An intensive week or course of rehabilitation has been shown to really enhance fitness, well-being and confidence in being a prosthetic user. Having a daily structured programme of exercise and challenging activities, alongside prosthetic or orthotic support when required, can really get our clients to their next level of ability. However, once this week or period is complete, it can be really hard to maintain impetus, especially when returning to family life and work. So what’s the best way to maintain motivation in both the short and long term? Below I’ve put together some key points which may be helpful for you.
Set yourself reasonable goals but not beyond three months and tell as many people about them as you can. Telling other people will keep your goal at the front of your mind as they will continually remind you.
Make your goals SMART:
S = specific, e.g. I will be able to walk along a forest track; I will be able to dress independently.
M = measurable, e.g. I will be able to walk a two-mile loop along the track; I will be able to do this in ten minutes.
A = achievable, e.g. do I have the right prosthetic and time to achieve this goal?
R = realistic, e.g. is this something I’ve seen other people achieve who are similar to me?
T = timescale, e.g. I will be able to do this within 3 months.
- You might want to consider a longer term goal as well, but make sure you split this up into smaller goals using the SMART system along the way. Your long term goal could be charitable – fund raising walks or events, giving up your time to help out, etc.
- Set a schedule for yourself and stick to it. Bodies love a routine, the simplest being our day/night pattern. Having a set time each day that you exercise, effectively a “date” with yourself, is the most effective way of sticking to your programme. Tell your family that this is protected time for you. Your physiotherapist will have provided you with plenty of exercises that can be done at home. For lower limb amputees, these will be a mix of aerobic exercises (things that make you puff somewhat), strengthening (some kind of resistance exercises) and balance or agility work. For upper limb amputees, there will be some general upper body strengthening, postural attention and some specific tasks to practise with your new limb.
- Reward yourself each week for achieving the week’s programme, but not with food! Maybe some extra “me time” with a good book or film, or a shopping trip for nice leggings or footwear.
- Make sure you have any equipment that you need. This doesn’t need to be expensive but could be part of your reward system. Small weights, an exercise mat, therabands, medicine balls, etc. can all be useful. However, there are many exercises that can be done just using bodyweight or household objects – just ask your physio. If you are able to afford some equipment, ask your physio for recommendations if you need to.
- Progress your programme. Lifting the same weights each time, or walking the same distance is boring and will not achieve the results you have set yourself. As a general rule, you should be aiming to increase your walking by around 10% per week, getting out 3-5 times a week. This could be 10% in distance or in time. Most phones have step counter apps which can be useful. With weights, your physio will advise you on progression. As a general rule, you will do weight training 2-4 times a week, each time fatiguing the muscles which you are working. With balance and agility training, this can be most days of the week and can get progressively more challenging.
- Add variety. If you are working towards a goal such as walking further or performing a task with a new upper limb prosthetic, then clearly this is what you need to practise most. However, there are advantages to “cross-training”, where you do a different activity to provide alternative movements and variety. Hence swimming and cycling can be useful alternatives to walking, and ball throwing or modified yoga might be useful alternatives as well.
- Track your progress. Use whatever works for you: spreadsheets, a chalk board, a note book. Mark off sessions as you go and maybe add a positive word at the end of each session regarding how you feel afterwards.
- And finally, if you miss a session, don’t overly worry. Make your session an important part of the day but sometimes other things crop up or you simply don’t feel up to it. Just write that session off and try to get back on track for the next one. As a good friend of mine once said, “I often don’t want to go out for a run, but I never ever regret doing it”.
Mary Tebb - Physiotherapist