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EXERCISE

Chris' Exercise suggestions 

Frenkel's Exercises for Ataxic Conditions

A placebo-controlled crossover trial of creatine in mitochondrial diseases

Julia Dube's Yoga suggestions

Passive/Active Exerciser with Biofeedback Display 

Mississippi Methodist Rehabilitation Center in Jackson

Exercise Equipment

The National Center on Physical Activity and Disability (NCPAD)

Chris's Exercise suggestions 

STRAIGHT LEG RAISES

Sitting on the floor leaning back against the wall and your hands on the floor either side of you, Raise your right foot 6" off the floor keeping your legs as straight as possible. Slowly and gently lower back to the floor. Repeat with left foot.

Lay down on your right side with your right leg bent at the knee and your left leg straight. Raise your left leg as high as it will go, keeping it straight. Slowly and gently lower back to the floor. Repeat laying on your
left side with your right leg being raised.

Lay face down in the begin push up position. Raise your right foot 6" off the floor keeping your legs as straight as possible. Slowly and gently lower back to the floor. Repeat with left foot.

To begin with, you should do no more than what you can without pain!! Try to work up to 20 repeats of each exercise for each leg.

CALF STRETCH

Holding on to the back of a chair or a wallbar for support, standing upright with the balls of your feet on a block of wood or something sturdy 2 - 4 inches high, lower your heels to the ground, streching your calf muscles and achilies tendons. Contracting your calf muscles, raise up on to your tip toes. Try to remain upright the whole time as the tendancy will be to stick your bum out and lean forward.

Many people with FA are well advised to begin and maintain this one as soon as possible after diagnosis. As many cases of FA progress, there is a tendancy to have toes pointing all the time as musle and tendons on the back of the legs contract. Just 5 minutes a day doing this will perhaps eliminate, but definitely delay the need for corrective surgery later on. When I first started with this one,my physio would massasge my calfs and ankles between sets of 10.

LOW TO HIGH KNEELING

If you can, kneel down, siting on your feet with your upper body upright. You may need to hold onto something in front of you to keep your ballance (I use a wall bar) Slowly raise to a kneeling -up position bringing your pelvis forward into a locked upright position (DO NOT PULL YOURSELF UP WITH YOUR ARMS - THEY ARE FOR BALLANCE ONLY!) slowly lower back to a kneeling down position. As you improve with this one you can :-

1 Try to let go with your hands (If they were needed to begin with)
2 Try it with your hands on your head (raising your C of G)
3 Try it holding weights. ( I wear a small rucksack with sandbags in)
4 When you lower, try it to the left and to the right alternately

BRIDGING

Lay on your back with your knees up and your feet flat on the floor. Your toes should be up against a wall or something solid. Your feet should be 9" apart, your hands palm down flat on the floor on either side of your body.
1 Pull your tummy in as flat as you can
2 Clench your buttocks, and by tilting your pelvic floor, raise your bum (6" will do) as your knees move toward the wall.
3 Hold for 10 secs
4 SLOWLY lower keeping your tummy pulled flat
5 Repeat.

MORE LEG WORK

Standing with your back against a wall or solid door with your feet about 12" from the wall, bend at the knee so your back slides down the wall. If you can go down till your thighs are parallel with the floor do so, if not, just go down as far as you can comfortably. Then back up again. Do it slowly, and if you can hold in the lower position for 10 secs or so then do
that too.

I do fully realise that these exercises are not possible for everyone, but there are some exercises EVERYONE can and should do. Keeping in good shape for as long as possible is so important, especially now as some form of FA therapy is no longer considered a fantasy.

I will gladly advise on specific cases if I know your limitations, you can post to Internaf or contact me privately.

Chris.

Frenkel's Exercises for Ataxic Conditions

These exercises prepared by Curative Services -- Courage Center

This program consists of a planned series of exercises designed to help you compensate for the inability to tell where your arms and legs are in space without looking.

The exercise routine takes about 1/2 hour and should be done 2 times daily.

1. Exercises are designed primarily for coordination; they are not intended for strengthening.
2. Commands should be given in an even, slow voice; the exercises should be done to counting.
3. It is important that the area is well lit and that you are positioned so that you can watch the movement of your legs.
4. Avoid fatigue. Perform each exercise not more than four times. Rest between each exercise.
5. Exercises should be done within normal range of motion to avoid over-stretching of muscles.
6. The first simple exercise should be adequately performed before progressing to more difficult patterns.

Exercises While Lying:

Starting position: Lie on bed or couch with a smooth surface along which the feet may be moved easily. Your head should be raised on a pillow so that you can watch every movement.

1. Bend one leg at the hip and knee sliding your heel along the bed. Straighten the hip and knee to return to the starting position. Repeat with the other leg.

2. Bend one leg at the hip and knee as in #1. Then slide your leg out to the side leaving your heel on the bed. Slide your leg back to the center and straighten your hip and knee to return to the starting position. Repeat with the other leg.

3. Bend one leg at the hip and knee with the heel raised from the bed. Straighten your leg to return to the starting position. Repeat with the other leg.

4. Bend and straighten one leg at the hip and knee sliding your heel along the bed stopping at any point of command. Repeat with the other leg.

5. Bend the hip and knee of one leg and place the heel on the opposite knee. Then slide your heel down the shin to the ankle and back up to the knee. Return to starting position and repeat with the other leg.

6. Bend both hips and knees sliding heels on the bed keeping your ankles together. Straighten both legs to return to starting position.

7. Bend one leg at the hip and knee while straightening the other in a bicycling motion.

Exercises While Sitting:

Starting position: Sit on a chair with feet flat on the floor.

1. Mark tine, raising just the heel. Then progress to alternately lifting the entire foot and placing the foot firmly on the floor upon a traced foot print.

2. Make two cross marks on the floor with chalk. Alternately glide the foot over the marked cross: forward, backward, left and right.

3. Learn to rise from the chair and sit again to a counted cadence. At one, bend knees and draw feet under the chair; at two, bend trunk forward; at three, rise by straightening the hips and knees and then the trunk. Reverse the process to sit down.

Exercises While Standing:

Starting position: Stand erect with feet 4 to 6 inches apart.

1. Walk sideways beginning with half steps to the right. Perform this exercise in a counted cadence: At one, shift the weight to the left foot; at two, place the right foot 12 inches to the right; at three, shift the weight to the right foot; at four, bring the left foot over to the right foot. Repeat exercise with half steps to the left. The size of the step
taken to right or left my be varied.

2. Walk forward between two parallel lines 14 inches apart placing the right foot just inside the right line and the left foot just inside the left line. Emphasize correct placement. Rest after 10 steps.

3. Walk forward placing each foot on a footprint traced on the floor. Footprints should be parallel and 2 inches from a center line. Practice with quarter steps, half steps, three-quarter steps and full steps.

4. Turn to the right. At one, raise the right toe and rotate the right foot outward, pivoting on the heel; at two, raise the left heel and pivot the left leg inward on the toes; at three, completing the full turn, and then repeat to the left.

5. Walk up and down the stairs one step at a time. Place the right foot on one step and bring the left up beside it. Later practice walking up the stairs placing one foot on each step. At first use the railing, then as balance improves dispense with the railing.

Upper Extremity Exercises:

When the arms are affected use a blackboard and chalk. Change a minus sign to a plus sign; copy simple diagrams (straight lines, circles, zig-zag lines, etc.) Various coordination boards may be used to improve eye-hand coordination.

Julia Dube's Yoga suggestions

Hi there! "Richard Hittleman's yoga 28 day exercise plan" is a wonderful instruction book with pictures and explanations. Many of the other books are too advanced and will scare you off. You will have to build up to some of the basic foundation positions. I note the half lotus positions left leg on top of crossed legs then switch and sit with right leg on top of your calf, make sure your back is completely straight while holding these positions. 

There are hand movements and deep breathing that will need to go along with these positions, Always note for every single Yoga position EMPHASIZE KEEPING YOUR SPINE STRAIGHT AND BREATH DEEPLY. Then another and more miraculous feeling position is to sit with your legs under you. Your butt will be sitting on the heels of your feet. This one is EXTREMELY painful when I sit with straight spine but it wakes up your legs and improves the circulation in them like nothing else! See when you constrict the blood flow like these positions do the blood vessels open and rush blood through with multiple force when you release the position. After weeks of repetition, this will strengthen your vessels and blood flow.

Two other tricks I do in bed help. Lay on your stomach then sit up on your elbows while your belly is on the bed. Keep your knees and your feet together, heels and big toes touching. This arches your back in the proper direction and generates proper conduction of the nerves in your spinal cord.  I can notice when I don't do this I fall onto the toilet when I get up and go potty. When I do this arch for twenty minutes before I get up I cansmoothly control my conversion to the toilet seat.

The other trick I do is. Sit with legs in front and grab my feet from the outer edge and pull them straight (ATAXIA CURVES THEM INWARD) Note - keep your legs straight. This should hurt but hold it at least ten seconds even in dire pain. You need to stretch those tendons.

You need pictures. 45 minutes a day of these basics will show results that blow your mind!!

Good luck.!

Julia

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