Programme Information

PHASE V (Center for Gait Training Excellence)

SCI Community Mission Statement:

To prove that most spinal cord injured clients can recover a functional gait if provided the proper stimulation.

Objective:

To provide advanced physical and functional gait training for those  with SCI who are moving their legs and are able to walk with or without  adaptive aids. Entry qualifications are a safe bone density for a high  performance training programme and the desire to improve.

Our  Functional Gait Performance Programme is about education and workout  design. Our goal is to teach each client the tools necessary to improve  on their own. This allows out-of-town clients to return home and  continue their progress.

Our “Finishing School” (as we like  to call it) was created out of demand. We have watched some SCI  individuals come to our centre with almost perfect gaits, while others  compensate so much that walking long distance isn’t an option. We have  determined that the difference is not due to the level of injury, but  how these people were trained and what was expected of them. The gait  is not predetermined but developed through the stimulation received.  Over time, just as with any person, compensation leads to loss of  function. It is not only an SCI problem, but a normal response to an  inefficient gait pattern. Correcting this compensation isn’t easy, but  with the right stimulation, workout programme and client determination,  improvement can happen. At Standing Start, we believe that progress  only stops when the client is satisfied with his or her results.

Over  the last five years, we have heard a lot about what someone with a  spinal cord injury can do, or in most cases, cannot do! We have talked  to, and have seen, hundreds of SCI individuals who can move their legs  and have been told “this is as good as it gets.” Most information is  negative, lacking hope, and all information is about limitations.  Placing limitations on people is wrong because no one knows what each  person is capable of, until that individual tries.

Because  each client is different, we can’t guarantee that every single person  that comes through our door will significantly improve. We do provide  the best environment and the best programme for healing in an  atmosphere of positive energy. We are all working for a common goal and  there is tremendous support for each other. With all of this working,  is it any wonder that most of our clients are proving that everything  they were told about limitations is wrong.

Theory of Gait Drills and Skills

We don’t teach you to walk; we teach you the skills necessary to walk well.

What  does this mean? It is our philosophy that a functional gait is  determined by the coordination between your mechanical centre of  gravity (hips) and your balance (ankles and inner ear). You don’t learn  how to coordinate these factors walking in parallel bars or a  mechanical gait trainer. In fact, those tools teach you to compensate.  Instead of function you have gained dysfunction, which creates an  occupational gait that causes you to rely on adaptive equipment. If you  want to walk with a functional, sound gait, you must first learn to  master the basic skills of controlling the muscles that support and  move your hips in a full range of motion. You must have control of your  hip, knee and ankle joints, and you must be able to coordinate these  movements with your upper body. Skills you must have are: the ability  to do full knee and hip flexion combined with hip flexor function, and  be able to maintain control throughout the full range of motion of the  femur; you must be able to move side to side, forward and backwards;  and you must be able to go to the floor and get back up in all  different body positions.

Posture and functional range of  motion is what sets our training programme apart from the old school  methods of SCI gait training. Our programme has nothing to do with  traditional methods or ideas of how someone with an SCI recovers; our  functional gait training programme is where we really have fun! We have  a history of training elite athletes and that’s the approach we still  use. This is why our clients recover faster, walk better, and are  stronger than their peers. Three decades ago, teaching coordination  within the sports world was something that just wasn’t done. Either you  were born with it, or you weren’t. Things have changed since then.

Each  year, performance trainers take average athletes and turn them into  successful athletes by teaching them all the aspects of performance,  including coordination. They do it by stimulating the nervous system  with specific drills designed to elicit certain responses. Once that  skill has been mastered, they design something a little more demanding,  requiring more from the nervous system. At Standing Start, our  performance training is designed to elicit a functional gait. Once this  is achieved, we design the next step. If you want to see some gait  training in action, please go to the Project Walk Storyline video page.  You’ll see some of their clients perform drills, as well as move  through all ranges of motion in different planes. Our job is to teach  you how to perform drills that will give you real world, everyday  practical skills that you can use in your daily life.

If  you have any questions on our drills and skills theory, please use our  message board and ask our clients. They are your peers and can tell you  about their workouts. Like we said, our programme is not for those that  believe in limitations. We do not choose our clients, they choose us.  We are very lucky to have some of the best and hardest training  athletes in the world to work with! If you don’t believe in  limitations, come visit us for a week and see for yourself.

Questions about our gait training program

Who can our gait program help?

• Someone who is walking now and wants to improve
• Someone who has movement in their legs but can’t walk yet
• Someone who has walked, but due to compensation is no longer able to do so

What is the program?

• It depends on the individual’s goals and  abilities. For someone who is a more independent walker and is looking  to fine tune their gait, the programme is designed at Standing Start, and then taught to the individual or their trainer to be performed at  their home or local gym.
• For those  needing more help, we recommend an in-house programme. It is more  effective and efficient because of the skill of the staff.
• The  misconception is that you have to spend years here; we are now working  with clients throughout the country and the world that train at home or  at their local gym. Our clients hire us as their recovery coaches.  Together we sit down and design long-term training programmes around  the client’s individual goals.

I have been to other programs and they don’t know how to work with me. Are your trainers experienced?

• Our staff is comprised of SCI Specialists that have hundreds and hundreds of hours of experience and have gone through our intensive certification programme. Only the very best became certified in The Dardzinski Method, practiced only at Project Walk and Standing Start. For more information on our certification process, please go to the SCI Specialist Training Programme at www.projectwalk.org.

Is the gait training program a long-term program and commitment?

• o Yes and no. Our programme is about education and exercise design.  Clients can continue their progress here or go home with the knowledge  to workout on their own, with or without a personal trainer. A  successful training programme only works with long-term, consistent  training. The biggest mistake people make at the gym is doing the same  thing over and over. Most do not know how to train and waste time doing  things that don’t work. This is why we develop long-term plans that  promote variation and consistency.

What makes this program so different?

• Like everything else at Standing Start, this programme isn’t based on  traditional rehab or insurance guidelines; it is based on scientific  sports performance training. We treat every client at Standing Start as  an athlete. And like other top athletes, our clients have set  performance goals with very high expectations for themselves, and us.  More importantly, our experience is second to none.

How long are the workouts?

• Don’t believe the common misperception that you have to train over  three hours a day to get results. In all our years of training SCI  clients, very few have made it more than two hours a day in our gait  programme. Clients rarely come five days a week because over-training  can cause injury and reduce the chance of successfully reaching goals.  Any coach or athlete will tell you that the most important part of  training is the recovery phase. Our clients train, at most, every other  day until they build up endurance. Nothing happens in a week; it takes  months of doing the right exercises and stimulus to improve.

How fast can I expect results?

• We don’t know, it’s as simple as that! The severity of your gait  problem and the length of time you’ve been compensating play a role in  how long it will take to see results. The attitude of “I want a quick  fix!” doesn’t work. In the athletic training world, the most important  factors are the determination and energy put into a programme.

How can I take the program home?  Don’t I need all that fancy, expensive equipment?

• Our programme is very simple. We don’t use fancy equipment for this  stage of the programme. Our expensive, passive gait trainers are only  used with clients that can’t move their legs. The equipment we use is  people-friendly and can be found at any health club or purchased over  the internet. We keep it simple so you can be consistent, no matter  where you live.

Is there any help with the program once I leave?  Can I return for updates?

• Yes to both. Ideally, you should visit occasionally for re-evaluation  and to make certain you are still going in the right direction. This  should continue until you are completely satisfied with your walking  gait.

What if I can’t return?

• If you want to continue the programme you will have access to a  Specialist to help with questions and workout modifications. If you  can’t come back, we recommend hiring a local trainer that you trust and  believe in, and most importantly, who is in it for the duration. You  don’t want to keep hiring and training new trainers. Follow ups can be  done with your Specialist via phone and internet conferencing.

Why do I need to modify my workout program?

• You will adapt to the stimulus provided by the workout and once this  happens, you will just be going through the motions. People that do the  same workouts over and over see very little gains. Any successful  workout programme has to evolve as you change.

Is this a lifetime program?

• Yes, this is a lifetime fitness programme. Once you are happy with your  results it is up to you to be consistent. Exercise and proper nutrition  is the only proven fountain of youth.

Don't tell me I Can't!

Nobody gives us any hope that we can improve our gait!

• At Standing Start, as soon as the client comes through the door, they  are given hope! It is said that with hope comes miracles..The Miracle  is in The Method. This centre is all about hope for the future. We know  we can’t change the past, but the future is yet to be determined!

I can move my legs but I was told that I will never improve to where I can walk.

• With our method, if you can move your legs, we believe that with the  right stimulation, mind set, determination, and hard work, you can  develop a functional gait. Because our programme is based on the  individual, each client ultimately determines how much function they  get back. We can’t promise anything except the best method, the best  programme, the right stimulation and highly skilled, caring Specialists.

Do braces help with a functional gait?

• Braces do not help with a functional gait; they are for occupational  purposes only. Braces eliminate gravity and load bearing forces.  Without these fundamentals, muscles and nerves will atrophy. For  example: someone breaks an arm and receives a cast for six to eight  weeks, when the cast comes off, what’s happened to the muscles? They  have atrophied.

I’ve heard that most SCI will end up back in the wheelchair.

• Project Walk has been studying and working with posture and functional  gaits in able bodied individuals for 13 years. Almost every person that  they have trained has had a muscle dysfunction where one side of the  body was stronger/weaker than the other. This ultimately led to an  imbalance. An example to illustrate this is a car being out of  alignment, over time, the tires wear unevenly and rather than  constantly replacing the tires, you fix the alignment. Unfortunately,  when it comes to our bodies, we are not that smart. We almost always  look at the symptom and treat it. At Standing Start, we don’t focus on  the fact that an individual has an SCI, we focus on that individual’s  goals; evaluate their posture and gait; then formulate a plan to attack  the weaknesses and bring about a more functional bilateral gait. Those  with a functional gait will have a very long life out of a wheelchair.

Does anti-spasm medication affect a functional gait?

• It is simple, think of oil and water..they don’t mix. If you want a  functional gait, you can’t be taking drugs to treat the symptom that  causes you to improve. Spasms and tone are not the problem; they are  only a symptom of a dysfunctional nervous system. If you treat the  symptom, you will never recover. Treat the cause, and your nervous  system will slowly mature into a functional system.

I have a good leg and a leg that doesn’t work--any experience working with people like me?

• Yes. This is one of the main reasons clients hire us to improve their  gait. We have been very successful at training the weaker leg with our  method, from creating movement where none existed to improving  deficient coordination. Almost every client we work with has a good and  bad side. Our clients improve because we focus most of our attention on  the weaknesses, not the strengths. With focused and efficient training,  our clients become more bilateral with their gaits.

These are only a few of the comments and concerns that we have heard. If we did not address your questions or concerns, please go to our message board and ask us. Please remember that our experience is with our method, therefore, we will not comment on any other treatments or surgeries.

The two types of gait trainers at Standing Start:

• In-house gait trainers: these are the people who will be spending more than a month training at our centre.
• At-home gait trainers: these are the people who visit for a week or so and continue their program at home, with or without a trainer.

The first week at the centre is the same for all clients. The only difference is, on the last day of the first week, the in-house clients go over their workout plan, goals, and schedule. The at-home clients review their workout programme and how to succeed at home, ask their questions, and schedule the first follow-up visit.

Appointment protocol for your week visit:

• Days One and Two: You will get to work right away. You will meet with the director of the centre to evaluate your abilities and go over your individual goals. We will test your gait and standing posture and film you performing a series of special movement patterns designed to bring out your weaknesses. Our programme is based on this simple premise: identify the physical weakness and design a programme to exploit the weakness until it becomes strength.

If you bring your trainer, he/she will be with you every day going through the filming of skills and drills, the evaluation, and programme design. Your trainer will be taught how to work with you and your programme. When you leave, both of you will have the knowledge to safely perform your workout at home.

You and your trainer will sit down with your SCI Specialist and review your video. We will educate you on your dysfunctions and discuss how we will attack and try to change them. Education is the key to success. If you do not understand what you are doing and why, you will have trouble committing to the programme. After reviewing your skills, we will begin to design a programme around your structural and postural weaknesses that cause your compensations. The rest of the day is understanding, performing and perfecting your exercises.

 
• Days Three, Four and Five: In addition to training for the five days, we have to cram a lot of  education into a very short time frame. The goal of a week visit is  workout design and teaching you and your trainer the proper technique  for the desired drills. Educating you on why you are doing these drills  is second only to the proper technique. Without complete understanding  of why and how, success will be less likely. During this first week, be  prepared for a crash course in theory, anatomy, kinesiology, and  biomechanics of the gait. We will go over the goals of the programme  and start to design a long term programme from the information gather  throughout the week.

• Day Five:  In-house clients: In-house clients: During the last hour, we will review your first week  and determine a plan for the upcoming weeks. Training days and hours  will depend on your abilities and needs. You will have a Specialist who  will supervise your workouts until you leave the programme. To promote  consistent workouts, each month you and your Specialist will meet and  go over your progress and workout design.

• At-home clients: At-home clients: The last hour of your session you (and your trainer),  will meet with your Specialist to review the week, answer any questions  and finalize the long-term plan. Before you leave, we should have an  understanding of how to work together so we may achieve the mutual  goals. A plan for the future is the most important aspect of the week  visit. Without it, success will be hard to come by. Returning dates and  goals should be written down and gone over to ensure success.

Follow-up visits, at Standing Start or via Internet:

Like any advanced training programme, doing the same thing too long is  ineffective training and a waste of time. Your body adapts to the  stimulation and stops improving and you will hit a plateau. If you are  dedicated, you have to be committed to a long-term programme that  changes as you improve. A new exercise programme will be designed and  implemented as your level of function changes. This can be done either  with a follow-up visit to the centre or via the internet. It is always  up to the clients to choose the option which is best for them, but  being in the centre under the supervision of a Specialist is always the  best option for the fastest recovery.

Maintenance Program:

• In-house clients:
  Once you are able to do  most of the workout programme without any assistance, we will offer you  a monthly gym membership. This membership allows you to use the centre  anytime during business hours. You will also spend one or two hours a  month with your Specialist designing new programmes for you to continue  your progress.

• At-home clients:
  When you have reached  your individual goal, it is time to design a programme that will  maintain that level of function. This routine has to fit your lifestyle  so that you will do it consistently. If you do, you will maintain your  function. Remember, maintaining is much easier than developing, so be  consistent!

A Final Note:

Thank you for your interest in this special programme. If you have any  questions regarding it, please use our message board and one of our  Specialists will answer you. We prefer questions this way because the  question you ask may be asked by others. Sharing information and  educating the public is our overall goal.