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Rehab Program Breaks New TRAILS To Benefit People with Spinal Cord Injuries

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Jun 29, 2010 1:00 AM

George Schoemaker

When Lena Schoemaker was paralyzed from the waist down in a car accident, she worried she'd never again lead an active life. Before she was discharged from University Hospital, the U's TRAILS program introduced her to handcycling. Now, three years later, the 21-year-old junior at Stanford University cross-country skis, kayaks, competes in handcycling and has taken first place in marathons.

Jeffrey Rosenbluth, M.D., director of the U's Spinal Cord Injury Rehab Center, works with an inpatient early in his rehabilitation process. Rosenbluth founded the TRAILS program 11 years ago so that patients, including those with high-level quadriplegic impairments, could participate in many recreational and social activities.

TRAILS member Wally Lee participates in downhill and cross country skiing, wheelchair tennis, kayaking and handcycling programs.

As 17-yr-old Lena Schoemaker lay in her hospital bed, her mind swept over her life before the car accident. The petite high school senior was an avid basketball player who hoped to attend Boston University. Now, paralyzed from the waist down because of a spinal cord injury, she worried that she would never play sports again. “Now what can I do?” wondered Schoemaker. “I knew I had to start over learning how to live life with my new body.” But how?

As a resident at University of California, Davis, in the late 90s, Jeffrey Rosenbluth, M.D., worked with patients like Schoemaker every day. “At the time, it didn’t seem like there was any comprehensive thought about how these patients would continue down a road to success after being discharged,” recalls Rosenbluth, assistant professor of physical medicine and rehabilitation. Frustrated with the high rates of re-hospitalization, infection, and depression as well as a lack of access to resources, he wanted to find a way to support a healthly lifestyle for spinal cord injury patients. “Just turning them over to go recreate didn’t seem reasonable; most patients were not physically, medically or emotionally prepared to get back to an active life.”  

So, in 1999, Rosenbluth founded the U’s TRAILS program, which stands for Therapeutic Recreation And Independent Lifestyles, as a rehab outreach program. “I wanted to harness that same brain power and energy we apply in the hospital to our outpatient initiatives,” says Rosenbluth, who’s the director of the U’s Spinal Cord Injury Rehabilitation Center. The idea is to promote health and active lifestyles for individuals with spinal cord injury or disease through recreation.To accomplish that, an interdisciplinary team works with patients to identify the unique barriers that might prevent them from returning to a healthy lifestyle. A social worker looks at transportation issues, a doctor helps manage chronic pain issues, a physical therapist coordinates the shift from a wheelchair to recreational equipment. The program—which offers 10 different sports requiring specialized adaptive equipment—is now a model for others around the country.

Before Schoemaker was discharged from University Hospital, TRAILS Program Director Tanja Kari had her try a handcycle and introduced her to other TRAILS participants who understood what she was going through. “She barely made it around Liberty Park once and now she’s taking first place in marathons,” recalls Kari, a four-time paralympian and gold medalist in cross-country skiing. 

Three years later, 20-year-old Lena, is a junior at Stanford University in Palo Alto, Calif., exploring a future in medicine. She cross-country skis, kayaks, competes in handcycling and has taken first place in marathons. “Being a part of this program, allowed Lena to break free,” says Stan Clawson, a participant in TRAILS since its beginning and a seasoned mentor. 

Five days a week TRAILS members can access an instructor/physical therapist and equipment from one of three sites along the Wasatch Front. The program collaborates with the U’s mechanical engineering students to design suitable equipment. “We adapt equipment to ensure that participants have a successful experience with as much independence and freedom as possible,” says Kari. 

TRAILS works with other community programs to expand its reach, and also hosts the annual TRAIL’s Spinal Cord Injury Forum, an eight-week seminar. “I wanted to push our rehabilitation model to empower people to exceed their own expectations—and ours,” says Rosenbluth. It seems to be working. In the past three years, TRAILS has turned 70 people onto downhill skiing, 150 onto handcycling (20 of whom are racing as a team), and also keeps in contact with more than 450 others.

“There’s this stigma that comes with spinal cord injury that it’s a death sentence. It isn’t,” says Clawson, who was injured 14 years ago. “TRAILS shows people how to transition into a life of mobility and all the possibilities. When you leave the hospital you look at the world through a cocktail straw. Then with each activity, your horizon opens up. You are looking through a windshield, then a convertible, and then you’re flying. Walls break down and it pushes you into the growth zone, giving you a positive distraction. When you are kayaking on that lake and your wheelchair is sitting there on the dock, you aren’t thinking about the world of disability.”

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