How to walk farther and get less tired - Why Make it harder to walk? - Personal - http://maxpages.com/happymspage/The_physics_behind_MS_and

Update Aug 30,2003 I still wear the carbon fiber braces but since have also aquired the caliper style .The shoe is attached by means of a caliper plate on the bottom of the shoe.I like this style because there is the least amount of skin contact ,therefore they are the coolest braces.RET

UPDATE:Sept.7,2001 Now with a full 3 months of using my new carbon fiber AFOs
I have to say it was well worth the effort to secure them as replacements to my old
Plastics.
If you want to see a picture of them go to the companies web site
www.campscandinavia.se They are Swedish made from Helsingburg Sweden,
They give you enough air circulation to keep cool.They can also be used with a
variety of shoes including sandals.
www.townsenddesign.com/KAFO

The real physics of saving energy a orthosist and a physical therpyist have to analize your gait or walk.Most of us with MS develope what is known as foot drop.Its the vary thing that makes walking very difficult.Thus you use up twice the energy of a normal walker. The only way to control this drop foot is a physical restrain of some sort.The short brace does this.
Actually once you get used to braces as i have ,and need them all the time.I really feel completely dressed once they are on me.
The truth be known of the over two hundred braces wearers I interviewed hardly any of them disliked wearing their braces as they have learned all the braces do for them .they aslo realize they walk further with them or it makes it possible for them to walk at all Otherwise they would be in a wheelchair most of the time.

Update: May 10,2001 My trip to the Orthotist and some topics in applied physics we
discussed.
I'm getting a new AFO set made of carbon fiber instead of plastic or metal.
Further information is on the AFO page of this web site.
But he put me up to an experiment . I was to with this new very light weight AFO set
and my forearm crutches to try to set a new record in distance.The crutches if used
properly will make longer trips.The cane is a tiring device and doesn't properly shift
the load to the arms away from the weak legs.The AFOs keep the legs from getting
tired.I did the experiment all against the advice of my wife who thought I was crazy
and should use my scooter to navigate the mall.
But I didn't heed her advice and went on with my experiment.To my surprize I was
able to do teh whole mall,both floors.The advantage over the wheelchair or scooter
is amazing.I even did the escalators with my new AFOs for the first time.You would be
amazed at the lack of fatigue with a super light AFO set made with carbon fibers.
The heat build up you get with plastics and the inconvience of the old style metal braces
which limits you to just one pair of shoes is amazing. The pair I got can even be used
with open toed shoes if you have good straps over the ankle and a good back strap.
The other benefit was the lack of fatigue over the whole experiment sure beats
taking meds to stave off fatigue.

March 28,2001. With the warmer weather coming on you will be giving a lot of thought to staying as cool as possible. Naturally indoors with the air cond. on this isn't a problem
But it's when you go outside is where the problems start. If like most MS folks you
are heat sensitive.
Heat and it's control is a branch of physics.Metals will conduct the heat away.
Even a tiny bit of metal like an ear ring will capture heat and radiate it to the air.
Then those of us who wear legbraces,AFOs or KAFOs will suffer with the thermoplastic
that is made to make many of these.I know some people who wear AFOs will just take them off when its very hot and sit it out in their wheelchairs.
That isn't necessary if you would have thought of what materials your braces were being made of in the first place.
The new composite materials are cooler. The old fashion metal caliper style braces are cooler.while they limit your choice of shoes,some of the newer caliper syyle braces will have a foot plate which slips into the shoe.
A recent discussion with a orthotist convinced me that we should never accept the plastic made ones if we live in a very warm climate such as Florida or ArizonaHe offered to make me a pair of the caliper style but the payment is still up in the air as
my insurance company has on record that they paid for one molded to me back in 1993.
They don't care about your heat comfort,they just tell you to go back to your
orthotist and get new velcro.
No I'll never get another plastic brace.RET

Jan.4,2001; Physics and the study of it's laws has always interested
me. Now that I'm disabled it is now even mor important as we are
always trying to see and impliment new ways to save one of our
most precious commodies, energy which as all who have Ms know we
us this up faster that we wish and end up extreamly fatigued.
When I'm using crutches I knew they were very important in
using the arm strength as part of my forward locomaotion efforts.
Now and even years ago i discovered the wheelchair or scooter
would keep me free of early exaustion.We sholdn't approch this
disease with resistance to using what ever device will save us
energy.Pride is the folly of the the disabled.RET

The science of Physics is an explaination of how the physical world
works. I'll attempt to address the connection of physics and MS.
First of all most of you are familar with your struggling walking
attempts. We have been described as sometimes walking like drunks.
This is just our lack of control. The reason for lack of control
is because the nerve signals are all not coordinated the muscles are
working against each other. This is the opposite of a well trained
athletic person who has grace of movement. The athletic person makes
all movements seem so easy. A flow of effort so to speak. The person
with MS and muscles which are working against each other will burn up
energy fast and not have much locomotion to show for it. Hence the
person tires very quickly. A task which used to be done in 5 minuites may
take 10. And in that ten minutes you may burn up 5 times the energy the
normal person would. Just walking soon tells you there are many forces
working at opposition to your desires.
When I get up, I shower, shave and make the bed,then get dressed.
All this takes me almost a half an hour. It is exausting because
I don't put the AFOs on until the dressing and the legs have had
a work out.But recently I have gone to puting the AFOs on after
drying my legs,even if the rest of me remains undressed for a
while. I have found this saves me a lot of fatigue.
Then the worst of all situations can happen so easy. YOU fall and you
have done many times before. Soon the need for assistive devices is what
you are told you need. A cane , or walker,crutches or AFOs. All will
keep you a bit more steady on your feet. All will help you to spread out
the energy you possess do more work in the day.

Pain will happen when muscles are doing too much work .
Training a muscle can only go so far with MS. The training process
is nullified by the MS frequently in the medium to advanced stages of
MS.The medium stages of Ms \starts when you have a EDSS rating of 5,
and you a severely disabled person at 6 on the EDSS scale.
It gets worse as you accend the scale in numbers.But take care and
don't let it worry you. As you know it doesn't always happen as you
may have seen it happen in other MS affected persons.And besides
what can you do about it any where? RET

Now what about the fairly small percentage of people who start out
MS\in what we call primary progressive MS. These people are not
repairing the damage. In some cases the PPMS person does have a slow
progression a their bodies are trying to undo the damage but no
complete remyelinazation takes place so the disability stays put.

The assistive devices act as levers for you. Your arms will help what
your legs don't seem able to do. Actually the arms were never made for
walking. And many things can happen to arm muscles now you are expecting
mose of them.
The AFO a ankle Foot orthosic device will stop the movement of drop
foot which is a complete waste of energy. It doesn't propell you any
where but a down ward sometimes uncontroled thump of the foot. It's
like a tire on a car with a bulge on the surface. It will take extra
energy from the car. The ankles are a very intricate structure.
The movement of the foot in motion has many different things it has to
do in a single step.The ankle muscles are usually among the first
to be affected with MS.That is because they are farthest from the brain
and the nerve message has the furthest to come.The most amount of
demyelinazation can take place.

The ankles are one of the first places spasms start in the early part
of MS.The bigger muscles of the legs in the calfs and hips will not
give you trouble near as soon.
Many people also loose control of their hands soon. These are just
as complex as your feet.Actually for many of us they are finely tooned.
The actual loss of myelin is a chemical action and the current going
through the nerve is physics again.All our motions are a combination of
chemistry of muscles releasing their energy and legs and arm, back , neck
and any part of movement is the physics of motion.
Actually one of the accomplishments of Clawson Rocker shoes was
originally a study in the physics of walking.And also how to save
some of that motion.
The forearm crutch is actually a better instrument than the cane.
The cane is only for minor balance problems.
Haven't you seen some one struggling with a cane all bent over and going
nowhere fast.Their waste of energy is very apparent.The Forearm crutch will
accomplish a better movement because you have a better grip of the
instrument.As you know the length of the forearm crutch isn't that much
more than the cane. It's the grip you have is better. There is a slight
gain with under the arm crutches but it is offset by other disadvantages.

Actually while it make keep your arms very busy, two crutches is better
than one. one puts you off balance a bit. It also throws the spine
into a strain, and will eventually give you trouble in another spot
you don't need. Actually Dr weaver on ER isn't in need of the crutch
she uses on stage. It's just a prop. But I admit I do it often
just to carry something a distance in the house.
Now with crutches the tip which comes into contact with the ground
is one of the most important parts of this instrument. I found out
this fact the hard way with a slip I took while taking a summer
course in my early MS days. I slipped on a slick floor because of
wet crutch tips. The smaller the area, the easier you go down.
Thomas Fetterman puts out a type of tip he calls proformance tips.
It sorto of reminds me of racing tires and how they take to the
track. It will increase your cooeffecient of friction. In other
words lessen you chances to slip and fall.
As progression takes place in your muscles or I should say in your
nerves going to the muscles they get tired sooner as they work against
each other.It is sort of like adding weight to a small car and expecting
it to bear the load over a long haul it will do damage soon and
you will have extensive repairs. The need for repairs to the nerves
is taken care of in the early days of the Remission/relapse type MS.

But as the process takes place over and over the nerves don't get
covered as well as the first few times and eventually they die.This
was a finding of research at the Cleveland Clinic.
With dead nerves no electrical messages are carried. What happens to
the muscles that was depending on that nerve.It gets it's electricity
from the near by muscle cells but then it comes then as a quiver or
becomes spastic . The work of the muscles is wasted. Therefore
we feel this strain and pain and we will adjust our walking to doing
less. With less movement comes muscular atrophy.We see eventually
a actual change in size of the muscle. Actually fat will usually
takes it place. and fat doesn't do any work, just add burden to be
moved.
The wheelchair or the scooter both being devices to save labor
and save energy will become a necessity for many.The doing of
the greater distances becomes so much of a chore we stop doing
them or we get a wheelchair or scooter.When the muscles in the
arms are starting to go as has your legs ,the power chair becomes
the only answer.Actually all these devices will accomplish one thing.

Your muscles take much energy just to hold you erect, without
any locomotion. This isostatis is one of the first place we loose
our leg strength. Remember in the early days how quick you found
out it become to just stand. It always makes me get very shaky
in the legs.I experienced actual shaking in the
legs if I was forced to stand more than just a short while. As
time and progression went by the time I could stand got much less.
Now strange things will also happen. With strain in the upper leg
muscles comes also strain on the back and other parts start to sag
Your posture becomes a problem and back aches are now muscles are
working even harder and fatigue is pileing up faster.
Eventually it is easier to just sit than do any motion.
Posture even in a chair becomes a problem. You need better cushions.
The bladder sags and it too becomes spastic,likely to loose it's
contents easily.

The dominos effect of one thing happening because of another
action is now in place and progression is on a roll. The boundry
between the various types of MS really is when the things going
wrong will happen faster than the body can repair the damage.
In the early days of your MS the remissions came when the body
repaired the damage and gave you a breather from MS \for a while.

But one of the negative things in PPMS or SPMS is the added strain
you have to deal with daily. RET
I have discovered that it takes 2 to 3 times more energy to walk
a given distance with crutches.then if you add braces it will be even more.
Fatigue remember is our worse enemy!!!
RET 5/21/06

Eileen Lukeman and Richard Tanner

FL.

Eileen(Lobosgirl) and Richard (RET1000) both at aol.com

Visitors: 05487

Page Updated Wed May 7, 2008 9:45am EDT