Awesome video , I’m focusing on my walk and balance . And as you mentioned I feel comfortable walking in home but when I go outside I feel nervous and fear falling down . So avoid going outside to walk . But I will try the strategies you told . Seem to be practical. Also putting hurdles in the way . Thank you so so much for the video
Thanks for watching and for sharing your story!! You are not alone. Many people go through what you are going through. I am glad you have some fresh ideas to add to your home program :)
@Lazarus Ominous thanks for sharing I do this but my feet are really bad and do whatever best I can do . But I must say DR Tara is incredible very practical approach and her exercises are helping me a lot . Only thing is neuropathy which kills me at night and as a result my day is tough as I’m unable to sleep well . But ok , I’m trying my best and very happy with the improvement after almost 9 years ... way to go !!!!
@Lazarus Ominous thanks I will try that . Please keep sharing useful info . I got injections in my spine which are supposed to help in pain . Let’s see how it goes
Thank you so much for this video. My very young PT at out patient therapy performed the procedure for vertigo. It toatally illiminated my dizziness. NOW I understand much better, the inner ear crystals and how they work.
Very informative as usual. Am always looking forward to the videos each week and slow down is so important and so easily forgotten. Thank you so much for making things clearer.
Thanks for watching Sigrid!! I am so glad that you find these videos informative. I could not ask for anything more out of this. :) I appreciate you sharing.
Tara , slow down is something i learned the hard way .On new years eve i had forgot to take my meat out of the freezer for New years day .I have RRMS .I turned to quickly to walk back to my fridge , I lost my balance and fell hard on my left 5th metatarsal bone .That bone was fractured so I cannot stress enough how important it is to slow down .
Thanks Dr Tara, Your videos is helping me to get recovery very well. I learned many things and exercises from you. Focusing on quality was the best advice. I wish you do more of advanced balance and coordination videos. Thanks. Yousef
watching the video makes me realize why, my foot gets inverted and toes curl up when i step out into places outside my home. thank you for enlightening us
I love listening to your explanations. I'm on my 4th month since my Ischemic Stroke Day in November, 2022 and I can truly relate on the things that you were discussing. I can well understand now that I learned to rely on my sense of vision as well as the tactile property of my feet in maintaining my challenged sense of balance, especially in dark places or rooms. Thank you Dr Yara Tobias. Keep helping!
I was never concerned about watching my feet. I did that before the stroke attack due to the kid's and pet toys. I never rushed recovery but rather repeated what I accomplished and today those movements are becoming more intuitive and don't require as much attention. I trained myself with the car seatbelts. I just buckled up and now buckle without thinking. Just takes time. Once an action is intuitive, I move toa new action. I compare it to busting cement. I keep hammering the same area until a corner breaks off. The hammering gives me muscle tone,repetitive movement and strength. Once a corner breaks off I move to another corner or simple action or movement and continue the process over the course of a day. I do not lose interest as I move over to an established movement returning to the challenge movement at a later time.
I live in an ancient city with the most uneven and chopped up sidewalks. I call it my obstacle course. And, it's unnerving at times. Forces me to control my breathing, gaze, and everything.
Dr. Tobias, I'm a fulltime wheelchair using Friedreich's #ataxia patient. I've began making a conscious effort to feel my soles and reposition 'em for greater surface area before any compound movement. And be less ballistic.
Namaste. Practice with balance and confidence. Prevent falls is important. And that you are teaching. Thank you so much for your support and guidance 🙏
Reading the comments I see very similar problems more or less present in most people. At the beginning of the walk I had to look in front of me due to insecurity, over time it disappeared. Walking on uneven terrain is a lot of effort. Why does exposure to solar heat bother me? The longer I walk or stand in the sun, the more my ankle twists, in the shade it stops. Thanks for the informative video, as always, first league.
Hi Dr Tara, Thanks again for another great video this is exactly what I needed. Your doing a great job and helping people get back on track. Thank you😊
I have found this video so helpful! It was great to hear you say slow down I have found that out myself but find it hard particularly going downhill to control my pace ? Can you recommend anything/ exercise to help !
No neurological problems eg. stroke etc Just a fuzziness or dizziness in my head that affects my balance eg. playing bowls even walking especially as it gets dark.
Great explanations, Dr. Tobias. Using the proper words are so important for accurate feed forward communication and feedback to and from our network of professionals and confidants; those whose opinions we've grown to trust when weighing the value of introducing new information into our daily regimen. It was one of the most impressive things about you that I find you matter-of-factly use in your teachings - real medical terms broken down along with simple explanations, and your liberal use of visual aids that you employ on a regular basis to reinforce your talking and texting of information. I tend to share some surprising and at times mildly shocking things I've learned from my doctors and from other experts, professors, teaching assistants and trainers. I'll try to limit today to just one thing along with some other terms directly related to it. I'll explain in my own simple terms and try to stay respectful of your teachings. If I've heard about it, whatever it is, it's a given that you have already talked about it in one or more of your lectures, Doctor Tobias. One word I've heard you use more than once is proprioception, the brain's ability to instinctively know where our hands are in space in relation to our body, or some other object effectively detached and in motion outside of our sphere of influence. We understand we have the ability to grab or catch objects like a ball thrown our way without need of watching the ball or our hand as they meet. It may be a thrown object. However, it could also be a barbell we are reaching for while lying on an inclined bench, or trying to land on a rack that we cannot see just behind us and above and slightly beyond our field of view. It can become a problem when we must drop weights blindly, hoping we'll hit the rack on the way down. Proprioception is an important word for me because I see different sizes of images with my two eyes due to a slight separation of the retina from the eyeball in my right eye. It could be an old injury or a birth defect. We'll never know. My new D.O. first told me about it during a routine eye exam. The really odd thing about it was learning that the eye projecting a 20% larger and clearer image was the eye with the defective retina, and naturally it is this "bad" eye that has become the dominant eye over time. She said I've probably been living with it for most of my life because most doctors avoid talking about this condition called Anisometropia. Mine is only one of related conditions due to misshapen eyeballs, nearsightedness and farsightedness combined, and a whole host of focusing issues. Mine is usually not correctable except by surgery and even then the surgery comes with considerable risk and zero guarantees. Recently I was told by the doctor who performed double cataract surgery on me that he's confident he can repair it. Still it scares me. My condition is most pronounced at the fovea, the point on our retina where the optic nerve attaches to the retina and leaves the back of the eye. This is more common a condition than most realize because the few who suffer from it don't even know about it. I know for sure that I've lived with it since my teens. It caused confusion seeing two overlapping images come into focus when trying to catch a ground ball or hit a tennis ball coming directly at me. It wasn't a problem when the ball was coming to one side or the other since I had unconsciously learned to use the image from the eye on that side of my head. Over the decades it's grown progressively worse and these days I close the eye with the smaller image, or reduce focus in that eye while I'm driving! Fun fact. The retina is actually a piece of our cerebral cortex, the thinking part of our brain, and the only part of our brain directly exposed to the outside world. The cerebral cortex resides on the paper thin surface of the brain. The remaining bulk of the brain is mostly wiring. The two optic nerves coming from our two retinas join together as one before being routed to the occipital lobe directly on the very back of our head, where visual perception, color, form and motion are processed and rerouted to other parts. A big element of sight is handled by the cerebellum which hangs below in the back of our head and recreates the images we see in our minds. It's said that there are as many neurons in the cerebellum as are in the rest of the brain. I think of the cerebellum as a bag shaped projection television screen producing mental images in 3-D hanging behind me as I walk around.
@@rehabhqofficial Well that was embarrassing. I got up early, read many articles on your channel. Had to write something. 500 words later...you, 12 words. Sorry, I will def try to keep it brief next time, lol. Read your wonderful articles about getting up off a chair, off a bed, off the floor. I would add to those, up & out of a car driver's seat. Simple. Flex center core abdominal muscles. Me, 6 words. Yes! We can do this!
Another useful video. Thanks Tara Question: what if you can’t plant your involved foot flat on the floor? This is my problem ( 7 yrs into the stroke) and so I get thrown off ( imbalanced) when trying to bear weight on my affected left leg
Very informative video Dr.T. It explains alot of what I have experienced. Walking in public around people who are in a hurry or crossing a street where the walk light tells me I have only 15 secs left to make it across virtually paralyzes me. Even a windy day throws me off when in public. But then I remember how terrified I once was to go shopping with my wife at the Sam's Club. Initially I would always use the motorized cart, but then on short trips decided to walk instead, increasing the distance each trip. That became a habit and now I can grocery shop with my wife like a pro at any store, except maybe Central Market where all the jerks tend to shop in high concentration. Maybe I should work on walking while spraying Mace! I will work to incorporate your suggestions, especially to slow down and also to calm down. On a side note, I would really love to regain the ability to balance on my involved leg. No problem doing so on my uninvolved leg. Any suggestions?
Thanks for sharing! Cross walks are a hole separate ball game. Generally speaking, someone needs to be able to walk at a certain speed (meters/sec) in therapy before I will tell someone to attempt a cross walk in public (if you want to be a little nerdy with me it is 1.2-1.4 meters/sec). And it is not just the speed but being able to maintain this speed while I add in additional thinking challenges (in therapy) 😬 All that being said, it sounds like you have come a long way!!! Keep at it!! You got this 💪
@@rehabhqofficial Thanks for the response, and I can be a little nerdy too! I took your 1.2 meters/sec and converted it to mph. If I did the conversion accurately, 1.2 meters/sec = 2.75 mph. The best I can do on a tread mill is 1.4 mph and I realize I walk much more slowly off the treadmill than on it even in perfect conditions, so I'm a ways off getting to 2.75 mph. I'm hard-headed enough to keep trying to improvr though. BTW, isn't it "funny" how much the walk light clicking down the number of seconds creates urgency in walking, but the urgency creates more anxiety, which in turn creates more muscle tension working against you? I think as part of my walking practice, we need to include going downtown during non-peak times and practicing. Again, thanks for all you're doing to help us..
@@awayne56 yes, it is ironic. :) As far as your calculation....you could also aim for completing 10 M distance in under 7 sec. :) That would be 1.4 M/S. Treadmill might not be the best "test" as the ground is moving at a certain speed versus you moving over the ground. This makes a difference in how you "correlate" that data. I hope that helps!
i have a problem with my left leg turning in at the hip my knee fals inwaed toward my other leg. thi is very frustrating whentrying pedalon my recumbant bike or trying to do mini squats
thank you for your video...I have some cerebellum brain damage and one of the things I am working on is to not feel unbalanced when walking/standing and my head moves (I end up walking off in the direction my head moves)....but your explanation makes sense of my problem,walking/standing is fine moving head is fine...two together not fine...the soma thing (muscles) balance and vestibular are working toward the same muscle output....so on a hanging balance board,I try to integrate them together,with slow controlled movements...it feels right.....thanks again.
Haha the balls simulating bumping into someone cracks me up! One of my falls last year was being bumped barely by my automatic rear van door. This is a great video great information and ideas of exercises. Spasticity is my biggest hurdle. Don’t know when my body will hold up or not. The total body vibration platform, massaging, and muscle building has been helpful as well and wearing my AFO more. Joining Planet Fitness has helped tremendously. Thanks! Aim higher than the new normal! Lifestyle not a destination! It’s hard but necessary!
Hi how you doing my name is Catherine I'm going through the same thing with this problem for long time I'm sorry I can't care good conversation I can't spell that good either I am I have walk like I'm drunk and I don't even drink alcohol my psychiatrist prescribed me medication over the years thank you for helping me out
What can you do if you have problems with the muscles around the eyes? What type of therapy exists, or how would one fully diagnose and pursue that issue? Thank You! Great videos...many of us are siloed and seeking help these days :-)
This is an excellent question! I should have mentioned this in a video, but a neuro-opthalmologist can help to pinpoint the root cause of the "eye problem". Generally speaking, to improve the eye muscles (to react appropriately with movement), add head and eye movement to the activity. I did a little of this in this video when I moved my head side to side. Also the juggling and hitting the beach ball can also help to improve the eye muscle response to movement. I hope that helps!
I love this question! Living in Florida, I don't work on this with patients that often. That being said (please always work with a therapist before trying anything on your own).....walking over a row of several soft, fluffy pillows might work for snow and practicing walking with socks on tile might work for ice. Again, these are very advanced exercises and never try anything on your own without working with a therapist first. I hope that helps!
YOUR A VERY CARRYING , PROFESSIONAL PERSON ( DOCTOR ) ....THANK-YOU VERY MUCH FOR YOUR TIME , EFFORTS AND AND THE WAY YOU EXPLAIN GREAT INFO WE CAN ALL USE,...YOUR A WONDERFULL TEACHER ...BLESSINGS SISTER ..PRAISE ALLAH !!
Good afternoon Dr. Tara. Your videos make me feel like I’m in school again studying for an exam. Very informative and always helpful. I experienced what you were speaking about when I tried to step over a curb outside of a bank and my brain would not allow me to lift my leg to attempt to step over. And this is something I’ve practiced during therapy and at home but this one particular day everything froze and my foot was glued to the ground. Practice and continuing to challenge myself has helped over time. Thank you!
Thanks for sharing! Generally speaking, when patients describe a similar situation to me (freezing despite practicing this in therapy), there was probably some condition that we did not account for in therapy that may have presented itself (ie: loud traffic, a crowd walking close by, bright sunlight, attention was on something else, and/or fatigue). I teach my patients not to panic, find something close by to hold onto and try and identify anything that might be different so we can re-create this in therapy. I hope that helps!
I was able to overcome the barrier later but at that time there was nothing on either side of me that I could use as security to advance over the curb. I agree there were people around but that had never happened before. Thanks for your input. I took it as a challenge.
Great video again but I did have wonder how often any of your clients ever have to worry about snow or ice in Orlando! Made me chuckle 😆, yes, good thing you added sand in there!
My problem, and I had it before the stoke, is I have Charco. I was able to deal with it before the stroke but I'm having trouble after the stroke. My foot is now fused to my body, something that happened a year and a half before the stroke. So getting myself to stand because my right is shorter than my left, makes me uncertain when I'm doing anything. I'm terrified of falling because getting up is difficult because I cannot flex my toes on my right foot. I can't bend them in order to get my right leg under me. I have special shoes to help me otherwise I'd be waking on a ball of bone, it helps but I always feel off balance. I just can't seem to get myself to walk without slightly dragging my toes. I'm impatient. As far as I'm concerned I should have been better by now. I HATE using a walker and feel more unsteady using a cane.
thanks for sharing your stroy!! CMT AND stroke makes your situation slightly more nuanced. Generally speaking, CMT without a stroke can result in muscle not firing in a timely manner (to make small balance adjustments) AND input to the brain from the feet is delayed. I strongly recommend working with a physical therapist to design a program unique to your balance problems. Hang in there!! And just keep moving and stay focused on little improvements each day 😊
My hearing is impaired and due to my vision problems, I can’t read the screen as fast as you talk. Is it possible to get a written transcript that we can download?
This video was really insightful, thank you for such a comprehensive take on balance and helping me understand and address my balance issues from BPPV. It appeals to my healthcare background. I will incorporate some of these exercises into my regime. I am now on the mend after doing some balance exercises tethered with the Apely movements so far, however I am keen to start running again like i used to 6 weeks ago. I have been walking quite a lot this week, but the world is still like a shaky camera (like the one you described). Is is advisable to do a short jog may be just 2 km at a slow pace keeping my head vertical? Also how often do you recommend doing these exercises, maybe twice a day? Many thanks Veena Patel
Hey everyone, I have been trying to get in touch with this lady for a long time how can I get in touch with her personally do I need to join or something???
My physical therapy doctor encourage me to check me for tomorrow to walk faster step longer to my effected side my left foot but my concern is what if i fall. My question is what’s the best thing to do. Because i always walking alone where i live around the block….
Hi my name is Catherine Shepherd I am going through the same thing I really enjoyed your videos I have walk like I'm drunk and I don't even drink alcohol I love you help me with this I've been to the doctor not long ago she gives me the runaround I don't think she likes me
Dr. Tars I was given a diagnosis of sca-3 & am experiencing major gait problems. Not to mention, I am experiencing walking challenges due to neuropathy in both hands and feet; additionally because of a pinch nerve in lower back causing sciatic pain in right foot, nothing I wear as shoes is comfortable every shoe hurts. Only temporary relief is bending forward. What can I do to help lessen pain when I walk? Thank you.
I had a cardiac arrest and stroke 3 years ago and have developed Dystonia. Is there anything you can recommend anything to help my walking with the walker?
I had a spinal cord injury T4, in may of 22, I’m almost walking without assistance but my hips are still to weak and my balance is terrible I am not finding anything that I can use for my injury, and I try to route through the exercises for a stroke patient, can anyone point me in the right direction
i need to say that you are amazing! your way of explaining things and showing/teaching us how to do and why to do is so good! i’m learning a lot with each video that you post! thank you! 😘😘😘🇧🇷🇧🇷
Thank you for watching and for the kind, encouraging comment. It is truly my pleasure. I love it when things start "clicking" with my patients and so that is always my intention when creating a video :)
I know it’s not a relevant question, but just wondering if there is any exercise to prevent neuropathy. It’s so bad at night I have gotten nerve block injections too but don’t see any relief yet . Pain just hinders my exercise program . After watching and following your videos I feel so energized and see significant improvement in my walk and strength . It has been eight years of continuous and consistent effort
Thanks for watching and for sharing! "neuropathy" is a symptom of some other medical condition. So, to answer this questions, it is hard without knowing the cause of neuropathy. I wish I could be more help.
Highly unlikely that the piriformis muscle could put enough pressure on a nerve to damage it to the point where it would cause muscle weakness. That being said, nerve damage to the point where it is causing muscle weakness needs to be evaluated by a doctor to rule out a serious medical condition.
Thanks for your quick response doctor! Yes, I've seen several doctors these past years trying to get to the bottom of whats causing my foot weakness! Peace!
@@edwardmartinez4695 Don't give up! sometimes it just takes finding that one doctor who happens to run a test and/or spots something that may have gotten missed
No way I'll give up, I'm too hard-headed! I won't lie that it's causes me great grief but there's got to be someone or something out there that will help! In the meantime, I keep stretching and doing strength exercises, including the one's in your videos!
Hello, Dr. Tara Tobias, why my hand are getting tied as I m progress better, walk better, balance better, but every morning, my hand up to shoulder, very tied,. 1st two months, I don't feel it. After that 5th month is the worst, every morning, as if I HV to break a point, have to re teach the brain telling brain them, I have hand and need to move better, very Tied and painful, is this normal?
Thanks for watching and for your question. Generally speaking, the leg recovers a little faster than the arm. Also, generally speaking, depending on where the stroke/brain injury occurred will impact which parts of the body are impacted. I would say it sounds like you are making excellent progress!! Don't give up on that arm!! Keep moving it and try to incorporate it into as many activities as possible. 😊 I hope that helps!
What does it mean when I have problems moving my foot to the side 2 years after a stroke. I can walk, but sometimes my foot gets stuck and I can't move my foot on a diagonal and end up falling.
@@rehabhqofficial sometimes objects are totally blocked from my vision like furniture or walls, I can’t see them and people, I bump into them. I can see an improvement from the start though
Hey dr. T. Howcome, contact us on your website page is malfunctioning when you fill out all fields and gives dictionary error dialog box? Btw, impressive explanation of sensory system.
Awesome video! I have a question, I know you talk a lot about the importance of bracing. I wear a bioness device to assist me with walking. It does seem to help me to lift my toes and keep my foot from turning onto its side. Do you recommend me wearing it while I'm exercising or exercising barefoot or putting a brace on?
Thanks for watching and for the question! This questions may turn into a video since the answer is kind of long and definitely dependent upon someones diagnosis (ie: stroke, MS, TBI..etc). The short answer is generally speaking, the bioness is great if someone does not have a lot of spasticity. In some cases, the stim is enough to overcome mild spasticity however, in my experience, spasticity eventually "wins" over any benefit someone might get from the e-stim lifting the foot. I home that makes sense. Again, I have lots of opinions on FES (functional e-stim) so this might turn into a video so stay tuned for my more indepth answer :)
Hello mam...am watching all ur videos specially related to stroke...thnks a lotttt...for such a knowledgeable information....could u plz let me know mam...in stroke pateint till how long electrical stimulation can be given for arm n leg...is it good n how many time it should be given...kindly reply mam...
I just admire your videos so much. You present an interesting scientific approach, clearly & understandable. Your voice is assuring & steady. So imporatant for elderly people. I've shared our tips with several older people. your techniques are clever. Great job!!
Thank you for the video Dr Tara. I'm having MS. With your exercises although I'm confident about balance, but after walking for 5 minutes or more, my legs start getting weaker. Do you have any exercises for strengthening the legs??
Thank you for sharing! MS and "muscle fatigue" is different than typical "muscle weakness". Generally speaking, focusing on how to manage your energy is probably going to be more valuable than focusing on how to "strengthen" a muscle. This video might help: ruclips.net/video/SOfeJ1FyjSQ/видео.html
Thanks for watching and for sharing your story! Lack of sensation are symptoms of some other medical problem. Best to work with a doctor to get to the root cause of your symptoms.
Timely video as we are about to go on a beach vacation for our 25th anniversary last beach vacation I didn’t factor in that I would be barefoot after doing PT in tennis shoes all the time so for the rest of the week I’ll try activities barefoot
I have the same issue I walk like I'm drunk and I'm not doing alcohol at all psychiatrist prescribe me psych meds over the years in the ears is stopped up to I love you so please help me thank you my name is Catherine
Dr Tara bonjour
Have only watched a few videos
Thank you so much
You fill me with hope
I thought I was doomed
Thank you
Awesome video , I’m focusing on my walk and balance . And as you mentioned I feel comfortable walking in home but when I go outside I feel nervous and fear falling down . So avoid going outside to walk . But I will try the strategies you told . Seem to be practical. Also putting hurdles in the way . Thank you so so much for the video
Thanks for watching and for sharing your story!! You are not alone. Many people go through what you are going through. I am glad you have some fresh ideas to add to your home program :)
@Lazarus Ominous thanks for sharing I do this but my feet are really bad and do whatever best I can do . But I must say DR Tara is incredible very practical approach and her exercises are helping me a lot . Only thing is neuropathy which kills me at night and as a result my day is tough as I’m unable to sleep well . But ok , I’m trying my best and very happy with the improvement after almost 9 years ... way to go !!!!
@Lazarus Ominous thanks I will try that . Please keep sharing useful info . I got injections in my spine which are supposed to help in pain . Let’s see how it goes
@@neelamsharma2196 u can also check doctor Gretchen hawley’s classes
@@neelamsharma2196 k
Thank you so much for this video.
My very young PT at out patient therapy performed the procedure for vertigo. It toatally illiminated my dizziness. NOW I understand much better, the inner ear crystals and how they work.
Very informative as usual. Am always looking forward to the videos each week and slow down is so important and so easily forgotten. Thank you so much for making things clearer.
Thanks for watching Sigrid!! I am so glad that you find these videos informative. I could not ask for anything more out of this. :) I appreciate you sharing.
Tara , slow down is something i learned the hard way .On new years eve i had forgot to take my meat out of the freezer for New years day .I have RRMS .I turned to quickly to walk back to my fridge , I lost my balance and fell hard on my left 5th metatarsal bone .That bone was fractured so I cannot stress enough how important it is to slow down .
Dr. TOBIAS, Why is motion sickness fairly common among stroke survivors? Never had it but now I do post stroke... thank you Dr. Tobias God bless you
Thanks Dr Tara,
Your videos is helping me to get recovery very well. I learned many things and exercises from you. Focusing on quality was the best advice. I wish you do more of advanced balance and coordination videos. Thanks. Yousef
watching the video makes me realize why, my foot gets inverted and toes curl up when i step out into places outside my home. thank you for enlightening us
Thanks for sharing this! Yes, this is extremely common. 😊
Spot-On! I sent this to friends/family and asked them to begin watching at 10:45. Thanks Tara!
I love listening to your explanations. I'm on my 4th month since my Ischemic Stroke Day in November, 2022 and I can truly relate on the things that you were discussing. I can well understand now that I learned to rely on my sense of vision as well as the tactile property of my feet in maintaining my challenged sense of balance, especially in dark places or rooms. Thank you Dr Yara Tobias. Keep helping!
Very pertinent and always well articulated, thanks for the invaluable information,
I was never concerned about watching my feet. I did that before the stroke attack due to the kid's and pet toys. I never rushed recovery but rather repeated what I accomplished and today those movements are becoming more intuitive and don't require as much attention. I trained myself with the car seatbelts. I just buckled up and now buckle without thinking. Just takes time. Once an action is intuitive, I move toa new action. I compare it to busting cement. I keep hammering the same area until a corner breaks off. The hammering gives me muscle tone,repetitive movement and strength. Once a corner breaks off I move to another corner or simple action or movement and continue the process over the course of a day. I do not lose interest as I move over to an established movement returning to the challenge movement at a later time.
YES!! I love this. Love, love, love the analogy.
You are so needed. I am listening and learning.
I live in an ancient city with the most uneven and chopped up sidewalks.
I call it my obstacle course.
And, it's unnerving at times. Forces me to control my breathing, gaze, and everything.
Dr. Tobias, I'm a fulltime wheelchair using Friedreich's #ataxia patient. I've began making a conscious effort to feel my soles and reposition 'em for greater surface area before any compound movement. And be less ballistic.
Yes. SLOW DOWN. Lesson that I need to learn!! So difficult sometimes
Namaste. Practice with balance and confidence. Prevent falls is important. And that you are teaching. Thank you so much for your support and guidance 🙏
Thank you for watching! I hope it helps you to take your balance confidence to the next level. :)
Thank you! More about balance and neuropathy in the feet please!
Wow! That is exactly what I have done. I improve my balance rapidly by EXPERIENCING Dynamic and challenging environments.
Reading the comments I see very similar problems more or less present in most people. At the beginning of the walk I had to look in front of me due to insecurity, over time it disappeared. Walking on uneven terrain is a lot of effort. Why does exposure to solar heat bother me? The longer I walk or stand in the sun, the more my ankle twists, in the shade it stops. Thanks for the informative video, as always, first league.
Great new format!! We love and share you up here in BC ;b
Thank you so much. From Ontario Canada
Your films are excellent. Thank you so much.
Hi Dr Tara,
Thanks again for another great video this is exactly what I needed. Your doing a great job and helping people get back on track.
Thank you😊
You ARE amazing…and so talented!
I have found this video so helpful! It was great to hear you say slow down I have found that out myself but find it hard particularly going downhill to control my pace ? Can you recommend anything/ exercise to help !
No neurological problems eg. stroke etc
Just a fuzziness or dizziness in my head
that affects my balance eg. playing bowls even walking especially as it gets dark.
Great explanations, Dr. Tobias. Using the proper words are so important for accurate feed forward communication and feedback to and from our network of professionals and confidants; those whose opinions we've grown to trust when weighing the value of introducing new information into our daily regimen. It was one of the most impressive things about you that I find you matter-of-factly use in your teachings - real medical terms broken down along with simple explanations, and your liberal use of visual aids that you employ on a regular basis to reinforce your talking and texting of information.
I tend to share some surprising and at times mildly shocking things I've learned from my doctors and from other experts, professors, teaching assistants and trainers. I'll try to limit today to just one thing along with some other terms directly related to it. I'll explain in my own simple terms and try to stay respectful of your teachings. If I've heard about it, whatever it is, it's a given that you have already talked about it in one or more of your lectures, Doctor Tobias.
One word I've heard you use more than once is proprioception, the brain's ability to instinctively know where our hands are in space in relation to our body, or some other object effectively detached and in motion outside of our sphere of influence. We understand we have the ability to grab or catch objects like a ball thrown our way without need of watching the ball or our hand as they meet. It may be a thrown object. However, it could also be a barbell we are reaching for while lying on an inclined bench, or trying to land on a rack that we cannot see just behind us and above and slightly beyond our field of view. It can become a problem when we must drop weights blindly, hoping we'll hit the rack on the way down.
Proprioception is an important word for me because I see different sizes of images with my two eyes due to a slight separation of the retina from the eyeball in my right eye. It could be an old injury or a birth defect. We'll never know. My new D.O. first told me about it during a routine eye exam. The really odd thing about it was learning that the eye projecting a 20% larger and clearer image was the eye with the defective retina, and naturally it is this "bad" eye that has become the dominant eye over time. She said I've probably been living with it for most of my life because most doctors avoid talking about this condition called Anisometropia. Mine is only one of related conditions due to misshapen eyeballs, nearsightedness and farsightedness combined, and a whole host of focusing issues.
Mine is usually not correctable except by surgery and even then the surgery comes with considerable risk and zero guarantees.
Recently I was told by the doctor who performed double cataract surgery on me that he's confident he can repair it. Still it scares me. My condition is most pronounced at the fovea, the point on our retina where the optic nerve attaches to the retina and leaves the back of the eye. This is more common a condition than most realize because the few who suffer from it don't even know about it. I know for sure that I've lived with it since my teens. It caused confusion seeing two overlapping images come into focus when trying to catch a ground ball or hit a tennis ball coming directly at me. It wasn't a problem when the ball was coming to one side or the other since I had unconsciously learned to use the image from the eye on that side of my head. Over the decades it's grown progressively worse and these days I close the eye with the smaller image, or reduce focus in that eye while I'm driving!
Fun fact. The retina is actually a piece of our cerebral cortex, the thinking part of our brain, and the only part of our brain directly exposed to the outside world. The cerebral cortex resides on the paper thin surface of the brain. The remaining bulk of the brain is mostly wiring. The two optic nerves coming from our two retinas join together as one before being routed to the occipital lobe directly on the very back of our head, where visual perception, color, form and motion are processed and rerouted to other parts. A big element of sight is handled by the cerebellum which hangs below in the back of our head and recreates the images we see in our minds. It's said that there are as many neurons in the cerebellum as are in the rest of the brain. I think of the cerebellum as a bag shaped projection television screen producing mental images in 3-D hanging behind me as I walk around.
Hi Andrew! Thanks for sharing this. Always good to learn new stuff :)
@@rehabhqofficial Well that was embarrassing. I got up early, read many articles on your channel. Had to write something. 500 words later...you, 12 words. Sorry, I will def try to keep it brief next time, lol.
Read your wonderful articles about getting up off a chair, off a bed, off the floor. I would add to those, up & out of a car driver's seat.
Simple. Flex center core abdominal muscles. Me, 6 words. Yes! We can do this!
Great video... Thank you .
Fabulous video!
Another useful video. Thanks Tara
Question: what if you can’t plant your involved foot flat on the floor? This is my problem ( 7 yrs into the stroke) and so I get thrown off ( imbalanced) when trying to bear weight on my affected left leg
Do you wear an AFO?
Very informative video Dr.T. It explains alot of what I have experienced. Walking in public around people who are in a hurry or crossing a street where the walk light tells me I have only 15 secs left to make it across virtually paralyzes me. Even a windy day throws me off when in public. But then I remember how terrified I once was to go shopping with my wife at the Sam's Club. Initially I would always use the motorized cart, but then on short trips decided to walk instead, increasing the distance each trip. That became a habit and now I can grocery shop with my wife like a pro at any store, except maybe Central Market where all the jerks tend to shop in high concentration. Maybe I should work on walking while spraying Mace!
I will work to incorporate your suggestions, especially to slow down and also to calm down. On a side note, I would really love to regain the ability to balance on my involved leg. No problem doing so on my uninvolved leg. Any suggestions?
Thanks for sharing! Cross walks are a hole separate ball game. Generally speaking, someone needs to be able to walk at a certain speed (meters/sec) in therapy before I will tell someone to attempt a cross walk in public (if you want to be a little nerdy with me it is 1.2-1.4 meters/sec). And it is not just the speed but being able to maintain this speed while I add in additional thinking challenges (in therapy) 😬 All that being said, it sounds like you have come a long way!!! Keep at it!! You got this 💪
@@rehabhqofficial Thanks for the response, and I can be a little nerdy too! I took your 1.2 meters/sec and converted it to mph. If I did the conversion accurately, 1.2 meters/sec = 2.75 mph. The best I can do on a tread mill is 1.4 mph and I realize I walk much more slowly off the treadmill than on it even in perfect conditions, so I'm a ways off getting to 2.75 mph. I'm hard-headed enough to keep trying to improvr though. BTW, isn't it "funny" how much the walk light clicking down the number of seconds creates urgency in walking, but the urgency creates more anxiety, which in turn creates more muscle tension working against you? I think as part of my walking practice, we need to include going downtown during non-peak times and practicing. Again, thanks for all you're doing to help us..
@@awayne56 yes, it is ironic. :) As far as your calculation....you could also aim for completing 10 M distance in under 7 sec. :) That would be 1.4 M/S. Treadmill might not be the best "test" as the ground is moving at a certain speed versus you moving over the ground. This makes a difference in how you "correlate" that data. I hope that helps!
i have a problem with my left leg turning in at the hip my knee fals inwaed toward my other leg. thi is very frustrating whentrying pedalon my recumbant bike or trying to do mini squats
thank you so much for sharing solutions to the people!
thank you for your video...I have some cerebellum brain damage and one of the things I am working on is to not feel unbalanced when walking/standing and my head moves (I end up walking off in the direction my head moves)....but your explanation makes sense of my problem,walking/standing is fine moving head is fine...two together not fine...the soma thing (muscles) balance and vestibular are working toward the same muscle output....so on a hanging balance board,I try to integrate them together,with slow controlled movements...it feels right.....thanks again.
I have sca waiting for whole genome sequencing in London as not available in NI yet So far gene similar to SCA45 identified this is very helpful
Haha the balls simulating bumping into someone cracks me up! One of my falls last year was being bumped barely by my automatic rear van door.
This is a great video great information and ideas of exercises. Spasticity is my biggest hurdle. Don’t know when my body will hold up or not.
The total body vibration platform, massaging, and muscle building has been helpful as well and wearing my AFO more. Joining Planet Fitness has helped tremendously.
Thanks!
Aim higher than the new normal! Lifestyle not a destination!
It’s hard but necessary!
Putting on and taking off shoes while standing is a very handy exercise for balance
lll
Thank you very much for the update.
You welcome :)
Hi how you doing my name is Catherine I'm going through the same thing with this problem for long time I'm sorry I can't care good conversation I can't spell that good either I am I have walk like I'm drunk and I don't even drink alcohol my psychiatrist prescribed me medication over the years thank you for helping me out
What can you do if you have problems with the muscles around the eyes? What type of therapy exists, or how would one fully diagnose and pursue that issue? Thank You! Great videos...many of us are siloed and seeking help these days :-)
This is an excellent question! I should have mentioned this in a video, but a neuro-opthalmologist can help to pinpoint the root cause of the "eye problem". Generally speaking, to improve the eye muscles (to react appropriately with movement), add head and eye movement to the activity. I did a little of this in this video when I moved my head side to side. Also the juggling and hitting the beach ball can also help to improve the eye muscle response to movement. I hope that helps!
Hello Dr. Tobias, if possible can you recommend how to treat a loss of proprioception in the right foot, after spinal fusion.
Thank you !!!!❤️
THANK YOU FOR A VERY NICE VIDEO. VERY IBFORMATIVE.
That was a fantastic description very easy to understand thank you very much that was a big help thanks again keep it up you are awesome
I Like your video but I won’t subscribe because I don’t like too many notifications, but your videos are very helpful . Thank you very much.
Um you can turn off notifications 😳
Thank you. I’ve learned a lot from you ❤😊
Dr. T. I walk outside daily but I have to look down when I walk. If I don’t look down , and look straight I loose my balance.
Thanks for great information.
Dr. T, it's awfully hard to simulate walking on snow & ice in a "controlled environment". Any suggestions?
I love this question! Living in Florida, I don't work on this with patients that often. That being said (please always work with a therapist before trying anything on your own).....walking over a row of several soft, fluffy pillows might work for snow and practicing walking with socks on tile might work for ice. Again, these are very advanced exercises and never try anything on your own without working with a therapist first. I hope that helps!
Would these exercises help with fine motor hand movements in patient with spinocerebellar ataxua
Brilliant!
YOUR A VERY CARRYING , PROFESSIONAL PERSON ( DOCTOR ) ....THANK-YOU VERY MUCH FOR YOUR TIME , EFFORTS AND AND THE WAY YOU EXPLAIN GREAT INFO WE CAN ALL USE,...YOUR A WONDERFULL TEACHER ...BLESSINGS SISTER ..PRAISE ALLAH !!
Good afternoon Dr. Tara.
Your videos make me feel like I’m in school again studying for an exam. Very informative and always helpful. I experienced what you were speaking about when I tried to step over a curb outside of a bank and my brain would not allow me to lift my leg to attempt to step over. And this is something I’ve practiced during therapy and at home but this one particular day everything froze and my foot was glued to the ground. Practice and continuing to challenge myself has helped over time. Thank you!
Thanks for sharing! Generally speaking, when patients describe a similar situation to me (freezing despite practicing this in therapy), there was probably some condition that we did not account for in therapy that may have presented itself (ie: loud traffic, a crowd walking close by, bright sunlight, attention was on something else, and/or fatigue). I teach my patients not to panic, find something close by to hold onto and try and identify anything that might be different so we can re-create this in therapy. I hope that helps!
I was able to overcome the barrier later but at that time there was nothing on either side of me that I could use as security to advance over the curb. I agree there were people around but that had never happened before. Thanks for your input. I took it as a challenge.
I had a stroke November 28, 2021. Now I am unable t walk without a walker or a walking stick. My balance is off also.
Great video again but I did have wonder how often any of your clients ever have to worry about snow or ice in Orlando! Made me chuckle 😆, yes, good thing you added sand in there!
My problem, and I had it before the stoke, is I have Charco. I was able to deal with it before the stroke but I'm having trouble after the stroke. My foot is now fused to my body, something that happened a year and a half before the stroke. So getting myself to stand because my right is shorter than my left, makes me uncertain when I'm doing anything. I'm terrified of falling because getting up is difficult because I cannot flex my toes on my right foot. I can't bend them in order to get my right leg under me. I have special shoes to help me otherwise I'd be waking on a ball of bone, it helps but I always feel off balance. I just can't seem to get myself to walk without slightly dragging my toes. I'm impatient. As far as I'm concerned I should have been better by now. I HATE using a walker and feel more unsteady using a cane.
thanks for sharing your stroy!! CMT AND stroke makes your situation slightly more nuanced. Generally speaking, CMT without a stroke can result in muscle not firing in a timely manner (to make small balance adjustments) AND input to the brain from the feet is delayed. I strongly recommend working with a physical therapist to design a program unique to your balance problems. Hang in there!! And just keep moving and stay focused on little improvements each day 😊
My hearing is impaired and due to my vision problems, I can’t read the screen as fast as you talk. Is it possible to get a written transcript that we can download?
This video was really insightful, thank you for such a comprehensive take on balance and helping me understand and address my balance issues from BPPV. It appeals to my healthcare background. I will incorporate some of these exercises into my regime. I am now on the mend after doing some balance exercises tethered with the Apely movements so far, however I am keen to start running again like i used to 6 weeks ago. I have been walking quite a lot this week, but the world is still like a shaky camera (like the one you described). Is is advisable to do a short jog may be just 2 km at a slow pace keeping my head vertical? Also how often do you recommend doing these exercises, maybe twice a day?
Many thanks
Veena Patel
I need consultation about my footdrop or spacity i dont know from which i m suffering from
Hey everyone, I have been trying to get in touch with this lady for a long time how can I get in touch with her personally do I need to join or something???
My physical therapy doctor encourage me to check me for tomorrow to walk faster step longer to my effected side my left foot but my concern is what if i fall. My question is what’s the best thing to do. Because i always walking alone where i live around the block….
Hi my name is Catherine Shepherd I am going through the same thing I really enjoyed your videos I have walk like I'm drunk and I don't even drink alcohol I love you help me with this I've been to the doctor not long ago she gives me the runaround I don't think she likes me
Thank you so much! That’s great advice!
Dr. Tars I was given a diagnosis of sca-3 & am experiencing major gait problems. Not to mention, I am experiencing walking challenges due to neuropathy in both hands and feet; additionally because of a pinch nerve in lower back causing sciatic pain in right foot, nothing I wear as shoes is comfortable every shoe hurts. Only temporary relief is bending forward. What can I do to help lessen pain when I walk? Thank you.
excellent!
& thanks for the confidence 😆
I had a cardiac arrest and stroke 3 years ago and have developed Dystonia. Is there anything you can recommend anything to help my walking with the walker?
I had a spinal cord injury T4, in may of 22, I’m almost walking without assistance but my hips are still to weak and my balance is terrible I am not finding anything that I can use for my injury, and I try to route through the exercises for a stroke patient, can anyone point me in the right direction
Good morning Doctor. How can I contact you for consultation for my mother. Kindly let me know. Thank you
Thanks
i need to say that you are amazing! your way of explaining things and showing/teaching us how to do and why to do is so good! i’m learning a lot with each video that you post! thank you! 😘😘😘🇧🇷🇧🇷
Thank you for watching and for the kind, encouraging comment. It is truly my pleasure. I love it when things start "clicking" with my patients and so that is always my intention when creating a video :)
How can I do that if my left side of the body is paralysis
How about walking in the yard?
I get anxiety. and can't process what's going on. and I find myself aggressive for no reason. or frustrated.
I know it’s not a relevant question, but just wondering if there is any exercise to prevent neuropathy. It’s so bad at night I have gotten nerve block injections too but don’t see any relief yet . Pain just hinders my exercise program . After watching and following your videos I feel so energized and see significant improvement in my walk and strength . It has been eight years of continuous and consistent effort
Thanks for watching and for sharing! "neuropathy" is a symptom of some other medical condition. So, to answer this questions, it is hard without knowing the cause of neuropathy. I wish I could be more help.
Thank you so much fir taking time to read the query about neuropathy. Really appreciate. My best wishes to you
Doctor,
Have you ever come across anyone with foot weakness due to piriformis syndrome (or do think that piriformis syndrome can cause foot weakness)?
Highly unlikely that the piriformis muscle could put enough pressure on a nerve to damage it to the point where it would cause muscle weakness. That being said, nerve damage to the point where it is causing muscle weakness needs to be evaluated by a doctor to rule out a serious medical condition.
Thanks for your quick response doctor! Yes, I've seen several doctors these past years trying to get to the bottom of whats causing my foot weakness! Peace!
@@edwardmartinez4695 Don't give up! sometimes it just takes finding that one doctor who happens to run a test and/or spots something that may have gotten missed
No way I'll give up, I'm too hard-headed! I won't lie that it's causes me great grief but there's got to be someone or something out there that will help! In the meantime, I keep stretching and doing strength exercises, including the one's in your videos!
Hello, Dr. Tara Tobias, why my hand are getting tied as I m progress better, walk better, balance better, but every morning, my hand up to shoulder, very tied,. 1st two months, I don't feel it. After that 5th month is the worst, every morning, as if I HV to break a point, have to re teach the brain telling brain them, I have hand and need to move better, very
Tied and painful, is this normal?
Thanks for watching and for your question. Generally speaking, the leg recovers a little faster than the arm. Also, generally speaking, depending on where the stroke/brain injury occurred will impact which parts of the body are impacted. I would say it sounds like you are making excellent progress!! Don't give up on that arm!! Keep moving it and try to incorporate it into as many activities as possible. 😊 I hope that helps!
@@rehabhqofficial Thank you for encouraging. I really appreciate it. Will continue with activities of my hand and hope to see progress soon.
What does it mean when I have problems moving my foot to the side 2 years after a stroke. I can walk, but sometimes my foot gets stuck and I can't move my foot on a diagonal and end up falling.
The talk doesn't begin until 12:00.
Hello doctor my only question is I couldn't move my invovled toe fingers . And my toe is not curled . Please please suggest any tips in this issue
Dr my wife foot it’s stronger from a stroke but the balance is an issue what should I do
If I have bad left side vision will that be bad for my balance. When I’m walking I catch myself looking at the floor a lot
Hi Steve! Generally speaking, field cuts, hemi neglect, double vision and other common vision problems after a stroke will have an impact on balance.
@@rehabhqofficial sometimes objects are totally blocked from my vision like furniture or walls, I can’t see them and people, I bump into them. I can see an improvement from the start though
Hey dr. T. Howcome, contact us on your website page is malfunctioning when you fill out all fields and gives dictionary error dialog box? Btw, impressive explanation of sensory system.
Thanks for letting me know. I have informed by team so hopefully this will be fixed soon :)
@@rehabhqofficial thank you. I will keep trying until in successful.
Why do I get stuck having progressive nuclear palsy from ATAXIA OF UNKNOWN CAUSE , Why
Awesome video! I have a question, I know you talk a lot about the importance of bracing. I wear a bioness device to assist me with walking. It does seem to help me to lift my toes and keep my foot from turning onto its side. Do you recommend me wearing it while I'm exercising or exercising barefoot or putting a brace on?
Thanks for watching and for the question! This questions may turn into a video since the answer is kind of long and definitely dependent upon someones diagnosis (ie: stroke, MS, TBI..etc). The short answer is generally speaking, the bioness is great if someone does not have a lot of spasticity. In some cases, the stim is enough to overcome mild spasticity however, in my experience, spasticity eventually "wins" over any benefit someone might get from the e-stim lifting the foot. I home that makes sense. Again, I have lots of opinions on FES (functional e-stim) so this might turn into a video so stay tuned for my more indepth answer :)
@@rehabhqofficial Thank you for your quick response. I look forward to watching your in-depth video on this.
Hello mam...am watching all ur videos specially related to stroke...thnks a lotttt...for such a knowledgeable information....could u plz let me know mam...in stroke pateint till how long electrical stimulation can be given for arm n leg...is it good n how many time it should be given...kindly reply mam...
I got a lot from this thank you but I’m so not at any point at the end video
I just admire your videos so much. You present an interesting scientific approach, clearly & understandable. Your voice is assuring & steady. So imporatant for elderly people. I've shared our tips with several older people. your techniques are clever. Great job!!
Thanks for watching and for your kind words! I hope the tips are helpful :)
Hos long recovery hand after stroke
Thank you for the video Dr Tara. I'm having MS. With your exercises although I'm confident about balance, but after walking for 5 minutes or more, my legs start getting weaker. Do you have any exercises for strengthening the legs??
Thank you for sharing! MS and "muscle fatigue" is different than typical "muscle weakness". Generally speaking, focusing on how to manage your energy is probably going to be more valuable than focusing on how to "strengthen" a muscle. This video might help: ruclips.net/video/SOfeJ1FyjSQ/видео.html
Sometimes makes you feel confused. the color seems to confuse me more. then usual.
for someone who has advanced - how many minutes of walking a day is recommended?
I still cannot feel my left knee & arm...? Why is my body like this?
Thanks for watching and for sharing your story! Lack of sensation are symptoms of some other medical problem. Best to work with a doctor to get to the root cause of your symptoms.
Dr please can you help me i am sci patient i am stay on bed before 10 years i am from India gyan choudhary injury level d 6 d 7 please help me 👍🙏
Sorry to disturb I just want to know why when I stand still my body sways forward and backwards..is it just natural sway or is something wrong?
Hi Ian! thanks for the question. There are a lot of things that can cause this. Do you have any other balance issues?
Timely video as we are about to go on a beach vacation for our 25th anniversary last beach vacation I didn’t factor in that I would be barefoot after doing PT in tennis shoes all the time so for the rest of the week I’ll try activities barefoot
I have the same issue I walk like I'm drunk and I'm not doing alcohol at all psychiatrist prescribe me psych meds over the years in the ears is stopped up to I love you so please help me thank you my name is Catherine
Tara Tobias,
I liked your video on RUclips 🙂❤️
TOP.
Any feedback according to Book: NeuroScience Fundamental for Rehab. by L.L. Ekman ?
no, but I just ordered it. I like to update my knowledge base to the most recent information. I will get back to you 😊