♪ Bob and Brad, the two most famous ♪
♪ Physical therapists on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Yeah, and we are the most famous physical therapists
on the internet.
- In our opinion of course, Bob.
- Today we're going to discuss the best walking--
Oh, I'm sorry, best balance and walking exercises
to prevent falls for seniors,
especially after like a stroke, knee or hip replacement.
- Right, well, all these fit together,
and you'll find out in just a couple minutes.
- Yeah, it's a very important thing to address,
because, obviously, poor balance leads to falls,
which leads to disability and debility.
- Right, serious disability at that.
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- [Brad] Okay, Bob!
They're wondering-- - Yeah, what's going on?
- "What about this balance and whatnot?"
So as therapists, you know,
we really look at balance and walking,
avoidance of falls at a very detailed and there's--
- There's a lot of components.
- Right, and there's three-- - That come into play.
- Three big ones that you need to address,
and this, we call it an obstacle course,
addresses all three.
The first one is vision.
- The next one is the vestibular system in your ear,
the things that make you dizzy sometimes,
it kinda relates to that,
and, then, proprioception.
In other words,
the feedback that your nervous system gives your brain,
telling you where your feet are, or the parts of your body,
without having to look at 'em.
All of those contribute to having good balance.
- All of them have to work together,
In order to have balance,
but you wanna make sure
you are addressing each one of those,
or you might have a deficit in that area.
- Right, and this is gonna solve all three.
It's gonna really work at three of them.
So the first thing we wanna do is,
if you are recovering, your balance is poor,
do not do this by yourself.
- Yeah, not by any means.
- You have to have at least one person,
and maybe two people.
You know, we often times have a person on each side.
You have to have a belt, a gait belt,
something that the helpers can hold onto,
'cause you don't wanna grab clothing or an arm.
This works very well, so I've got my gait belt on,
and then the person walking,
has to at least be able to walk with a cane.
If you're walking with a walker, this is too advanced.
- Yeah, that's too advanced, exactly.
- Right, so a cane or without a walker.
I have some people that, in the house,
they can walk without a cane,
but once they get outside, in the yard, uneven surfaces,
they have to have a cane,
and then they need to do something like this
to achieve that goal.
- Or, when you're in public. - There you go.
- I mean, 'cause, that's where we're gonna talk about
how you get distracted and have to look different directions
with your vision.
- Right, people can walk fine on the flat with their cane,
but you put them on the flat in a mall
with 200 people walking around, they become very unstable.
So, that addresses that too,
so, should we get started, Bob?
- Sure.
- We're gonna use hurdles.
You know, in Therapy World, I call these hurdles,
and you can use anything.
We've got a couple canes that we're gonna step
over the top of.
- Now, again,
visualize that Brad's being--
I'm gonna stay outta the way, Brad, but normally,
I would be holding on to Brad's belt.
- Right, so he'd be standing right next to me,
and, again, sometimes you have two people.
If they're that poor-balanced,
you'd probably better take 'em to a therapist.
So we've got two hurdles, and you could put more of these,
three or four.
So, you need to step over those without touching 'em.
Now this, is a squishy pad.
You can use a cushion
off of a piece of furniture and put it down.
Anything that's soft and squishy,
that works your proprioception.
We're gonna step over that, and then we've got a step.
Now, if you don't have a step like this,
which you probably don't at home,
but you may have a stairway at home,
and you could go up to the stairway,
and we're good 'cause you have a handrail to hold onto
and practice that.
We can practice turning slowly,
or you can go back down backwards.
So, we'll demonstrate.
- So, the obstacle course is set.
- Yep, here's the first set.
Okay, start out easy.
Again, someone's there, standing by you,
holding onto your belt, ready to help you if you need it.
I'm going to use a Booyah Stik.
You could use a cane,
or you may not need anything, depending on your balance,
and we're gonna step,
and when you start out,
you're going to look where you're going,
making sure you don't hit the cane.
Everything is going smooth.
You can go one step at a time,
go up here like this,
like this,
and up, and just get a feel for it,
and, then, turn around,
and once you can do that and you feel pretty comfortable,
it's easy, well,
then you can just try the step-over like this,
speed it up a little bit, maybe turn up here.
You gotta be careful 'cause you got only half a step
to step on, if you're on stairs,
and then go back.
When that gets pretty easy,
then, we're gonna work on your vision.
You have to have the person,
going to pick out a point in front of you,
right in front of you,
a point on the wall to the left,
and a point on the wall to the left,
or to the right,
and you're gonna look at those points,
glance down to where you're going,
but then get up and look again,
as if you're walking through a crowded hallway.
- This makes it much more difficult,
and, I mean, as Brad and I have found,
a lot of people end up falling
at events like Christmas, Thanksgiving,
and what's happening, they're getting distracted.
You know, normally they can focus when they're walking,
but all of a sudden, Aunt Lily says, "Hi."
when she's walking and she goes like this,
and then she loses her balance.
So, this is to help train for these unexpected,
you know, distractions, basically.
- Exactly!
So, if you're the helper, what you can do is say,
"You know, we're gonna look at these."
And you can start talking to the person at the same time,
which also distracts the person and that's real life--
- That's all part of the training.
- Exactly.
Now, the next one we want to go to is side-stepping.
- So, 'cause you know, in your house, in the kitchen,
you side-step all the time.
Sometimes, you have to turn to get through a narrow spot.
- Or get into the bathroom, or get into a closet,
or whatever. - Exactly.
- So, If you're not working on this aspect--
- [Brad] I'm gonna use this.
- Then when you do run into it in real life,
you may lose your balance, so you need to train for it.
- Particularly, if you've had a stroke or a replacement
on one side, that one leg is typically weak,
or you don't attend to the side if you had a stroke,
so going one direction is almost always
much harder than the other.
So, we want to try and get 'em equal,
and take your time, get over it.
You know, and if you find yourself
one leg keeps bumpin' the cane or can't get up and over,
then you're gonna need to spend some time
on really exaggerating with the weak leg
or the leg that's not working so well.
And here, and then up.
If the step is difficult,
just practice goin' up and down
on the step a number of times.
- Yeah, do some repeats.
If there's any particular thing that is giving you trouble,
Do the repeats.
Do the reps.
- And if you're getting really good,
and I'll do this with some people,
I'll have 'em go backwards
because there's times you do need to back up
into a chair or whatever.
- Again, emphasizing that you're gonna
need to have somebody on the belt.
- Oh, yeah, 'cause this really would make someone fall easy.
So this is--
- This is very difficult.
- And the person that's helping is able-bodied, strong,
and able to assist properly.
- That they can stop 'em from falling.
- Right, and you really take your time going backwards,
and that one, like I say,
I only do that with people who are really,
that are not typically with a cane.
- Pretty high, high level.
- They're out walking around and doing well.
All right, Bob, what do you say?
- Well, there you go.
Nice little obstacle course, very easy to set up,
but very effective in training.
- Right, so take your time with it.
Be cautious.
Always be safe with your belt
and good able-bodied person to help, so...
- Brad and I can fix just about anything--
- Except for...
- A broken heart.
- But, we are working on that as well.
- There we go.
Finally, you're doing something right.
- Well, you know, I thought about it last night.
(laughter)
(upbeat synth tune)