All my PTs work in a barren environment that doesn't 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. Home health PTs walked me around the block in the middle of the day when nobody was outside. Walking in wide empty spaces didn't prepare me for tasks that force me to think while I'm walking. Football coaches don't stop after they have players throw and catch footballs, do foot agility drills, and tackle partners. Football players eventually have to stop concentrating on their body and start thinking about strategy so coaches have them play football with their teammates. Athletes and musicians are shown how to make the transition from exercise to function so why aren't stroke survivors getting the same kind of help?
Immediately after my stroke I had to concentrate fiercely on my hemiplegic leg. Yet my PTs never expanded their focus to environments that demand more. My fantasy is that home health PTs will meet clients in the community in the middle of the afternoon. At a restaurant, walk sideways between tables and go down stairs that have a railing only on our hemiplegic side. At a store, walk in circles around racks of clothing and stop for people who aren't watching where they are going. At a hair salon, sit down in the hairdressor's chair that has a big metal footrest and sit up after you lean back in the sink where hair is washed. At church, get into a pew, close the door of a bathroom stall, and turn around in front of the toilet regardless of which side the grab bar is on. After you rehearse dealing with barriers in the community, go home, rest and plan a real outing. A PT can't 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.
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 feet...it was unlevel with pits, dips, small rises because of tree roots, overgrown so you couldn't see these things.
ReplyDeleteTry 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.
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.
ReplyDeleteSo 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.
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