This is an important innovation.
We all rely on some form of treadmill to encourage muscle development and
general health. Rather obviously, spinal
injuries end that option with natural deteriation as a consequence.
It appears that placing a patient
in a water filled tank along with a treadmill is able to overcome the
gravitational loading no longer been handled and allows effort to be better
targeted.
The results as described here are
excellent and unprecedented. Thus we
seem to have an effective way to rebuild mobility in severely injured people.
Released: 7/26/2011 9:00 AM EDT
Newswise — The result of research often is shown in hard and fast
metrics. For Janette Rodgers, the only metric she cares about is that her
wheelchair, once her prison day in and day out, now sits empty 90 percent of
the time— in large part because of the hours she spent in 270 gallons of water.
After suffering a broken neck and spinal-cord damage in a car accident
in 2007, Rodgers, 53, was nearly taken off life-support. Later, doctors told
her she would never walk again. A year later, she was a participant in Dr.
Sandra Stevens’ underwater-treadmill study at Middle Tennessee
State University
Today, Rodgers’ husband, Terry, watches as his wife walks 500 feet
every day to the mailbox at their home in Rockvale ,
Tenn.
“She pretty much does all the housework now—dishes, laundry, cleaning
floors—and she keeps up with the shopping a lot better. There’s a big
improvement in her outlook,” Terry Rodgers says, as he glances over at his wife
going through her underwater paces. “I used to do most of it, and I didn’t care
for it,” he added with a grin.
“When I first started therapy, I was out of my power chair maybe 10
percent of the time,” Janette Rodgers adds without breaking her rhythm. “Today
I’m out of it 90 percent of the time. It has really made a difference in my
mental outlook. In the four years since my accident, my doctor says he has
never seen such improvement.”
“If you quit trying, you’ll quit improving,” Stevens yells over the
whirring of the treadmill.
“It’s relatively new technology,” said Dr. Don Morgan, MTSU health and
human performance professor, who brought the treadmill to the university a few
years ago. Morgan and his graduate students, including Stevens, began their
initial work with the treadmill thanks to funding from the National Institutes
of Health.
After Rodgers finished her therapy session, got dressed and walked out
the door with her husband, Stevens sat down and reiterated what she preaches so
often.
“It’s a self-fulfilling prophecy. If we constantly tell patients that
you’ll improve over a year then level off and that will be it, then after that
one year the patient will stop trying so hard. They think that’s about as good
as they’re going to get.”
Stevens graduated from MTSU in December of 2010 with a doctorate in
human performance. Throughout the previous year, she worked with 12 people who
had severe spinal-cord injuries, utilizing the controlled speed of the
underwater treadmill. A training session with each smaller group lasted
eight weeks, three sessions a week. When the study came to an end, Rodgers
wanted to continue her therapy. Stevens agreed to work with her.
“I have a couple of people who won’t quit,” Stevens said. “A couple of
them, like Janette, are going on a year of training.”
During her study, Stevens said she looked for leg strength, balance,
preferred walking speed, rapid- walking speed, the amount of distance they
could cover in six minutes and how many steps they took in their own environment
in one week.
“What I found that they demonstrated as a group was a 57 percent
increase in leg strength, 39 percent improvement in balance, 34 percent
improvement in preferred walking speed, 61 percent improvement in rapid-walking
speed, 82 percent improvement in a six-minute walking distance and a 121
percent increase in the number of steps they took in their own environment,”
Stevens said, as she referred to her notes on a clipboard. “Everybody had some
measure of improvement.”
Participants demonstrated greater typical cardiac responses to training
as well, Steven said. As training increased, the more muscles worked to
increase the blood flow to the heart and the nerves in the muscles sent signals
to the brain, which triggered the appropriate cardiac response to exercise.
Most everyone reported improvement in mobility, greater independence,
better general health and improved mental well-being, Stevens noted. Some said
they could climb stairs without assistance. Some said they could reach over and
pick up something off the floor, including themselves if they fell. One
participant who had leg braces said he stopped wearing them because he had
built up so much muscle in his legs, the braces no longer fit.
“Then he realized he didn’t need them—greater weight loss, decreased
stress,” Stevens said excitedly.
“Janette said she started dreaming of herself as a walker,” Stevens
recalled. “She said before the accident she walked in her dreams. After the
accident, she lost the ability even in her dreams and was in a wheelchair in
her dreams. During [the therapy] she started walking again in her dreams.”
Was there a relationship between the kind and rate of improvement and
the person’s attitude toward wanting to improve?
“Yes, to a certain extent,” Stevens answered. “But everyone in the
study had a good attitude because they wanted to improve. These were all people
who had exhausted the resources they had. There is a portion of the population
who become content with where they are. They will become the best wheelchair athlete
they can be—they have made the modifications, and their life is happy and
content. And that’s an appropriate choice. But there are some people who are
not content. There should be resources for those people as well. I was working
with a group of extremely motivated people.
“I was surprised. I went into it expecting that people could get
better,” Stevens continued. “But I didn’t expect over a hundred percent
improvement on steps in your own environment. Ultimately, regardless of whether
or not balance or strength improves or whatever the component is, if the
results are that you’re walking more in your own environment, that’s the
measure we want to look at. And the implication for cardiovascular health—I
mean the decreases in so many health consequences related to a sedentary
lifestyle—that is a very meaningful and clinically relevant outcome.”
Stevens said in a perfect world it would be great to have the funds to
put an underwater treadmill in an out-patient setting.
“It doesn’t take a skilled therapist to oversee treatment,” she said.
“Just someone to open the door, get the water in and they’re good to go. This
needs to be in a community-center environment to have the greatest impact.”
But would the results be the same as in a clinically controlled setting?
The beauty of the whole thing is that it’s water,” Stevens said. “It’s
not complicated and not that technical. If you could submerge a treadmill in a
pond, they could do it. Something that provides this kind of improvement at
hardly any expense … this is where you want health care to go.”
####
Postscript: Stevens has landed a post-doctoral position at MTSU for the next two years. Her next study with the treadmill will be with participants who have no lower-torso mobility whatsoever.
Postscript: Stevens has landed a post-doctoral position at MTSU for the next two years. Her next study with the treadmill will be with participants who have no lower-torso mobility whatsoever.
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