speed and assurance. Within a month the synapse time to initiate movement in both forearms and both legs was practically instantaneous—a sure sign that just like the index finger, the signals were coming from the correct part of the motor cortex.
By January 2001, I was spending as much as three to four hours a day on physical therapy. We would work the lower body one day, the upper body the next, combining E-Stim, the FES bike, and voluntary motion against resistance. The forearm extensions had led to gaining the ability to fully extend both arms and raise them up like wings. Then I learned to start with myarms fully opened horizontally and bring them down to rest at my side. I could do this one at a time or simultaneously, with an aide giving light support at the wrists and elbows.
One day I decided to see if I could sit up by myself out of the wheelchair. Again, there was no reason to assume I could do that, but no reason to assume I couldn’t. (I had been using the E-Stim on my abdominal and paraspinal muscles as part of my regular routine.) Dolly and Chris positioned the chair next to the tilt table and transferred me onto the edge. Chris stood behind the table in case I fell backward, while Dolly covered the front. I asked her to plant my feet the width of my shoulders to give me a base of support, and I asked Chris to pull my upper body fully upright, making sure that I wasn’t leaning left or right. Then I asked them both to let go. Nothing happened, which (for once) was exactly the desired outcome. I just sat there. All the other exercises required strenuous effort; sitting upright on my own required me to relax and allow the continuous, subtle interactions of nerves and muscles to create balance. When I started to fade to the right or the left, I commanded the muscles on the opposing side to compensate and bring me back to center. I was overjoyed to find that sitting on my own wasn’t very difficult. I reflected on the fact that balance is natural, it’swhere the body wants to be. Maybe after all these years it still remembers. That’s why practically anybody can get on a bicycle after twenty years and pedal away.
I closed my eyes, just as an experiment. I didn’t know if visual reference was necessary to keep me upright. Once again, nothing happened. For nearly five minutes I remained motionless, and then I started to slump forward as fatigue set in. My head, which weighs about twenty-six pounds, was the first to go and then my upper body followed. But I had been sitting virtually untouched for more than half an hour.
Today I look back at that experience as one of the three most significant milestones in my history as a spinal cord patient. The first was discovering that my injury was not complete; the second was finding out that I could breathe on my own, if only for short periods of time. The ability to initiate movement far below the level of my injury and simply to sit with little or no assistance meant there was even more reason to hope.
I went back to St. Louis in February for another round of testing and evaluation. The functional MRI showed that all the movements I had acquired since the last visit were also being directed by the correct part of the motor cortex, with some recruitment from the opposite hemisphere of the brain. The ASIA exam was a great success: because my motor and sensory scoreshad improved dramatically, I was reclassified as an ASIA
C
. Dr. McDonald was again ecstatic, describing these results as “history in the making.” I was encouraged by the thought that since my improvement was the result of exercise, it might translate into insurance companies paying for equipment that could help other patients recover enough function to return to work or school. Wouldn’t it be more profitable to give patients who meet certain criteria the tools and training they need to get better and go away?
Proof of that principle had already been convincingly demonstrated by Dr. Reggie Edgerton
By January 2001, I was spending as much as three to four hours a day on physical therapy. We would work the lower body one day, the upper body the next, combining E-Stim, the FES bike, and voluntary motion against resistance. The forearm extensions had led to gaining the ability to fully extend both arms and raise them up like wings. Then I learned to start with myarms fully opened horizontally and bring them down to rest at my side. I could do this one at a time or simultaneously, with an aide giving light support at the wrists and elbows.
One day I decided to see if I could sit up by myself out of the wheelchair. Again, there was no reason to assume I could do that, but no reason to assume I couldn’t. (I had been using the E-Stim on my abdominal and paraspinal muscles as part of my regular routine.) Dolly and Chris positioned the chair next to the tilt table and transferred me onto the edge. Chris stood behind the table in case I fell backward, while Dolly covered the front. I asked her to plant my feet the width of my shoulders to give me a base of support, and I asked Chris to pull my upper body fully upright, making sure that I wasn’t leaning left or right. Then I asked them both to let go. Nothing happened, which (for once) was exactly the desired outcome. I just sat there. All the other exercises required strenuous effort; sitting upright on my own required me to relax and allow the continuous, subtle interactions of nerves and muscles to create balance. When I started to fade to the right or the left, I commanded the muscles on the opposing side to compensate and bring me back to center. I was overjoyed to find that sitting on my own wasn’t very difficult. I reflected on the fact that balance is natural, it’swhere the body wants to be. Maybe after all these years it still remembers. That’s why practically anybody can get on a bicycle after twenty years and pedal away.
I closed my eyes, just as an experiment. I didn’t know if visual reference was necessary to keep me upright. Once again, nothing happened. For nearly five minutes I remained motionless, and then I started to slump forward as fatigue set in. My head, which weighs about twenty-six pounds, was the first to go and then my upper body followed. But I had been sitting virtually untouched for more than half an hour.
Today I look back at that experience as one of the three most significant milestones in my history as a spinal cord patient. The first was discovering that my injury was not complete; the second was finding out that I could breathe on my own, if only for short periods of time. The ability to initiate movement far below the level of my injury and simply to sit with little or no assistance meant there was even more reason to hope.
I went back to St. Louis in February for another round of testing and evaluation. The functional MRI showed that all the movements I had acquired since the last visit were also being directed by the correct part of the motor cortex, with some recruitment from the opposite hemisphere of the brain. The ASIA exam was a great success: because my motor and sensory scoreshad improved dramatically, I was reclassified as an ASIA
C
. Dr. McDonald was again ecstatic, describing these results as “history in the making.” I was encouraged by the thought that since my improvement was the result of exercise, it might translate into insurance companies paying for equipment that could help other patients recover enough function to return to work or school. Wouldn’t it be more profitable to give patients who meet certain criteria the tools and training they need to get better and go away?
Proof of that principle had already been convincingly demonstrated by Dr. Reggie Edgerton
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