Out But Not Down

For many patients who have neurological conditions, insurance dollars for rehab can run out quickly. But this patient group is in no position to stop moving. Perhaps even more than the general population, they need to continue cardiac and strengthening exercises to keep their bodies functioning.

To address that need, a handful of gyms in the Dallas-Fort Worth area have found a way to help these patients continue their treatment with adaptive exercise equipment and classes designed specifically for neuro patients that cost little or nothing to its members.

One facility, the Neuro Fitness Foundation gym in Euless, offers a studio filled with wheelchair-accessible equipment for workouts in an open gym atmosphere that includes weekly modified yoga classes. Two other gyms in Dallas and Fort Worth run by the Multiple Sclerosis Society offer fitness workout classes using modified gym equipment and taught by a personal trainer for patients with MS.

All are designed to continue therapy without the high-costs to the patient of a medical facility. “If they didn’t have the gym, a lot of our members would be sitting at home doing nothing,” said Shelby Lauderdale, a former physical therapy technician who manages the Euless gym. “Or they would be scraping for every dime to get every bit of therapy or rehab they could get.”

Making a difference
For T.J. Griffin, a C4-5 quadriplegic who fractured his cervical vertebrae playing football in high school 21 years ago, the Neuro Fitness Foundation gym has made “a huge difference in my life.”

“It’s important for everyone to exercise, but it’s more important for us to stay healthy,” said Griffin, who also is a board member of the foundation. “With an injury like mine, you’re lucky if you have two months of rehab — then insurance says you’re done.”

Griffin said he gained weight and lost strength by not continuing to work out after he was dismissed from his physical therapy. Now he goes to the gym four times a week, has lost 34 pounds, and said he has regained most of the strength needed for his daily living. “I go there with a purpose,” he said. “The gym has a group mentality — it’s not like a rehab center.”

Lauderdale said most members come in knowing their physical therapy regime and once their workout plan is set, don’t need too much oversight. “We try to keep it as gym-like as possible,” he said. “I use what I learned working as a PT technician to make sure they have good form and are doing their exercises the correct way.”

The 235 gym members include patients with MS, spinal cord injury, stroke, closed head injury, Guillain-Barre syndrome, muscular dystrophy, Parkinson’s disease, Lou Gehrig’s disease, cerebral palsy and other neurological conditions, he said.

Equipment at the Neuro Fitness Foundation gym is designed for easy access for walkers, wheelchairs and powerchairs. Caretakers are welcome to help members on the equipment. Volunteers and Lauderdale also are on the floor at all times to oversee the members’ workouts.

Strengthening equipment available at the gym includes an adapted Equalizer 1000 that has workout stations including a vertical bench press, seated rowing and seated overhead press, high/low pulleys with a preacher bench, vertical butterfly, lateral deltoid, gripless biceps curl and triceps extension, lateral deltoid and cable crossover. Other equipment for strengthening and flexibility include parallel bars, mat tables and standing frames, along with free weights, rickshaw, leg press and knee/leg extensions.

Cardiovascular training equipment at the gym includes NuStep, Stand Aide Easy Glide, Saratoga Cycle, Vita Glide, Motomed rack, Ex N’ Flex, treadmills and seated recumbent cycles.

Keeping the doors open
Most of the equipment has been donated, Griffin said. With just one employee and minimal rent and utility costs, the gym costs about $2,500 a month to operate five days a week.

The foundation holds golf tournaments and other fundraisers in the area, and collects donations at its website, NeuroFitnessFoundation.com. Members are asked to donate $25 a month. But the gym is open no matter what they can afford, if anything.

Weekly yoga classes are taught by Lorna Bell-Curran, RN, author of the book “Gentle Yoga: A Guide to Low-Impact Exercise.” A teacher of modified yoga to neurological patients for nearly 30 years, Bell-Curran is adding a second class at the gym for patients with MS sponsored by the local MS chapter.

Contractures and circulation are the biggest problems for this patient group, she said. “[Contractures] cause the body to flex forward if extender muscles aren’t used. Their fists clench, they can’t walk, their shoulders droop causing neck pain. Physically the body eventually becomes frozen into inactivity.”

Neuro patients also experience a loss of blood circulation that lowers joint fluid, Bell-Curran said. “They are too stiff to get out of their chair,” she said. “Then they lose motivation and end up sitting in an apartment by themselves.”

Barclay Burrow, a member of the gym who has MS, said the yoga classes and daily workouts on the equipment are vital to maintaining his condition. “I have been told by my doctors that if I didn’t work out like I do, I would be in a chair,” he said. “But I couldn’t afford this anywhere else.”

MS patients often face a gap in exercise when physical therapy coverage runs out, said Erin Fogerty, manager of programs and services for the Lone Star MS Society. “What we found was MS patients go to a PT to help improve a specific issue or goal, but when they are released, they don’t have a wellness industry that understands MS to keep them exercising in their communities,” she said.

(Source: Today in PT)