The Ground Beneath Your Feet

For the last few months I have been taking Rosemarie to physiotherapy sessions every Tuesday afternoon. This has only really been possible since we got the regular wheelchair and the smaller reclining chair; the original recliner was far too big and unwieldy. 

The physiotherapist is a pleasant, garrulous Brazilian who has worked at the Home for many years. When Rosemarie was first there (and could still stand and walk with assistance) I tried to schedule individual PT sessions for her but it didn't really work out. She was allocated a 15 minute slot but was only rarely awake enough or co-operative enough for it to achieve anything. After a while we stopped trying.

But then I found out there were group sessions every Tuesday for an hour (well, 15 minutes physiotherapy and 45 minutes of the PT talking about everything under the sun) and so I started taking her myself.

It is all pretty basic stuff, mainly standard chair-based exercises. Rosemarie needs assistance to do them and usually resists me moving her arms and legs because she doesn't understand what is going on. From time to time she cottons on or stops resisting for some other reason and is able to release the tension she has built up in her muscles with sometimes evident signs of relief. She spends so long with her arms and legs tensed and twisted that it must be a pleasant change to relax the muscles.

Usually I take her in the wheelchair, which has a footbox to contain her wandering feet, but last week the PT suggested we try her in the reclining chair, which has an electrically controlled footplate. His thinking was that it was months if not years since Rosemarie had feld solid ground under her feet and maybe some of her restless foot movement was consciously or unconsciously seeking this sensation. 

So this Tuesday I took her in the reclining chair, and when we tilted it as far forward as possible and lowered the footplate to its fullest extent she was able to touch the ground with her feet. At first it was dainty tiptoe touching, like she was exploring it, but after a while we noticed that her feet were flat on the floor and the restless movement seemed to have stopped. It is difficult to read her reaction, but it seemed positive, especially given that she was actually tilted forward and although I held her arm firmly it must have felt quite precarious. 

She stayed in that position throughout the seated exercises, with no signs of distress.

The seated exercises are followed by assisted standing for those who are capable. In the past we have never tried this with Rosemarie for several reasons: her leg muscles have shrunk dramatically through lack of use, there is a residual paranoia at the Home about her falling, and her wheelchair's footbox makes it impossible anyway.

So the PT suggested we try anyway, since she was now in the reclining chair, her feet were unrestrained by a footbox and were at this moment flat on the floor. We got either side of her and told her what we were going to do. No reaction - but I didn't expect one. We hooked our arms under her armpits and eased her weight forward, encouraging her to stand.

And she did. She needed help and for most of the movement we were taking her weight, but there was a definite co-operation in the movement. She made a sound like a tremulous moan, and held position with our help for about three seconds before her legs gave way and, taking her full weight, we lowered her carefully into the chair. There was applause and encouraging comments. That was the first time she had stood on the floor for probably a couple of years.

We tilted the chair back so she could completely relax. Her face was totally unreadable but somehow....busy.

I don't seriously expect her to stand for long let alone walk again, but I think the PT was right and she did enjoy having her feet on the ground. Somehow I was still smiling as I drove home several hours later.

We will see what happens next week.