Student sees progress with Reeve’s program

College PE department involved in rehab

In 1999, Chrissy Parker was a typical 14-year-old high school freshman riding home from school with a friend. Now, Parker is a college freshman whose name is frequently mentioned these days in the same sentence as Christopher Reeve.

That’s because that ride home from school ended tragically: The car Parker was riding in was rear-ended, throwing her from the car and severing her spine. The incomplete spinal cord injury — she has a slight ability to move but little feeling in her legs — left her in a wheelchair. She went through rehabilitation in her hometown of Anderson, IN, but with the goal of adjusting to life in a wheel-chair, not of walking again.

After completing her initial rehab program, she spent 2½ years thinking life in the wheelchair would be as good as it would get. Then her hairdresser saw an article about Christopher Reeve’s amazing improvements after he was paralyzed in a 1995 horseback riding accident. Parker’s family contacted the Rehabilitation Institute of St. Louis, where Reeve has demonstrated slow but progressive results since 2000.

Last spring, Parker began a rehabilitation process based on studies of Reeve’s progress, which suggest regeneration of the nervous system is possible. In 2002, researchers at Washington University School of Medicine in St. Louis published an article asserting that Reeve was the first documented case of partial recovery more than two years after traumatic spinal cord injury.1

"In light of science’s perception of spinal cord injuries, it’s remarkable to recover any sensation or movement whatsoever long after the injury has occurred, particularly in those most injured," the study’s lead author, John McDonald, MD, PhD, said in a press release after the study’s publication in 2002. McDonald is medical director of the Spinal Cord Injury Program at Washington University School of Medicine.

"It is impossible to determine the cause of recovery in a single patient case study. However, these results are likely due to Reeve’s dedication to an activity-based approach to rehabilitation since his injury in 1995," McDonald said. "Our goal is to make recovery from spinal cord injuries a feasible option for most individuals. I believe rehabilitation is going to shift to being a home-based, lifelong process that almost anyone with determination and proper medical supervision can achieve."

Parker is a case in point. In St. Louis, she began an aggressive prescription exercise program using the LiteGait therapy device from Mobility Research — a Tempe, AR-based rehabilitation technology company. The LiteGait is a harness-type device that bears some of the patient’s weight to allow walking therapy. She continued the program at Saint John’s Health System in Anderson.

"When I first started out, I wasn’t able to move my legs very much," Parker says. "Now I’m able to move them a lot more, and I have a lot more range of motion. I can tell my muscles are getting stronger. Before the LiteGait, my therapy was getting me to transition to my life in a wheelchair. Now the goal is to get me walking."

Parker enrolled at Ball State University in Muncie, IN, last August. She brought the LiteGait with her, and students in Ball State’s adapted physical education program are helping with her therapy.

Ron Davis, PhD, coordinator of the adapted PE program and professor in the school of physical education, says he jumped at the chance to help when he got the call from Saint John’s about continuing Parker’s rehab program at Ball State.

"I saw it as a tremendous opportunity," Davis says. "Ball State students work with Chrissy, and they are getting a great experience. At the same time, this should help us learn more about servicing this type of spinal injury."

A graduate student and two undergraduates help Parker with her exercise program three days a week for 90 minutes. "We start out and stretch the major muscle groups in the legs," she says. "I get into the LiteGait. They buckle me into this machine, and it will raise and lower you. It suspends me in the air so I can walk on the ground. I’m not able to put weight on my legs, so it holds me up. I walk on the ground and also on the treadmill."

Davis says after a short walk down the hall, Parker walks at 1.3 miles per hour on a treadmill for about 10 minutes. But according to the research, that’s not fast enough to get the desired results.

"That’s where the students come in. The heart and soul of the therapy is that we have to move the treadmill to 2.5 miles an hour," Davis explains. "She doesn’t have the ability to do that on her own. Each student takes a leg and patterns the step to keep up with 2.5 miles an hour.

"The literature supports the idea that at a particular walking speed, reflex characteristics are indeed activated or somehow brought into the pattern that is going to help with this re-education of the muscles. The literature appears to support the speed. They were not seeing it at a lower speed. 2.5 or faster is where you get the results."

Parker has enough recovery in her hips and buttocks to get some movement in her legs, but walks with a lot of hip abduction and adduction instead of the regular flex and extension, Davis says. "The theory behind this approach is we’re trying to use the reeducation of the muscles to help her regain some ability to walk. The goal is to get her walking with braces eventually," he explains. "We’re trying to get as much recovery and function as we can so that can happen."

So far the improvements are anecdotal. Parker reports feeling more movement, and her parents were amazed at her progress when they visited Ball State after about two months of the program.

"They were astonished. Very anecdotally, they could see some changes," Davis says. "At the end of the routine, she does standing leg exercises during cool down. I watched her move the other day, and she had greater movement. That’s what’s driving us to quantify the movement to get some real numbers on what’s happening."

He is planning some research with the university’s biomechanics lab to do electrical measurements of Parker’s muscle activity. Davis intends to start systematic videotaping and periodic bone scans to measure her progress.

This program is a new twist on his normal goal of teaching students interested in physical education and exercise science how to exercise people with disabilities. "We are not claiming to be therapists," Davis points out. "We are providing a prescription exercise program. Rehab was done; they were finished with her. I’m interested in the transition from outpatient therapy — where do they go and what can they do? Adapted PE can step in. Many folks still need that prompt, that guidance. That’s what we can contribute."

Davis and his students also are contributing to a potentially amazing recovery. "She wouldn’t be walking without this. The only thing we could have done was gotten her in the pool and try to use the water as a medium to get her to do range and strength work," he adds. "This is obviously a different way to go."

Reference

  1. McDonald J, Becker D, Sadowsky C, et al. Late recovery following spinal cord injury. J Neurosurg 2002; 97:252-265.

Need More Information?

  • Ron Davis, PhD, Professor, HP213 School of Physical Education, Ball State University, Muncie, IN 47304. Phone: (765) 285-1462. E-mail: rdavis@bsu.edu.