Able to move again

LINCOLN — Russ Canick likes to see his legs move.

It's a sight he hasn't seen much of since his spinal cord was injured in a motorcycle accident in June.

The 29-year-old Omahan suffered paralysis in both arms and both legs, but he can ride an exercise bike with the help of new technology.

“It keeps my muscles strong, so they don't wither away to nothing, you know?” Canick said.

Canick is the beneficiary of science and gadgets that are ever-advancing to give people with spinal cord and brain injuries, stroke victims, people battling multiple sclerosis and other challenges the chance to work out or be more comfortable.

Madonna Rehabilitation Hospital has several of those devices.

Other hospitals in western Iowa and Nebraska, such as Immanuel Medical Center and Methodist Hospital in Omaha, provide considerable rehabilitation services. Immanuel, for instance, plans to open a new facility for outpatient rehab early next year.

But Madonna is the only hospital in Nebraska that is solely devoted to rehabilitating people with debilitating injuries and illnesses.

Canick worked out earlier this month on Madonna's RT300, an exercise bike that he can use without having to be lifted from his wheelchair. He pulled up behind it and had his feet strapped to the pedals and electrodes attached to his legs.

The electrodes are hooked to a cable that connects to a computer device that sends electrical stimulation to the leg muscles so that they pedal the bike, which the Food and Drug Administration signed off on this year.

Canick wore sweatpants and a hooded sweatshirt over a baseball cap. On the display panel were a photo of Canick's 5-year-old son, Elijah, and a rubber bracelet that says Canick still loves motorcycles: “Live to Ride. Ride to Live.”

His biggest hope is to walk again. He'd ride motorcycles, too, if possible. But for now, he takes some comfort from riding an exercise bike.

“I just deal with it,” Canick said of his paralysis. “It's something that's here and it's not going away. Got to keep pushing forward, looking ahead.”

The SmartWheel

More than 2 million Americans use manual wheelchairs.

Long-term wheelchair use can strain and injure shoulders and arms, and cause arthritis and carpal tunnel syndrome, said Wade Lucas, a physical therapist at Madonna.

The SmartWheel collects data that help measure the stress placed on the arms of wheelchair users. The $25,000 device's computer is 7 inches in diameter and attaches to a wheel placed on the chair. It feeds to another computer information about how much force the user must apply to propel the chair, how long his hand is on the wheel, how frequently he must push and other data.

Lucas said the goal is to decrease the force and repetitions required. Comparing the data to national averages, Lucas said, physical therapists can assess the chair's weight and adjust the axle position and wheel alignment.

Lokomat

This Swiss apparatus, purchased by Madonna this year for $275,000, is designed to help stroke victims, people with spinal cord injuries and others regain their ability to walk. The large metal device suspends the patient in a harness as robotic technology helps his legs walk on a treadmill.

Mark Rasmussen, a business owner from Harlan, Iowa, is re-learning his gait after suffering a stroke in late September. The stroke affected his right side, including his arm and leg.

“That is one hell of a device,” Rasmussen said.

They strap you in “and it walks you,” he said of Lokomat. “I walked over a mile with that. It felt great.”

Madonna purchased the gadget through its ongoing $8.5 million capital campaign. Treadmill walking assisted by therapists and technicians is labor-intensive and hard on staffers, who sometimes must move a patient's legs for him.

Rasmussen said his right leg wants to push to the side rather than straight ahead. Lokomat is helping him get back on stride.

“But a machine can't do it all,” he said. “I've got to do part of it, too.”

Diaphragm pacer

Larry Schroetlin fixed cars for a living and rode bicycles for fun.

The 58-year-old Butte, Neb., man lost his career and his pastime when he hurt his spinal cord severely during a training ride in 2006. Schroetlin has no mobility from the neck down and had breathed strictly through a ventilator since his injury until a new technology provided some relief.

Attached to the transistor radio-sized diaphragm pacemaker are a sensor and wiring, which are implanted below the chest. The device creates electrical stimulation to force the diaphragm to contract, as it does when inhaling. The lungs fill with air, which then is naturally exhaled.

The FDA approved the device, which costs about $30,000, last year. Schroetlin has been able to be ventilator-free for more than 22 hours at a time.

Staying off the ventilator for extended periods may reduce the risk of infection, Madonna officials say. The diaphragm pacer also gives a patient somewhat more mobility, because he isn't connected to ventilator tubes.

And his sense of smell is stronger when on the pacer because a ventilator, inserted through the trachea, functions without the nose or mouth.

“I get a better breath than from a vent,” Schroetlin said. “And I'm a lot more mobile. And I can smell.”

ICARE

Dr. Judith Burnfield wants to create a device that patients can use in fitness centers and home rec rooms. Burnfield, director of Madonna's Movement and Neurosciences Center, soon will put the ICARE machine through a clinical trial.

ICARE — Intelligently Controlled Assistive Rehabilitation Elliptical — includes grab bars and a bench that the exerciser can sit back on if necessary. It also has a sensing device that propels the elliptical machine with just enough force for someone with a disability to get it moving but not so much that the patient doesn't have to work at it.

Burnfield has designed the machine with Dr. Caroline Goulet of Creighton University and Dr. Carl Nelson of the University of Nebraska-Lincoln.

The add-ons are expected to increase the cost of a typical elliptical machine by $1,000 to $1,500.

Kim Brown, a 48-year-old Lincoln resident, has seen her ability to walk increasingly diminish because of multiple sclerosis. She uses a walker now.

Brown has tried the ICARE out a few times and plans to participate in the clinical trial. “Oh, I'm excited,” she said.

Contact the writer:

444-1123, rick.ruggles@owh.com

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