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.

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.

Don’t Drag your feet get your toes off

Street observations often show that quite a few people of all ages seem to drag their feet, gliding slowly on pavement. Some walk slowly, taking small steps, careful not to trip or fall. Are these people tired, weak, in pain or depressed? Sometimes all of these are in play. Emotion disorders for some may loosely involve motion disorders. This mode of walking is called Foot Drop. It is where the ankle does not elevate your foot to stride comfortably. The key to a normal and smooth gait is placed on what is called a dorsal muscle that, basically, works to get your toes off the ground. In some cases, a Toe-Off orthosis might help lift your toes off for better walking.

The ankle of each foot lies at the base of each leg as it meets the foot. It is often vulnerable to sports injuries or falls. How many kids complain about sprained ankles? How many game players have to sit through a season because of an ankle problem? Usually, these wounds heal. For others, there are diseases that chronically affect the foot. This makes walking difficult and painful. This makes walking alongside friends annoying. Most people adapt to it while others use orthotics, canes, walkers, and wheelchairs. These are entirely different perspectives than those that normally walk.

The joint at which the leg meets the foot is called a dorsal joint. This connecting joint consists of bone, ligaments, and muscles. There are four muscles involved – Tibialis anterior, extensor hallucis-longus, extensor digitorum longus and fibularis tertius. The largest and most evident of these muscles is the tibialis anterior, which can be seen superficially in the front of the lower leg. Dorsiflexion involves these muscles for just a couple functions, primarily lowering and lifting the foot for walking. It also aids left/right motion for smoothness and capability of coping with hills. Dorsiflexion helps establish the toes off and toes on movements that are necessary. When dorsiflexion doesn’t function, the foot remains in a dropped position. Getting your toes off for a normal gait is virtually impossible.

There are other muscles that help the dorsal muscles function. Nearby, Plantar flexion involves lifting the whole body. These go together because the world does not exist as a straight plane and body’s weight creates all sorts of subtle adaptations to the differences of weight, angles, and voluntary movement. Because the ground constantly has variables, human feet need to adapt to smoothly interface with it swiftly on contact. In normal function and anatomical position, the ankle joint has flexion (dorsiflexion) and extension (plantar flexion). Foot draggers have a lot to do to get their toes off the ground.

For many foot draggers, a trip to a physiatrist might help deal with the problem. Some may require physical therapy to help break old habits. Others may need a prescription orthosis. The latter occurs when certain diseases chronically influence the dysfunction of the dorsal muscles. One particular orthosis for helping people get their toes off the ground is a bracing device called Toe-Off.

Toe-Off is part of a group of products, called an Ankle Foot Orthosis (AFO), that help replace the action of the dorsal muscles, when the muscle group has been compromised. This is common in muscular dystrophies, myopathies that can waste these muscles to the point that your foot can longer raise on its own. Toe-OFF is a new generation AFO, covered by several patents. While most AFO get your toes off and up to facilitate a more natural walking gait, and share some similarities, Toe-Off is lighter and easier.

Toe-Off is known as a dynamic AFO. It is made of a lightweight moldable carbon fiber composite material and works with various shoe types. It employs a high activity design that enables freedom of motion and allows for simulated walking that functions and appears as if you aren’t using any form of brace, with the exception of a few chronic cases. Whether custom of off-the-rack, a dynamic AFO encourages range of motion, allowing children to learn movement by moving and providing minimal support, only where the patient needs it. Scientific research on dynamic AFO devices show improved performance, though studies must be further explored.

Many AFO allow use of your own shoes. You remove the insole of the shoe, slide Toe-Off inside and then replace the insole. Most shoes aren’t adequately sized to hold your foot and an AFO. Sometimes you may find greater comfort by shifting to a wider shoe. New Balance and Dr. Comfort are recommended brands. Do not anticipate normally long wear from your shoes. Typical daily wear might be around 6 months and leather shoes should be changed every 6 weeks or so to keep it supportive (as leather stretches).

Toe-Off uses a Swedish technology that uses a carbon fiber for support or action. When worn, it does take your toes off the ground. Your walking gait is more normal.

Toe-Off resembles an over-the-calf shin guard, set in place by adjustable Velcro straps. Shoes are ties normally. It provides leg support and foot support as it aids that toes off process.

To say that use of Toe-Off will let you run marathons or play basketball is a rare exception. It helps a foot dragger with foot drop walk virtually normal. That is remarkable.

The feel of the Toe-Off is like standing on a suspended rocking chair. It rocks your foot into the appropriate position. Depending on your condition, getting up from a chair or using stairs may be a little difficult. Toe-Off primarily focuses on replacing the simple dorsal inaction that results in foot drop. Maneuvering other than walking may still be difficult or impossible. For someone who can’t walk normally, Toe-Off is a necessary option for those who want mobility without resorting to a scooter or wheelchair device.

Because even smoothly paved roads have variable surface changes, use of a cane is helpful in those cases. Many times you may not need it or use it lightly. When the walkway has cracks, embedded rocks, or other surface irregularities, that cane could be the difference from walking to falling.

A physiatrist or sports physician usually must prescribe an AFO and Toe-Off requires a prescription. It’s an expensive technological tool but is covered by many health insurances. Usually, your doctor sends you to an orthosis specialist. Prothotic Labs is a New York based progressive Prosthetic and Orthotic facility. David Zwicker is one of their specialists. He is particularly attentive to patient’s comforts in using any of these devices. While Toe-Off, for example, is an excellent product, it may need to be fitted for comfort for individualized use, Zwicker specializes in this. Developing a cordial relationship with your orthosis specialist is necessary. Finding one is crucial. An AFO is a walking mobility device that replaces poor natural muscle control. You and it must act comfortably as one.

As for support, there are 3 Toe-Off models that cover children, moderately affected adults, and severely affected adults. Due to Myotonic dystrophy (one of the muscular dystrophies) I use the Toe-Off BlueRocker pair – their offering for severe cases. It is designed for helping Footdrop from disorders such as stroke, MS, post-polio, Myelomeningocele, Cerebral Palsy, Muscular dystrophy, CMT, and forms of Neuropathy. This is my second Toe-Off AFO and I find it to be very supportive. It does require the Comfort Link accessory for extra padding around the leg.

Braces have changed a lot since the days of President Franklin Roosevelt. They help easily mobilize the otherwise immobile. Getting your toes off the ground as a means of alleviating foot drop means you have many choices to explore from exercise to using an orthosis. A dynamic AFO, like the Toe-Off family of products, may just be a possible answer. So don’t drag your feet when walking. Get your toes off and seek professional help. Treatment is often easier than you might think.

Toe-Off is not a miraculous cure for the causes of dorsiflexion. You may or may not be comfortable using it, and may not restore your walking range before your ankle disorder. Depending on the severity of your condition, Toe-Off helps provide a sense of dignity at the challenges of achieving upright mobility when walking. Many people do regress to needing scooters. It’s an acquired, adaptive taste and a quiet idea of walking using your own two feet, albeit with an AFO brace like Toe-Off. A dynamic AFO, under advisement from your physician, may help you cope with walking challenges a little differently (at least for a while). Isn’t it time to get your toes off and walking?

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.