December 03, 2008

New device gives hope for independence to patients

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A revolutionary device that significantly improves rehabilitation for patients with spinal-cord injuries, stroke and degenerative diseases is in use at Spain Rehabilitation Center.

Martel Smith doesn’t remember what happened to him Tuesday, July 8. The Birmingham native was told his SUV flipped four or five times. He was told he was thrown from the vehicle some 50 feet from where it stopped. He knows he had to have emergency surgery.

Martel Smith gets set to begin his therapy on the TheraStride machine with the aid of physical therapists at Spain Rehabilitation Center.
“I don’t know much about the accident,” he says, “but I know it was horrible.”

Waking up was worse. That’s when the doctors told him about his spinal-cord injury and that there was a 99 percent chance he never would walk again.

Now a revolutionary device that significantly improves rehabilitation for patients with spinal-cord injuries, stroke and degenerative diseases is in use at Spain Rehabilitation Center (SRC) gives Smith new hope.

The device is TheraStride, a state-of-the-art, bodyweight-support treadmill system; it enables physical therapists to help patients achieve proper motor function and control, improve balance and walking and increase weight-bearing abilities for standing. Smith has used the machine more than seven times in the past month, and that slim chance he had to walk again is increasing.

“This has given me hope,” he says. “I took that 1 percent chance they gave me to walk again and ran with it.”

Wave of the future
The SRC is the only rehabilitation facility in Alabama with a TheraStride system.

TheraStride combines a treadmill and support harness system with sophisticated computer software that measures variables of gait training, including speed, weight supported, amount of time walked and amount of assistance needed while walking. It enables therapists to provide safe, hands-on training to restore function.

“The TheraStride machine is an integral component of what is referred to as locomotor training – learning how to walk again following neurologic injury or damage,” says Cathy Carver, a physical therapist who has been working with Smith. “TheraStride combined with proper therapeutic skill will help patients recover the ability to walk rather than simply help them learn to compensate with walkers, canes or other assistive devices.”

The TheraStride system cost nearly $100,000 and was paid for by the Women’s Committee Of Spain Rehabilitation Center, the Department of Physical Therapy in the School of Health Professions, the Alabama Power Foundation and private donations.

Cathy Newhouse, SRC administrative director, says TheraStride is the wave of the future for to rehabilitating neurological injuries such as stroke, traumatic brain injury, incomplete spinal-cord injury or Parkinson’s disease. She says TheraStride represents the major shift in philosophy of the rehabilitation field away from the traditional compensation approach to focusing on functional neuro-recovery.

“When someone experiences these types of injuries their brain has the ability to be re-trained. A simplistic way of explaining the process is to liken it to the normal developmental process in an infant’s first year of life,” Newhouse says. “The first thing a baby does is learn to get head control. Then the baby learns how to roll over. The next is learning to roll over, then sitting up, then working on crawling and finally working on walking. Every waking hour the baby is practicing movement and training their brain and developing those pathways.

“Well, after an injury, damaged brain cells are waiting to be re-trained, just like a baby has to train their brain cells,” she explains. “That’s why TheraStride is so good for neurological-involved patients. This is just retraining the brain. This is the new rehabilitation model, neuro-recovery. The evidence shows that this has significant, reliable and valid outcomes.”

Labor intensive
The therapy is beneficial for the patients and hard work for the therapists.

As many as five people work with a patient during a therapy session. One is positioned behind the patient, helping with posture and hip positioning. Two other therapists are positioned on the side of both legs and another person works the computer, setting the speed and weight distribution for the patient. The therapists on the legs are helping the patient with each step, massaging muscles as they go along.

“What we try to do is enable the patient to adapt and start taking our hands off a little bit at a time,” Carver says. “Typically we try to get to 20 minutes of walking. After that, we get them down and see if they can carry over the training on the ground where we try to get them to walk some.”

The TheraStride is as labor intensive for the therapists as older rehabilitation machines, but it’s much more beneficial in measuring the success of the patient’s therapy. The therapists know that Smith, for example, began walking on TheraStride supporting 60 percent of his body weight. Now he is supporting 70 percent of his weight.

“That shows us a concrete, objective measurement and improvement,” Newhouse says. “And we were never able to have those concrete, measurable changes before.”

Walking the sidelines
Smith has many goals left to achieve in his life. Walking the sidelines of a football stadium is one of the biggest – he is the head coach of the Hudson Middle School football team and an assistant at Woodlawn High.

He has hope. He has feeling in both of his legs, including complete feeling in his left leg. He can feel his muscles in both legs. He can lie in bed and raise his left and right legs, and even move his left foot. “I’ve come that far from being able to do nothing,” he says.

Smith is progressing so well that he and his doctors believe he could be walking with the assistance of a walker in three months.

He is convinced he will walk again and is thankful for the opportunity UAB has given him to recover.

“I know this machine and the people here at UAB are a big reason why I have that hope and belief,” Smith says. “I love coming here. The atmosphere is great. The people that work with me are wonderful. We work hard, but we have fun.”

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