Wheelchair-Bound to Walking
Michael E. DeBakey VA Medical Center (MEDVAMC) Physical Therapist Sheryl Vandeven listened intently as Army Veteran David Pruitt told her about the day he had surgery and realized he “could not feel anything in his lower legs.”
Pruitt spoke to Vandeven in the MEDVAMC Physical Therapy Room where he was in the ninth month of an astonishing recovery from a horrific back injury. The journey had taken him from a wheelchair to walking on his own two feet. Pruitt’s recovery was possible because of special electrical stimulation devices, excellent VA physical therapy staff, and plenty of hard work and determination.
Pruitt’s journey to the DeBakey VA started several years ago and more than 7,000 miles away when he was serving his country in the Middle East.
“He was hit in the head with something heavy,” said Vandeven, who has been with the VA for 12 years. “He also suffered extensive back injuries which required multiple complicated surgeries, and was left with some spinal cord damage.”
Initially, Pruitt sought help at a VA medical center in Arkansas. When he moved to Houston to be closer to his family, his doctors referred him to the DeBakey VA for treatment. It was there, that the Houston native first came into contact with the MEDVAMC Physical Therapy Team.
The team includes Physical Therapists Mathai George, Conrad Clemente, and Ryan Ardoin along with specialists in Kinesiology, Occupational Therapy, and Vocational Therapy.
“When he arrived here, he was unable to walk,” said Vandeven. “He was wheelchair-bound and his back injuries left him unable to recognize where his legs were. His injuries occurred in the posterior part of his spinal cord which tells you where you are in space. He had a really hard time walking because he couldn’t feel his legs.”
“My right leg would start jerking and did not know where it wanted to go because I couldn’t place it down myself,” said Pruitt. “I was confined to a wheelchair and I couldn’t stand up long enough to really walk.”
“He had to think very hard with every step,” said Vandeven. “To even walk a short distance, it was obviously mentally and physically exhausting. The first thing we did here was develop a goal-orientated plan for him.”
At MEDVAMC, physical therapy is goal-based. Patients begin physical therapy only after a set of goals for the patient has been mapped out. Pruitt worked with Vandeven to develop his therapy goals.
“The first thing we wanted to do was get him out of the wheelchair,” said Vandeven. “To accomplish this, we started by attaching a set of ‘e stims’ to both of his legs.”
‘E Stims’ (functional electric stimulation units) are medical devices that allow individuals with brain or spinal cord dysfunction to walk with increased speed and balance, and regain freedom and independence. The device applies low-level electrical stimulation to targeted areas to activate the nerves which control the muscles to lift the foot.
“The ‘e stims’ worked with David by stimulating the nerves in both of his lower legs,” said Vandeven. “The devices stimulated the nerves just below his knees that make the ankle bend upward and a little outward, so that his toes don’t drag when walking.
“The units were particularly helpful to David because although he is strong, he can’t tell what position he is in,” said Vandeven. “The electro-stimulation units make it easier for him to feel where he is in space.”
While the electrical stimulation units are expensive, they are an important part of what makes the MEDVAMC Physical Therapy Program one of the best in nation.
“Thank goodness we have them,” said Vandeven. “The benefits of having the device are tremendous. If you can move someone out of a wheelchair and get them moving around independently; then, not only are you improving the patient’s quality of life but, also decreasing the serious complications from constantly being seated. This includes back pain, weight gain, and muscle atrophy.”
Pruitt’s goals included progressing from a using a rolling walker to a four-point cane to getting by with only a single-point cane.
“By putting my mind to the recovery process and making goals, I have been able to make an amazing recovery,” said Pruitt. “The goals were simple goals; but, just having reachable goals that I could accomplish with hard work has been very helpful. So far, I have achieved every goal except for one: unassisted walking. I think I will do that very soon.”
Pruitt’s physical therapist also thinks this goal is well within reach.
“We are working toward normal, comfortable, and confident walking,” said Vandeven. “David is well on his way.”
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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 130,000 veterans in southeast Texas. Veterans from around the country are referred to the MEDVAMC for specialized diagnostic care, radiation therapy, surgery, and medical treatment including cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, and treatment of spinal cord injury and diseases. The MEDVAMC is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; an award-winning Cardiac and General Surgery Program; Liver Transplant Center; VA Epilepsy and Cancer Centers of Excellence; VA Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; VA Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; and one of the VA’s six Parkinson’s Disease Research, Education, and Clinical Centers. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, Richmond, and Texas City, MEDVAMC outpatient clinics logged almost 1.3 million outpatient visits in fiscal year 2011. For the latest news releases and information about the MEDVAMC, visit www.houston.va.gov.