Step and stand to sit

We concentrated on Jo’s step and stand to sit with Jo’s physiotherapy session today. After her fall last week we wanted to get practice in transfers without the damned rotunda.

Jo was hesitant but actually did rather well. The only hindrance was her left hand, which has become relaxed and is not gripping the zimmer frame. I had noticed this last week when Jo was walking using the frame. Normally this would be a good sign as that means the muscle spasticity is decreasing, a sign of possible returning movement. The fact that Jo is also experiencing the waking up pain in her left arm and hand lends further weight to this. Let us hope so.

Time to get rid of the rotunda

Yesterday I asked Jo to use the zimmer frame instead of the rotunda to stand whilst I changed her. She was definitely much steadier, although she didn't think so, which is largely confidence.

A fall has upset us both

Jo suffered another fall today. I was transferring her to the wheelchair using the rotunda. Whereas the last fall was backward, which I have been taking precautions to prevent since the last fall, this time she fell forward. I tried to catch her but her weight and gravity were against us.

The sooner we start doing transfers without the rotunda the better as the rotunda is inherently unsafe, having contributed to two falls now, none of which helps her confidence.

Even better in the water

Jo's hydrotherapy session showed continuing improvement today, with the scissor kicks stronger then ever and increasing power in the left leg when pedalling. Her squat to stand was good and Jo performed really good stands in the changing room, using only the bar for assistance.

A few more steps in the right direction

Jo had another physiotherapy session today and it definitely demonstrated the beneficial effects of having multiple sessions close together. Sadly there won’t be another session until next Monday.

This time she began her walk in the kitchen, walking down the hallway, turning left and continuing to the front door. At this stage she was tired and sat down. After a few moment’s rest the physiotherapists turned her around in the chair, whereupon Jo stood up and walked back down the hall and turned left into the front room and continued to her chair in the front room.

Once again there was no physical support beyond the zimmer frame and Jo was stepping and placing her left foot with increasing confidence. Navigating corners was much easier than Friday, with no complaints or anxiety from Jo.

The next phase will be to get approval for Jo’s carers to make transfers from bed to chair, assisting her in walking with the zimmer frame. This is an important next step and cannot happen soon enough in my opinion as today’s performance has demonstrated that Jo needs such exercise with increasing frequency.

A few steps in the right direction…

… Jo finally seemed to be making these with today’s physiotherapy session. The physiotherapists began in the summer room, at the back of the house, getting Jo to stand using the zimmer frame for support. With an ankle brace and new, velcro-fastening, shoes Jo was able to accomplish this quite easily.

The physiotherapists then coaxed Jo to walk out of the summer room, turn left and left again and walk to the front door. The first left turn saw increased muscle spasticity as Jo had to concentrate on two things, walking and changing direction and so she became anxious. A lot of coaxing saw her through the two turns and then Jo made rapid progress to the front door.

At the front door she sat down and was then wheeled back to the door of the front room, whereupon she stood again and walked back to her chair and sat down with a fairly smooth step and turn.

The whole time Jo was lifting her left foot clear of the floor and placing it herself. She need reminding to prepare herself for the next step, straightening her leg and shifting the weight but there was no physical assistance from either of the two physiotherapists.

Treading water

Jo’s hydrotherapy session today was good, insofar as she demonstrated increasing strength in the scissors movement and improved ability in pedalling whilst on her back. Standing from a squatting position was also better.

The physiotherapist did not have her colleague there so could not try walking in the water again and  we both came away slightly deflated at the slow rate of progress.

The beneficial effects of hydrotherapy…

… manifested themselves in Jo’s physiotherapy session today. Following on from yesterday’s session in the water Jo was able to complete the nine yard walk using only the zimmer frame and lifting and placing her left foot more than before. She also performed some impressive stands from a sitting position unaided.

Sadly the next physiotherapy session isn’t until next Friday, which has us both wondering if we should invest the money into paying for private physiotherapy sessions and stepping up (pun intended) the frequency to five one half hour sessions a week. That would be £250 a week but, as I keep telling Jo, how can you put a price on the ability to walk?

A little trouble walking in water

Jo had a really good hydrotherapy session today. She continues to gain in strength performing scissor kicks whilst floating on her back. Pedalling from the same position is still a problem though.

However standing from a squatting position is improving no end, so much so that the physiotherapist decided t see how Jo did walking in the water. Unfortunately she didn’t tell Jo what she was planning to do, merely asking her colleague to get into the water to assist.

Once Jo realised what was being asked of her and that she was in the middle of the pool without the psychological comfort of the side rail, I saw the anxiety in her face and, sure enough, after one step the muscles in Jo’s left leg went spastic and she cried out in pain. Concentration and multitasking trigger spasticity and in hindsight it might have been better to build Jo up to this and conduct the exercise from the side of the pool where the side bar provides psychological reassurance.

Stepping up to the mark

Jo really seems to be picking up the pace with her rehabilitation. Today's physiotherapy session saw Jo stand and walk with the zimmer frame, in itself an advancement on performing the same feats with the gutter frame, made all the more encouraging by the improvement in Jo's proficiency in performance.
Instead of dragging her left foot Jo was really stepping and placing it. Her left hand was also visibly doing some work holding onto the zimmer frame. It truly begins to feel as if real progress is beginning to be made.

Water baby!

Once again Jo's hydrotherapy session demonstrated her affinity with water and the efficacy of that medium for physical rehabilitation.
Jo's enthusiasm manifested itself even before she got in the water as she opted to stand without the rotunda or any other assistance whilst changing into her costume.

Once in the water Jo began performing the scissors movement with her legs whilst floating on her back unprompted and with as much visible control of her left leg as the right.

She also performed stands with much more positivity than last week and with no cries of pain. She truly is a water baby.