Thread by @BadgleyLaurence

The exercise program is only for persons with less severe forms of Hypermobility (those who are still physically active) & who have not advanced to Fibromyalgia/ wasting disorders (who should begin an exercise only in warm water & until they are ready for walking on land).

https://twitter.com/cortdoesscience/status/1343535658074304512

My theory how persons with Fibromyalgia, wasting diseases & severe fatigue should exercise is that they should start with very gentle activities whereat gravity is negated & then through gradations of activities whereby exposure to gravity is gradually increased.

The first phase of exercise for persons with Fibromyalgia & wasting diseases should be similar to what was done with polio in the 1900’s: Warm water relaxes spastic muscles & enables joint range of motion exercises with gravity relatively negated.

During warm water physical therapy, efforts include specific exercises to strengthen muscles supporting a body tower able to stand on land; the goal. Trapezium, Serratus ant., Rhomboids, Rectus abd., Transversus, para-lumbars, Glutes, & all leg muscles must be strengthened.

Once standing on land has been achieved, then moving on land is the next goal. Moving would include crawling & walking. During this phase, people might need extra support of a sacroiliac joint belt &/or perhaps even knee supporters in the beginning. Walking sticks might help.

Once a person has progressed to standing on land, physical therapy efforts in the water should continue & advance from stationary muscle building efforts & walking around inside the pool and to greater efforts at gentle swimming.

Walking on land should be gradual and guided by fatigue & pain, which can be used to judge how much walking can be tolerated. Of course fatigue and pain were also the limiting factors during the Aquatherapy efforts of Phase I (see discussion above).

Other body restorative efforts, once standing on land has been achieved, might include Tai Chi & Yoga. Of course these modalities will need to be modified from the usual routines and into exercises that are gentle and abbreviated at first.

Over time, body restoration will advance to greater amounts of walking (Phase II), a major exercise for physical restoration. Successful walking provides opportunity to advance physical endurance of the body by gently increasing the force of gravity: ellipticals & rucking.

Phase III of body restoration includes gently increasing force of gravity. This follows a successful walking exercise program. Ellipticals are a way to expose muscles that support a body not exactly vertical, & in this way further strengthen the body tower to move vs. gravity.

Phase III of body restoration has goal of person being able to independently conduct basic activities of daily living: dressing, bathing, toileting, & food preparation. Advanced exercises in Phase III include increasing gravity forces upon the body tower: rucking & trampoline.

There are 2 simple ways to increase stimulus of gravity on the vertical body tower: Rucking includes walking with 10-15% of body weight added to a backpack; placing weight along body long axis, & when waking around with this weight the muscles of upright posture will strengthen.

Another way to strengthen the muscles of upright posture in Phase III is a small round floor trampoline. Gently jumping up and down will strengthen the muscles of upright posture. Additional strengthening of these muscles will enhance walking times & distances.

Goal of progression through Phases I-III (described above), is to enable the body to transcend from a totally bedridden state to upright posture & able to accomplish activities of daily living. Progressive exercises are intended to use graduated gravity as the exercising force.

An important aspect of body restoration from bedridden to functional activity is nutrition. As body is restored, efforts must be made to introduce nutrients dense in raw materials for growth of soft tissues that provide for upright body support, i.e, ligaments, tendons, & muscles

Certainly, while pursuing gradually escalating exercises to restore upright body functioning, the patients themselves are the meters that measure levels of pain and fatigue. These meters are what guide the degree & intensity of the exercise efforts.

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