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> From: Denise D. Goodman <[log in to unmask]>
> To: [log in to unmask]
> Subject: Re: Right Hemi/Spasms
> Date: Wednesday, April 07, 1999 12:10 PM


Sorry to have taken awhile to answer your post.  I figured you'd want one
that was thought out.

> I've found all the posts on PT and the stims units very interesting.
First
> off, I am ignorant about exactly what the stims is.  I'm guessing it's
like
> what the chiropracters use to fatigue the muscles before an adjustment.
A
> repetious pulse or current to beat the spasms into submission :D  - Maybe
one
> of the PT's or OT's can explain why this has the opposite effect on me.

You are probably getting something more like TENS unit um let's see that's
Transcutaneous Electronic Nervous Stimulation or something like that.  The
theory behind it is to overload the nervous system so that it stops sending
pain signals (I'm not a PT or hand therapist so physical agent modalities
aren't my specialty).  It's something like once you keep smelling something
eventually you accomidate and don't smell it anymore.

> The same thing happens when I try to stretch.
> All the old routines from therapy (standing on a phone book, leaning
forward
> to stretch the achellies (sp?) tendon, leaning against the wall trying to
> stretch out the old hamstrings.  Within five minutes of stretching, my
legs
> begin to spasm so badly, I can't even stand up on my own.  Even after
sitting
> down they just keep on jumping.  If I really stress my legs (like the
time I
> decided how great it would be if a wall-papered the bedroom before my
hubby
> came home from work- and stood on the bottom rung of a ladder for 15
mintues)
> not only do my legs spasms for the rest of the day, I even have trouble
> getting around for a few days after that.  I'm taking 60 MG of Baclofen
> already and Ativan at night, and STILL my body is very prone to spasm if
> stretched or stressed.

People with spastic forms of cerebral palsy have to be especially careful
when stretching or strengthening.  Pulling on your muscles often have the
opposite effect and the muscle contracts (spasms).  Stretches should be
long and slow and done after warming up such as literally warming the body
up in warm bath, shower or application of heat.  Stretches should be
accompanied by exercises that help strenghten the extensors (those muscles
that tend to straighten body parts out).  The problem with spastic muscles
is they aren't as strong as you think they are, their pull just isn't
controlled by the antagonistic muscles that are normally responsible for
fluid movement.  Better stretches for the hamstring we've found are getting
the person on the floor, out of the chair, on their belly (prone).  Put a
pillow underneath you armpits or do this on a wedge.  Let gravity help with
pulling the muscle down.  Try relaxing hips first and then knees.  This has
the added benefit of stretching hip flexors and if you do a yoga position
of pushing up on your arms and stretching up like a cobra you work those
all important back extensors and get weight bearing through the hands.
Don't force yourself into that position, relax yourself into it. Take a few
breaths.

> Over the past few years I've tried to go in for a tune-up with PT.  My
back,
> neck and arms tend to feeze up horribly.  I have great respect for PT's
(who
> know what they are doing), the problem is I can never find anybody who
has
> worked with an adult cp patient.  I suffer through with those who treat
me
> like an injured athlete.  I end up feeling like I've wasted time and
money
> and get no results.  I know PT works for some, but in recent years my
faith
> in it has waned.  I've been rationalizing my lack of organized PT by
telling
> myself just doing stuff around the house is excercise enough.  I wasn't
too
> certain if this was true or I was only trying to make myself feel better.

Hey, your talking to an OT here, I'm a firm believer in embedding exercise
into daily routines.  Your right though, you need to find a PT who is
versed in NDT and PNF techniques and also understands the cerebral palsied
body.

> Then Kyle writes, "I'm the "laundry man" as I wash, fold, iron (rarely)
and
> put away all the clothes.  Yeah, I know it's not weight-bearing, but
> manipulating the left hand kind of puts it through its paces (can't
easily
> fold clothes one-handed)."

Of course, I'm thinking to myself, Kyle, you want to teach my husband?

> AH HA.  This seems to be my own take on household chores.  When I put
dishes
> away, I stretch out to reach up to higher shelves.  When I put clothes
away,
> I stretch down to open the lower drawers.  Washing the floors, dusting,
> scrubbing the tub, none of it is weight bearing, but I feel these motions
do
> "put my body through the paces."

You bet these chores put your body through your paces.  Just be aware of
properly positioning you body to do them.

Thanks; Deni

Elizabeth Thiers, OTR
email: [log in to unmask]
homepage: http://www.bv.net/~john/bethsot1.html

se.