gait training - walking

I had a great workout at the gym today! I "graduated" from physical therapy last week, so now that I'm somewhat on my own, I'm going to the gym three days a week.

I started with a walk on the treadmill. Treadmills are not for everyone, and may or may not be safe for you. If you've not walked on one before, or recently, have a friend or gym staffer help you on it the first time and show you how to use the controls. Always attach the pull cord (to your clothes) that stops the treadmill were you to stumble or fall!

I start the speed at 0.0 and then slowly increase until I get to a speed that feels comfortable for me, and then do the reverse when I am finished, slowly decreasing the speed down to 0.0. Today I walked at 1.2 miles per hour for about 15 minutes and made it to 0.30 miles. It is my goal to increase the distance I walk by 0.05 miles every time and slowly work up to 1 mile.

The gym also has a track that is 1/12 of a mile. But sometimes I like to walk on the treadmill because it helps me to work on my "gait". Since my hips and legs are weak, I tend to walk kind of crooked. Walking on the treadmill allows me to focus on perfecting my gait rather than focusing on getting all the way around the track a certain number of times.

If you don't have access to a treadmill or indoor track, pick destinations in your neighborhood that you want to walk to and back (always remembering you have to be able to walk back to where you started). Perhaps, consider measuring by blocks or landmarks in your neighborhood. It is even more fun (and safe) if you can find a buddy to walk with you!

When I practice walking I focus on picking my toes up with each step, and raising my legs upward rather than out to the side. It is not uncommon for those of us with chronic health problems to have trouble in these areas. The benefit to improving your gait is that it makes it easier to walk and therefore allows you to walk farther while using less energy. Who wouldn't love that? :)

Mini-Biking (Cycling)

Does your dialysis clinic have a mini-bike to use during your treatment? My clinic has a small white mini-bike that is basically a wheel, pedals, resistance knob, and an electronic device to measure distance, speed, etc. It is portable and can be pulled up to my chair for use during dialysis.

It is a great way to start your treatment and get some exercise in while you are stuck there anyway. Doctors recommend that you do it at the beginning of your dialysis session, they also say it helps to keep your blood pressure even if yours tends to drop at the end of dialysis. I usually do it for 15 to 30 minutes at the beginning of each session. But you can do it for anywhere from 5 to 30 minutes.

If your clinic does not have a mini-bike, you can talk to your social worker about how to go about getting one. Some clinics write grants for a bike. Other ones, the patients help fundraise in order to purchase one. Some cheaper models can cost as little as $60.

Check out this article about one patient and his dialysis center biking challenge: Dialysis patients improve energy, treatment through cycling

While biking on your own can be rewarding in and of itself, it can also be fun to challenge your fellow dialysis patients to a friendly competition. Pick a destination nearby in your state, keep track of your miles over a period of one to three months, and see who can "get to the destination" first. This can be easily done by keeping a log in a binder in your dialysis unit. (and have a prizes for the participants!)

Here is an example of a mini-bike on amazon.com: Mini-Cycle

If it fits in your budget, you might even consider getting one for your home!

Exercises for Standing

When we go through chronic illness or aging we get weaker, and as you may have noticed it gets harder to stand up. It becomes especially harder to stand from lower heights. These are three exercises you can do to improve your ability to stand up.

Bridges:

1. Begin by laying on your back either in bed or on the floor. Your feet should be on the bed/floor hip width apart, and your knees should be bent upward. Keep your arms at your side.

2. Contract your stomach muscles and pull up your hips up with your thigh and butt muscles.

3. If you are able, hold your hips up a couple of inches for 3-5 seconds.

4. Lower your hips slowly. Repeat this 5-10 times, according to your ability. As you get stronger do up to 3 sets of 12 of these.

Here is a link to an image of the exercise: Bridge Exercise

At first you may not be able to lift your hips up enough to even feel like they are off the bed or floor. However, even just the act of trying to lift your hips strengthens the muscles necessary for standing.

Bridges are the best way to help with standing, but there are two other important leg exercises to strengthen legs. These are good to do especially if you are not able to do bridges yet.

Heel Slide:

While laying on your back bend your knees while slowly sliding your heel towards your hips. Depending on your mobility you may not be able to pull it far, try to pull as close to your hips as possible. Hold for a few seconds and then slide back down. If you can already do this exercise easily, try adding ankle weights in 1/2 pound increments.

Straight Leg Lifts:

While laying on your back extend your legs straight out and flat. One leg at a time, raise your leg up as high as you can, and then return to the neutral position.

If you're already standing fairly well, try doing short squats to increase your ability to stand from lower heights. While standing with your feet hip width apart, squat down halfway and then stand back up. Repeat 10 times for up to 3 sets. Or try doing one-legged bridges.

Goal Setting

Goal setting has been the primary motivating tool in my physical recovery. No matter what level of physical activity you are at currently, your goals should be appropriate to your fitness level. It has been very helpful for me to set small goals to work towards. For instance, if you are just starting to work more, running a marathon my be good long-term goal, but short term goals are instrumental in building momentum.

My very first goal was to be able to move my legs independently without anyone having to help me. It might not seem like a lot, but at the time it was an important step in doing seated transfers and standing. Your first step is to assess what you are capable of now, and identify the next level of activity that you want to reach.

These are some of the small goals I have had:

- move legs independently
- do seated transfer
- be able to stand independently
- walk several steps
- walk with a walker
- walk with a cane

Also, goals do not all have to be mobility related, they can also be about independent living tasks, such as cooking your own meals, or driving. The important thing is to have both long-term and short-term step by step goals. These kinds of goals give you something to work towards.

One way to think about identifying goals is to make sure that they are measurable and time-based. My most recent goals were to be able to walk up and down curbs without my cane and to be able to walk a 1/4 of a mile. My next three goals are to be able to go up stairs without my cane, to go up two flights of stairs with my cane, and to be able to walk a 1/2 a mile by the middle of July.

My First Post

First of all, I am so thrilled to be starting this blog. This is for two reasons. One is that I know it will help keep me motivated! Very few people "enjoy" exercising. I'm no different than any body else, I use all kinds of strategies to keep myself going, one of them is going to be keeping up this blog. The second reason I am so excited to be starting this blog is because I hope to inspire other kidney patients to exercise more and improve their quality of life!

That being said, what kind of posts can you expect from me? Well, I don't want to limit myself. However, you will definitely see information about my workouts, how-to's for specific exercises, milestones I reach, events I participate in, links to related information, and hopefully posts from guest bloggers. I want to also give information about the various exercises and workouts I have done along the way. I started with not even being able to do a seated transfer, to now walking over a 1/4 of a mile.

I'm in no way a trained physical therapist, but I have a lot of experience, and know that just moving your limbs around and doing simple stretches can get you going.

Here's to a fit and active future!