QUESTION:
I have a client who suffered from a condition called Guillain-Barret Syndrome a couple of years ago. The situation progressed so much that due to malpractice she slipped into a coma. To make this long story shorter, she has made a recovery from her coma and is now mobile and functioning again. I have been hired through her Physical Therapist to continue to work with her to gain coordination and strength. She can not jump, has some trouble with short term memory and has trouble using her hands and limbs with any kind of fluid motion. She has had to learn how to live all over again from scratch. My question is if you have any suggestions on how I can train my client so she may gain strength in her legs to be able to jump and walk up and down stairs with out holding on to the railing (or someone's hand). Can you suggest any 'drills' I can give her that would challenge her memory and eye/hand coordination along with lower extremity balance and strength?

Some added information: The physical therapist who I'm working with has told me to work on bimanual motor skills, balance and coordination exercises. Things like walking up and down stairs with little help, hitting objects with her hands and most especially throwing, catching and bouncing balls. Also, simple jumps in place.

Jane has a hard time gripping things and has a hard time throwing overhead. Her jumps are practically non existent as she can not make her body move with grace or coordination. (all things you and I take for granted!) The physical therapist also tells me to challenge her memory. I have her tell me what exercises we do together so that we can do them again. The doctor says repetition is key - for everything we do...even if we spend an entire hour throwing a ball back and forth to each other.

A drill I've given Jane is with sticks. She can hit them with some force but she has a hard time following directions with regard to hitting patterns. She can do only one task at a time. But the one thing that we've always had success with is simply sitting and standing with a kitchen chair (to simulate squats and to build endurance in her legs and glutes for proper muscle activation). I've also seen success when I've had her do low step ups with a balance. If she holds on to the banister in a stairwell she does this very well. She however, has a profound and crippling fear of falling on stairs. So, it's been hard building her confidence.

ANSWER:
First I want to start off by saying this, KNOW YOUR ROLE! I am slightly confused why the PT and the MD wants you to do all of this work? As well, is somewhat focused on your client jumping, when she has trouble even walking, etc.? I am a Registered/Licensed Occupational Therapist and have worked with many patients in the past with this syndrome. If your client has insurance, they should cover inpatient and even outpatient OT, PT and Speech Therapy, which she needs. I am not saying you might have the knowledge, but if you are at simply the personal training level you are stepping some boundaries. There are many things you can do when working with clients such as this, when they come to you. You can be the intermediate person or coordinator that gives them recommendations on where to go and what the next step in her healing process is.

Personally, I would refer your client back to her MD to see if she can get outpatient OT, PT and Speech. All the fine motor, gross motor, and memory dysfunctions will be addressed by these professionals. The other course of action you can take would be to find a CHEK Level 3 or 4 Practitioner, as well as a CHEK NLC Level 3 Practitioner to refer your client to (www.chekinstitute.com). This individual would be better able to suit the needs of your client through assessments, program design, addressing Nutrition and Lifestyle principles to rebuild her immune system, etc. At the same time you can be in there as well absorbing all this info like a sponge.
So at this point I think at this point if you are at all in doubt of what to do, refer out!

Most trainers are not skilled enough to work on fine motor/gross motor skill development, memory and hand eye coordination, attention span, activities of daily living, etc. This as well is not the job for one person. That is why we have OT’s, PT’s and Speech Therapists. You might be able to help her to some extent, but it sounds like it would be father down the road when she needs conditioning. The best thing you could do for your client at this time would be to refer her out.
Most people can recover from this syndrome. There are many physical, mental, emotional, nutritional, and lifestyle principles that need to be addressed. Getting her with a skilled PT, OT, or Speech Therapist, as well as a CHEK Practitioner will assist in this recovery. Go to www.chekinstitute.com to find a practitioner in your area. As well, feel free to email me if you would like some assistance. Good luck!

Joshua Rubin