03 November 2009

Learning to walk again: Neurological rehabilitation overcomes paralysis


James Loris is walking again. The father of five who owned his own construction business was in a wheelchair, paralyzed from the chest down following an off-highway vehicle accident that fractured his C6 vertebrae.

"When I broke my neck, it pinched my spinal cord," Loris says, adding that the injury disrupted the brain's communication with his body, causing the paralysis. "He just turned the system back on."

Loris is referring to Steven Bennett, a physical therapist at Mountain Land's Southwest Neurological Rehabilitation Center in St. George. Bennett utilizes a neuromuscular training program to restore function to paralyzed or dysfunctional muscles resulting from a variety of medical conditions, including strokes, spinal cord injuries, brain injuries cerebral palsy and other neurological and orthopedic conditions.

The program utilizes electrodes placed on a patient's muscle group to read electrical signals transmitted from the brain to the muscle. An attached computer reads electrical impulses, displaying the signals on a monitor for the therapist and patient to see during treatments.

The therapist then uses a conditioning protocol to teach the brain to use alternate paths to communicate with the muscles. This conditioning is tracked by watching the signals on the monitor.

Once the brain learns to communicate with muscles through new paths it remembers the alternate paths for future use and, in effect, overcomes the paralysis.

That is how Loris came to walk again.

"You have to have determination," Loris says.

He's not quite back to his pre-accident mobility. Loris walks with a limp and has to concentrate on lifting his leg so he doesn't trip over his foot. Bennett says they have not yet been able to restore movement to the muscles in one of Loris' feet.

It's a long way from using a wheelchair because he didn't have any movement from the neck down.

"He'll come back in and we'll tune him up and smooth out that walk," Bennett says.

It's not an easy process. It's hard work. It requires strength. Yet Loris says he was driven because he had to provide for his family. He can even drive a vehicle with a standard transmission, clutch and all.

Bob Mower

The treatment is not just effective for accidents like what happened to Loris. Bob Mower, a retired Dixie State College chemistry professor, suffered a severe stroke in May and was unable to walk because he lost mobility on his entire left side.

"It was a long time before I could even move," Mower says.

Bennett says Mower was not supposed to be able to walk again. That was before he went through the neuromuscular training program.

"We had to turn on his whole left side," Bennett says.

Because Mower had the determination to move again, he checked out of both inpatient rehabilitation and home health before he was supposed to so he could begin working with Bennett.

Mower's wife, Susan, calls Bennett a "miracle worker" and says he's "perpetually optimistic and encouraging."

"Bob's in far better shape than anyone ever thought he would be," she says.

When he first visited the Southwest Neurological Rehabilitation Center, Mower couldn't walk or move his left hand. His goals were to overcome both of those obstacles and he has.

"Now I can walk from the parking lot into the therapy office, from the parking lot into the grocery store, and from the parking lot into church," he says. "I can move my hand and fingers well enough to hold onto things. I can hold the television remote so tightly my wife can't get it away from me."

Mower also likes how Bennett appreciates a good joke, because Mower is full of them.

Richard Cox

He still uses a wheelchair to get around but Richard Cox is much farther along in his recovery than he thought he would be after his injury more than three years ago.

"I had absolutely no movement," Cox says. "I couldn't type. I couldn't write my name. It's been a long 3 1/2 years."

Now he is slowly regaining movement. Although he still needs the wheelchair for everyday movement, he can walk short distances with the aid of a walker and knee brace.

Cox was riding in the back of a Jeep when he hit the roll bar and blood began to flood his spinal cord. Blood clots suffocated the spinal cord and peripheral nerves, leaving him paralyzed.

Then his aunt, who lives in St. George, mailed an article about Southwest Neurological Rehabilitation to Cox in Phoenix, where he lived at the time. About six months ago Cox moved to St. George to pursue treatment.

Like others who have sought Bennett's help, Cox has damage to the pathways normally used by the brain to communicate with his muscles. Because these pathways don't regenerate, Bennett has to work with Cox to teach his brain to follow different pathways.

To do this, Cox positions his wheelchair between two horizontal bars in Bennett's office. He uses his upper-body strength to pull himself up to a standing position. From there he slowly puts weight on one leg at a time to send signals to his brain. Through trial and error of placing the weight in different spots he can train his brain to find different communication pathways to the muscles.

"Once the brain sees it a couple of times it will repeat it and repeat it until it's locked into motor memory," Bennett says.

It's not easy.

As Cox puts weight on his leg he groans loudly, almost like he's bench-pressing weights in a gym. Because of his injury, his nerves are more sensitive than normal. Cox says everything is magnified by about 10 times. The process is both painful and exhausting.

Still he's determined to push through and regain mobility.

Cox meets his goal of sending a powerful signal to his brain as tracked on the computer monitor. Yet he wheezes, "One more."

He puts his weight on his left leg again, groaning under the effort once more. He meets another goal and Bennett asks Cox if he has enough energy to go again.

Without hesitation Cox replies: "Yeah."

Then he decides to show off. With Bennett blocking Cox's weaker left leg so it doesn't give out on him, he walks a few steps, using the horizontal bars for some support.

He pulls his hands from the bars, putting his entire weight on his stronger right leg for a few seconds. He is standing without assistance.

"I can, with my right leg, support my weight," Cox says with an optimistic smile.

For about three months after his injury, Cox was one of about 20 patients in the hospital with similar injuries. He got to know the other patients quite well during that time. Now he says they have all given up except one other and him.

That is why he wants to spread the word about this treatment.

"I figure this accident had to happen for a reason," he says.

He didn't know services like this were available until his aunt sent him the newspaper article. Only about a dozen locations around the country offer the neurological rehabilitation services.

Cox has been working with Bennett for less than six months and has seen many successes during that short time. Bennett says he's walked up and down the length of the center's gym with the walker.

Ever the determined optimist, Cox pats his sleek, black wheelchair and says: "I look forward to donating this to someone else."

For more information on Mountain Land's Southwest Neurological Rehabilitation Center, call 628-5194

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