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Clinical Reasoning Typical cases are discussed there. The cases are brought by practioners.

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Old 31-08-2007, 10:38 PM   #1
clarett
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Default walking to running in neuro pts

Does anyone have any ideas on progressing from walking to running with someone who has neuro deficit in both lower limbs e.g. following central cord syndrome or the like? Obviously they can walk well!!!!
I have no access to gym equipment so a treadmill is out of the question.

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Clare
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Old 01-09-2007, 05:49 AM   #2
nari
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Hi Clare,

As no-one has yet answered, I'll give it a go. It has been a while (5 years) since I was in the neuroRehab environment, so I may be out of date...

As he has some function in both legs and he can walk safely on various surfaces, an obstacle course would be a start, if you have the room.
Place tables, chairs, blocks in the way and get him to devise a route of his own making.

If you haven't already done so, check out his motor responses while under a bit of pressure. Following a tape circuit on the floor, circles, squares, rhomboids can be done in a few sq metres of space. Then time his progress and watch his cadence under pressure. If all is well, can you take him outside anywhere: a quiet pavement or a courtyard, to start short bursts of rapid walking-->a jog-->sudden stops etc.

Let him pace himself, and tell himself to turn, step backwards, sprint a little, stop, etc. It is important that he anticipates his own actions. I'm sure you are aware of it already, but keep the sessions brief, say 5-10 minutes only. Fatigue is not what he needs!

Hope this helps a bit.

Nari
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Old 01-09-2007, 10:15 AM   #3
Randy Dixon
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Why are you progressing to a run?

I don't have much experience in your situation but besides what Nari wrote I would consider the differences between running and walking and what physical actions are required. For example, you will need a higher knee lift, more range of motion through all phases, the ability to land on one leg. Something like one legged hopping to test the latter might work. Practicing the swing through while balanced on one leg, might be an idea. Break down the run.

A good book on running and running drills would be helpful. Drills are often designed to work on one phase of running at a time and I think this is what you are going to need to do.
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Old 01-09-2007, 02:21 PM   #4
emad
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Hi clare :

The general patient's state is factor , age , weight . However, I do believe training and practice make every thing possible .
cheers
Emad
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Old 22-09-2007, 11:05 PM   #5
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Thank you - sorry the delay.

Progressing to a run because that is one of the patient's aims and it is one of the last ones we have left!
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Old 04-10-2007, 03:35 AM   #6
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Hi clarett,
Well i have some ideas, perhaps you can use this if you think it's appropriate...
I too have a client with central cord syndrome at C5 Spinal cord injury ASIA score B on initial examination. he was injured while playing soccer and he is young 30 years, well determined.After going through an intensive rehab for 8 months now, i can make him run and he's preparing for full marathon in december. He is fully active now back to community, work, involved in social activities, driving etc...

besides all the regular stuffs like strength training, Mobility training etc. I started with dynamic balance training with trampoline, wobble cushion then progressed to tandem walking, stairs training(outdoor) with skiping steps. Consequently i tried fall recovery training then i started engaging him soccer simulation with big ball and of course, i do give him treadmill with progressive speed. He engaged himself in swiming twice/week, and i used to play badmition and basket ball during weekends.

Shuttle run in 5 meter/10 meter is another option...

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