After introductions, permission requested of and granted by Jim to observe his therapy sessions, Jim and Ryan get to work. Upon arrival, and with Ryan’s assistance to stabilize his balance, Jim mounts a stationary bike to spend anywhere from six minutes as a warm up to twenty minutes as part of building endurance. Watching Jim transfer from his wheelchair to the bike reveals the balance challenges and weakness of his legs, as well as the mental effort he must exert to move them when and where he wants them to move. In this transfer, Jim expends focused energy to lift his right leg over the stationary bike centerpiece to sit in the seat, then to place his feet into each pedal. For this session, Jim is on the bike for approximately six minutes to open the range of motion in his hips, knees and ankles as he pedals, and to warm up his legs for the other strengthening exercises Ryan will have him do later in this session.
Ryan often involved Jim in deciding the day’s exercises designed to strengthen his leg muscles, increase his endurance level, and develop muscle coordination between movements. Each session may consist of one major movement exercise, such as repetitions of walking within a set of parallel bars or walking back and forth with the assistance of a walker. These activities might be followed with two or three muscle strengthening exercises, such as squats, side steps, and/or knee bends. Sometimes, Ryan simply stretches Jim’s muscles. He’s always by Jim’s side helping him mind his balance and physically spotting him with a hold on a waist belt worn around Jim’s mid-section.
Walking the parallel bars wouldn’t seem like any big deal but if you’ve depended on a wheelchair as your main source of mobility, it’s a big deal! Jim has some use of his legs, so one therapy goal includes regaining better steadiness and mobility on his feet with the use of a walker so he can move about within his home a little easier. The parallel bar exercise not only gets Jim on his feet, but helps him practice the motor skill movement of putting one foot in front of the other, as well as coordinating movement of his hands grasping the bars with feet movement. This exercise also helps him be more aware of his core balance to increase greater stability on his feet. He holds both bars, one in each hand, and Ryan moves backwards while in front of Jim with a hand lightly on his waist belt to help him maintain and regain balance if he wobbles in his efforts. Two or three round trips later, the exhaustion is evident in Jim and on his face as he sits in his ever-waiting wheelchair to rest, despite having a minute-long breaks between roundtrips.
I thought Jim doing this parallel bar walking exercise was a big challenge for him; but what Ryan would ask Jim to do in the next PT session baffled my mind! One, I never would’ve dreamed Ryan would ask Jim to do this next PT exercise which I equate to his “climbing a mountain”; and second, I realized I completely underestimated Jim and what he’s was capable of doing, and willing to do to better his mobility, reminding me again to not underestimate people’s potential or their determination!
In the Next Blog Entry: I’m Gonna Take that Mountain: “I sit on a bench off to the side of the stairs and watch, holding my breath to the point my body forces me to breathe as I watch Jim take one wobbly step up at a time. . . .”We want to hear from you! Please share your responses and comments by clicking below on “Comment” – you may post them anonymously or using your gmail.com profile name.
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