Wednesday, 6 February 2008

January 2008 Update - Walking With Braces

Update: January 2008 - Braces With Walker

Much of the summer months of 2007 were spent using the ‘sit-to-stand’ frame which, with the help of counterweights helped me stand. Leg muscles were strengthened by repeatedly sitting and standing for ever increasing periods of time. As muscles strengthened and balance improved, the counterweights were reduced until I was standing unassisted-hoisting my full weight under my own power.

September 2007: An orthotics specialist met with my physio and myself in order to fit me with leg braces. In spite of my being able to stand under my own power within the frame, muscles still did not work in unison and in the proper sequence . Ligaments did not hold the joints in proper position due to the year of inactivity. My legs could raise me but couldn’t hold me upright unassisted as my knee joints would hyperextend and I would begin to topple over. Braces were cast using a fast setting compound on a cloth like material wrapped around my legs. Once set, they were removed and used as a mould in which high density plastic would form a sleeve like brace extending from the sole of the foot almost to the crotch. Stainless steel locking hinges joined the upper thigh section to the calf section. Once in the standing position the hinges would lock and walking resembled “waddling” like a duck or like Frankenstein in the movies. The braces could be unlocked using a lever behind the knee. Once the knee joints strengthened and muscle “memory” returned to hold the leg in proper alignment, it is my understanding that the braces would be “cut down” to below the knee cap.

September 2007 to January 2008: There was some difficulty in just standing in the braces for any length of time as the braces held me in the proper upright posture. My Achilles tendon had shortened from non-use and as a result I was unable to stand flat. With my feet flat on the ground, I wouldn’t manage to stand perpendicular to the floor. I would lean backwards. I’m finding it difficult to stretch out the tendon so that the foot is flexible and that the feet don’t make me fall over backwards. The same year long activity has tightened my lower back muscles - causing them to resist my efforts to straighten upright and they ache when standing for any length of time. Over this time period I progressed from needing assistance in getting upright in the braces, to getting up with relative ease and walking the parallel bars back and forth repeatedly. The length of the parallel bars is about 10-12 feet and I would walk the length, turn and come back - repeating about 4 to 6 times before resting.

January 2008: Graduated from the parallel bars to the walker. The walker is an alluminum frame with Teflon sliders on the rear posts and wheels on the front posts. Because the walker isn’t attached to the floor as the parallel bars are, it was more difficult to stand up as the there was nothing ‘anchored’ from which to haul myself up. Once up I would walk up and down the hospital hallway about 100 meters at a time, and return - usually twice per session.

Walking with the braces and walker is now done three times a week within my hour session. A slow process - trying to undo a year’s inactivity an hour at a time, less than 3 hours per week. Fatigue sets in quickly and endurance has to be regained.

February 2008: My physiotherapist thought that massage therapy on my tight ham-strings, quads, calves and Achilles tendons would help in loosening them up. After an hour assessment session, a half hour weekly session was decided upon - for as long as the insurance coverage lasted.
I continue to walk weekly with the braces and walker, receive massage therapy on the lower limbs once a week and have a pool session once a week.

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