A League of Their Own: Rehabilitation Institute of Michigan Stroke Survivors Start Golf League

Members of Rehabilitation Institute of Michigan (RIM) Novi Center’s Stroke Support Group are getting their lives and game back on course. The group recently started a golf league for stroke survivors and their family members.

The group meets bi-weekly and is comprised of stroke survivors, some who have golfed before and some who are new to the sport. Some of the golfers are ambulatory and some golf from a specialized adapted golf cart. The cart has a swivel seat that allows golfers to hit the ball from a seated or supported standing position.

According to RIM Novi’s social worker and case manager, Jay Devereaux, the league has provided physical and psychological benefits. “Golf is a very physical game so it is great for them to be outside and exercising and from a psychological standpoint it is a huge self-esteem builder for them to be out here and enjoying something they loved prior to their stroke.”

Steve Freilich had been a golfer for 35 years. He thought his days on the golf course were over when he suffered a stroke four years ago.

“After my stroke, I couldn’t talk, or walk or drive. Thanks to my rehab, today I am able to do all of those things, including golf.”

“My game is not what it used to be. I golf one handed and my ball doesn’t go as far, but I still enjoy it and I’m grateful to be out here. I think I will probably be golfing another 35 years now.”

Why are women more susceptible to sports injuries than men?

Research has shown that there is an anatomical difference between men and women which unfortunately puts a greater risk on women for injury during sports.  Women have a larger pelvis than men which causes increased stress to the knees.  Women also tend to have looser joints due to laxity in their ligaments.  Many have attributed the laxity of ligaments to female hormones. 

In addition to the anatomical factors, women are becoming more and more athletic and often times are not trained properly for their sport. Also, manufacturers are just recently designing specialized equipment to accommodate a women’s anatomical structure.

Unfortunately, women can not change their anatomical structure, but, they can use these helpful tips to prevent injuries.

1.      Keeps knees bent and land on both feet when landing from a jump.

2.      Work with a physical therapist or personal trainer to learn how to properly cut or pivot.

3.      Correct muscle imbalance.  Strengthen the hamstrings (muscles in the back of your upper leg), gluts (buttocks) and inner thigh muscles.  These muscles are often weaker than your quads (muscles on your thigh).

4.      Replace running shoes (see your local running shoe store for frequency).  General guideline:  Replace every year if running 10 miles per week and every six months if running 20 miles per week.

5.      Make sure there is adequate calcium in your diet to avoid osteoporosis which may lead to stress fractures.

6.      Take advantage of equipment designed to fit the anatomical structure of females.

7.      Develop a strength training program that emphasizes multiplanar, multijoint, and functional exercises.  These exercises will help develop intermuscular coordination, proprioception, and balance which transfers to increased strength required for sports or daily activities.

Consult with a physical therapist or personal trainer to help develop a safe exercise program to meet your needs.  A well designed program will significantly reduce the chance for injury and help improve your performance for your sport.

Consult with a nutritionist regarding a well balance diet and to make sure your getting sufficient calcium.

By: Suzanne Schmidt, MPT

Exercise Safely in Hot, Humid Weather

Hot summer weather doesn't need to sideline outdoor exercise. But it does become more important to modify your routine in order to exercise safely in hot, humid weather.

Combining physical activity with hot temperatures and bright sunshine increases stress on the heart and lungs. Not only does the heart have to work harder to deliver blood and oxygen to exercising muscles, but it also must circulate more blood to the skin where it can be cooled off through sweat evaporation. If the humidity is also high, your body can't be cooled as effectively from its own sweat either.

When exercising outdoors during summer months, it becomes important to adjust your routine to the cooler morning or evening hours – to avoid the midday sun. Some other tips to help keep you safe:

Stay well-hydrated. Drink lots of water when you're exercising, even if you don't feel thirsty. If your workouts are lengthy, consider alternating sports drinks with your water intake. Such drinks help replace important nutrients you are losing through sweating.

Take it easy as you start working out. As your body gets used to the heat, you can gradually increase the intensity and duration of your workouts.

Dress appropriately. Light-colored, loose-fitting clothing does a better job of keeping you cool. Dark colors soak up the heat, so avoid wearing them. Wearing a hat with a brim can reduce sun exposure.

Use sunscreen with an SPF 15 or higher. This reduces sunburn risk. Apply liberally 30 minutes before heading outdoors and reapply during extended workouts.

Symptoms that the sun may be getting to be too much for you during hot-weather exercise could include:

·         Muscle cramps

·         Headache, nausea or vomiting

·         Paleness and weakness

·         Heavy sweating

More severe warning signs include:

·         Dizziness or confusion

·         Red, hot, dry skin with no sweating

·         Rapid heartbeat

·         High body temperature

If you suspect a heat-related illness, stop exercising immediately and get out of the heat. Seek shade or move indoors. Drink plenty of water and cool your skin by wetting it with a damp cloth. Seek immediate medical attention if you or an exercise partner becomes faint or confused, or develops a fever higher than 102 degrees Fahrenheit.

Pilates Helps Stroke Survivors Connect Mind and Body

Stroke affects approximately 795,000 Americans each year and is the leading cause of severe, long term disability in the United States.  A stroke can rob a person of their speech, mobility and independence. Additionally, stroke survivors may experience sudden changes in mood and suffer depression when parts of the brain controlling emotion are affected.  While many of these challenges may diminish in severity over time, the road to recovery and independence is long and emotionally taxing.

It is connecting the mind with the body that presents the biggest challenge after a stroke. 

Physical, occupational and speech therapies are often prescribed to help a patient recover lost function. Medically, these treatments are proven to help. But a number of stroke survivors are finding success with alternative treatments, such as Pilates, to help them rediscover body awareness and strength. 

Pilates is a system of exercises designed to improve physical strength, flexibility, and posture, and enhance mental awareness. Exercises work the abdominals in almost every move, and involve laying on the back, side or stomach and lifting legs and arms using the body’s core in combination moves that build coordination and strength

Pilates instructor, Francine Burgess, believes that in addition to increased core stability and strength, Pilates fosters mind and body awareness.  “Anything that can foster mind/body strength is beneficial. Pilates works on breath control and is connected to movement of the body, while moving outwardly connecting mind and body,” says Burgess.

There’s also an important psycho-social component. Patients interact with one another, and they support one another. It’s an activity-based therapy in a patient support group setting.

Burgess, a first year physical therapy doctoral student, teaches two Pilates classes at Rehabilitation Institute of Michigan’s (RIM) Brasza Outpatient Center, where her classes include both stroke survivors and others just wanting a strengthening core workout. She is currently working with researchers on curriculum for a targeted Pilates class that will focus on the specific needs of stroke patients. Burgess hopes that with the published results of this focused curriculum, that stroke survivors can find great benefit in participating in a very detailed program geared exclusively toward their unique needs. 

For more information on our Pilates classes and other community education classes at RIM’s Brasza Outpatient Center, call (313) 745-9748.

By: Carly Knazze, Rehabilitation Institute of Michigan

Rehabilitation Institute of Michigan Selected to Study Robotic Legs for Persons with Spinal Cord Injury

DMC Rehabilitation Institute of Michigan is among 10 rehabilitation centers in the country that will participate in an investigational trial of eLEGS. eLEGS is a wearable robot developed by Berkeley Bionics, that powers wheelchair users up to get them standing and walking.

eLEGS is a ready-to-wear, battery-powered exoskeleton that is strapped over the user's clothing. The user initiates the steps by triggering non-invasive movement sensors in the crutches that communicate with the computer carried in a backpack. The patient doesn't bear the weight, however, as the device transfers its load directly to the ground. eLEGS provides unprecedented knee flexion, which translates into the most natural human gait available in any exoskeleton today. The device can be adjusted in a few minutes to fit most people weighing 220 pounds or less, and between 5'2" and 6'2", with at least partial upper body strength.

The rehab centers selected for the investigational trial will be the first eLEGS Centers in the world, conducting ongoing research, and offering the device for the rehabilitation of their patients. Physical therapists at Rehabilitation Institute of Michigan’s (RIM) Center for Spinal Cord Injury Recovery will be using eLEGS to primarily treat spinal cord injury patients for balance, posture and gait training.

“The Center for Spinal Cord Injury Recovery has a history of seeking out the most innovative and state-of-the-art technologies and therapuetic treatments for improving function and quality of life after a spinal cord injury,” says William H. Restum, PhD, President, RIM. “We believe eLEGS is an exciting opportunity to further advance the functional recovery of the patients we serve.” 

Berkeley Bionics plans to introduce eLEGS to the market in early 2012.

To learn more about eLEGS, watch this video http://www.youtube.com/watch?v=WcM0ruq28dc

Lower your Blood Pressure with Exercise

The pressure to succeed at home, at work, and even to find the lowest gas price is constant. As we take these pressures head on, there also could be pressure building up inside us without notice. Blood pressure as we know is the force on our arteries as blood is transported throughout the body.

Exercise and blood pressure have a close connection. Regular physical activity helps to build a stronger heart. A stronger heart will send more blood throughout the body with less effort, in turn placing less stress on your arteries. It takes at least one to three months of regular exercise to have sustained results. Exercising this regularly, can lower your blood pressure by 10 millimeters of mercury, and possibly eliminate the need to take medications.

So, what do you have to do? Moderate aerobic activity of at least 20-30 minutes on most days of the week is recommended. Aerobic activity can be anything from mowing the lawn and other yard work to walking or jogging. If you don't have time for 20-30 consecutive minutes of activity, break it up into shorter bursts of 5 to 10 minutes, and before you know it, you have reached your 30 minutes for the day.

By Craig DeLeon, ATC, Rehabilitation Institute of Michigan

Sports Related Concussions—What You Need to Know

The most common head injury in sports is concussion.  Concussions are direct injuries to the brain and are usually due to direct blow to the head.   They are common in contact sports with the highest risk found in those athletes who participate in football.  It is estimated that in high school football alone as many as 250,000 concussions occur each year and that up to 20 percent of players sustain a concussion.   Other sports in which players are at risk for concussion or head injury include boxing, ice hockey, wrestling, gymnastics, lacrosse, soccer and basketball.

Concussions can range from mild to severe, but they all share the common factor of interfering with the way the brain works.  They can cause problems with memory, balance, judgment, speech and coordination.  Symptoms of concussions may include headaches, dizziness, amnesia, difficulty with concentration, personality changes, disturbances of vision and coordination and occasional loss of consciousness. 

Concussions don't always involve a loss of consciousness. In fact, most people who have concussions never black out. Many athletes may suffer a concussion and may not even realize that they had one and therefore, do not undergo evaluation by medical personnel.  It is important to educate athletes and coaches about concussions especially in the instances in which an athlete sustains a concussion, but does not lose consciousness or have symptoms severe enough that would draw attention to the athlete during the course of competition.

Once a concussion has occurred, the athlete becomes much more likely to sustain a second concussion.  Repeated concussions can result in cumulative damage to the brain, even when the injuries are separated by months or years.  Therefore, it is recommended that a detailed record of all concussions sustained by the athlete during the course of his/her playing career is kept.  It is also important for athletes to report any type of symptoms that they might have and also for teammates and coaches to be suspicious of the athlete that exhibits changes in his/her personality or behavior during the course of a game.   While most concussions are mild and resolve without any long term complications, it is very important to evaluate them thoroughly to avoid potentially long-term brain damage or possibly even life-threatening outcomes.

By: Dr. Tariq Awan, Sports Medicine, Rehabilitation Institute of Michigan