The term “paralysis” conjures up images of spinal cord injury resulting in paraplegia and quadriplegia. But a stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, Parkinson’s disease and many other neurological conditions result in varying degrees of debilitation that may require years or even a lifetime of continued care — with varying degrees of insurance coverage.

“Once paralysis patients are medically stabilized, they are transferred to the rehab unit of the hospital for up to four weeks,” says Michele Arnold, MD, chief medical officer at Swedish, Spine Sports and Musculoskeletal Medicine. “The problem is, neurological recovery and physical strengthening for these patients often comes in small increments. Insurance doesn’t cover long-term rehabilitation for those small returns-on-investment.”

Pushing Boundaries, a nonprofit exercise rehabilitation center in Redmond, helps to close that gap with a long-term, broad approach to serving the paralysis and movement-disorder community. “Our approach is two-pronged,” says Pushing Boundaries Associate Director Michael LaTour. “First, we support those navigating paralysis in maximizing their potential physical function and independence. Some clients use the exercise therapy programs to regain function and strength, while others focus on maintenance. We also provide resources to clients, their families, and caregivers to help ease functioning in their day-to-day lives.”

The online resource center is the second prong; it may help someone to find financial or legal assistance, a contractor to build a ramp at their house, or transportation support. This comprehensive library averages 350 uses per month.

Erin Ciliv (who has cerebral palsy) uses Pushing Boundaries to maintain and improve strength, balance and function.
Erin Ciliv (who has cerebral palsy) uses Pushing Boundaries to maintain and improve strength, balance and function.

Motivation affects recovery from paralysis

According to research reported in Science journal, motivating patients is crucial for promoting recovery in rehabilitation after brain injury including spinal cord injury. The research team found that there is a relationship between the neuronal activity in the part of the brain that controls motivation and the part of the brain that controls motor function.

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Pushing Boundaries uses a variety of creative means and specialized equipment to keep clients motivated. The Milestone Board is used to highlight client victories. “Many clients have a long-term goal of walking again, but that is not the only milestone worth celebrating,” says LaTour. “Every goal achieved is an important step in increasing client independence.”

Pushing Boundaries uses the Milestone Board to highlight client victories.
Pushing Boundaries uses the Milestone Board to highlight client victories.

Kevin Carpenter, ACSM/EP, CIFT, an exercise therapist at Pushing Boundaries, was recently working with a 13-year-old boy struggling to fully engage in the challenging and sometimes tedious work of physical conditioning. When Kevin learned the client liked the video game “Minecraft,” he got creative to increase motivation. He built an exercise regimen that mimicked the game, with different game-related activities throughout the facility. He even downloaded the theme music to play in the background. Kevin’s extra effort paid off with the best therapy session he’s ever had with the client, as well as strengthening their relationship.

Going the extra mile

Dealing with a long-term partial or full paralysis condition can be frustrating, time-consuming and expensive,” says Arnold, who frequently refers clients with long-term rehabilitation needs to Pushing Boundaries. “Ongoing support for the whole patient can be a huge part of the recovery process.”

For example, Rob was in a severe accident resulting in a spinal cord injury, severe burns and the amputation of his right arm below elbow. One day, Rob came into Pushing Boundaries complaining about his wheelchair. He had recently had a component added to the chair, resulting in his right armrest sitting three inches lower than the left side. Rob was frustrated because the technicians told him the armrest would have to stay that way. After a week like this, his amputated arm was in severe pain from sitting in this position. While Rob worked with his exercise therapist, three Pushing Boundaries employees dropped everything to spend nearly two hours meticulously taking the chair apart and putting it back together again, to get the armrest to sit correctly.

“When people know you really care, that can be a great source of motivation for them to push their limits,” says LaTour.

Pushing Boundaries relies on donations and volunteers to help supplement the cost of their unique services. For more information, please visit their website.