Reactivation is the way to make your nervous system relearn (or reorganize) how to work. When a nervous system is traumatized by a spinal cord injury, it may cause spasms trying to get itself to function again. With proper external stimulation, the nerves can start functioning again. Without external stimulation, the human nervous system deteriorates. NASA and the Russian space programs have both spent millions of dollars researching how the body deteriorates when exposed to reduced gravity, including loss of bone density and muscle mass.

Workout Prescriptions for Phases I and II

Daily exercise prescriptions include some or all of the following techniques:

• Developmental movement patterns 
• Active Nervous System Recruitment™ or ANSR™ 
• Active load-bearing 
• Active spin bike pedaling 
• Passive gait training

Creating Change

Phases I and II are the most difficult stages of our program, and they can be the longest in the road to recovery. It is different for each individual because each individual brings us a different nervous system. Some have uncontrolled muscle contractions (spasms); others have pain; and others have nothing at all. Spasms and pain are just symptoms of a spinal cord trying to heal, and without the proper stimulus, these symptoms get worse. With The Dardzinski Method™, these symptoms slowly go away as the nervous system matures. This is also the stage of the journey when most of our clients choose to decrease or completely eliminate antispasmodic medications.

No one learns to walk during these phases. It's not about walking: it’s about improving your quality of life. It’s about achieving little things that are huge, like being able to feed yourself, rolling over in bed, driving, and becoming independent of care.

Results of Phase I (Reactivation) & Phase II (Development/Stabilization)
 

• Increased central nervous system activity 
• Increased muscle mass 
• No loss of bone mass 
• Increased circulation 
• Increased sensation in some clients 
• Increased hot and cold in some clients 
• Decreased pressure sores 
• Decreased use of medications 
• Decreased health problems associated with a spinal cord injury 
• Increased control of their lives

Phase I & II Training Guidelines
 

Appointments

Clients start with either two or three hour appointments, depending on the level of injury. For example, clients with a C injury need to work both upper and lower extremities, and in general, require longer appointments. Each client will come in a maximum of three days a week to start. Our research shows that clients who come in five days a week do not give themselves the proper amount of recovery time between sessions. Five-day-a-week clients come in with tired nervous systems that do not respond to our stimulus; while those that come in three days a week come back stronger each session. These clients are able to make more out of the time they spend in the center.

Expectations

Change—it’s that simple! Physical changes occur almost immediately from improvement in overall health to your nervous system reacting to the stimulus it receives. One of the first things you may notice is a change at night. You may begin to get uncontrolled muscle contractions (spasms) in the evening or while you sleep; or you may notice more burning or even pain in the evenings. Why in the evenings? During the day, while you workout, your nervous system is reacting to the stimulus that is provided. At night, it starts to recover and heal. Night-time will get very interesting as you progress through Phases I and II.

Success Measurements

Every client is an individual with individual needs and goals.

We have also developed a scale that rates clients when they first enter the program and then every three months thereafter. Our staff collaborates with every client on at least a monthly basis to establish short and long-term goals. Daily activities and new “breakthroughs” are documented. A video is taken of each client upon entry in the program to establish a baseline, and subsequent videos are completed when significant changes occur.

Many of the changes clients experience are subjective and difficult to access, including increases in endurance and feeling stronger overall. However, other changes can be observed, including muscle growth, the amount of weight lifted, and the duration of activities.

Pool Training

At this stage of your recovery, pool therapy is not the most productive modality for the lower extremities. Since Phase I is Reactivation and Phase II is Development/Stabilization, a reduced gravity environment is not very efficient. In general, swimming promotes flexibility and hyper-mobile joints. This is just the opposite of what we are trying to do—joint stability. One the most important features of our method is closing the connection with the nervous system. To do this, you need direct stimulation from either a highly skilled Specialist, or a weight bearing exercise.

Exception: Those with C injuries can begin pool therapy on their off days from Project Walk-Austin. However, the focus should be only on the upper extremities, working on coordination and overall strength.

Those with T injuries should wait until entering Phase IV (Function/Coordination) before beginning pool training.

Psychological Outlook

A good, strong mental outlook is one of the most important facets of Phases I and II. Understandably, most clients enter our program with some aspect of depression. Most clients will tell you that the first couple of months they are here is the happiest they’ve been since their accident. As they improve physically, so do their spirits.

Please take this advice into consideration: you need daily distractions away from the recovery process to mentally survive and achieve your goals. For example, our college-age clients take classes, our high school clients finish high school, and many clients work. If you don’t have a local support group, you need to have something outside of Project Walk-Austin.

Additional Modalities

We have found that the addition of the following modalities help in the road to recovery.

Acupuncture can begin anytime during Phases I and II. The goal of acupuncture is to help the nervous system connect and repair itself, and since acupuncture is passive, it is a good adjunct to the early recovery phases.

Hyperbaric Chamber treatments are an excellent addition, particularly during the early phases of recovery. Injuries, infections, and diseases can result in decreased levels of oxygen in the body’s tissues. Hyperbaric treatments promote wound healing and fight infection because 100% oxygen is provided to all areas of the body.

Standing Frames are very important in this early stage of recovery. You will begin to lose bone density and muscle mass so it is very important to your future that you maintain your bone density. Although blood pressure is sometimes a problem, it is still imperative that you get up in the standing frame. Each week you will be able to last longer. Insurance may not cover a standing frame, so you may have to be creative and have someone build it for you. But don’t wait--without load-bearing forces on your legs, you will lose the bone and muscle functions.

Nutrition for a spinal cord injured client is very important in all phase of recovery. It is extremely important to know what and how much to eat so there is no excessive weight gain.

FES Bikes and other forms of electrical stimulation are important during the early stages of recovery. The external electrical stimulation will maintain muscle mass and help with circulation, which as you are now learning, are very important.

Moving to Phase III

During the recovery process, your nervous system is always re-learning; the phases only represent a change of function. Change of function is very important in a physical training program for paralyzed clients, because the stimulation can only change when a clients’ physical function changes. Moving out of Phase II, the client’s nervous system has improved to a point where they begin to get some basic control of their muscles which should be very strong and tight. At night, the legs should be doing all kind of movements: the flexors flexing and the extensors extending. With tight legs, our clients can now feel a stretch reflex, even some of our ASIA A completes.

Clients now have stable joints for load-bearing, because the shoulder, hip, knee and ankle joints are all being held in place. At this time, we move into Phase III of our program, Strength: Eccentric/Concentric Muscle Contractions.