The road to recovery

New rehabilitation technology gets patients back on their feet
Sunday, August 22, 2004 | 12:00 a.m. CDT; updated 4:10 p.m. CDT, Tuesday, July 22, 2008

Chris Salas, 27, celebrated a victory Thursday when he walked out of Rusk Rehabilitation Center.

He has been working on the AutoAmbulator, a walking machine installed in May, to get to this point.

Life changed abruptly for Salas two years ago. He had taken his pregnant wife to visit her mother in Rolla only a few days before he was to ship out to Navy boot camp. The car he was riding in went off the road and rolled several times.

Salas damaged his spinal cord, crushed his pelvic bone and had to be revived from cardiac arrest three times.

“My child kept me alive,” he said. “I knew I had to hang in there so I could meet her.”

His daughter, Keani, has been the motivating factor behind his rehabilitation. Judging by the stories told at Rusk, she has spread joy to the other patients as well.

Injuries such as Salas’ often result in paraplegia, but he regained motion on his right side a few days after the accident.

The AutoAmbulator helps therapists improve the suspended gait therapy they provide for patients with walking impairments.

The ambulator carries parts of the patient’s body weight while robotic arms move the feet in a walking pattern on a treadmill.

“My balance and posture is better now,” Salas said.

Before he started using the ambulator, he could only walk with the aid of a walker and three people. His left leg would not move on its own.

The ambulator’s purpose is to let the patient experience equal steps and cadence, as well as midline balance. Balance is more important for stroke patients, while normal gait is more important for spinal-cord injury patients such as Salas.

HealthSouth, headquartered in Birmingham, Ala., developed the ambulatory machine. The company owns Rusk in a partnership with MU Health Care.

Before the ambulator, therapists had to move patient's legs manually, which did not produce the rhythm the robot arms can. The therapists normally would tire before the patient did. The ambulator helps the patient move at normal walking speeds.

“I like to start my patients on the ambulator early in the treatment regime,” said Kathy Morris, a physiotherapist who works with stroke patients at Rusk.

Stroke patients often work hard to regain normal functions, and if they learn to do something the wrong way first, it is difficult to retrain them, she said.

There are only 10 ambulators in the United States. Two of them are in Missouri — one in Columbia and one at the Rehabilitation Institute of St. Louis.

Each machine cost between $75,000 and $85,000, and the team of engineers that designs each ambulator also builds and installs it.

Rusk’s medical personnel are excited about the possibilities the ambulator presents.

Gregory Worsowicz, chairman of the Department of Physical Medicine and Rehabilitation at Rusk, said he wants to explore the benefits of using the machine as reoccurring exercise for patients who can’t walk on their own.

He also said he thinks it might help break the cycle of elderly patients who become bedridden because they are afraid to walk after falling once or twice.

“The ambulator may help the patient regain confidence by reproducing the motion of normal walking,” Worsowicz said.

The extensive network of trauma care and rehabilitation facilities in Missouri treats patients from the entire country.

“The synergy between the centers provides the patient with a care continuum, regardless of where in the care cycle they are,” said John Bennett, manager of the Missouri Rehabilitation Center.

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