Interviewer: Harnessing the power of physical therapy for stroke recovery, Dr. Steven Edgley is the stroke rehabilitation medical director at University of Utah Health.
Dr. Edgley, just first off, what is the importance of physical therapy for stroke recovery?
Recovering from a Stroke
Dr. Edgley: The reason why physical therapy is so important, and walking specifically, is that physical therapy will facilitate better walking. Better walking will facilitate better function in the home and the community, and better function will facilitate a better quality of life. And that's what we're really after. It's very important to the individual patient to regain walking and moving around capabilities.
Interviewer: Dr. Edgley, in the past few years, from what I understand, the technology or the ways that you help people recovering from a stroke start to walk again has actually changed quite a bit and improved. Tell me more about that.
Physical Therapy Tech
Dr. Edgley: Over 15 years ago, so many stroke patients did not get the therapy they needed because it was too labor-intensive. Now we are able to use advanced techniques like bodyweight-supported harnesses.
Interviewer: Tell me what that harness does.
Dr. Edgley: Early on in the recovery process, we used to use three and four therapists. Now we can use one, maybe two therapists with the bodyweight-supported training.
We actually have in the new Neilsen Rehab Hospital have the longest what's called the ZeroG track in the world. Also possible is unweighting the body through using a pool therapy, and we now have a treadmill on the bottom of a pool that partially unweights the body. And that is actually going along with the same concept of partially unweighting of the body for increased reps and practice.
Walking After a Stroke
Interviewer: What I'm hearing is walking is just that important. That should be your goal, just to get out and do it. It might not necessarily be pretty at first. You've just got to go through the motions. And if you go through the motions, it will get better and your recovery will get better. Is that a fair assessment?
Dr. Edgley: To be able to effectively walk, you typically need to compile a lot of repetitions. And typically, starting from square zero, a lot of people don't really get out of bed and stay in bed for months to years. And so we find it's critically important to ambulate early and often use these advanced techniques to help in the process.
Interviewer: Dr. Edgley, if an individual recovering from a stroke doesn't have access to a ZeroG track or the treadmill that's underwater like you talked about to help them get in those reps necessary for regaining their ability to walk, what would you recommend for that individual?
Stroke Physical Therapy
Dr. Edgley: Everyone should have access to a physical therapy gym or location. Encourage your therapists to actually walk with you. And it may be that you have to have four hands on deck to fully walk safely at first, but that is what it sometimes takes.
Interviewer: I feel like if there is just one thing that somebody should take away from this is just if you've had a stroke, you've just got to start walking and figure out how to make that happen. And if you have access to great technology like the ZeroG track at University of Utah Health . . . and by all means, if you can take advantage of that, great. If not, have those people help you walk on the treadmill that has the sidebars. You've just got to get those legs moving to get that brain muscle reconnection going again and those repetitions. That's what really matters.
Do you have a story that illustrates just how important walking is, getting those repetitions in is, to stroke recovery?
Dr. Edgley: I'm thinking of one young stroke patient who was despondent and discouraged, so discouraged that she really did not walk and put forward the effort that is necessary for recovery. And that went on for months. Couple of years actually.
And when she started to be more receptive to these therapy techniques, her whole life changed as she began to be more able to walk, more able to get outdoors, and more socially active. And now she is married and chasing a toddler around. So it can have very, very wide-ranging impacts.
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