May 17, 2015

Walking in a Barren Environment

All my PTs work in a barren environment that does not make them aware of the cognitive demands I have to deal with while walking.  In-patient and out-patient PTs walked me in gyms that have equipment and people sitting around the periphery.  When two clients who are walking approach each other the PTs look at each other and decide who will stand still while the other person moves first.  This gave me the luxury of concentrating fiercely on my hemiplegic leg.  Home health PTs walked me around the block in the middle of the day when nobody was outside.  Walking in wide empty spaces did not prepare me for tasks that require me to think while I am walking.

My fantasy is that home health PTs will meet clients in the community in the middle of the day.
At a restaurant they will help stroke survivors walk sideways between tables and go down stairs that have a railing only on the hemiplegic side.  At a store - walk in circles around racks of clothing and stop for people who are not watching where they are going.  At a hair salon - sit down in the chair without tripping over the big metal footrest.  At church - get into a pew and turn around to sit on the toilet regardless of which side the grab bar is on.  A PT cannot be with me every time I try a new activity.  However, PTs can make clients safer by helping us understand that walking requires problem solving as well as physical mobility.  After you rehearse dealing with barriers in the community go home to rest and plan a real outing.

Football coaches do not stop after they have players throw and catch footballs and do foot agility drills.  Football players eventually have to stop concentrating on their body and start thinking about strategy as they move so coaches have them play football with their teammates.  Athletes and musicians also have rehearsals to make the transition from exercise to function.  Why are stroke survivors not getting the same kind of help?


  1. When I was discharged from the hospital, my Pt had pretty much thought of every kind of walking condtions except my front yard. We had walked outside on their well manicured grass did some curbs and steps, But that;s not my front yard. My daughter parked fairly close to the front door, with five was unlevel with pits, dips, small rises because of tree roots, overgrown so you couldn't see these things.

    Try as I might I couldn't find a single place where all four legs of my hemi walker could be level. Let's just say I had wished I had gone ahead with my plan to enlarge the front walkway. I finally made it inside.

    I've stopped going to walmart. It's just too big. While I'm walking with a cane now the spaces are just too narrow, people don't watch where they are pushing their cats...I have the bruises to prove it. There is never one of their motorized scooters available. Te racks are too tight together to get around them or between them. My last visit there it took me two hours because 1) it's in the back of the store, 2) the benches to sit on wad covered with debris and merchandise,and 3) several ladies children were playing on them unattended.

    I was so frustrated and angry by the time I left the store, I store I'd never go back.

    Problem solving would have been a definite improvement. Like how to shop for groceries, bending and lifting objects, and purring them in a cart one handed when you need your cane for support with only one hand.

  2. I put my cane in the shopping cart and use the cart like a rolling walker. People don't notice my cane, but they can see a cart coming and are more likely to get out of my way.

  3. So true! I walk without my cane most of the time, now. I'm constantly on the lookout for people not paying attention to where they're going (kids in stores especially). I'm conscious that a good bump could topple me.