Walking--Right foot. Left foot. One in front of the other. Moving forward. Moving backward. It’s an ability most of us take for granted. However, for those people suffering from stroke, Parkinson’s, and other neurologic diseases that impact gait, the research efforts of McGowan Institute for Regenerative Medicine
affiliated faculty member Jessie VanSwearingen, Ph.D., P.T. (pictured), Director of Rehabilitation at the University of Pittsburgh Facial Nerve Center, Associate Professor in Physical Therapy, and Assistant Professor within the School of Nursing, help patients go the distance.
As reported by Amy Paturel, M.S., M.P.H., Neurology Now, problems with gait (how a person walks) and balance are pervasive across neurologic disease. And while the area of the brain that's affected may differ depending on whether a patient has Parkinson's disease, stroke, multiple sclerosis, or even old age, the end result is the same: a loss of coordination, mobility, and independence. “Even when patients need assistance to live, if they can walk (and walk well), that level of dependence is greatly reduced,” says Dr. VanSwearingen.
Walking is actually a very complex task that requires an integration of multiple systems in the body. It's so complex, in fact, that if there is a disruption to any of the centers that are related to processing information coming into the brain (like where your foot is in space or where your body is) or the centers responsible for sending commands back out from the brain (like “lift your foot”), your ability to walk will be compromised. Add frailty and fear to the mix, and it's amazing any of us gets around.
“Some people think of walking as a sixth vital sign because it's so sensitive to changes in almost any body system,” says Dr. VanSwearingen. Some medications—such as those for Parkinson's—may improve patients' ability to walk. But more often than not, the medications people receive for neurologic disorders cause more problems with gait than they alleviate.
If you have problems walking and often lose your balance, or if you're out of shape and get winded quickly, those warning signs should prompt you to consider a regular exercise program to improve function. “Walking should be as good as it can be so you don't have to expend much energy just to get around,” says Dr. VanSwearingen.
To help with remaining or becoming as independent as possible, patients and experts weigh in with their top 10 tips to help get you moving again. Check with your neurologist before attempting these.
1. Use a walker (or a grocery cart)
2. Walk to the beat of music
3. Walk in a swimming pool
4. Watch your shadow
5. Rock in a rocking chair
6. Shift your balance
7. Walk around the table
8. Set small goals, then keep expanding your goals as you meet the smaller ones
9. Be safe
10. Get emotional support
Illustration: McGowan Institute for Regenerative Medicine.
Neurology Now (May/June 2010)
Bio: Dr. Jessie VanSwearingen
Abstract (Physical Therapy; 2010 May 20)