Regaining Balance

[Geert]

Hello again

Balance is a difficult concept.
In the earlier days, people thought it had a hierarchical organization with a lot of neural elements in the subcortical region.

That view has changed now and people like to speak about the dynamic systems framework. This framework sees balance as an interaction between
- the individual;
- the task and
- the environment.

The environment has a great influence on balance, whether it's sitting or standing balance. Walking up stairs will be quite different in the home environment or in a dark cinema room to go to the toilet for instance.
The task relates of course to what you want to do and with increasing difficulty, more demands will be necessary to keep balance. Quiet standing is a basic prerequisite, reactive balance (as a reaction when being pushed) and proactive balance (as an anticipation on an incoming balance challenge) require more balance-related skills.
The individual is of course another crucial part. The motor system with its relevant muscle synergies need to work optimal for good balance; the sensory components for balance include vision, the vestibular system, and the sensory system and then there are of course cognitive aspects like being able to perform dual tasks.

As you can see, one had to look at all these different elements in order consider what treatment would be suitable.

I found it interesting that you mention balance problem of the trunk. Good strength and able to stand...
I would certainly check two things: is the balance problem of the trunk in sitting after coming from supine? Maybe it's dizziness? Then that could mean the vestibular system. Or selective trunk ataxia is also seen in what is called a vermis syndrome where the central part of the cerebellum is affected and what typically gives trunk ataxia in sitting.

Best of luck
Geert

[ADDABAD]

Hi, I am begging for some help. It's been just over six years now, and I cannot go on any longer. Don't get me wrong. I am thankful to still be alive, just not like this. I need help. Intense physical therapy. Perhaps I should elaborate. On the night of Sept. 23, 2003 I was in a near fatal motorcycle accident. And I was not speeding or wasted. I don't really remember it but here it sis, in a nutshell: I was changing the location of my karate school, and had to clear my head, so I took a drive down the coast on my Yamaha VMAX motorcycle when I ran into 6, I am told, dead Wild Boar, lying on the highway.
I was thrown from the motorcycle. And luckily for me my 30+ years of martial arts training paid off. As I tucked and rolled. This move definitely saved my life. But, as I was thrown ahead of the motorcycle, it caught up to me and hit my head. So I suffered a Traumatic Brain Injury.
I was in a coma for 30 days. And in, what I am told is a semi-coma for five months after. I am at home now, but am disabled. I cannot walk. And not because of loss of limbs. As I am very strong and can stand easily. It is a balance issue. I have none. My doctor says that the nerves in my ‘core’ are damaged.
It is just very difficult. As I am very strong. As at the time of the accident I was a US amateur middleweight kickboxing champion.
Anyway I am now begging for some help. I want to walk. Don’t get me wrong. I am thankful to be alive. It’s just, not like this. I can’t even roll myself in my wheel chair. As when I hit, like I said, I tucked and rolled. And I landed on my left shoulder. Breaking my left clavicle. So I cannot use my left arm or hand. And cannot hold onto or grip a walker.

Adam Rogers
456 Oak St. Apt. J
Monterey, CA 93940
(831)717-4139
[email protected]

[gcoe]

Hi Adam

What sort of rehab did you have?
Did you get extensive physical therapy from a neurological physiotherapist? And if so when did it stop?

My guess is that getting one-to-one treatment with a competent neurological physiotherapist would be your best bet.

Seven years have now passed since your injury so further brain recovery maybe somewhat limited at this point. However if you haven't had treatment for a while or you didn't get much to start off with you may benefit from a burst of rehab.

there are many aspects of balance that can be affected when you can't walk. One technique that has gained some interest in recent years is body weight support treadmill training (BWSTT).

22883.jpg

The technique is quite simple in theory. You wear a harness that is suspended above a treadmill, that supports some of your weight and stops you from falling over while you practice walking on the treadmill. this can give you the opportunity to get considerable practice in to improve you skill at balance walking.

there are also some quite fancy robotic versions but the technique is basically the same:

Lokomat.jpg


I don't know if BWSTT would be right for you but it may be worth finding out if you make some enquiries

[ADDABAD]

Thank you. And where can I find help. I am just very frustrated. I am growing tired of waiting for balance to just come. I am willing to work for it. Just where? Where can I go for therapy?

Adam

[Fyzzio]

Hi Adam,
I have just googled Monterey and neuro rehab and came across this:

Director
Phone: 831-625-4835
Community Hospital of the Monterey Peninsula - Community Hospital of the Monterey Peninsula
Community Hospital of the Monterey PeninsulaRehabilitation Services
PO Box HH
Monterey, CA, 93942
USA Certified vestibular therapists.

Specialties: General Balance Retraining, Geriatrics/Elderly Fallers, Neuro-Rehab, Orthopedic Rehab, Vestibular Assessment , Vestibular Rehab

They are not neccessarily TBI specialists, but should be able to do a thorough assessment and/ or refer you on to a specialist Physiotherapy service.

Regrads,
Andrea

[ADDABAD]

Thank you all, so much. I am trying to keep the faith. And just so everyone knows, I have never had intense physical therapy. I just know it is a balance issue. As I can walk easily, with asistance. And I stand everyday, holding onto a rail outside my apartment.