When you are unsteady on your feet

Representation of a Polio victim, Egypt 18th D...
We’ve had problems since then  Wikipedia

Hitting lamp posts isn’t funny

Patients with core stability and balance issues can have problems keeping their balance, especially if  they have had  muscular and other problems affecting mobility and balance.  As one sufferer comments, “I have formed an intimate relationship with the local lamp posts – they have saved me from many a fall”.

It’s even worse if you are unable to work because of moblity problems.  Those who can’t work can have a humiliating and tiring journey trying to get assesed for entitlement to benefits.  Long delays to see over-worked doctors;  these doctors often don’t have time to do more than a cursory test, so the patient may be able to ‘steal’ themselves to complete one test.

If there were time for repetitions (which there should be) the doctors would see that climbing stairs rather than three steps in a corner, walking for more than a few feet, and carrying out other tasks for more than a few seconds is impossible.  But there is never enough time, so patients can be denied benefits to which they are entitled.

Patient after patient has spoken of the almost-cruel indifference with which they are treated when they have mobility problems.  There can be long delays trying to get benefits, and if the assessor doesn’t understand your condition, you end up being told you don’t qualify. If you are trying to get medical help if your chronic condition worsens,  today’s NHS patient services are being cut and cut.

Conditions such as heart problems cancer, etc.  can leave behind poor mobility, but patients are made to feel it is part of the process, as they try to find ways to relieve joint pain and loss of momentum.

One polio survivor showed me a large X-ray of her spine outlining a well-defined S-bend of scoliosis, and said she had gone to the Lane Fox unit at St. Thomas’ Hospital to see if she could get onto their physio programme.  After a cursory examination, a doctor told her, “your spine is perfectly straight”. And denied her the treatment she desperately needed.

However, she was lucky – she ended up being looked after by Prof. Roberto Guiloff of Charing Cross Hospital.  When she told him what the Lane Fox doctor had said, he was so surprised he dropped her spinal X-ray.  He sent her to Esther Palmer (recently elected Physio of the Year by the Polio Fellowship), and the specially targeted exercises Esther gave her have reduced excruciating spinal pain to almost nothing.

She was lucky, but it is worrying that so many patients in Britain have problems being assessed, so that they can get the appropriate treatment and benefits.

Serendipity

But sometimes things are meant to happen, and when I went to Petriolo medical spa resort near Sienna, chatting to the Director, Dr. Brocchi, I mentioned I wrote articles about polio.

Immediately his eyes lit up.  “Have you tried our Pedana Stabilometrica machine?”  When I said no, Elizabetta Urgelli was summonded to take me through its paces.  Not only did I have great fun as I tried to work out what the machine was doing – but I could see immediately how it could help patients who have difficulty proving to assessors that they have mobility and balance problems.

It could also cut down on doctors’ time when assessing patients, and even help point out where problems might lie.

Elizabetta said they could use the computerized postural platform (see picture) for more efficient “treatment and prevention”.

“It’s fundamental for everybody and above all for sportsmen to have good neuromuscular stabilization, because our nervous system elaborates a series of muscular contractions which must be balanced by other muscles which work in decontraction”.  It had started out as an idea from a dentist, who was worried how lack of balance can affect our bite and our jaw.

So what is a posturometric examination, and what does this involve?

It’s an exam which is done with a posturometric and stabilometric platform (see picture) to find out if we distribute our body weight correctly, and to value the eventual presence of foot, articulation and occlusion problems.

On the platform, I was told to stand on two foot plates.  Elizabetta fiddled with the computer – then I had to stand with my eyes shut – and then stand with my mouth open. All time the machine was producing computerised print-outs.

When these print-outs were shown to me, I was astonished to see that although the measurements were almost the same each time, each one showed that my left leg was bearing 40 kilos – my right leg only 24 kilos.  No wonder I find it difficult to walk straight.

Then, if you look carefully at the picture (above), you can see plumb lines that are there to measure how straight is your spine.

These are used for what Petriolo Spa say  is “a postural check up.  This is given in order to prevent future damage and to recuperate functions through better compensation”.

Diagnostic indications

I wished I had had medical training;  the machine was churning up hundreds of questions in my mind, but I could not find the correct words to use, and probably I would not have understood the answers.  So I bought information back to England, and phoned the British Polio Fellowship – who were very, very interested.  Then spoke to Prof. Guiloff who asked for more information, and finally spoke to Hilary Boone,  of the Polio Survivors’ Network. She has numerous studies of the massive difficulties faced by those who had polio, and find it incredibly difficult to obtain benefits, as they are assessed by people who don’t understand how the disease worked.

So what do the Italians  say the machine can measure?

  • prevention and early diagnosis of disorders and of postural pathologies and of balance disturbances
  • control of induced variation (due to clinical tutors, plantar support, therapies)
  • analysis of correlations (occlusal, etc.)

Therapeutic indications

  • postural re-education
  • correction of position errors
  • re-education of balance disturbances
  • occlusal re-education

As you probably realise, I am quoting from the Italian – but if you are medically minded I am sure you will understand what things mean – especially as Latin is basis for much medical language, and of course Italian.

What’s in it for the British?

I could immediately see that having a computer print-out in one’s hand would be able to show doctors exactly what is the extent of a patient’s problems.  A cursory examination might reveal that a patient makes great efforts to walk as straight as possible, and not much can be assessed by them walking two or three yards, unless the person understand their condition.  But have the weight that each leg is bearing confirmed in black and white – Simples!

  • A disability assessor for the Benefits Office wouldn’t be able to argue with a computer print-out giving factual evidence of a disability
  • Or an athlete might have problems getting back to peak performance, but has difficulty in finding out what is causing this
  • Or someone with neurological problems finds that cursory ‘clinic’ appointments with a junior doctor don’t produce any helpful treatment

But show a doctor, or disability assessor a computer print-out giving the extent that you are unbalanced, and how many kilos each leg supports, and they can’t possibly argue with that.

There are so many possibilities, but at a cost of £40,000 for each machine, I can’t see many NHS hospitals installing this.  I did ask Technogym if there was a machine in Britain  – but apparently not yet.  However, In January the EU is yet again going to discuss cross-border medical treatment, and it might be possible to get the NHS to fund a visit for investigation.  See http://healthspanews.com/eu-citizens-right-to-medical-treatment-in-another-eu-country/

What next?

Remember, I am not medically trained.  I found that the machine seemed to offer incredible possibilities, but to a professional the information might not be any use.  My advice would be to contact Dr.Brocci at Petriolo Medical Spa first, then take it from there.

Two things in its favour:

1.  This is an approved Medical Health Spa, licenced by the Italian Ministry of Health.  These medical spas offer incredible treatments,  often far in advance of what we have in Britain, and have to keep to strict guidelines.

2.  This spa has wonderful resort facilities, sits in the middle of a vast but tranquil forested area, and offers a lovely holiday with very, very good cooking!

Barbara provided excellent interpreting when I met Dr.Brocci, but Elizabetta and most of the staff speak excellent English.

Click on link below to find out more about the spa and its facilities http://healthspanews.com/petriolo-spa-is-2000-years-old-but-offers-latest-high-tech-rehab/

Contact Barbara Scorza for more information about the resort or its medical facilities   B.Scorza@atahotels.it

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3 thoughts on “When you are unsteady on your feet

  1. Irene November 5, 2010 at 4:11 pm Reply

    Thanks once again for a brilliant article. I agree these hurdles are one step too far when you have a disability to live with.

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