The Importance of Ambulation to Independence
“Human walking is a unique activity during which the body, step by step, teeters on the edge of catastrophe.”
—paleoanthropologist John Napier
Ambulation is defined as the physical ability to move from one place to another. Independence is being able to live life with no or minimal assistance. NeuLife post-acute rehabilitation is the bridge to enable an individual to move from where he or she is, due to a traumatic brain injury, a spinal cord injury or some other catastrophic injury, to a normal state of mind, strength or health consistent with his or her physical and psychological abilities.
A study conducted by McGill University dealt with variables related to independent ambulation of individuals who sustained severe traumatic brain injury. The study was conducted in an acute-care facility and included only individuals who were unable to ambulate because of the TBI and excluded individuals who could not ambulate because of some other reason, such as a spinal cord injury, trauma or other catastrophic injury. Although there was variation based on age, severity of injury, initial gait score and several other factors, on average, a majority of the individuals became independently ambulatory within two to five years post-injury. The long-term prognosis as to gait speed and balance problems in the acute-care setting could not be determined[1].
Preliminary physical therapy is often administered in an acute-care setting such as a hospital. However, at NeuLife it is a vital part of the design of each client’s personalized Client Goal Plan and the rapid delivery of clinically relevant services providing specialized rehabilitation.
The first step of the client’s re-education for ambulation will be to get him or her to be able to balance on his or her feet. In order to accomplish this early element of rehabilitation, NeuLife’s skilled rehabilitation professionals assist the client from a seated position onto his or her feet. The client is then supported by parallel bars and shifts weight from side to side and front to back. To ensure safety during this rehabilitation process, the therapist stands in front or behind the client. Some clients may require adaptive devices like a walker, an assistive belt or a weighted shoe. Other clients may need to improve a joint’s range of motion, so a brace may be employed.
After the client becomes sufficiently balanced on his or her feet, ambulation exercises can be started, often beginning on parallel bars. As the rehabilitative or specialized rehabilitative process advances, the client may progress to crutches, a walker or a cane.
Once the client can safely walk on a level surface, further steps toward independence may be taken by re-teaching the client how to step over curbs and to climb stairs. The rehabilitative process for climbing up stairs involves stepping up with the unaffected leg. The process for climbing down stairs involves stepping down with the affected leg first[2].
The ability to ambulate implicates virtually all phases of rehabilitation — mind, body and soul. The regained ability, made possible through the innovative therapies of NeuLife — and our clients’ hard work, gives them greater control over their own lives and activities of daily living (ADLs). The traumatic brain injury. The spinal cord injury. Another kind of catastrophic injury. They are the past. Hope is now. Independence is in sight.
Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achieve, for all of its clients, maximized, sustained outcomes that exceed the expectations of all persons served.
NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
Call: 800.626.3836
Email: [email protected]
Visit: NeuLifeRehab.com
[1] The Relationship between Acute Functional Status and Long Term Ambulation after Severe Traumatic Brain Injury, deGuise, E., et al, ISRN Rehabilitation. Vol. 2012, Article ID 534856; Hindawi Publishing Corporation
[2] http://www.merckmanuals.com/home/fundamentals/rehabilitation/physical_therapy_pt.html
