Sarcopenia muscle loss with aging

Is it possible to maintain muscle strength and integrity through the duration of life? Sarcopenia may be against you. Can you battle against sarcopenia? Maybe. If not today, perhaps soon.

There’s an old Grimm fable that when living things asked God about longevity, God like the number 30 years.With a little negotiating, humans got 70 years but at a price. Sometimes these fairy tales are true. At age 30, lean muscle tissue decreases and is replaced by fat. This decrease is partly caused by a loss of muscle tissue (atrophy). The speed and amount of skeletal muscle changes seem to be caused by genes. This muscle loss happens very slowly yet gradually – usually noticed un 10 year differences. The process is Sarcopenia that, thus far, is an untestable condition.

Barring genetic diseases such as Muscular Dystrophy and DDNX3, sarcopenia is a normal process of aging. Body builders have been using a pseudo-genetic chemical called Myostatin, that some believe may help slow sarcopenia muscle loss with aging.

Myostatin (also known as growth differentiation factor 8, abbreviated GDF-8) is a myokine, a protein produced and released by myocytes that acts on muscle cells’ function to inhibit myogenesis: muscle cell growth and differentiation. In humans it is encoded by the MSTN gene. Myogenesis is a form of regeneration as the process by which damaged skeletal, smooth or cardiac muscle undergoes biological repair and formation of new muscle when other muscle fibers waste or die due to disease. This process may slow with aging and hormonal changes.

When discussing sarcopenia and myostatin, there are two sides of a coin. Muscle atrophy is a decrease in muscle mass; muscle hypertrophy is an increase in muscle mass due to an increase in muscle cell size. Hypertrophy is a very rare condition and sarcopenia is more associated with aging and conditions like muscular dystrophies. As a possible method at treating sarcopenia, myostatin inhibitors are being explored by doctors albeit at mouse level experiments.

The potential side effects of using myostatin inhibitors provoke heated debates in research communities. With few studies, there are some negative side effects reported:

One potential concern is that increased muscle growth will lead to an increased risk of injury due to increased stress on the muscle fibers. This is especially true for individuals using myostatin inhibitors as workout supplements instead of as part of a medical treatment for muscular dystrophy or other disorders.

Other possible side effects of myostatin inhibitors include increased the chance of tendon rupture, heart failure due to inflamed cardiac muscle, and rhabdomyolysis, a breakdown of muscle fibers that often leads to kidney failure

Despite few thorough clinical trials, Myostatin has become a main target for the development of drugs for cachexia and muscle wasting diseases. While sarcopenia behaves at wasting skeletal muscles, The cachectic state is observed in many pathological conditions such as cancer, chronic obstructive pulmonary disease (COPD), sepsis, or chronic heart failure. These are also muscles. The other problem associated with Myostatin is it is not targeted for research by the US Food and Drug Administration for testing and approval. It is available as a supplement.

In the United Kingdom, use of a myostatin inhibitor is targeted for experimentation for Duchenne Muscular Dystrophy, one of many muscular dystrophy diseases.

While muscle wasting is associated with muscular dystrophies and other emerging genetic conditions, including sarcopenia, there is no certainty whether myostatin might reverse muscle wasting that has already happened. Among small and possibly skewed studies it is generally accepted that age-related changes in skeletal muscle structure and function are inevitable, whether these deleterious effects on skeletal muscle can be stopped or reversed is debatable.Some studies support myostatin inhibitor supplementation, most studies agree that more research is needed. In 2017, a reasonably thorough German study of myostatin inhibitors as treatment for muscle wasting concluded with interest but for further experimentation required.

The general wisdom is that muscle integrity within normal sarcopenia is activity – virtually any activity – may reduce muscle wasting over time. Activity may also benefit hippocampus growth for cognitive support. Unused muscles can waste away if you are not active. Even after it begins, this type of atrophy can often be reversed with exercise and improved nutrition. Muscle atrophy can also happen if you are bedridden or unable to move certain body parts due to a medical condition.

Muscle wasting with age varies but sarcopenia may not be considered a leading cause of death in aging. There are some foods that include flavonoids that dietitians believe may work as myostatin inhibitors. They are: green tea, chocolate (especially dark chocolate and raw cocoa powder),
blackberries, pomegranates, and broad beans, broccoli, cauliflower, and spinach.

There are genetic tests to evaluate your myostatin levels. Discuss with your doctor to determine whether you need one.

Aging well seems to many a fantasy as new diseases and conditions creep in unrelenting succession. Living is an activity. Damned genetic muscle wasting diseases may one day be curbed. Will it be myostatin related? There seem to be many promises but all we can do is wait. Might as well go for a walk while waiting. Wisdom points that activity may be helpful. Sarcopenia and many other neuromuscular disease treatments is definitely worth researching as the aging population increases.

As you battle with the bulges and size upgrades as you grow older, sarcopenia might be the cause behind the results.

Endurance and stamina over 60

“Yoong people gotta dance, dance. Old people gotta sit there and watch.” Frank Loesser, Most Happy Fella

Thinking about dancing, walking, exercising? It isn’t about gaining or losing. It’s about developing endurance and stamina over routines through time…and enjoying it. When you are over 60, there is a compendium of problems that restrict starting an exercise regimen as you reach 60. Nonetheless, there are many peers who have found that activity not only treats pains. It elevates moods, emotions, consciousness, and memories. You endure a better sense of living. Shall we dance?

Endurance and stamina should not be exclusive to the young. While, biochemically, there may be less hormonal energy in adults over 60, healthy people over 60 don’t just have to sit and watch. You can develop endurance and stamina at practically any age. It may just require more effort as you get older. Young and old can dance!

Lack of endurance and stamina may shift up and down in a lifetime. Many attribute the lack of energy, endurance, and stamina to poor diet and exercise habits. The battle with the bulge is a natural byproduct of aging for most people. Based on averages, people tend to lose 3 to 5 percent of lean muscle tissue (replaced by fat) every decade after age 30. Then something happens in your 40’s. After age 45, adults begin losing about one-quarter of a pound of muscle and gain that much body fat every year. By 60, you’d have naturally lost 4 pounds of muscle and gained about 4 pounds of fat from average natural body processes from 45 to 60. The adage that “the more you do diet and exercise” the victory of suppressing the bulges seems mire difficult. The loss of endurance and stamina over 60 seem to make movement more difficult over the years as you try to age better.

The term stamina is sometimes used interchangeably with endurance. Stamina deals with the concept of muscular strength or how much weight you can move at a 1-time interval or the amount of time that a given muscle or group of muscles can perform at maximum capacity. Imagine a runner losing breath and energy after speeding 500 feet or a weightlifter lifting 300 pounds once or twice. Stamina training builds strength in other ways than cardio-endurance does.

Endurance is best understood in relation to time. While stamina is defined as the amount of time that a given group of muscles can perform at or near maximum capacity, endurance is defined as the maximum amount of time that a given group of muscles can perform a certain repetitive action. An example of this might be a runner doing a marathon. Running over 26 miles is one of the best tests of human endurance. Stamina is brief and endurance is long. It takes endurance to go the extra mile(s).

Endurance training is associated with cardiovascular health. Endurance testing involves determining the amount of time a person can maintain an activity or perform a task or activity of daily living before becoming fatigued and needing to stop. The level of activity used to test endurance can be minimal to maximal. Endurance testing is often used by cardiologists.

Beginning to train for strength (stamina) and endurance (length of time and breathing) are your goals. Mixing endurance and stamina gives you easy roads to health at 50, at 60, and beyond. The idea is to follow a routine at least 2 or 3 times each week. And you can build stamina and endurance on a chair while getting a great workout for cardio, muscle strength, and weight loss.

There are many exercises for endurance and stamina that you can do at home. Some can be done in a chair. When you’re over 60, there are many options to gain strength and longer workout time with as little impact as possible. The nice thing about familiarizing your self with chair exercises is you can exercise while watching TV! No gym or large equipment necessary while building endurance and stamina. Weights can be a can of soup or a bottle of water. Standing or sitting, build endurance.

One key, research tends to indicate, for building physical endurance and stamina over 60 is regularity. Claims indicate that, with regular exercise, healthy people over 60 can regain some muscle mass.

But getting to 60 is still filled with many perils along the way. Disabling neuromuscular diseases such as the muscular dystrophies and multiple sclerosis can confound both stamina and endurance at any age.

Yet lifestyle based statistics, collected by National Council of Aging, show that 90% of Americans aged 55+ are at risk for hypertension, or high blood pressure. Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population. According to the American Heart Association, for the 60 to 79-year-old age group, 70.2% of men and 70.9% of women have some form of cardiovascular disease. According to the Center for Disease Control, approximately 38% (among men and women over 60) are considered obese. Of persons ages 65 or older, 49.6% ever have doctor-diagnosed arthritis to some degree and about 20% have some form of fibromyalgia. Of these conditions, many doctors have suggested diets and exercises as part of a relief and maintenance regimen.

Approximately 75 million people are over 60, according to AARP. Most can develop active lifestyles.

Aiming toward the development of endurance among human skeletal muscles appear to indicate that, over time, lean muscle tissue will replace body fat percentages.

More extensive tapping into research is exploring skeletal muscle tone and cognition integrity. Sports programs are internationally trying to link skeletal muscle development and cognitive issues.

Obesity and aches at ages over 50 may be associated with decreases in key hormonal changes that occur in women and also men. The get-up-and-go drive delivered by adrenaline is specially noted in long-term memory storage and reaction to stimuli (as part of the stress cycle. As a hormone, adrenaline helps activate body and mind and, while endurance and stamina may help increase adrenal activity naturally. While there are many nutritional supplements that report aiding the production of adrenaline, efficacy and quality aren’t always assured. When playing with hormones, seek help from a physician.

In the baby-boomer over 60 generation that are healthy seem to know that endurance and stamina are crucial. We see many communities that cater to active adults by providing safe fitness and recreation facilities. Unlike the movies of yesteryear, there are more active adults than any previous generation engaging in endurance and stamina activities. Unfortunately, only 35 – 44% of adults 75 years or older are physically active, and 28-34% of adults ages 65-74 are physically active. Less than 5% of adults participate in 30 minutes of physical activity each day; only one in three adults receive the recommended amount of physical activity each week. In 2013, research found adults in the following states to be most likely to report exercising 3 or more days a week for at least 30 minutes: Vermont (65.3%), Hawaii (62.2%), Montana (60.1%), Alaska (60.1%). The least likely were Delaware (46.5%), West Virginia (47.1%) and Alabama (47.5%). The national average for regular exercise is 51.6% (among all ages). Activity and diet may account for younger attitudes at older ages within a healthy peer group.

Adopting a lifestyle to increase endurance and stamina at age 60 from previously low or zero activity levels is a difficult challenge. With chronic aches and pains…overwhelming. Old habits die hard. New habits are even harder to form. Yet when doctors take a stricter tone that your lack of endurance and stamina may be fatal, you might try. When you realize your clothes sizes are shifting to big-and-tall or plus-sizes, that may be even more daunting. Developing endurance and stamina via routine activities three-times weekly requires constant motivation and stubbornness to move from low to moderate to high. Increasing endurance and stamina at or over 60 is difficult but very possible. You will notice a significant differences within a year.

A senior fitness program called Silver Sneakers is available at many gyms across the country, It consists of classes that cater to people over 60. Silver Sneakers enables seniors to access gyms at around $25 per year. Membership? Many insurance carriers and supplemental plans cover Silver Sneakers programs. But…Medicare Advantage plans may cover SilverSneakers. SilverSneakers is considered a basic fitness service and Original Medicare, Part A and Part B, does not cover this benefit. However, Medicare Advantage plans, also known as Medicare Part C, may provide this benefit.

Many Supplemental Medicare insurance plans do cover Silver Sneakers programs, based by States. You might seek this benefit if you are searching for supplement plans to Medicare.

Silver Sneakers isn’t absolutely necessary, You can seek and boost endurance and stamina from home and exercise seated or standing. YouTube is a massive source of exercise videos. What you need to do is simply say you will. For starters both endurance and stamina can be developed following activity routines two or three times a week. Endurance and stamina over 60? Beyond the pains, possibilities exist.

Beyond gyms and exercises, many hail the virtues of Walking For Health. While many people have mobile disabilities, if you can walk 20 to 30 minutes per day, it offers many benefits at any age.

Sadly there are those who are disabled by various different diseases that are beyond the scope of cure or treatment. Some seek adaptive sports (such as wheelchair basketball) as exercise options. Not many can adapt. Those that do are exceptional at overcoming impossible challenges to be active again.

Being over 60 may seem challenging itself. Developing endurance and stamina through routine activity may seem challenging. It may even feel challenging. You can treat and heal many of your woes and anxieties by getting you and your body to move almost every day. The sun will come out. Celebrate it by taking some time to be active each day.

Transitioning to regular diet and activity routines require concerted efforts to break old habits, preferences, and tastes. In addition to muscle aches and excess weight, prevalent within mostly sedentary work groups and lifestyles, those transitions may be painful. Learning to develop endurance and stamina toward and over age 60 are fundamental to assure comfortable longevity. Yet, in retirement, that endurance and stamina activity are essential to deliver more satisfying years and happier living.

At older ages, routine activities help elevate moods and outlooks. It even may help reduce aches and pains. Developing endurance and stamina over 60, as impossible as it seems, is very possible. It doesn’t require much effort. All you have to do is make the choice to activate your body almost each day. Overcoming challenges may reap many rewards. Soon you’ll forget that you are exercising.

It’s all part of (trying) to live happily after.

Muscular Dystrophy and Protein

It was believed that muscle weakness resulted from poor nutrition. In many countries protein isn’t part of traditional diets. The problem is that many of the inhabitants had good muscle performance. Muscular dystrophy causes muscle weakness. Is there a link in Muscular Dystrophy and Protein?

Per United States Department of Agriculture, Protein is an essential nutrient. The focus on vitamins simply aren’t enough. Foods made from meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds are considered part of the Protein Foods Group. Understanding protein isn’t so simple. Protein consists of amino acids and not all amino acids may be supplemented as pills. Of the 20 various amino acids, nine are “essential,” meaning you can only get them from food.

Proteins in many shapes and forms are associated with the fitness or illness of body muscles whether voluntary (skeletal muscles) or autonomic (heart and organs). Proteins found in the brain may be associated with storage and loss of memories. Every living cell in the body requires protein to build and maintain bones, muscles and skin.

In the United States, the recommended daily allowance of protein is 46 grams per day for women over 19 years of age, and 56 grams per day for men over 19 years of age. There are variables for activity. Considering dietary protein is important. Consumption of some proteins may lead to allergies or respiratory effects. Red meat proteins may aid cholesterol accumulation in arteries as cause for heart attacks.

Conversely, certain near ketosis diets combining vegan protein A 20-year prospective study of over 80,000 women found that those who ate low-carbohydrate diets that were high in vegetable sources of fat and protein had a 30 percent lower risk of heart disease compared with women who ate high-carbohydrate, low-fat diets.

If you are normal, getting your vitamins and protein drearily may help healthy aging and longevity.

Unfortunately, there is a group of over 100 disease variants that cause progressive weakness and loss of muscle mass. In muscular dystrophy, abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle. There are no cures and treatments. These muscular dystrophies may occur at birth and in adulthood. From mild to severe, the illness is pervasive and crippling. While dietary protein still is significant for general health, it is believed that key protein and peptide conversions do not work in activating or stimulating muscle growth.

Prior to the classifications of muscular dystrophy it was a widely held belief that s lack of protein or nutrition resulted in myopathy or weak muscles. The word “dystrophy” comes originally from the Greek “dys,” which means “difficult” or “faulty,” and “trophe,” meaning “nourishment.”

It is believed that Muscular Dystrophy, affects less than 200,000 people in the US population and is considered a rare disease. There are 70,000 known cases in Western Europe.

Muscular Dystrophy, as genetic, is considered a form of mitochondrial diseases that affect several symptoms. These diseases may affect 1 in 4,000 people. This makes it less rare than most statistics for muscular dystrophy.

Muscular dystrophy is a disease related to muscles exclusively. Mitochondria diseases may be behind neuromuscular diseases. Neuromuscular diseases affect both nerves and muscles. One such disease is Multiple Sclerosis. Paralysis rom brain or spine is neuromuscular.

Inconclusive research seems to indicate a genetic protein called dystrophin. Dystrophin is part of a group of proteins (a protein complex) that work together to strengthen muscle fibers and protect them from injury as muscles contract and relax. Research suggests that the protein is important for the normal structure and function of synapses, which are specialized connections between nerve cells where cell-to-cell communication occurs. So far, The Muscular Dystrophy Association might see possibilities for only 2 of the many muscular dystrophy issues.

A 2015 study showed some evidence that a protein carbohydrate shake after an MDA approved exercise may be beneficial to muscular dystrophy patients.” The findings suggest that postexercise protein-carbohydrate supplementation could be an important add-on to exercise training therapy in muscular dystrophies, and long-term studies of postexercise protein-carbohydrate supplementation are warranted in these conditions.”

If you’re healthy and well. Feed your muscles, cells, skin, and bones with positive sources of protein. While genetic testing is not considered routine in the USA, following a responsible dietary vitamin and protein regimen may support wellness over your lifespan. Consider responsible consumption of high protein foods or have a protein shake.

People suffering from acute or chronic pain or disabilities generally need more nutrition to exert any movement. Subsequently, having portable protein and nutrition sources are almost necessary. The flaw is nutrifying without gaining weight. Being overweight can make movement more difficult.

Lean sources of protein help normal people preserve their bones, muscles, and skin longer. Check with a nutritionist or your physician.

Nothing remains conclusive about Muscular Dystrophy and Protein consumption relieving or treating symptoms. As I have mobile challenges from Muscular Dystrophy, I find that a Protein/Nutrient bar is essential assurance. It may be a placebo or may be necessary. Perhaps, one day, there will be more3 conclusive studies into the co-factors that help reverse the challenging effects of wasting muscles. It just might include the needs for (more than) basic nutrition. For now, it is just a fantasy.

Britain debates 3-parent babies and mitochondria

When we talk about nature and nurture in child rearing, nature meant mom and dad’s genes. What happens when a third party is introduced? That is what Britain is beginning to debate. It can stir a lot of feelings about traditional and progressive marriages. New concepts and biological research seem to point to mitochondria cellular components that help bring energy to different cells.

The long hope of British scientists is to help eliminate mitochondrial diseases that can result in nerve, brain, muscle, and organ diseases. The debate rides on many traditional and progressive issues. Based on theories and research, testing the effect of using a 3-parent baby with an extra sample of mitochondria may take generations to foresee a reasonable outcome. Then again, can science be inadvertently producing a class of monsters?

The British aren’t the only ones targeting mitochondria alterations at a genetic level. The United States Food and Drug Administration or FDA is pondering implications. The scope of questons include how genes are transmitted through subsequent generations.

As one of the countries offering nationwide health insurance, Britain’s stake is more than bottom-line economics. People with mitochondrial diseases are significant burdens to the nation’s insurance budget. Finding a way to reduce incidences is a good long-term investment for Britain, beyond moral indignation.

USA has no such program. Funding can be an economic disaster. With about 100 years as a gap for successful return, it is a risky long-term investment. There’s more study needed on mitochondria and how, when and why they mutate. As a business, can quality control be assured? How will research and clinical evaluations be studied with no or limited insurance policies? Is it profitable? Many US businesses that championed progress in the 1900’s are no longer around. Can USA rely that current champions will be around to see the results of 3-baby parenting?

The scientific goal is a noble one. Three-parent babies are human offspring with three genetic parents, created through a specialized form of in-vitro fertilization The future baby’s mitochondrial DNA comes from a third party. The procedure is intended to prevent mitochondrial diseases including muscular dystrophy and some heart and liver conditions that currently disable offspring with disabling conditions.

Essentially, nurture is a 2-parent baby. Nature is still 2 parents but with sperm from a “healthy” donor. You don’t have to change your bedroom furniture. The 3-parent baby is a choice of several options. At its early stage, it’s exciting and bringing mitochondria into the forefront as a means of fighting or preventing mitochondrial diseases.

Mitochondria are important aspects of a cell that theoretically account for 90% of the energy required to sustain cellular health. What can happen when the mitochondria fail? Diseases of the mitochondria appear to cause the most damage to cells of the brain, heart, liver, skeletal muscles, kidney and the endocrine and respiratory systems. Mitochondria are associated as powerhouses of genetic material within cells. They help provide energy to your entire body. It’s simple but, at the same time, mitochondrial disease can effect all of use to certain degrees.

Conventional biology instruction associates mitochondria at cellular levels but recent research cite evidence that it is oversimplified. It takes about 3000 genes to make a mitochondrion. Mitochondrial DNA encodes just 37 of these genes.Mitochondrial diseases are the result of either inherited or spontaneous mutations within different aspects of DNA which lead to altered functions of the proteins or RNA molecules that normally reside in mitochondria. Mitochondria are also associated for cholesterol metabolism, for estrogen and testosterone synthesis, for neurotransmitter metabolism, and for free radical production and detoxification. Cellular roles in transmitting genetic diseases seem a little more complicated than a crap shoot. In the human condition, diet and health management may be fighting the norms of your cells.

The North American Mitochondrial Disease Consortium or NAMDC is one of several research institutes that study the many roles that mitochondria play behind disabling diseases that can span lifetimes. Over a couple years, Britain scientists have been developing research and techniques to produce the first 3-parent babies as a revolution betting on healthier outcomes. As with all revolutions and research results, it is a role of dice type of gambling.

The stakes are high. Responsible parents often debate about having children when development or neuro and muscular diseases are in their lineage. Birthing babies with autism, muscular dystrophy, and others pose incredible stress to parents and growing children as they attempt to cope with disabilities in a very able world.

Equally disruptive is that some of these mitochondrial glitches may remain dormant through a life-span and attack adults at many ages. This can be equally shocking and often misdiagnosed by medical specialists. Many of these mitochondrial myopathies introduce vast symptoms that take normal people into tunnels of greater challenges, with no available cure.

The gamble of theories that challenge traditional thought of the etiologies of many diseases may actually be results of this gelatinous material that resides in each and every human cell.

For those suffering with neuropathies, myopathies, and countless other diseases that may benefit from 3-parent baby research, the results are of a very long range. We are counting on better statistics from future generations. Further mitochondrial research may result with better treatments for current diseases but is more hope than fact.

Faiths who have lost political struggles with homosexual marriages might see 3-parent babies as further affronts to religious traditions. The thought of a 3-parent baby does seem puzzling in battling something that causes mitochondrial disease. There are choices of pre-natal testing to discover whether your baby has mitochondrial disease. At that point, you might choose to abort the child. The Right to Life movement hotly debates this choice. For all god’s miracles, there are the victims.

Yet…if 3-parent baby research can play roles to route selective, healthy mitochondria and effectively reduce mitochondrial diseases, this may be a great thing. Research has a target to fund. The rest are matters of hopes and prayers.

Scientific reason is questionably noble. Many experiments, however, are like quixotic battles with dragons in search of a holy grail. Mitochondria and 3-parent babies may or may not partner with positive conclusions. In successive generations, there may be more invasive dilemmas facing humanity than mitochondrial disease. Or mitochondrial disease may be more pervasive. Is it a roll of the dice? Either the fictional Frankenstein or the majestic hero awaits. Beyond dreams lie answers that we may not live to realize. There are other choices to control mitochondria diseases and we may want to deal with their moral implications before jumping into newer, possibly consequential technologies.

DARPA Airlegs for military mobility

It is often debatable whether all is fair or unfair in love and war. When it comes to the latter, the costs of war often require technology developers like DARPA to help the military and those we love. DARPA was created nearly 60 years ago under President Eisenhower’s administration as a part of the USA Department of Defense. Many of the technologies you use today, from smartphones to GPS and voice-to-text capabilities probably came from ideas from DARPA.

Few might recall that many of the basic principles of the internet were founded by a government agency for sharing information. Defense Advanced Research Projects Agency or DARPA created the first computer-based web network to collect and share research from various centers under DARPA grants. One of their recent projects is Airlegs, that helps energize walking power for soldiers climbing extreme levels of terrain.

Many of the prosthetics and walking devices used by those with muscular dystrophy or multiple sclerosis, that are generally available today, may have been results of earlier DARPA research.

Ankle Foot Orthoses or AFO that are dynamic braces that assist those with weak ankle muscles may have originally been designed for use by veterans. Today, these are mechanical devices that help make walking easier for those that normally can’t. Without the use of AFO devices, many would only be using wheelchairs or mobility scooters. Those patients and health care professionals who are aware of AFO technologies may help some patients with ankle and lower leg muscular problems choose the option of walking at close-to-normal levels.

Of course DARPA primary focuses are catering to military excellence in the field and those that are casualties of war. Engagements in Iraq and Afghanistan have motivated the need to revolutionize upper-limb prosthetics for use by wounded veterans. The program, launched in 2006, has been designed to allow those with upper-leg and upper-arm problems to enjoy nearly normal mobilities and lives.

Mechanical lower extremity prosthetics have been available since World War II as shown in the movie Best Years of Our Lives. A Navy soldier was one of the actors and demonstrated his adroit capabilities with mechanical hands. Of course, those were bulky and heavy and required quite a bit of strength to wear. The dilemma with upper-limb prosthetics is facilitating weight balance and lower extremity control with a lightweight product.

The DEKA-3 is a result of DARPA development. This and other next step technologies are being commercially produced for use by patients in need.

DARPA pushes the leading edged of the sciences and often are society’s first encounter with the legal or ethical dilemmas that can be raised by new biological and engineering technologies. When considering these, the Department of Defense does need to integrate the necessities of USA interests along military usefulness.

Airlegs uses an exoskeletal backpack that generate air impulses that help normal soldiers walk faster, and better in rough conditions. As superheroes go, Harvard University (under a DARPA grant) developed an Exosuit that conforms to the body, allowing for natural joint movement while augmenting effectiveness in combat. Both these technologies may one day be beneficial to those suffering with incurable muscular-skeletal problems.

Somewhat lower in scale to Airlegs, there are numerous commercial devices available for neuromuscular disorders that use air to enhance mobility. People with foot injuries may benefit from AirCast that is a post-surgical cast that can be customized with air pockets for comfort and greater walk ability.

The WalkAide system uses electro-stimulation of nerves to help patients with nerve diseases like multiple sclerosis walk more naturally. It’s a fair and less cumbersome device to most AFO braces but does not influence those with muscular exclusive diseases.

Electrical stimulation therapy has been co-sponsored by Christopher Reeve and DARPA funding to help treat paralyzed patients as an aid for possible recovery or some mobility.

DARPA is not exclusive in setting these trickle-down technologies from military to public use. The National University of Singapore has been studying robotics as an aid to improve gait and walking abilities of patients under care of physiotherapists.

While many of these independent research projects and DARPA projects offer exciting reads, some succeed and some fail.

DARPA is intended primarily for defense technologies and the resulting products are intended for use by skilled soldiers. Some products derived from DARPA research grants do manage to trickle down for use by medical professionals and the general public. The internet was one of those DARPA projects! The efficacy of applying some of those technologies on wider samples may be difficult, while many promising projects fail in production.

Some limitations may stem from health insurance coverage restrictions or professionals with no education of newer methods at handling certain problems. It becomes more economic than practical.

Physiatrists, Orthotists and Prosthetists often work jointly in accessing and finding ways to help mobilize immobile medical patients. Some of the hardware come from archival DARPA studies. Because conditions vary from one patient to another, experimentation and therapy are necessary for adaptation to different individuals. “The evolution of orthosis and prosthetics is very promising,” says David Zwicker, a New York specialist. He adds, “Customizing these for each patients use is a must for performance.” As advanced as these appliances are, they aren’t always 100% perfect. Benefits and consequences partner in each design.

Of course, there are exceptions. There are wounded soldiers and athletes using DARPA-sponsored prosthetics that are so exceptional that they manage to compete in Paralympic games. The Paralympic Games are organized in parallel with the Olympic Games, while the IOC-recognized Special Olympics World Games include athletes with physical, sensory, and intellectual disabilities.

Perhaps the most famous (or infamous) of these is Oscar Pistorius. Although both of Pistorius’ legs were amputated below the knee when he was 11 months old, he has competed in events for single below-knee amputees and for able-bodied athletes. He competed in the 2012 Olympics. At his unfortunate criminal trial in 2013, he discussed how prosthesis evolved at such great levels that he was able to compete and win many Paralympic awards.

Zwicker concedes, “These are more exceptions than the average patients.” As a Myotonic dystrophy patient, using the Toe-Off AFO braces Zwicker recommended, my dynamic brace is indispensable as a walking tool. Sometimes they are like a balancing act and they stretch walking shoes beyond limits. Nonetheless, these braces allow a smooth (if slow) walk for someone with my degree of uncurable muscular ailment. The basic mechanics of the dynamic orthosis may have been introduced in earlier DARPA-funded experiments for wounded veterans.

More people resort to more orthodox, less challenging methods like wheelchairs, scooters, and walkers. I notice very few that recommended or prescribe dynamic braces. Thankfully, more children with neuromuscular development diseases find new technological tools that help them through their lives. Some have been adopted from DARPA products targeted for military use. Unfortunately, at this point, they are exceptions. They are the few fortunate ones.

Mobility devices make up only a small portion of DARPA sponsored research. Most go to weaponry, targeting, and reconnaissance. People are fortunate to inherit the by-products of some of these as available apps in smartphones and tablets.

According to the US Department of Labor, training and employment of Orthotists and Prosthetists is projected to grow 36 percent from 2012 to 2022, much faster than the average for all occupations. The large, aging baby-boom population will create a need for orthotists and Prosthetists, since both diabetes and cardiovascular disease, which are the two leading causes of limb loss, are more common among older people. In addition, new methods are likely to challenge this growing field as more people suffer from incurable immobilizing diseases.

When you see what may seem as inordinate government spending toward the military, realize that some of that money fuels DARPA research. You inherit some of the DARPA outcomes indirectly. Any transaction requires weighing benefits and consequences, DARPA funding sponsors at-the-edge research at many universities and labs that work toward advances of all kinds. There may be consequences. Yet, the next time you use GPS, the Internet, or a form of prosthesis, remember benefits often outweigh the consequences that may result through personal needs and interactive abuse.

Perhaps nothing is fair in war but being triumphant may be a necessary good or evil. Reaping other benefits from war-based research may indirectly help many. DARPA helps balance the scale.

ToeOFF Walk Aide is for New Balance

Imagine, if you will, that a child or adult is stricken by an event that leaves muscles inactive. There is loss of movement and, with it, losses of freedom. New technologies and research are helping mobility challenged to meet those extra challenges that bring more than the sense of normal movement. We are talking 21st-century ways to help you move much better than you’ve dreamed.

Muscular Dystrophies, ALS and Multiple Sclerosis are leading diseases that immobilize patients. There are also conditions due to compressed or damaged nerves as results of development, accidents, and war. When nerves and muscles can’t evoke action potentials to stimulate movement, you are unable to move. There are many levels of research to infer causes and effects. Biochemistry has thus far been leading symptom control. Over the past 20 years, giant strides have developed technological devices that can help promote movement, albeit better movement than none. There are perhaps only a few million people in the USA where chronic immobilization is a symptom. New tech research is helping those walk forward.

Immobilization may often occur in the mind but many suffer immobility from muscle weakness to severe paralysis. Those with spinal cord injuries may become permanently paraplegic with the inability to move their legs at all but new studies with electrical impulses can help carve ways to mobilize the immobile of body. For those with weak leg muscles, pushing walkers or using wheelchairs and scooters are the common ways of finding mobility. Precious few seek out trying to walk with braces. Braces are changing. They are no longer clunky and heavy. ToeOFF is a leading orthosis that you fit in your shoe. For those who have a form of ankle weakness, ToeOFF offers dynamic mechanical devices that help people walk more naturally. In recent years, alternate technologies, such as Functional Electric Stimulation of nerves have been emerging (FES). Is there attractive hope toward mobilizing the immobile?

Until FES experiments began in the late 1990’s, if you couldn’t walk you used a cane or crutch for support. In more severe cases, you might have used a wheelchair or would have been bedridden and constantly dependent on others.

In the mid twentieth century during the polio epidemics, leather and steel leg-braces were quite a common sight. A Persian, in the 15th century, first described the coating of plaster for fractures and other bony injuries of the limb. By the 17th century, there were braces for those who could not walk but they were heavy and cumbersome. President Franklin Delano Roosevelt was stricken with polio and used braces to stand when making speeches. They were those heavy leather and steel contraptions that were difficult to put-on and take-off. His braces were extremely difficult to use. In recent years, uses of aluminum and carbon fibers make braces lighter. Adjustable rubber and/or Velcro straps make them easier to adjust. AA Swedish designed brace, sold in USA as ToeOFF, is a prescription brace that helps certain people walk better and more comfortably.

Allard ToeOFF is known as a dynamic Ankle Foot Orthosis, often referred as an AFO that aid those people that have muscular weakness from the muscle groups that disable ankles to move up and down. The result is foot drag. ToeOFF using a lightweight, mechanical carbon-fiber device that helps restore a more normal walking gait. It’s a great device and helps many people with muscular dystrophy, multiple sclerosis, neuropathies, and myopathies that are aware of ToeOFF and the availability of the ToeOFF line and the use of other dynamic AFO devices.

ToeOFF is an appliance that allows people to easily put on and fit into different types of shoes. It is a lightweight, supportive brace specifically designed to correctly position feet for walking without foot drop. It covers the symptoms attributed to weaknesses in dorsiflexion of the ankle. Dorsiflexion problems may come from acute or chronic conditions. ToeOFF is a non-electric device that acts as a dynamic brace that normalizes the way you walk when a group of muscles don’t allow that seemingly simple action. Foot Drop is a relatively common problem among people of all ages but is also a symptom of nerve and muscle diseases. It can disable walking. ToeOFF is a prescription brace that helps facilitate “normal” walking (within degrees and limits) in those people with dorsiflexion from weak muscles.

ToeOFF has become a great aid for people with diseases where dorsiflexion is a symptom. Where other muscles are not as weak, ToeOFF is a fantasy device that helps people with muscle diseases walk. For overcoming the challenges of biped walking, ToeOFF really offers an alternative to some from being confined to a wheelchair or scooter.

Science fiction sometimes becomes reality and neurokinetic and neuromuscular researchers have more avenues and tools with which to explore how to stimulate movement and mobility for many muscle group problems. Of course, many studies are too small to deliver impact. Through various independent resources, including injured veterans from recent and ongoing Asian wars, there has been a drive to test electrical impulses as means of preventing pain and restoring movement. It seems like fantasy but small steps are being realized every day. For some, small steps bring large results.

Stimulating muscle movement to enable the motion-challenged to find motion is now being experimented with as a means to help people walk. The principle isn’t a new one. About 300 years ago, Luigi Galvani at the University of Bologna in Italy. He realized that if he sent an electric impulse at the lower spine of a frog, the frog’s legs would twitch. Similar experiments helped Galvani create neurophysiology as a study of how nerves can activate muscles in the body.

Galvani’s studies transitioned to studies of stress. In law enforcement, a Galvanic Skin Response in the hand helps determine whether a person may be telling the truth or not. The skin conductance response, also known as the electrodermal response (and in older terminology as “galvanic skin response”), is the phenomenon that the skin momentarily becomes a better conductor of electricity when either external or internal stimuli occur that are physiologically arousing. It occurs in the fight or flight response at the root of placing the body on stress alert.

A Superman on screen, actor Christopher Reeve suffered virtually total paralysis after a spinal injury. The Christopher Reeve Foundation offered grants (in the last decade) to study Functional Electrical Stimulation of nerve tissue to help induce movement. Functional Electrical Stimulation applies small electrical pulses to paralyzed muscles to restore or improve their function. FES is commonly used for exercise, but also to assist with breathing, grasping, transferring, standing and walking. FES can help some to improve bladder and bowel function. There’s evidence that FES helps reduce the frequency of pressure sores.

For research, FES is extremely valid when FES is used with a functional task such as walking, cycling, or grasping objects for a number of rehabilitative purposes and across differing diagnoses. FES has demonstrated the capacity for strengthening muscles enhancing circulation and blood flow, reducing pain, and retarding muscular atrophy.

In 2001, Case Western Reserve University, Department of Veterans Affairs, developed an intramuscular implanted system that activates the hip, knee, and trunk muscles to facilitate ambulation. At the time, the problems of electrode integrity in addition to adjusting the wavelength and amplitude signal measurements demonstrated promise.

Over the years, Federal Drug Administration worked at approving several devices that could provide enhanced results. Bioness L300 Plus adds a thigh component that facilitates knee extension and adds stability during walking as well. Other similar peroneal nerve (associated with the muscles that cause foot drop) stimulators commercially available are the WalkAide System and the Odstock devices. These systems have demonstrated long-term improvement in walking skills for persons with stroke as well as persons with multiple sclerosis and, possibly, other (thus far) incurable muscular diseases.

Alas, the rub is that virtually all these disabling diseases and conditions have no cure. Devices like ToeOFF and FES help the immobilized meet the challenges of moving. When you’re immobile or paralyzed, the facility of movement is like a light from the sky, even if only a short one.

The AFO and FES devices available for public use have been approved by medical agencies and federal groups like the FDA. This doesn’t mean that there are no side effects and contraindications as patients use them. While ToeOFF and WalkAide (and similar devices) are approved for certain conditions, each individual may be affected uniquely. Improvements may be individual specific and may not likely be generalized to work equally for a general population.

FES seems to be laying the groundwork toward the future of orthosis and. thankfully, there are products that offer advanced alternatives to the AFO. As relatively new, and somewhat unknown through the medical profession, FES is still somewhat expensive and most insurances do not cover use of a device like WalkAide. In addition, a pair of AFO (generally covered by insurance) may cost in the $1,000 to $2,000+ range. The WalkAide System may cost around $5,000 for a single and, a bit more, for a pair. Often these conditions may affect both left and right legs. Poverty and lack of adequate health insurance for those disabled by chronic nerve and muscle diseases. The merits of these prosthetics, however, could be life-changing to those afflicted by conditions.

In cases like multiple sclerosis and muscular dystrophy, understanding the etiology (causes) of the disease dynamics and causes is extremely important. Dorsiflexion is only one of possibly hundreds of symptoms. ToeOFF and WalkAide are examples of special devices that assist at making immobilization levels more mobile. While FES is promising for some, others may not benefit from neural electric therapies and devices.

ToeOFF and other AFO may work better with patients of muscular dystrophy and diseases of weakening muscles that are not necessarily associated with nerve damage. WalkAide may have little or no effect in those cases and, ominously, dystrophies have not been indicated to be (possibly) effective using an FES product. FES has been shown to be effective by generating electrical signals along nerve pathways and the nerves that are primarily associated at controlling muscles in certain areas. Some cases of dystrophy patients may not gain positive effects from an FES device because weakness is due to a genetic disruption of a neurotransmitter called Dystrophin and those signals may not change the efficacy of those muscles that affect foot drop and some other gait issues. That is why ToeOFF may still be the most advanced form of orthosis for muscular dystrophy patients.

Understanding those subtleties requires an integrated approach between physiatrists and rehabilitation specialists familiar with the problems behind neuromuscular conditions of different severity and sources. This is one of many reasons why ToeOFF and WalkAide are prescription products. For the most part, the etiologies of many of these conditions still require further research as well. In limited studies, however, products like ToeOFF and WalkAide remain to offer considerable help for those that can benefit by them.

ToeOFF is a partial solution and professional orthotists like David Zwicker, in conjunction with your prescribing doctor, can help patients optimize mobile functions. An AFO is an appliance and the appliance fits in a shoe, primarily a New Balance sneaker is recommended. As shoes are designed for feet and not necessarily a foot and an orthosis, the material of the shoe needs to be strong and stable enough to support it. Otherwise your balance may be compromised. You may require a wider size and may find that shoes last months instead of years. It’s a consequence that can be annoying. It’s fortunate that New Balance makes shoes with several width selections. That helps. Afflicted with moderate to severe dorsiflexion, ToeOFF helps you walk more normally than if you did not wear it. As an alternative to one of those electric wheelchairs, ToeOFF is a good device.

WalkAide does not require to be placed in a shoe. The battery powered unit may be placed anywhere on the calf around the peritoneal nerve fiber that is beneath your knee. That makes WalkAide an attractive alternative but only where nerve fibers and muscles interact with functional electrical stimulation. It may not work with patients suffering from muscular dystrophies or certain myopathies.

An orthosis, like a dynamic AFO (such as the Allard ToeOFF device) is a form of prosthetic. You might have your physical leg but the muscles related to dorsiflexion (and walking) don’t work. For the past 100 years, these prosthetics were heavy and large. While wealthy victims of Polio (i.e. President Franklin Delano Roosevelt) had to learn how to use them, ToeOFF is part of a group of AFO that are light and easy to use. Neuro-prosthetics is the study and development of medical devices that replace or improve the function of damaged neuromuscular organ systems and restore normal body processes, create or improve function, and/or reduce pain.

There is no 100% solution as of yet. It is promising that technological strides are being researched to offer immobile, afflicted people some more choices at the ease of getting around. Ranges might be limited. I guess it’s better to have some mobile range than none. There is promise in better AFO and FES development as the future unfolds. At least, there is hope.

Normal to age and get fat with sarcopenia

Believe it or not, if you’re over 50 and are disconcerted with that tire growing around your waist, it is normal to age and get fat. There are things you can do.

There’s a crisis at getting fat as you age. Suddenly fat begins showing where it never appeared before. Sizes rise and appearance seems to enlarge in all the wrong places. The human body is made up of fat, lean tissue (muscles and organs), bones, and water. After age 30, people tend to lose lean tissue. Your muscles, liver, kidney, and other organs may lose some of their cells. This process of muscle loss is called atrophy. These changes result in changes in function and in appearance. It is normal to age and get fat but it’s very difficult or impossible to prevent. Diets may only help marginally. Atrophy has an enemy. It is activity. All those cell losses reduce your energy levels as your body gets fat.

The bulk of the population have a common disease where it is normal to age and get fat. It is called Sarcopenia and is a condition that is virtually impossible to cure. Sarcopenia affects millions of people who gradually become weak and frail as they age due to loss of muscle mass.

While not everyone has Sarcopenia, research does show that it is closely associated with the process that is normal to age and get fat. In Sarcopenia, it is the severity.

Starting and following through with an exercise program might help control the progression of fat and Sarcopenia but it won’t cure it. Sarcopenia develops rapidly with a lack of physical activity, especially the lack of overload to the muscle, as in resistance exercise. The amount of physical activity generally declines with age. Physically inactive adults will see a faster and greater loss of muscle mass than physically active adults. The problem is that the loss of muscle mass reduces the metabolic production of energy. The results include developed intolerance of exercise that is all too real. It is not fear. It is a form of myopathy.

In most myopathies, weakness occurs primarily in the muscles of the shoulders, upper arms, thighs, and pelvis (proximal muscles). The symptoms are capped by general fatigue because muscles and energy production efficiency are closely associated. Other symptoms may include aching, cramping, stiffness, tenderness, tightness, and pain.

Sarcopenia and myopathies ARE NOT always present as people get fat with age. It is normal to age and get fat and Sarcopenia or myopathy may be fundamentally associated with symptoms. That is why exercise is extremely important over age 30 for those who not have chronic diseases. such as muscular dystrophy, multiple sclerosis, and myasthenia gravis, among others.

There are other subtle conditions associated with weight gain. These include an underactive thyroid gland (which can also cause weight gain despite eating less, intolerance to cold, constipation and dry skin) and diabetes (other symptoms include needing to pass water more often, feeling thirsty and recurrent minor infections like boils and thrush). Several medications can also lead to tiredness – beta-blocker tablets for heart conditions and antidepressant tablets are top of the average doctor’s list. Stress often leads to tiredness, but so too can symptoms of depression. Believe it or not, among aging individuals, weight gain is a cause for depression. Depressing generally reduces activity.

In the case of coping with the symptoms of normal muscle loss, changing habits from inactive to active is extremely difficult. For most, walking can help a lot. As you get older, your metabolic rate – the rate at which your body burns energy – will probably slow. Adjust your meal size and make a resolution to do a brisk daily walk of 20-30 minutes – just a 10% loss in weight will reduce the fat inside your tummy up to 30%! That means, if you are 200 pounds, you will lose about 30% of belly fat if you reach 180. If you’re 150, you may lose 30% belly fat when you reach 135 pounds. Doing so, however, requires a persistent, gradual habits that may be contrary to your known lifestyle.

Once you get over the “work effort” associated with exercise, you will find that you feel better because the body releases endorphins that help pick you up. For most normal people, exercise makes you feel better, perform physical tasks better and reduce the risk of disability due to arthritis. It now appears that exercise – specifically, resistance training – actually rejuvenates muscle tissue in healthy senior citizens. Resistance training doesn’t necessarily mean joining a gym and hoisting weights. There are rubber stretch bands. They are normally called Therabands and are used by many physical therapists. Like walking, these exercises must be approached in graduated steps.

As you evolve, Yoga and Seniors is a gaining partnership for overall conditioning and stretching. There are many community centers that offer free classes. It is recommended that you work towards 3 classes per week.

Of course, the process that is normal to age and get fat leaves muscles tense, stiff, and painful. Senior citizens should seek out massage therapy from a certified therapist or acupuncture. None near you? Try to find a nearby school that teaches massage and acupuncture.

According to WebMD, People who are physically inactive can lose as much as 3% to 5% of their muscle mass per decade after age 30. Even if you are active, you will still experience some muscle loss. If you are 60, you may have lost about 15% of lean muscle because it is normal to age and get fat. The lean muscle you lost helped make you look trim because muscle fibers kept your fat from showing.

If you are aging and reminisce about times when you were thin and strong, remember how normal it is to age and get fat. Lifestyle changes help but it’s all in the routine. That’s the most difficult thing. The hardest part is starting. After a few repetitions, it does get easier and your body will be trimmer. Just give it time. It took years to grow.

Toe-off braces against foot drop

While most evident with aging, foot drop is a condition when ankle muscles or nerve signals cause your foot to drop when walking. Foot drop makes it difficult to lift the front part of your foot, so it might drag on the floor when you walk. It can affect people of different ages as well. While some mild foot drop conditions respond to physical therapy, moderate to severe cases often require a brace that helps reposition your foot to a normal gait. The Allard Toe-off is one such brace and the best of its kind. There are others as foot drop is more common than most people think. Statistics are difficult to ascertain because so many people function with foot drop and don’t recognize the mobility challenge. Certain diseases, however, make it a clearly disabling symptom. Toe-Off makes that disability somewhat less disabling for young and old challenged walkers.

Foot drop can be associated with a variety of conditions such as flexor injuries, peripheral nerve injuries, stroke, neuropathies, drug toxicities, or diabetes. Basically, Foot drop can be defined as a significant weakness of ankle and toe dorsiflexion during movement as you walk and stand. You drag your foot while walking. Some compensate when approached by hills and steps by elevating the hip. The result is a Frankenstein-monster like foot drop that results in imbalance and consequences like frequent falls. On level ground, the feet drag on the surface. Carpets and walkway cracks can often be threatening as a foot fails to lift.

Allard ToeOFF is a leader among several manufacturers making devices known as Ankle Foot Orthoses for children and adults to help cope with chronic foot drop. These are braces that fit into shoes and create a rocking motion at the base of the foot. It helps the foot simulate a smooth walking gait by lifting the toes off the ground, as evident in foot drop cases.

Foot drop may also be evident in young babies who have difficulties toddling at toddling ages. They have difficulty standing and walking. Pediatricians may recommend a Supra Malleolar Orthosis (SMO) if the child is 18 months or older.

Up to age 3, the diagnosis is usually hypotonia. Hypotonia is the medical term for decreased muscle tone. Healthy muscles are never fully relaxed. They retain a certain amount of tension and stiffness (muscle tone) that can be felt as resistance to movement. When it comes to orthotic management of pediatric patients with hypotonia, the medical literature is only beginning to document the effectiveness that clinicians have been reporting anecdotally for years. There may be several reasons for hypotonia in babies, including nerve, muscle, and metabolic syndromes.

An SMO is shorter than an AFO and usually has a baby-friendly decoration. It will help babies stand. Walking may require physical therapies. Sometimes a pediatric physiatrist (medical specialist in rehabilitation medicine) may organize a team of multifaceted supporters. Small studies indicate that the SMO with phased rehabilitation may help children overcome foot drop and walking issues within a couple years. After that, genetic testing may be required to determine whether hypotonia is more of a symptom of another disease than a condition itself.

Hypotonia is not the same as muscle weakness, although it can still be difficult to use the affected muscles. Depending on the cause, weakness may sometimes develop in association with hypotonia. As people age, muscle weaknesses may develop along with normall loss of lean tissues. Hypotonia influences the movement, condition, and action of muscles.

Foot drop is very evident in diseases like Muscular Dystrophy, Cerebral Palsy, CMT, Stroke, and Multiple Sclerosis patients. An Ankle Foot Orthosis (AFO) helps relieve foot drop. It resembles a brace but it fits in most of your shoes. Worn beneath long pants or skirts, an AFO is practically invisible.

While an AFO may not directly repair dorsiflexor problems or neuro-muscular conditions, it helps deliver a near-normal gait when walking. The key is near-normal but that is a vast improvement. You may experience difficulty ascending and descending stairs. Your speed may be slow, but significantly faster than dragging. Your maneuverability may be somewhat compromised. Compared to foot drop, an AFO is a very significant mobilizer for the somewhat immobilized.

The Dorsi-strap is the least invasive AFO and also relatively inexpensive in the $150 range. While users should first consult a sports medicine doctor about using it, purchase does not require a prescription. The manufacturer seems to promote its use as a cure-all, even supportive for obese and big people, but the Dorsi-strap is really only effective for very mild foot-drop conditions.

For moderate and severe foot drop, dynamic braces are often prescribed. These are light, generally made of carbon fiber, a foot-length foundation is placed in your shoe and covered with shoe’s (or your) orthotic. A vertical support goes up and the brace attaches to your leg by one or two Velcro straps. A dynamic response Orthosis helps support a stable, balanced gait for walking and enable better posture while doing so. These are expensive but when you’re immobilized, they help you become (somewhat) mobile. They are covered by Medicare and most insurance providers.

Some people might say that, if you’re immobile, why not get a wheelchair or scooter? It’s a good question from an outsider’s view. There are classes of stubborn immobilized adults who want the illusion of mobility as a biped (not including cane support) in a world designed for most healthy people that can walk normally. There are fewer doctors and people aware of dynamic AFO devices so few are seen. They are used, though a minority compared to wheelchair devices.

Among dynamic AFO manufacturers, Allard’s Toe-Off family recognizes this for adults with varying degrees of disability. They also remember children who can suffer at many levels when confined to wheelchairs when they have foot drop as a main concern. Allard’s KiddieGAIT offers innovative options that have never been available for AFO management of these challenges. Functional environments can be created that supplement gait function instead of immobilizing and inhibiting that function.

Designed to provide dynamic toe-off assist with maximum control for the unstable ankle, Toe-Off is available in five sizes from X-Small to X-Large to fit children through adults. The unique, patented design features a lateral strut which “wraps” over the instep to provide maximum medial-lateral and rotational control of the foot and ankle complex, when none or little normally exist. Approximate weight variations are Size 01 (XS) weighs 3.6 oz., Size 02 (S) weighs 4 oz., Size 03 (M) weighs 4.9 oz., Size 04 (L) weighs 6.4 oz. & Size 05 (XL) weighs 6.7 oz. This permits an almost invisible sense of added weight. There is, however, a training period to get accustomed to the rocking support of these braces. Significantly advantageous, the Toe-off AFO fits into the shoe like an insole and accommodates most shoes without having to increase shoe size. New Balance sneakers are recommended for daily use.

Beyond the KiddieGAIT and the regular Toe-Off AFO, Allard has introduced the Toe-Off BlueRocker to their AFO family. BlueRocker is identical in shape and design as Toe-Off but offers more orthotic control. It is developed primarily for bilateral patients and those with more involved pathology. The extra stability will improve both balance and posture and give the wearer greater security, especially individuals with weak quadricep muscles.

It is also the most preferred orthosis to be used in conjunction with a socket and toe filler for management of partial foot amputations. Every BlueRocker should be padded on the inside towards the tibia crest. The SoftKIT padding system is designed specifically for use with BlueRocker for optimum patient comfort and product performance.

There are several other dynamic response AFO brands available for all degrees of foot drop. Helios (Helical Energy Loading Integrated Orthotic System) focuses on the category that the Toe-off BlueRocker targets. Helios is quite different as it does not use Velcro straps but requires a custom wrap-around shell for additional support. The double-helical construction is designed to correct skeletal structural deformities and provide an increase in walking function. This unique energy loading design offers the potential of normal walking. Because of its energy return in walking, the manufacturer claims there is less fatigue. Like the Toe-Off, it targets muscular dystrophy, peripheral neuropathy, CMT, Stroke, Cerebral Palsy, Polio, and many other neurological and muscular diseases that compromise function of the dorsiflexor.

If you find walking painful and your feet are consistently dragging, find a physiatrist or sports medicine doctor. These doctors study and serve patients with movement disorders. Orthopedists primarily deal with bones. A thorough exam will help form a diagnosis. Physical therapy may help most people. If it doesn’t, an AFO may be prescribed. Use a recommended practitioner.

I was advised to go to Prothotic Laboratory for my AFO orthosis. While there are hospitals and other providers, this place was highly recommended by my physiatrist. David Zwicker is their certified orthotist and was a pleasure to work with. He suggested the Toe-Off and considered the basic model as satisfactory. I must admit that, once I put the Toe-Off on, it seemed a radical improvement. As with a cane, I’d advise moving up to the Toe-Off BlueRocker for maximum strength and support, though it does require a suitable get-comfortable period. Zwicker offers seasoned experience and provides an intuitive, independent approach to help maximize comfort. When using an AFO device, your relationship with the orthotist is very important. Do not get an AFO unless you are certain that your orthotist is right for you. If you are in the New York City area, David Zwicker of Prothotics offers excellent service, although many pediatricians and physiatrists offer AFO and SMO devices.

There are varying degrees of foot drop and many reasons behind it. There’s no assurance that a dynamic AFO will get you running or even fast-walking. In cases of muscular dystrophy (and my Myotonic dystrophy), happiness comes from the ability to walk without foot drop, or the use of a wheeled scooter. The myotonia is still there and instability and weakness may dominate. Using the Toe-off offers significant help in walking from point-A to Point-B. Without the Toe-off AFO, trying to walk is a monstrous challenge. Be thankful that world technology is designing products to help the significant few sample the illusion of normalcy again.

Ultimately, an AFO or SMO is an aid to enhance mobility against foot drop due to weak muscles and nerves. Seeking medical or rehabilitation help may be advised to avoid accidents or falls is advisable.

New 2013 cholesterol guidelines

Sometimes it may be the binge eating you had before your medical exam. Other times it may be the dietary recommendations that eating chicken and fish are healthier than red meat. Any animal-source food has cholesterol. According to the Center of Disease Control, 71 million Americans or 1 in 3 have high LDL or bad cholesterol levels. LDL cholesterol is associated with lining arteries with plaque that may lead to organ damage, particularly leading to heart attacks and strokes. For some people, it is dietary, and is easily controlled. For others, these may be familial, chronic conditions. There’s no wonder why cholesterol management is a big topic and essential indicator examined on general blood tests. When the American Heart Association announces new guidelines for cholesterol management, doctors listen. The new report promotes high statin dosage to control high LDL levels.

A group of researchers from the American College of Cardiology and the American Heart Association put their weight on new cholesterol management guidelines. Their emphasis is to increase statin treatments to more people who might be at risk of having a heart attack. The origin of these reports were designed to effectively care for those who already had some level of a cardiovascular episode.

As with all cases, the panel took a traditional approach. As with all patients, they emphasized lifestyle guidelines (i.e., adhering to a heart healthy diet, regular exercise
habits, avoidance of tobacco products, and maintenance of a healthy weight). They cited that use of one of the 4 statin groups would help those who can’t manage to keep their LDL at a normal range. They did not discuss HDL/LDL ratios.

Establishing a target range under real circumstances still remains vague but they deemed that an LDL-C of 190 is considered threatening.

The new guideline recommends moderate- or high-intensity statin therapy for these four groups:

1) Patients who have cardiovascular disease;
2) Patients with an LDL, or “bad” cholesterol level of 190 mg/dL or higher;
3) Patients with Type 2 diabetes who are between 40 and 75 years of age
4)Patients with an estimated 10-year risk of cardiovascular disease of 7.5 percent or higher who are between 40 and 75 years of age (the report provides formulas for calculating 10-year risk).

Chronic use of statins may have negative effects on neuromuscular systems, particularly peripheral myopathies. While Cleveland University research cites that 72.5% of statin-intolerant patients may be treated with statins. There are those that have diseases like muscular dystrophy or multiple sclerosis for which statin use may be almost fatal. Recommendations of high stain dosages may be more dangerous holistically than cardiology specialists realize.

For example, many people suffer from rheumatism and fibromyalgia. These involve muscle pains, affecting over 10 million people, that have no succinct etiology to infer causality and results. There is little data to support that high-dose statins may induce more extreme pain or inflammation. While cholesterol management is vital, average cardiologists may not take these other common diseases into consideration when prescribing statin drugs.

Specialists that read these guidelines may take easier approaches at high-dosing statins to force cholesterol management to those that may not need it. The November 2013 guidelines of the American College of Cardiologists and the American Heart Association seems to sanction this. Most cardiologists adhere to the average and this report definitely targets the average. Patients are then forced to seek out cardiologists that see patients as individuals instead of group numbers. Groupings are attractive at writing presentations. Patients as clients require more specific attention.

Yet statins are touted well beyond cholesterol management with research demonstrating efficacy in treating cancer and other diseases. It’s as if all the leading drug companies that produce cholesterol are behind all the experiments. In some respects, companies like Merck and Pfizer are using cardiologists as drug pushers, especially when two major heart organizations sanction high dosages of statin medications to help lower LDL cholesterol.

I have genetic cholesterol and management requires an almost vegan diet along with exercise. Because of a form of muscular dystrophy, all statins have been proven toxic. I use Source Natural Cholesterol Complex on a daily basis, along with non-statin prescription Zetia and Lopid. Policosanol is a key ingredient in my supplement mix and policosanol research shows that 20mg can help reduce LDL cholesterol by nearly 30%. For people that suffer from statin intolerance, statins are not the conclusive treatment.

Cholesterol is only one of many indicators that may lead to heart disease. Relying on statins to lower LDL cholesterol levels may be great for many people. For those that exhibit statin intolerance, there are other routes and physicians should understand and study these.

Sifting through this 80 page document from November, it’s a rather unimpressive work and further extends that the two leading organizations continue to fail at examining holistic approaches to cholesterol management. Cholesterol levels correlate differently with age and this report didn’t cover that well. As people rise over 70, 190 to 200 LDL is more tolerable than that of a 25 year old.

Prescribing high intensity statins as a rule instead of an exception, may actually harm some patients in those groups due to side-effects. The fervent faith in statins for cholesterol management that seems to be shared by traditional cardiologists may be taking cardiovascular care in wrong directions. There must be more exploration into alternative approaches that place responsibilities on both doctor and patient.

Finding a reasonable target that I can maintain without statins is my goal. In the overall wellness mix, I prefer to be in control. Control requires an active goal-oriented approach. That control persists between routine visits to my practitioner.

Patients, as drug consumers, will accept statins and will likely not report intolerances. While statins for lowering cholesterol may be beneficial, the overall goal is to help patients (as clients) pursue healthy lifestyles and feel well. On the patient’s side, you must be willing to take necessary drug-free steps to improve your heart and cardiovascular health. Ultimately your health is your responsibility!

As to the new stricter standards proposed by the ACC and AHA regarding cholesterol borderlines and statin medications, everything and anything is subject to change. Each year new studies and interventions lead to new perspectives of how to approach cardiovascular conditions. The ACC and AHA are traditionalists and are likely to follow Statins as a holy sword. Statins are not exclusive. Seek out other options and, if possible, find integrative health centers that offer more holistic and educational approaches to help resolve what may be a chronic condition. There are lifestyle choices that can help you manage your LDL cholesterol levels.

WHIPS or Walk Helping Instruments and Power Scooters

Whips often bring negative and uncommon associations to mind. WHIPS as in Walk Helping Instruments and Power Scooters are necessary devices for those with impaired walking and mobility. Use of WHIPS such as canes, walkers, crutches, braces, wheelchairs and powered scooters are becoming more prevalent and help the mobile-handicapped preserve some degree of independence. For those with ambulatory challenges, the use of WHIPS may be perceived as a negative milestone. Whether temporary or permanent, WHIPS help mobilize the otherwise immobile.

In 2011, according to Cornell University statistics, 5.8% of males and 8% of females, not institutionalized, in the United States have some form of ambulatory disability. Some States have over 10% ambulatory disability statistics. The percentage of non-institutionalized, females and males, with a ambulatory disability, ages 16-64, all races, regardless of ethnicity, with all education levels in the United States who were employed in 2011 is about 24%.

At a recent Myotonic Dystrophy support group meeting I attended, many complained of balance issues when standing or walking, slow mobility, and fear of tripping or falling. Myotonic Dystrophy is a form of Muscular Dystrophy, a genetic transmitted disease, that involves the destruction and wasting of muscles throughout the body. The disease, made popular in the USA be decades of Jerry Lewis televise telethons, currently has no treatment or cure.

I have Myotonic Dystrophy. While I might have had it since birth, most symptoms became evident in the past 5 years, though I was officially diagnosed in 2011, by genetic testing. I really appreciate and mourn the inability to walk distances, skate, bike, and a whole group of things that are now past tense. Even at my less than 1 mile per hour walk, I feel potential tip-overs to left, right, and rear. My steps are very deliberate with a constant fear of falling. As such, I added more supportive shoes and use of a cane. They offered little help. Adding prescribe therapeutic braces helped restore some walking ability. I haven’t been able to use subways for over two years. I definitely rely on WHIPS and, even with those, basic movements are often challenging. Without those WHIPS, home confinement is more likely.

Yet, at that Myotonic Dystrophy support group, many people did not use canes, wore regular sneakers, and didn’t wear supportive socks. Those that did have canes or walkers had the wrong sizes. When it comes to WHIPS, few people have access to proper information regarding proper support specifications. As a cane user with a background in research, I’m now more aware of other cane and walker users. I see the inadequacies of selected WHIPS among some and the denial of using WHIPS by others. While there are different degrees of Myotonic Muscular Dystrophy, proper WHIPS are very important.

Choosing a proper, supportive cane was an educational experience. The HurryCane is a popular cane advertised on TV. It allows one to stand the cane temporarily for certain conveniences, such as swiping a credit card at the counter or near a bench. Canes can be cumbersome when shopping or sitting in public places. I ordered one and found the cane too short for support and its adjustability was too flimsy to rely on. If you’re up to 5’9″ tall and weigh under 170 pounds, the HurryCane might be adequate. I saw too many taller and bigger people bending down to use that cane and say the cane bending with their weight. A probable accident seemed evident with continued use, especially if this is to be your personal partner for support.

The generally accepted rule for proper cane size is half your height in inches. If you are 5 feet, you are 60 inches. If you are 6 feet, you are 72 inches. I’m 74 inches and most of the sold canes were up to 36 inches. There are many online cane retailers. After lots of research, I found Fashionable Canes as a great source and resource. They offer a wide variety of styles, sizes, accessories, and tips for proper sizing. I was able to get a 37-inch wood cane that fit my height comfortably so I can walk straighter.

Weight capacity is also an issue. If you weigh 180 to 200 pounds, your cane needs to have a 250 pound capacity. You often lean down on the cane for additional support. This level of inertia adds weight on the cane, sometimes as much as 50 pounds. To assure adequate support with integrity, seek a cane that supports at least more than 40 pounds of your body weight.

While Amazon offers many cane styles and sizes, I found their specifications somewhat inaccurate. If you’re a Prime member, delivery and return privileges are rapid and liberal. But the Fashionable Cane online store, physically located in Florida, is extremely accurate and the customer service is very helpful.

One of the unexpected cane features I found at Fashionable Cane is the cane tip. The tip of the cane is very important since it meets the walking path of varied surfaces. Most canes have soft, smooth tips. Fashionable Cane tips use steel supported rubber with circular treads, providing better traction than most tips. Among accessory tips that they offer, you’ll find among the selection that deliver support like the HurryCane (quad-tip) and for walking on snowy surfaces.

Vista offers a wide variety of canes found in shoe and shoe repair stores. They are also premium WHIPS but generally are around 36 inches in height for most canes. Seek them out if you are 68 to 72 inches tall and prefer to buy one at a local provider.

Another popular instrument in the WHIPS category is the medical walker and these are very popular among women. For the most part, these are used by people around 60 to 65 inches tall, though some models adjust to 72 to 75 inches high. These permit broader walking support, especially for those suffering from osteoporosis, a crippling bone disease. These often have seats and storage available. Height is a problem here too as chronic users may develop a bent-over posture due to recalibration of the spinal vertebrae. I’ve seen some people with muscular dystrophy using these and some have already developed a hunchback appearance. Proper height and weight support are key issues here and often overlooked by providers and consumers, when considering chronic use.

Another extension of the WHIPS category are powered scooters and wheelchairs. These battery powered mobile assistive vehicles have been growing in popularity. They can greatly extend mobility range and can offer independence for advanced cases of immobility.

Most powered scooters are designed to fit on public transportation devices to help save battery power (usually up to 10 miles while carrying a 170 pound load).

I had considered this option in my earlier stages of ambulatory challenge but observed some restrictions in door entry of various stores without automated doors. I was thinking of using this as a vehicle to be able to enjoy use of nearby parks, though I haven’t seen too many in parks. The reason is these battery power devices offer minimal torque for uphill and downhill use. The convenient 3-wheel scooters may tip on the uneven leveling of paved park paths.

The EMS-48 Adult Scooter would have been perfect for use in the park but is too large for use in public transportation. At speeds up to 20 miles per hour and a huge up to 45 mile range on a battery charge, this would seem perfect. It’s like a supportive electric moped. Unfortunately, that distinction makes it illegal for use in city parks.

Mobile challenges aren’t just targeted at older people, though it seems that way. I do see people older and younger than me making use of WHIPS. Being mobility challenged is disabling in many ways, shapes and forms. Using WHIPS may help make existence more palatable. There are, as in life, benefits and consequences. The biggest consequence is the challenge and often the challenge seems insurmountable.

Elizabeth Kubler-Ross is a prominent psychologist that studied patients who were dying. She came up with the DABDA process that all patients went through. The DADA process involves Denial, Anger, Bargaining, Depression, and Acceptance. I observed in my neurocognitive research that this also applies to those that find challenges in overcoming other diseases, though most remain stuck in Denial.

Muscular Dystrophy, Multiple Sclerosis, Arthritis, Osteoporosis, Cerebral Palsy are diseases that can severely immobilize and affect perceptions and choices of “I can” and “I can’t”. It feels like an invisible whip striking deep to the core of being. Fortunately, with medical guidance, family support, and the responsible use of the right WHIPS, people can accept their plights and make life appear less challenging in contrast to definitions of normality. Proper WHIPS help bring redefinition and acceptance to feel better against the odds you encounter each day.