At home in the kitchen of their Black Forest home, Robert Dudding said to his wife: “Boy, those fajitas smell good.’’
An instant later, Dudding’s speech turned to mumble, and he dropped to the floor. His wife, Trisha, knew immediately that her husband had a stroke, so she retrieved an aspirin from a container, placed it under her husband’s tongue and called 911.
An ambulance rushed him to a hospital. Only a day earlier, in March of 2023, Dudding had been diagnosed with atrial fibrillation and had been given blood-thinning medication. That made him ineligible for clot-busting drugs in the emergency room.
Steadfast in his desire to walk again, Dudding started going to physical therapy at UCHealth Physical Therapy and Rehabilitation Clinic – Interquest. There, Dudding had the advantage of using a new, zero-gravity tool, the only one in southern Colorado, to assist him in his therapy.
The Bioness Vector Gait and Safety System is an overhead track system that helps patients avoid falling, adds high-intensity therapy and boosts a patient’s confidence. A sturdy lanyard attached to a harness hangs from a 40-foot track.
With help from Luis Barva, a physical therapist, the harness was attached to Dudding. The zero-gravity physical therapy equipment helped Barva “offload’’ 30 pounds of body weight, making it easier for Dudding to move his left leg, which had been compromised by the stroke.
Instead of having to wrap a gait belt around Dudding and hold on to him the whole time to prevent a fall, Barva was able to facilitate the therapy session better. He tapped on the back of Dudding’s hamstring to stimulate the brain to move the leg and used a strap placed under Dudding’s left foot to spur movement.
Incorporating additional therapy benefits recovery
One of the biggest benefits to a patient using the safety system is that it allows therapists to incorporate additional therapies into a session. This helps to promote neuroplasticity, the ability of neurons in the brain to forge new paths away from damaged brain tissue to healthy brain tissue.
“The big thing is, a patient is not going to fall,’’ said Matt Kudron, manager of outpatient rehabilitation services at UCHealth. Preventing injuries, which can further debilitate a patient, is a top priority in any therapy session.
The other big advantage is the neuroplasticity piece. Study after study shows that introducing additional tasks in a high-intensity therapy session benefits recovery. While Dudding walked on a treadmill, Barva held up playing cards. He asked Dudding to name the suit, such as the queen of hearts.
“We are trying to get him to multitask because, at the very start, it was hard to get him to do two things at once,’’ Barva said. “If I tell him to move his leg, he forgets about everything else.’’
Dudding has a tendency to look down while he is walking and fixate on his legs to ambulate. Adding the additional therapy helps replicate everyday activity. When people walk, they visually process their environment, talk with others, or think about a recent conversation or a great book they’ve read.
Adding multiple activities helps the brain create new pathways, helping it “rewire’’ itself around the damaged portion of the brain.
“I was working with the cards, one, for the visual fixation but also to get him to multitask so he doesn’t have to fixate down at his legs visually. Instead, he can walk and talk, and we’re facilitating that, so multitasking gets a little bit better for him,’’ Barva said.
Kristen Van Ackeren, a physical therapist and clinic supervisor, is working with a patient who has a spinal cord malady, and he has difficulty walking. The patient’s goal is to play golf again.
After Van Ackeren helps the patient into the harness, she asks the patient to walk along uneven surfaces – different levels of Astroturf – while swinging a golf club. This helps promote neuroplasticity and strengthen the spinal column, upper torso and core. The Astroturf helps to more accurately depict uneven surfaces that may be encountered on a golf course.
The computer-guided system can be calibrated to pull a patient with limited ability. The mechanism can also be set to give a patient who is stronger and regaining function more time to catch themselves in a stumble.
“The device itself can be a support and follows you along, or it can be that it gives you a pull, where it is actually leading you,’’ Kudron said. “For some conditions, where you’re trying to get a faster walking pace, it will actually pull you forward. In other conditions, you can add resistance behind you, so it will give you manual resistance as you are trying to walk and build up a little more strength.’’
The therapy also helps athletes who are trying to return to a sport. For instance, a person who has torn an ACL can use the machine to offload body weight but begin to do squats again or begin light jogging. The machine also helps patients who have recently had a leg amputation or total hip or total knee replacement.
For physical therapists, the zero gravity tool allows them to be less encumbered. For instance, one of the key skills therapists teach is for patients to “step and reach.’’
“If we’re standing with the patient and holding onto a gait belt, it’s hard to give them a target. If they’re fully supported in the harness, we can give them some space and say, ‘Reach out to me. Step to me,’ instead of me hanging on to the gait belt. It allows the therapist more freedom to guide the patient,’’ Van Ackeren said.
For patients who may only be able to walk 10 feet or so, it is difficult to create a high-intensity therapy session because a patient can’t participate long enough to complete a session aimed at developing neuroplasticity. When the weight is offset by the equipment, it makes it easier to move the legs because they are not as heavy.
For neurological patients, including those who have a stroke, just the ability to be upright and vertical (in the harness) is advantageous.
“Shortly after a stroke, it probably took one or two people to get him to stand and then at least one therapist to hold onto the belt, whereas, with this, with something like standing, you can get them to do that much sooner.
“For the neurological patients, a lot of it is that neuroplasticity. When you have a neurological issue or a spinal cord issue, there’s actually damage to the nerves. And the sooner you can get things going, that early intervention, the faster those can start to repair themselves. If somebody had a stroke and had difficulty doing things, if you just let them be, they’re going to have a lot of loss of function.
“The sooner you can get them back to regular activity, the less long-term damage that you are likely to have,’’ Van Ackeren said.
Mental health benefits of physical therapy
Working to restore function has immense benefits for mental health.
“You can see yourself doing the things that you used to do before the event or injury occurred,’’ Van Ackeren said.
Since stroke patients often experience depression after a stroke, physical therapy helps to turn that around.
“Bob is getting physical therapy, occupational therapy, and speech-language therapy. If he is concerned about cognition, he can solve problems and do other tasks while he is walking – and that’s real life. So it allows you to feel like you again, and anytime we can get those endorphins from exercise, it will always help to boost mental health,’’ Van Ackeren said.
Trisha Dudding said that her husband needed to have a brace fitted for his lower leg before he could begin the physical therapy using the zero-gravity device. For the first two months after his March stroke, he was mostly unable to move his left side.
Since then, he has regained function. He can stand on his own, has discarded his walker, and now relies on a cane to help steady him while walking.
“He goes up and down stairs. He can feed himself now. He brushes his teeth and washes his face,’’ Trisha said. A cardiologist shocked his heart back into sinus rhythm, so he no longer has AFib. He’s taking fewer medications.
He’ll continue to work to restore ability on his body’s left side through physical, occupational and speech therapy.
As long as he continues to make progress using the zero-gravity safety system, he’ll continue to use it.
“Since Nov. 7, he has been walking without me holding on to his gait belt,’’ his wife said. “He didn’t realize it, but he was doing it all himself.’’