Pachyonychia Congenita Core Exercise Training Video by Dr. Helaine Alessio





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Published on May 28, 2013

The following video was presented at the 2009 Patient Support Meeting by a PCer. It is especially made for those with pachyonychia congenita or others who have difficulty or pain by walking.
Core Exercise Training for Persons with Pachyonychia Congenita
Helaine Alessio PhD, FACSM & Dean Smith PhD, DC
The exercises shown in the video accessed in the Pachyonychia Congenita (PC) website are designed to present safe and effective core exercises that are: a) tolerable, b) safe, and c) effective in improving many aspects of health and fitness. Some exercises can be performed on a carpeted floor or mat; others use aids (e.g. rubber exercise band, exercise ball, and BOSU ball). These are not PC exercises, but rather, exercises that can be tolerated by many PC-ers because they are non-weight bearing and yet stress many different parts of the body. Soft, comfortable, open shoes, sandals or socks can be worn during most exercises. Soft gloves can be worn to provide a cushion and protect hands from friction. It is recommended that persons include a minimum of 20 minutes of non-weight bearing cardiovascular exercise such as swimming, biking, rowing, or elliptical walking. In addition to cardiovascular exercise, some or all of the core exercises in the video can be performed. This would result in a 45-60 minute long workout session. This type of exercise routine can be performed 3-7 days per week, with noticeable benefits. Long-term benefits of improved cardiovascular and core strength may include:
1. healthy heart, blood, and lungs;
2. increased muscle strength for all types of activities
3. increased endurance for all types of activities
4. reduced risk for obesity and obesity-related diseases
5. increased pain tolerance for activities of daily living
6. increased sense of well-being
Basic principles in stability exercise training include:
a) Intensity: exercises should be done with less than 50% of your maximum effort
b) Sets and repetitions: start with 1 set of approximately 6 repetitions and progress to 3 sets of 10 repetitions
c) Hold times: emphasize endurance by holding for 1 to 2 breaths (5 to 10 seconds)
d) Form: movements should be performed slowly with appropriate form to promote proper control and prevent injury
e) Frequency: daily or twice daily to improve neuromuscular control
Exercise training should follow a step-wise approach from simple introductory exercises with wide margins of safety/stability to advanced functional performance training with much smaller margins of safety/stability. For many with PC, simple exercises may be sufficient to improve health and reduce back pain that may be caused in part from altered gait patterns. The goals of the program are to offer palliative care, improve muscle tone and strength, and stabilize the spine. Spine stability training includes 3 distinct levels of activity. First, introductory exercises to find a patient's functional range should be given. Second, low-load endurance training of stability patterns is emphasized. Third, such stability patterns should be trained in functional activities to enhance performance during activities of daily living (ADLs), sport or work demands. The exercises that follow include examples from each training category.

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