We tried several assistive devices. (platform walker, standard walker, neck brace for positioning) Nothing seemed to benefit posture with walking, but we stayed consistent and kept pushing forward.


We began to increase our distances going from 25 ft 2x in the hallway of the home initially to over 400 ft in the hallways of the condominium lobby, to up and down stairs with mod assist and verbal cueing and finally  to over 1000 ft with standing rest breaks as needed.


The Dedicated soon requested trial of walking in the pool. I thought it a good opportunity to work on balance in standing using the buoyancy of the water. Due to the decreased muscle mass on the left leg, we had to use a water weight to decrease the buoyancy of the left leg. Pool ambulation and balance exercises in the water had now become a staple in our exercise sessions during the summer months over the course of 4 years. Ambulation on land after being in the pool did seem to improve requiring less verbal cues for movement and improved fluidity of leg movement.
 

Currently The Dedicated has been given an exercise program to complete with caregivers in addition to the walking exercise that is performed 3 x a week with me.


The home exercise program consists of standing balance, transitioning from sit-stand, dynamic balance exercises, and ube interval training x 40 minutes with rest breaks as needed.
Total of 6 years working with The Dedicated in aggressive adaptive training has yielded positive results that even surprised the doctors who followed the The Dedicated’ care.
 
The Dedicated has overcome many challenges, but worked very hard to do so.
 
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Keep Pushing, Never Give Up!
 
-Devon
 
 

Sunday, August 4, 2013

Relentless Training- The First Fully Functional Quadraplegic

Hey Team,

In my last post I listed the top balance exercises that I recommend for those with disabilities looking to improve balance, stability, and control.

I spoke on how over stimulation of the Central Nervous System is in my belief a significant factor in improving mind muscle connection.

I strongly believe, and research does show that intensive physical training yields positive results for those recovering from disabilities.

I started to think about a man named Patrick Rummerfield, I remember in my early days working with Spinal Cord Injury patients hearing the stories about Patrick and how he was relentless in his training. The Stories about how he would have someone load cuff weights on his legs and set him up on a bike to cycle even though he was barely able to make a movement. How he would do this daily, and how eventually he was  able to move, then able to complete a full revolution on the bike, then stand, and ultimately walk.

I remember seeing him during a Spinal Cord Injury rally, and being inspired all over again, It is Patrick's Never Give Up attitude that motivates me to want to motivate anyone with or without a disability to improve themselves.... to improve myself.

He has a quote that says it all on his site “If you’re going through hell, keep going.” Sir Winston Churchill


That speaks volumes to me, and it should to everyone. Keep pushing, be relentless....Whatever the struggles, Whatever the disability, Whatever the difficulty stay consistent and push a little more every day!





Check out Patrick's site here:


Keep Fighting, Never Give Up!

-Devon

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Tuesday, July 30, 2013

3 must do exercises to improve your balance

Hey Team,

I've been inspired this week by so many of my recent patients/clients demonstrating their improved balance and core strength that I decided to list the 3 best exercises to improve balance and stabilization for those of you who are recovering from an injury or illness.

These balance exercises are for those of you who are ambulatory with or without an assistive device. Could be someone who is really deconditioned following surgery, or someone who is trying to improve their walking following a stroke or spinal cord injury.

What I love most about these 3 exercises is that they are really dynamic compound exercises ( what the hell does that mean? lol) 

That means they require the use of many muscles at one time. They challenge strength, balance, and stability at the same time, and they force you to stimulate your central nervous system.

What is your central nervous system?  you ask....

"The central nervous system is composed of the brain and spinal cord. Your brain and spinal cord serve as the main "processing center" for the entire nervous system, and control all the workings of your body" -http://www.nlm.nih.gov/medlineplus/ency/article/002311.htm

In other words, your CNS is the control center for all functions that your body can and does perform.

So, it is my belief that overstimulation of your CNS will force you to improve muscle control, by improving mind-muscle connection under stress.

This type of stimulation is used in Physical Therapy, Personal Training and everyday life.

For example, In Therapy or Training we use proprioceptive neuromuscular facilitation to improve or learn movement patterns. In everyday life we learn new tasks with repetition until it becomes automated, we tend to pick up these tasks more quickly when we are under pressure. (Think a Starbucks barista during rush hour)

These 3 balance exercises progressively stress your body, and your CNS, under pressure (your fear of falling) so that you improve your mind-muscle connection and begin to control your movement.

What are the exercises already?!

As I mentioned above, they are progressive exercises. Meaning you start with #3 before you move onto #2 etc...

And again, this is for individuals with significant balance deficits following a stroke, spinal cord injury or  a severe deconditioned individual looking to maximize and improve balance for ambulation.

Please make sure you discuss these exercises with your doctor or therapist before attempting them, and make sure you have someone with you to assist if needed.

#3 Tall Kneeling






With or without support, practicing balance on your knees while engaging your core and glute muscles to maintain an upright position.




It's much more challenging than it sounds, but can also be modified to increase the difficulty by adding overhead weight holds.

The key is to engage all of your muscles to stabilize and balance yourself and of course while breathing.

Try it, do 3 sets. Time each one and try to beat your best time.

#2 Half Kneeling






Your base of support has shifted from two knees down to one which now decreases your stability and balance and makes you work harder.

Modify it for more difficulty by adding weight holds as mentioned above.

Try it, 3 sets timing each one for the best time.

#1 Dynamic Tall kneeling/Half Kneeling

You've mastered the above two, now it's time to get serious.....













Get in either position and play a game of catch ( if its with me, we're using medicine balls) or grab a golf club and start swinging, or grab some dumbbells and do some alternating curls or shoulder presses.

The idea here is that know that you can maintain balance in either or both positions we need to increase the challenge and make you start moving in these positions while keeping balance or trying to catch yourself from falling.


Make it fun, start pillow fighting in this position with a friend 2 out of 3 wins


There you have it, 3 great balance exercises that will attack your muscles, your endurance, nervous system, balance and stability.

A great way to work on improving your balance for ambulation/walking.

Questions/concerns? Let me know what you think, drop a comment.


That's all for now Team.

Keep fighting, Never give up!

-Devon