February 19, 2001
Support, motivation and technology aid in spinal cord injured patient's recovery
By Collin Johnson
Health and Research News Service
JACKSON, Miss.—It’s a natural rule of life. You fall off your bike, you get up, dust yourself off and climb back on. But for one Petal teenager, falling off a bicycle has lead to a much longer, much harder climb back up. It’s become a battle with spinal cord injury.
In September, Petal High student Brett Hornick, 15, fell off his bike while riding with his friends. He wasn’t wearing a helmet. He broke five ribs, his neck and sustained a cervical spinal cord injury.
Brett remembers almost nothing about the accident. “We think his chain broke and he flipped forward over the handlebars,” said his mother, Denise Hornick. He was rushed to a nearby hospital where he underwent emergency surgery. The news wasn’t good, his parents were told. Brett was quadriplegic and might never walk again.
Doctors recommended he be taken to Methodist Rehabilitation Center in Jackson. “When he came here, he was flat on his back,” said Brett’s father, Chris. “But, he’s 100 percent better than when he first got here.”
Thanks in part to new technology, Bret is walking with crutches and a cane and stands a good chance of walking independently. “Fortunately, he has had good neurological recovery,” said Dr. Michael Winkelmann, Director of the Spinal Cord Injury Program at MRC, who treated Brett when he arrived at MRC. “It seems he is getting where he can walk for short distances and I think he’ll have further improvement,” he added.
Brett finished his inpatient stay in November and began twice weekly outpatient visits that have included treadmill gait training with his therapists and Dr. Dobrivoje Stokic, Director of the Neurophysiology Lab at the Center for Neuroscience and Neurological Recovery (CNNR) at MRC.
Brett was first evaluated to see if he would be a good fit for the treadmill gait training program, Dr. Stokic said. “It’s not for everyone. Potential candidates have to be carefully examined to determine whether treadmill gait training might be beneficial. Even though Brett came to us unable to make steps on his own, we recognized early on potential for recovery.” Through treadmill gait training, Dr. Stokic hopes to be able to re-train Brett’s spinal cord to walk again. “The benefit is we are able to use the remaining spinal cord functions below the level of injury to re-establish a gait cycle,” Dr. Winkelmann said.
The treadmill—which uses a harness, pulleys and a pneumatic system to support a patient’s weight—helps in several ways. By taking away some of Brett’s weight, the machine allows trainers to induce a stepping motion. It’s not easy, Dr. Stokic said. “It requires trained therapists to work with the patient and continuously monitor his progress,” he said.
MRC is one of only about a dozen hospitals in the country that provides treadmill gait training. Researchers at CNNR are studying the effectiveness of the new therapy in both spinal cord and brain injured patients. Since the study began in 1998, several patients have seen significant improvement in their walking ability.
Brett has made a lot of progress in a short amount of time through hard work, said his physical therapist, Teresa Ware. “He’s a very motivated young man.”
That’s one of the most important ingredients, say both physicians. “Having a supportive family is half the battle,” Dr. Winkelmann said. “The family can help keep the patient motivated. I can’t stress how important that is.” Attitude is also important, Stokic added. “If the patient doesn’t have support or motivation, it will not work.”
Brett has both in spades.
“When he first came here, he was kind of down. He didn’t talk to us for weeks,” said Bridgett Pelts, an occupational therapist who worked with Brett. “But right about the time we did his home assessment and he started on the treadmill, I think everything turned around for him.
“He became very determined that he was going to be as independent as possible,” she added. A few weeks later, Brett was changing his own clothes. “He went from needing a moderate amount of assistance to needing almost no assistance. We’re really proud of him,” she said.
For months, his mother has brought him the 90 plus miles every Tuesday and Thursday to MRC for treadmill gait training. Whenever possible, Chris Hornick makes the trip with them.
Whether walking on the treadmill during therapy or showing off the wheels on his new chair, at times it seems Brett can’t help but break into a smile.
“We’re just very pleased with everyone here,” Denise Hornick said. “We’d recommend Methodist Rehabilitation Center to anyone,” Chris Hornick added.
Armed with determination and hope, Brett has picked himself up and is catching up on his school work at home. When he asked his parents for a motorcycle for Christmas he wasn’t kidding. Mom’s vetoing that one for now. But Brett’s dusted himself off and really wants another shot at that bike.