Creative physical therapy improves lives of people with paralysis

Published: November 4, 2008  |  Source: nwnews.com  | Spinal Cord Injury: ,
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rehabEvery 41 minutes someone sustains a spinal cord injury. Almost half of these injuries are due to Motor vehicle crashes, followed by the next most common cause, falls. The majority of those affected are males between the ages of 16 and 30. One minute they’re leading active, independent lives and the next, they’re paralyzed, confined to a wheelchair and destined to a sedentary existence.

Such was the fate of Allan Northrup. Seven years ago, the Eastside man was in a car accident off of I-90 on Thanksgiving weekend. He sustained a C7-T1 spinal cord injury and ended up with a metal plate in his back to realign his spine. He spent two months in rehab and eventually learned how to transfer himself from his bed to his wheelchair.

“Before I left, I asked the therapists what else they could teach me to do” says Northrup. “I thought there had to be more I could learn. They told me if I got some feeling back in my lower body within six to nine months, they could work with me; otherwise, they could do nothing more for me.”

Northrup, who had been an active, athletic man before his accident, became increasingly depressed and almost suicidal in the months following his release from rehab.

Then he and his wife Sharon heard about a special center in San Diego that offered exercise therapy programs for people with spinal cord injuries and other forms of paralysis. The couple subsequently packed up and moved to California so that Northrup could participate in the center’s programs. After two years of intensive therapy, he had made significant strides in his strength and overall physical fitness, leading to greater independence, but more importantly, he had regained hope.

“I left there a new man,” he adds. “I had gotten my sense of personal self back and I felt positive about my future.”

The couple eventually filled two rooms of their Eastside home with specialized fitness equipment, which led to their decision to open a non-profit spinal cord rehab center in April of 2005. They initially called the place NextStepsNW, but now, almost four years later, the name has been changed to Pushing Boundaries.

“We feel the new name more clearly defines what we do here every day,” explains Northrup. “We give those living with paralysis the opportunity to push the boundaries that have been forced upon them and allow them to get stronger, more independent, and to share ideas with others who are in similar situations.”

The Redmond-based organization offers intense exercise therapy programs to individuals who have paralysis due to illness or injury.

Highly skilled and nationally certified exercise therapists work with clients to regain as much physical function and independence as possible. The exercise programs extend for months and even years beyond traditional Rehabilitation periods.

“We believe it’s never too late,” says Tricia Lazzar, Pushing Boundaries managing director. “Whether your injury is new or it’s one you’ve had for years, participating in an exercise program can help build and maintain muscle mass which keeps tissues in the paralyzed limbs healthy. If you don’t use your muscles, they Atrophy and the neural circuits turn off. You’re at risk for getting dangerous pressure ulcers, as well as a host of other problems, such as weight gain, diabetes, cardiovascular disease and loss of bone density.”

Lazzar continues to explain that through exercise, clients build cardiovascular endurance, increase circulation, decrease spasms, improve blood pressure fluctuation, increase Range of Motion and facilitate respiration.

The organization operates out of a 3,000-square-foot space equipped with state-of-the-art exercise equipment. Therapists work one-to-one with clients, designing individualized programs to help them achieve optimum fitness.

Three fundamental components are utilized: locomotor treadmill training, electrical stimulation cycling and visualization-activation muscle training.

Locomotor treadmill training helps people visualize and fully experience supported weight bearing walking, establishes normal gait patterns and creates new motor pathways.

Electrical stimulation cycling allows individuals to independently cycle with the assistance of low-level electrical impulses which stimulate leg movement.

And visualization-activation muscle training works to replace patterns of nonuse by utilizing applied pressure and limb resistance. Mirrors are used effectively in all exercises to provide visual feedback.

Pushing Boundaries currently serves about 30 clients on a regular basis, who come to the center from all over the Puget Sound region and work out two to three times a week for two-hour sessions at a time.

For many, the center is more than an exercise facility. It’s a community that offers support, education, socialization and camaraderie.

“Part of our mission is to support not only our clients, but their families, too,” says Lazzar. “These types of injuries impact the entire family. Everyone is affected. We have a special corner set aside in our facility with comfy chairs and a couch and this is where family members and caretakers can sit, rest, talk amongst themselves, share resources and information and find others who understand and can relate to what they’re going through.”

As for the clients, they get to know the faces around them and friendships and bonds are formed, both with other clients and with the therapists.

“We’re a family here,” adds Sharon Northrup. “Our staff is a caring and compassionate group who go the extra step. They’re here because they want to make a difference in people’s lives. I’m very proud of them. They’re remarkable individuals, just like all of our clients.”

Jerry Daniels has worked at Pushing Boundaries for a little over a year after doing an internship at the center.

He says, “As soon as I interned here, I knew I wanted to work here. I love it here because the rewards are so great. It’s a gift to be able to see the transformations, both physically and emotionally, that happen to the special people who come here.”

Loa is one of Daniels’ clients. She’s been coming to the center for about a year now and makes the trek from Everett three times a week. Loa was in a car accident seven years ago and sustained a spinal cord injury as well as a broken neck. Coming to the center has made a huge difference in the young woman’s life.

She says, “It has significantly improved my quality of life. I’ve made physical gains that are very noticeable plus emotionally it’s really helped. When I’m here, I feel like I’m doing something normal. And the companionship from the trainers and the other clients is so important to me.”

Loa views all those who work at the center as special people with big hearts. But, she also emphasizes their talents and adds, “They’re creative and think outside the box. They find unique ways for us to exercise. I really get a great workout when I’m here.”

Another client, Dennis Leingang, views the staff as “dedicated, intense and inspirational” and calls them the “Michelangelos for the disabled” because of their ability to “sculpt a body into a Functional work of art.”

Lazzar notes the progress that the clients make, from breathing easier and spending less time on a respirator to actually taking their first unassisted steps. She explains that realistic, attainable goals are set in three month increments.

“We break goals down into small objectives to make them achievable,” she says. “This way they’re manageable. We find that accomplishing small steps really helps with a person’s psyche.”

Soon the center will be able to significantly expand the type of rehab services offered to its clients. It will be adding the first robotic Gait Training system in the state to its arsenal of equipment.

The Swiss-made device, known as Lokomat, will be coming to Pushing Boundaries, making it one of only 55 facilities in the nation to have this amazing technology. The Lokomat supports clients in a weight bearing harness while a robot powering the lower extremities moves their legs on a treadmill. It creates a smooth repetitive walking motion that may help to stimulate areas of the spinal cord that control the ability to walk.

“This device really does the work of two exercise therapists, who would otherwise have to pick up and move a patient’s legs, one at a time, in a walking motion,” explains Lazzar. “Manual gait training is extremely labor intensive for exercise therapists and does not provide the uniform steps that the Lokomat does.”

Studies suggest that specific neural circuits within the spinal cord are largely responsible for an individual’s ability to walk. If damaged circuits can get input from the sensation of locomotion, the idea is that it might be possible to restore function.

“When looking at the services we provide and the clients the Lokomat treats, we know that this new technology is a good fit for us,” adds Lazzar. “It will have a tremendous effect on clients with spinal cord injuries, strokes and other traumatic brain injuries and those with MS, too.”

The organization is in the process of raising the funds needed to subsidize the cost of the $300,000 piece of equipment and hopes to have it on board by next year.

Allan Northrup takes pride in the work that Pushing Boundaries is doing. “We are the only place in Washington that does this kind of work,” he says. “What we do here is next to amazing. We don’t make promises or give false hope to anybody, but we do help people feel stronger and healthier. Someday there will be a cure, but the candidates for this cure will only be those who are healthy. Our job is to help our clients maintain optimal health and wellness through regular exercise so if and when a cure comes, they will be ready to receive it.”

Deborah Stone