September 14, 2007
Cycling Again After Spinal Cord Injury
BETTENDORF, IOWA - Genesis 1st clinic in Iowa to have RT-300 technology Shari Karnstedt bites her tongue when she hears people complain about having to exercise. For her, the thrill of seeing her legs pump up and down on a cycle and feeling her heart rate rise cannot be rivaled.
The out-of-breath exhilaration of a good workout lifts her mood like nothing else.
For nearly 10 years, Karnstedt of Eldridge, Iowa, has been paralyzed from the chest down. She broke her neck in a Dec. 6, 1997 car accident, and the spinal cord injury changed her life. Before that, she was a whirlwind of activity -- from working as a substitute secretary and special education aide in the North Scott School District to landscaping and gardening in her free time.
“I never sat down, from 6 in the morning to 10 at night,” she says, “so this has been a hard 10 years just sitting and watching the world go by. I’ve done far more than they ever expected, and my saving grace has been a positive attitude.”
Although she can exercise her arms, Karnstedt had missed the vigorous activity of exercising her legs. As a result of being sedentary, her weight had begun to climb.
So she relished the opportunity when Conway Chin, D.O., asked if she wanted to exercise on a bicycle like the one used by the late actor and spinal cord injury patient Christopher Reeve.
“Very liberating”
The RT-300 by Restorative Therapies, Inc., uses functional electrical stimulation to allow people with little or no voluntary leg movement to pedal a stationary leg-cycle, or ergometer. It transmits computergenerated, low-level electrical impulses through electrodes to activate the quadricep, hamstring and gluteal muscles, enabling the legs to make a pedaling motion.
“Emotionally, it’s very liberating,” Karnstedt says. “It’s the first time in 10 years that my legs have done something like this on their own.”
The RT-300, located in Outpatient Rehabilitation at Genesis Medical Park, Maplecrest Road in Bettendorf, is easy to use. She can operate it straight from her wheelchair. She has learned to hook up the electrodes to her legs and use it independently.
So momentous was the first time she used it that her daughter videotaped the experience. “On camera, I waved, said ‘Hi’ to my grandson Dylan, and told him I was pedaling my way to Wal-Mart,” she jokes. “Each time, I exercise for one hour and go 10 miles. If I do this 2-3 times a week, I’m exercising 20-30 miles a week on the bike. It’s been very rejuvenating.”
1st in Iowa
Genesis physical therapist Karen Steidler, who rallied to bring the technology to Genesis, has patients from as far away as Burlington, Iowa and the state of Indiana use it. After a successful trial period, Genesis recently purchased the RT-300.
“We are the first clinic in Iowa to have this,” she says with pride. “I’ve had at least five patients with spinal cord injuries under 30 who were extremely sports-minded and goal-oriented and needed some way to exercise. The RT-300 is a great way for patients who can’t use their legs to get a cardiovascular workout without using their arms, which get so much use anyway.”
Functional electrical stimulation (FES) increases muscle mass, cardiovascular fitness, blood circulation and joint range of motion and flexibility, says Dr. Chin, medical director of Genesis Physical Medicine and Rehabilitation at Genesis Medical Center, Davenport. It can reduce the complications of prolonged immobility by reducing muscle spasticity, minimizing muscle atrophy, reducing the frequency of pressure sores, and improving bowel and bladder function.
In addition, the pioneering research of John McDonald, M.D., Ph.D., the lead neurosurgeon for Christopher Reeve, also suggests that repetitive neural activity from the FES bike can stimulate cell growth in the central nervous system and promote regeneration and recovery of function.
“Dr. McDonald while at Washington University, St. Louis, felt that not enough time was spent rehabilitating patients after they had a spinal cord injury,” Dr. Chin says. “Typically in the U.S., people have rehab for 60-90 days after spinal cord injury, but other places like the Netherlands spend up to two years working with these patients. He thought: ‘What if patients utilized this bicycle to stimulate their muscles for an extended period of time...what results would we see? Before his patient Christopher Reeve died, he had markedly reduced his muscle spasms, had fewer sores, less episodes of aspiration pneumonia and had clearly benefited from the exercise.”
Shari Karnstedt has benefited from the RT-300, too. “She has reduced her muscle spasticity,” Dr. Chin says. “She’s also healthier, so when she gets sick she’s not laid up so severely. She has improved posture and more tolerance for sitting up longer and for working in an adaptive garden at her home. She has better weight control, and can get out in the community more often.”
Dr. Chin added, “We want more people with paralysis to benefit from this device at Genesis. It can help with their range of motion, promote their wellness, and possibly help them make further gains in their neurological recovery.”
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