Programme Information

Phase I (Reactivation) & Phase II (Development/Stabilisation)

Reactivation (some researchers call this stage reorganisation or the relearning of the nervous system) is what causes the most controversy regarding the Dardzinski Method practiced at Project Walk and Standing Start. We believe that a nervous system traumatised by a spinal cord injury can reorganise itself when introduced to proper external stimulation. Without external stimulation, the human nervous system deteriorates. When it is drugged to prevent sensation and muscle contractions, when it is exposed to supposed treatment that refuses to touch the paralysed body parts, how can you expect it to improve? NASA and the Russian space programmes have both spent millions of dollars researching how the body deteriorates when exposed to reduced gravity, including loss of bone density and muscle mass. If you ever wonder why someone thinks your nervous system can’t reorganize just look at the environment in which a person with SCI is placed, add the perception of no hope of improvement, and you understand why! Place them in a power chair, pump them full of drugs, and leave them alone, what do you expect will happen; nothing!

Project Walk and Standing Start ’s idea of the future

Hope of recovery from day one. No one knows the future and nothing is guaranteed, but venturing into the unknown is better than sitting waiting for nothing!  Our hopes are that our clients are:

• Drug free
• That their muscle contractions are increased and used to build muscle mass and control
• Proficient and comfortable with load bearing exercises in developmental movement patterns from day one
• Beginning the external stimulation of the nervous system to promote reorganisation
• Removed from their reduced gravity environment while working out

Since 1999 Project Walk has been working with people with spinal cord injuries from C3 to L2. Their clients are happy. They are happy because they are doing something about their situation and seeing the accomplishments. While visiting their centre and watching their clients work out, a leading SCI scientist once said that one of the reasons their clients are improving is because of their attitude and hope. Standing Start will bring that hope to the UK.

Results of Phase I (Reactivation) & Phase II (Development/Stabilisation)

• Increased central nervous system activity
• Increased muscle mass
• No loss of bone mass
• Increased circulation
• Increased sensation in some clients
• Increased hot and cold in some clients
• Decreased pressure sores
• Decreased use of medications
• Decreased health problems associated with a spinal cord injury
• Increased control of their lives

With the Dardzinski Method, these two phases go hand in hand. As reorganisation of the nervous system begins to occur, there is muscle development which leads to increased stabilisation of the joints. Think about this statement for a moment. Increased tightness around the joints, isn’t this the complete opposite of traditional treatment? Of course it is, but have you ever tried standing on a pair of wet noodles! You need strong stable joints and muscle mass before you can ever move your legs.

This is what separates us from traditional rehabilitation. We are all about getting spinal cord injuries out of the wheelchair. Project Walk and Standing Start should start with the client leaving the hospital. We work with all types of injuries (Asia A completes to incompletes), as long as the client can breathe on their own and has their doctor’s clearance to start an intensive fitness programme. We reactivate the nervous structure with a goal of developing it into a mature, controlled working system.

Increased muscle size/tightness, nervous system activity, and joint stabilisation are the goals of Phases I and II. Stabilised joints allow load bearing. Increasing the nervous system activity is like unleashing an internal electric stimulus or FES bike. What makes this more productive than the passive external machines is very simple, YOU are doing it and it is an active response from YOUR nervous system, not a passive response to an external device.

Phases I and II are the most difficult stages of our programme, and can be the longest on the road to recovery. We compare this part of improvement to back country skiing, you spend all day getting up a mountain for a 30 second trip downhill. Some of our clients have spent over two years in these phases, where others have spent a few months. What we have learned over the last six years is that the level of injury doesn’t really affect how long it takes someone to move through Phases I and II. It is different for each individual because each individual brings us a different nervous system. Some have uncontrolled muscle contractions (spasms); others have pain; and others have nothing at all. Spasms and pain are just symptoms of a spinal cord trying to heal, and without the proper stimulus, these symptoms can get worse. With the Dardzinski Method, these symptoms slowly go away as the nervous system matures. This is also the stage of the journey when most of our clients choose to decrease or completely eliminate antispasmodic medications.

Simply stated, In Phase I (Reactivation), our goal is to act as your nervous system; to create, change, and excite it. In Phase II (Development/Stabilisation), we are building the nervous pathways that you will use in later phases of our programme.

No one learns to walk during these phases, it is not about walking, it is about improving your quality of life. It is about achieving little things that are huge, like being able to feed yourself, rolling over in bed, driving, and becoming independent of care. Traditional methods give you a lifetime of depending on care. We are about giving you a lifetime without it.

TRAINING GUIDELINES

Over the last four years at Project Walk they have been trying to figure out what is the most appropriate amount of time to spend in the centre to get maximum gains. Clients start with either two or three hour appointments, depending on the level of injury. For example, clients with a C injury need to work both upper and lower extremities, and in general, require longer appointments. On their advice we suggest at Standing Start that each client will come in three days a week. Research shows that those who come in five days a week do not give themselves the proper amount of recovery time between sessions. Five day a week clients return with tired nervous systems that do not respond to stimulus; while those that come in three days a week come back stronger with each session. These clients are able to make more out of the time they spend in the centre.

At this stage of the programme, recovery time is the MOST important aspect of the training day. The Dardzinski Method is an elite performance training programme for SCI patients and works best with an active nervous system. Allowing the nervous system to recover between workouts allows your body to strengthen the new connections. Without an active nervous system, the only thing we can do is passive range of motion which does not benefit the client at all. We like to maximise time and effort in order to achieve the client’s goals in the shortest amount of time.

Now that we’ve given you our training guidelines, it is important to note that we realise every client is an individual with individual needs and goals. To keep up with each client’s evolution through improvement, we re-evaluate workout prescriptions on a monthly basis and may change the training guidelines based on their improvement process.

Daily exercise prescriptions include some or all of the following techniques:

• Developmental movement patterns
• Active nervous system recruitment
• Active load bearing
• Active spin bike pedaling
• Passive gait training

Change—it’s that simple! Physical changes occur almost immediately from improvement in overall health to your nervous system reacting to the stimulus that it receives. One of the first things you may notice is a change at night. You may begin to get uncontrolled muscle contractions (spasms) in the evening or while you sleep; or you may notice more burning or even pain in the evenings. Why in the evenings? During the day while you workout, your nervous system is reacting to the stimulus that is provided. At night it starts to recover and heal. Night time will get very interesting as you progress through Phases I and II.

ADDITIONAL MODALITIES

We have found that the addition of the following modalities help in the road to recovery.

Standing Frames are very important in this early stage of improvement. You will begin to lose bone density and muscle mass as soon as you sustain an SCI, so it is very important to your future that you maintain your bone density. Although blood pressure is sometimes a problem, it is still imperative that you get up in the standing frame. Each week you will be able to last longer. Without load bearing forces on your legs, you will lose the density in your bones.

FES Bikes and other forms of electrical stimulation are important during the early stages of improvement. The external electrical stimulation will maintain muscle mass and help with circulation, which as you are now learning, are very important.

PSYCHOLOGICAL OUTLOOK

A good, strong mental outlook is one of the most important facets of Phases I and II. Understandably, most clients enter our programme with some aspect of depression. However, being surrounded by their peers on a weekly basis, that individual has access to some of the greatest counsellors money can buy! Most clients will tell you that the first couple of months they are here is the happiest they’ve been since their accident. And, as they improve physically, so do their spirits. There is no better support group! Clients that have graduated from the programme have great support from peers, family and friends. Those that have trouble are usually by themselves with just a caregiver, miles away from family and friends. Please take this advice into consideration: you need daily distractions away from the improvement process to mentally survive and achieve your goals.

GRADUATION FROM PHASES I AND II

During the improvement process your nervous system is always re-learning; the phases only represent a change of function. Change of function is very important in a physical training programme for paralysed clients because the stimulation can only change when a clients’ physical function changes. Moving out of Phase II the client’s nervous system has improved to a point where they begin to get some basic control of their muscles which should be very strong and tight. At night the legs should be doing all kind of movements: the flexors flexing and the extensors extending. With tight legs our clients can now feel a stretch reflex, even some of our ASIA A completes.

Clients now have stable joints for load bearing because the shoulder, hip, knee and ankle joints are all being held in place. At this time we move into Phase III of our programme, Strength: Eccentric/Concentric Muscle Contractions.