Paraplegic from Spain is making strides in therapy here

Published: April 3, 2004

Oscar Segovia pedaled a stationary bike in a crowded gym. He’d already done some stretching and gone for a short walk. After lunch, he planned to hit the pool.

But Segovia, 24, of Manresa, Spain, is no ordinary gym member. He has been a Paraplegic for eight years since a car struck his motorcycle on his way home from work. Segovia will compete Sunday in the wheelchair division of the St. Louis Marathon.

Win or lose the race, Segovia says certain victory is in his grasp. He will walk again, he asserts.

Segovia came to St. Louis last month for intensive therapy in the Washington University Spinal Cord Injury Program at the Rehabilitation Institute of St. Louis. There, he follows a program designed by Dr. John McDonald, director of the program, to treat Christopher Reeve and other people with spinal cord injuries.

Reeve and McDonald made headlines when they announced that the actor-director of “Superman” fame had regained some feeling and motion seven years after a riding accident paralyzed him from the neck down. The degree of recovery was remarkable given the length of time Reeve was paralyzed. Most patients improve the most in the first six months after injury and don’t make much progress after two years of standard therapy. After that, doctors and therapists often counsel their patients to get used to living with their Disability.

That sort of attitude never sat well with Segovia. The moment he emerged from a coma two weeks after his accident and learned that he was paralyzed, Segovia vowed to walk again. His doctors and therapists said it was a vain hope.

Segovia had been a construction worker in his father’s company. He played soccer, swam, rode his motorcycle – did all the things a vital teenager enjoys.

He wanted that life back. And for a while, he worked hard to recover it. But when he stopped seeing improvement, Segovia fell into a Depression that lasted for almost two years.

“You have to fight”

Then he met a girl – now his girlfriend, Monica Garcia – and his resolve returned.

“I understand now that it’s a test that life has given me, and that I have to overcome with good will, strong will,” Segovia said through an interpreter. “If you really love this life, you have to fight until you don’t have one drop of sweat left.”

Segovia began working out again and saw minor improvements. Then a documentary on Reeve prompted the couple to track down McDonald and ask for his help. The doctor reviewed Segovia’s medical history and arranged for him and his mother, Loli, to come to St. Louis for six weeks.

Segovia was anxious to start the intensive program of exercise and electrical stimulation to strengthen his muscles and perhaps heal his injury. Reeve and his doctors say that stimulating his muscles with electrical currents may have prompted dormant nerves in his spinal cord to reawaken. Some animal studies suggest that the therapy may stimulate regrowth of the Myelin sheaths that insulate nerves, McDonald said.

No studies have proved that electrical stimulation causes nerve Regeneration in people, said Dr. Sushmita Veloor, Segovia’s attending physician at the rehabilitation institute. But doctors don’t yet have other good scientific explanations for the source of returned sensation in long-sleeping limbs. Even if the electrical therapy doesn’t cure paralysis or restore feeling, most patients experience improvements in muscle mass, bone density and cardiovascular fitness, she said.

Making strides

Segovia has done remarkably well in the four weeks he has been at the center, she said. When the young man arrived in St. Louis, he could not stand on his own and had trouble sitting upright. He “walked” a few steps at a time by twisting at the waist to throw his legs forward, but only with a therapist holding him. His undisciplined feet landed at odd angles that put his ankles and knees at risk, Veloor said. He had no feeling in his lower limbs. His weak bladder and bowel control led him to use the bathroom a dozen times a day.

Now, Segovia bikes two hours a day – the equivalent of 6,000 steps, McDonald said. He can stand on his own in leg braces for several minutes. He can walk 300 unassisted feet in leg braces and crutches to the institute’s cafeteria and stroll short distances outside on the sidewalk. His feet are ticklish, and he can feel the burn of an alcohol swab wiped across a scratch on his thigh. His bathroom visits have been cut in half.

That degree of improvement is unusual, McDonald said. Segovia has all the features that optimize his potential for recovery, McDonald said. “He’s very young, an athlete and very motivated. He has the right attitude.”

He doesn’t promise that everyone can make the strides Segovia has. “Rehabilitation is an experimental therapy,” he said. “No one can guarantee anything in any individual, ever,” but “almost everyone can have some recovery.”

All patients see some benefits from the therapy “as long as they put the effort into it,” said Cassandra Pate, Segovia’s primary Physical Therapist at the institute. “They’ve got to be willing to make this a full-time job.”

Segovia works hard toward recovery. Eight hours a day, five days a week, he rides the bike, stretches, walks in the braces, and has electrical stimulation to strengthen his abs, back, bladder and bowel muscles. He does aquatic exercises twice a week.

His effort shows. In the supportive Environment of a therapeutic pool, Segovia stood in chest-high water Thursday, his forearms resting lightly on the side of the pool, chest muscles quivering with the effort to remain upright. Later, he sat with his arms crossed over his chest while Pate made waves. Segovia’s neck and jaw tensed, he breathed hard, his back rounded, but he stayed sitting. The water calmed and Segovia leaned back against the side of the pool, smiled and flashed a thumbs up.

His recovery is worth the physical exertion and the roughly $90,000 he borrowed to pay for the therapy and equipment he will need to continue his rehabilitation, Segovia said.

“Since I’m going to obtain my goal, even if I have to have a mortgage for the rest of my life, it’s worth it,” he said.

Reporter Tina Hesman
Phone: 314-340-8325
By Tina Hesman
Of the Post-Dispatch