Poor physical fitness nearly harmful as smoking for heart health

When it comes to wellness and longevity, what might be the best method of achievement?

A nearly 50 year study in Sweden asserts that physical wellness and breath capacity are key variables for cardiovascular wellness. Basically, when compared to hypertension, high cholesterol, high triglycerides, and smoking, poor physical fitness was noted nearly harmful as smoking for heart health.

What are some of the factors that help determine the length of your life? Is it diet? Is it physical activity? Is it obesity? Is it smoking? Is it genetic predispositions? Study shows poor physical fitness is nearly as harmful as smoking as risks for getting a heart attack or stroke. Does aerobic fitness determine an improved life length? I think fitness has to do with weight management AND exercise together.

How many hours do you sit in front of your TV in a week? How long do you sit in front of your Mac or PC each day? How far do you walk (or do any aerobic activity) per week? When it comes to heart health, two factors scored high as risks – smoking and aerobic exercise. This 45 year longitudinal study seems to assert that poor aerobic physical fitness is nearly as harmful as smoking, at least, in Sweden. Is it applicable elsewhere?

Swedish researchers followed up on nearly 700 Swedish men for 45 years (1967 to 2012_ years to find risk factors for heart attacks and death. This is one of many longitudinal studies that Sweden generates. The reports showed fairly obvious and startling results. Smokers, men with high cholesterol levels or hypertension ran a higher risk of a premature death. Low levels of aerobic capacity – or poor physical fitness actually represented a higher death risk than high blood pressure and high cholesterol levels. Only smoking was found to be a higher risk factor than poor (aerobic) physical fitness. Is it time to consider walking more than watching TV or staring at the monitor?

A longitudinal study is an observational research method in which data is gathered for the same subjects repeatedly over a period of years, decades, and longer. Compared to short studies, longitudinal studies show responses over time, sometimes lifespan.

This study, by a team from Department of Molecular and Clinical Medicine, Sahlgrenska Academy at the University of Gothenburg, Sweden. A representative sample of 792 men were followed for 45 years. All subjects were 50 year old men when they were selected in 1963. The study and research aimed to investigate the risk factors for cardiovascular disease and mortality. The remaining participants would be in their 90’s. The study inluded men born in 1913, 1923, 1933, 1943, 1953 and 1963.

In 1967, the group’s members all completed an exercise test. 656 of the subject group carried out a maximum exercise test where they were required to push themselves to the limit (the others were exempt due to health concerns that might have made the exertion dangerous). Oxygen uptake was measured using with consistent instrumentation that measure respiration and gas metabolism during exercise. Subjects were monitored every 10 years. Data on smoking habits, leisure time physical activity, mental stress and previous diseases, including hypertension and diabetes, as well as on pharmacological treatments were collected by questionnaires.

Smoking was the most likely lifestyle factor to kill a person early, but low aerobic capacity as measured by peak oxygen uptake (better known as VO2 Max) was linked to higher mortality than the other cardiovascular factors assessed. The men with the lowest VO2 Max (maximal oxygen uptake) had a 42 percent higher risk of dying of premature death than the men who were the fittest, and about 21 percent higher risk than men with average aerobic capacity.

Of course, previous mortality rates conducted by the American Heart Association indicate that high LDL cholesterol, high triglycerides, and hypertension have been evident in patients with cardiovascular incidents. LDL Cholesterol and (in less than 2% of population) Homocysteine may contribute to to artery blockages. Left unchecked, these have been observable causes of strokes and heart attacks.

The American Heart Association (AHA) suggests at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity). Thirty minutes a day, five times a week may help minimize the risk of a heart attack, a leading killer.

Of course you join a gym and use treadmills, joggers, stair-masters, or join a spinning class to boost your aerobic fitness. It’ll help meet those recommended lifestyle guidelines. Considering most people’s busy lives, is it really possible?

Cardiovascular health is likely more associated with exercise constancy. Taking routine time each day or two for 30 minutes of moderate cardiovascular activity. It has to be integrated and mindful in your lifestyle as a routine, not as an option. Cardiovascular exercises help increase breath volume capacity, movement of body fluids, and use of calories.Sound difficult?

Try walking! Make time to walk to work, walk to meetings, walk around your neighborhood or walk when shopping. Walking briskly, even moderately may help boost aerobic fitness and improve your cardiovascular integrity. The AHA cites a recent study that indicates, “walking briskly can lower your risk of high blood pressure, high cholesterol and diabetes as much as running.” Many studies suggest that walking improves cardiac risk factors such as cholesterol, blood pressure, diabetes, obesity, vascular stiffness and inflammation, and mental stress.

Just 30 minutes walking every day can increase cardiovascular fitness, strengthen bones, reduce excess body fat, and boost muscle power and endurance. Even if you don’t smoke, don’t have high levels of cholesterol, and don’t have hypertension, the benefits of walking are prime at thwarting many health risks.

While the Swedish study examined men, primarily because 45 years ago, more men had cardiovascular incidents than women. Studies indicate that women doing aerobic activities reduce risk of coronary issues in the future.

The exciting data from Sweden’s longitudinal study and those of USA cross-sectional studies clearly match. All infer that the causality of cardiovascular and respiratory health and heart wellness are associated with marked levels of activity.

Aerobically poor physical fitness is near the top of the list of variables that increase risks of cardiovascular episodes, sometimes even if there are no indexes of other cardiovascular risks.

While following a healthy diet is important, a motivated routing of aerobic exercise seems to offer assurances that you will have a higher quality and longer cardiovascular life if you try to walk moderately brisk 30 minutes per day. The Swedish know it. USA medical specialists know it. So should you.

Ancient Asian practices addressed poor physical fitness with breathing as an important facet. Persia, India, and China all focused how breathing bears influence. Chinese medicine believed that poor physical fitness required Qi Gong, to achieve balance and strength. The Swedish results demonstrate the significance these ancient practices had at insuring cardiovascular health over time.

Understanding cardiovascular health means opting for lifestyle choices, with no interruptions. And no smoking.

While cholesterol levels, triglycerides, and diet may be causes of havoc within arteries leading to the heart, brain, and some other areas, the Swedish study prioritizes how crucial breathing is to upgrade your status toward cardiovascular health.

Of course, there are those that may have chronic asthma or COPD and other respiratory conditions that wouldn’t have qualified for the respiratory segment of the Swedish study. They are likely to be already treated by another specialist.

For most, however, in this cardiac risk study, healthy breathing was an important variable in assessing longevity of cardiovascular wellness.

As part of normal daily activities, if you find you lose your breath on short walks or climbing a few stairs, it may be an indicator of cardiovascular disease, even if your cholesterol and other blood indicators are within the normal range. The importance of respiration integrity with stress is a good marker for potential cardiovascular risks. This stress-test is usually given by a cardiologist exploring possible symptoms. If you don’t smoke but experience breathing problems, consider adding a cardiologist on your To-Do list.

It is also suggested if you feel changes in the way you breathe, seek medical attention as there are many serious respiratory illnesses that may occur during your aging process. Unawareness or ignoring symptoms contribute to degrees of poor physical fitness.

Overall, if you have any of the indicators that may contribute to cardiovascular events that could lead to heart attacks or strokes, be wary of them. Find out more from a medical specialist or alternative cardiologist and what you can do about them. You would be surprised that physical fitness and weight management are two common approaches to help alleviate ongoing cardiovascular diseases. The Swedish study may be valid. Poor physical fitness is, as the Swedish study asserts, is almost as bad as smoking as a lifestyle that might contribute to heart diseases.

Sweden is very serious about fitness, exercise, and diet. This could be a confounding variable in the overall results and report. Nonetheless, world organizations support physical fitness and diet responsibilities as keys for life extension. Breathe well and move.

Cardiovascular illnesses may be genetic but, in general, they may arise by lifestyle choices and poverty. While this study demonstrates the significance of physical fitness to suppress some symptoms of this silent killer, routine blood tests covering lipids are very important. Ask your physician to give you a copy of the blood test results so you can track them. You may never know whether you are a candidate or not. Becoming fit doesn’t guarantee happily ever afters. Fitness may just help sweeten and lengthen your odds of living well, as part of an integrated approach. Isn’t that what you want? What’s stopping you?

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.

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?

Women being always true to your fashion

Is society still about books and book covers? You couldn’t tell if you looked at June Squibb, the 84 year old star from the Nebraska movie, and noticed her fashionable, radiant appearance at the Oscar Awards red carpet. Though the octogenarian appears like a great-grandmother, she mentioned that she had played a stripper in the Broadway cast of Gypsy in 1960. Who would have guessed? It’s alarming how age helps change the human form. Accepting fashion to your form is normal but many get anxious and frustrated as they shift from vital, young fashions to somewhat matronly designs. Isn’t it hard being true to your fashion?

Fashion is image and fashion and form are related. Aging often changes a woman’s idea of being fashionable as skin softens and the nature of naturally gaining fat and losing lean muscle creeps up. Buddha once wrote, “Without health life is not life. It is only a state of languor and suffering – an image of death.” In a society where obesity is on the rise, remaining fashionably youthful as you age means maintaining health and activity. As you find yourself moving up from small to medium to large and extra large, your self-image declines. Is it because of age? Is it because of lifestyle? Are you true to your fashion?

Most fashion models display clothing in true, artistic form but most of these models retire before age 30, and only few retain their amazing figures. This puts normal people to shame. Does that mean that “normal” means losing a fashionable image?

Fashion is designed for normal people but people’s norms vary to the extent they want to remain fashionable. On Red-Carpet displays, fashion is demonstrated in all shapes and sizes. It’s a rational definition. Most women develop anxieties as they see their sizes rise and their forms distort what they had once believed to be attractive. As women leap through menopause, any irrational anxiety is amplified many times. Does age mean you need to be fat?

Preventing the eventual image of dying and death is a difficult one. Waiting to pursue an active lifestyle at age 60 is like taking on climbing the highest mountain. Is it possible? It is. Only 1 in 10,000 manage to follow through.

Fitness and diet as a lifestyle often runs contrary to your ethnic foods and media advertising. Fitness needs to be integrated at young ages and diet needs to be learned over a lifetime. Will life be healthy or not? Barring genetic and other chronic diseases, most people could maintain fashionability by doing low-impact exercise each day.

Walking is a perfect exercise and walking at a brisk pace for 30 minutes daily is an excellent routine to be true to your fashion. Many women tend to be goal oriented when walking. There must be a destination. Only a small portion of people enjoy walking for pleasure. A constant walk on a firm surface can burn upwards from 100 calories per hour, based on a 150-pound person. Carrying and walking with 15 pounds of groceries can burn about 40 calories in 15 minutes.

Walking has been shown to have cardiovascular benefits. According to an article in New England Journal of Medicine, constant walking aids in reducing the risks of cardiovascular diseases. According to a Harvard study, among 72,488 female nurses, walking at least three hours a week was linked to a 35% lower risk of heart attack and cardiac death and a 34% lower risk of stroke. Chronic sitting will add to weight gain and cardiovascular risks.

Walking alone requires more effort for weight loss and being true to your fashion goals. Basically, walking to expend 500 calories per day (while following a low fat diet) each day may help you lose one pound per week. In essence, walking gets you moving and more movement brings increased weight loss.

The fashion industry isn’t blind and more stores, like Forever 21 for example provide affordable and stylish clothes for those who wear “plus sizes”. If this is true to your fashion decisions, this is fashionably satisfying.

If you are plagued by anxieties regarding weight, form, and image, targeting to get back to your optimal weight may seem a herculean task. Using a combination of hormone replacement therapy (that may indirectly help get you moving) and exercising/walking 300 to 500 calories per day may just help you meet your true to your fashion desires. Can you do it?

Sometimes body size is a product of genetics or may be associated with certain diseases, many yet to be discovered. Surgical procedures may help reshape your body but, often, for only short terms. These people may find fashionability as well. Not everyone can be a size 4 or 6. Being true to your fashion is understanding your reality and expression.

Fashion is associated with art, science, fantasy, self-esteem, and a sense of empowerment. Feeling fashionable may be your positive. It is frustrating when you look at your appearance change over decades. Where did your style go? Staying and being true to your fashion and style is an activity that may elevate your mood in many ways. To get back to size 6 takes lots of effort when you haven’t done any for over 10 years. Sometimes you may need to adjust to your new body or work double hard to get one you like better. Are you true to your fashion?

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.