Use of hand in physical rehabilitation

Everyday living
1

Date: 16 December 2012 09:17

Hi Everyone!

I realised it has been more than 15 years that I have been sufferiing from a mobility problem.

15 years ago , I could still walk without support although I could not finish a run if I embarked in jogging activities…

I was diagnosed with MS in 2004.

At the moment I need to use a crutch & s support to walk, although it is now clear that I would actually need 2 crutches to walk in open space.

I have been advised by a physiotherapist to use my hand to help moving the lower extremities , i.e. feet & legs.

While I think it would be very natural to do that, I am wonderiing if this is really advisable?

Will this not encourage a bad habit?

I would like to have your opinion on this.

Thanks & Regards

Bryan

2

Date: 18 December 2012 22:00

Hello!

Anyone there?

Bryan

3

Hi Bryan

Sorry I can’t help.

I always do what my physio says, she is brilliant.

It depends how much confidence you have in the physio. Is he/she a specialist neuro physio?

I hope somebody can answer your question

Anne

4

hiya bryan

my right side has been affected since june. i used to lie in bed willing my right arm to raise. after 2 weeks it did! thumped back down on to the bed cos i had no control. then i did the same with my leg-took longer. but chatting this over with my physio this week she was impressed by my gut instinct. she reckoned that i had re-established the normal nerve route. years ago folk talked of passive exercise being a waste of time but i now understand its well thought of. i believe that a physio (or any other able bodied person) carrying out exercises such as raising left hand does not automatically enable the stroke person to copy but it does start the brain trying to make the right connections and the physical ‘doing’ will follow. (depending on damage done)so why cant it work with ms as well?

so-i would say the suggestion of using hands to move lower limbs is a good thing based on what i have said above.

hope this makes sense!

ellie x (typing in lower case cos fine motor on right hand is still being worked on-and am naturally right handed!)

5

Date: 18 December 2012 23:15

Hiya Chocorange!

Thanks a lot for your post!

This means that as I suspected , exercises when done religiously can help rebuild nervous pathways.

The problem I am facing is that improvement is very slow and very tiring…

So slow in fact that I am now wondering about its effectivess.

6

hiya again

never underestimate the power of the mind! in 6 months i have gone from being washed and fed,being helpless in fact to showering, dressing and talking again. i have learnt alot re patience. think long term-in my opinion its always worth the effort

ellie x

7

well done Ellie, i too had a severe relapse( started in april ),that floored me, i am just starting to do a bit more, i.e.having a shower,washing my hair,making myself a snack,still cant stand for more than a minute or two,and i am still in bed 24/7,i make a diary and focus on what i can still do,and when i write it down,i see that actually i can do more than i think,so when i start to feel hopeless i go to my diary.Hope you get stronger each day.

jaki xx

8

hey jaki

thanks! i cant write it down yet! i can move pieces of macaroni from one plate to another so fine motor slowly improving. i had help for the month of aug but since then have been ‘going it alone’. thats not as bad as it seems because real help doesnt exist even if i wanted it! before i get shot,plentyt of help to take me to hosp appts or help for me social wise but trying to make folk understand that as a mum i want to take my kids to the local panto-20 miles away-theres no help for that. social work are involved and have tried. in the past 6 months i have learned so much re theory and in practise-they are not even similar!

the kids keep my diary up to date!

ps did enquire at local mss re transport-still waiting if i (and my youngest 2 kids) fit their criteria!

ellie x

9

you are right there isnt any help,i had a team in to ‘help’ all they were interested in were,filling forms in,and the help i got was a bowl of water brought to my bedroom,so i could wash myself,and a comode,of which i never used, i said if i can stand i can manage to get to the bathroom,with difficulty,but at least i could get there,the days i couldnt lift my head from the bed, had to use a bedpan,but luckily,that didnt happen often,its all about form filling and meeting criteria,the more ill you get the more you realise.xx

10

Bryan,all I can do to advise you is to get all me me me,and 'praps that might give you food for thought.Diagnosed sept 2001,left side weaknesses, but no real hassle.Seven years ago feet started being uncomfortable and left hand a bit strange.Am right handed.Walking deteriorated so five years ago started on stick,but hard work and becoming painful at over 100 m .Bought mobility scooter,tripod one and able to sling into boot of car easily.

Thjree years ago couldn’t get buggy in car,feet becoming a real issue,stick walk dodgy,so got good on wheelchair.Two years ago,feet really painful when driving automatic, left hand dodgy,couldn’t use chair and losing sensitivity.Walking down to indoor stagger between solid objects. Bought big class III scooter for road use. Now,feet horrendous,can’t walk,left hand used with extreme caution,surrendered licence,and done nearly 3,000 miles on buggy on road.Right hand going like left and trying to plan ahead for having 10 dodgy thumbs.Very frightening,as nothing particularly to slow speed of progression. Liberation might,but FDA have banned it throughout Europe.

I made all the decisions to start using different gear,but had no options in trying to prevent proggression as Copaxone did nowt Steroids have helped over the years,but side effects too bad now. If I was in your situation,I would get off my feet,use wheelchairs,buggies etc,because I wouldn’t sacrifice my hands to help walking when there was no need.Would exercise legs and be aware of hands. At this rate of deterioation with right hand I’m going to be in big heap trouble in six months if I can’t find some way of saving it.I can cope in my flat by use of a highly modified wheelchair with which I can move around using only with my feet and transfer onto, bog,telly chair,either buggy and any lucky lady.

It has not been my intention to winge,it’s “Just the way the mop flops” and what I’ve done to survive…I’ve given you the version of what I’d do, with ‘Handy hindsight’ of my past seven years.We all have our own version of MS and this is my self indulgent story.By the way, nobody has told me I’m not still a climbing instructor.As for Fizzios,“They are the experts, but we are the users”.

Good luck, Steve

11

I can’t advise on using hands to help legs, but I wanted to back up Ellie’s point about (re)building nerve pathways because there is a load of research evidence to support it from lots of different angles. For example, repeated use of a nerve pathway strengthens it (this is also protective - stronger connections are less likely to be completely damaged), imagining doing anything activates the areas of the brain that would actually do the thing you’re imagining to the extent that repeated visualisation of using a muscle actually increases the size of that muscle, and even watching someone else doing something activates the areas of the brain that would do that same task. That last bit is thanks to things called “mirror neurons”.

So if you are too knackered to do your physio, get someone else to do it, watch them and imagine that you’re doing it too - even if it doesn’t make things better, it might help to stop things from getting worse!

Karen x