Hope On Wheels

Due in part to the late Christopher Reeve’s spinal cord injury and aggressive advocacy, the world is finally beginning to acknowledge the possibility of a cure for paralysis. Research in the area of spinal cord injury (SCI) grows exponentially each year as scientists explore this frontier of medical miracles. Until that discovery is made, however, the health of these spinal cord injury survivors must be optimized. A spinal cord injury is one of the most complex traumas the body can sustain. Depending on where the cord is cut, bruised, stretched or compressed, an injury can cause paralysis, loss of bowel and bladder control, sexual dysfunction, pain and spasticity, breathing impairment and other serious complications. Today, more than 250,000 people live with spinal cord injuries and 11,000 more are injured each year. Forty-six percent of these individuals are quadriplegic. With proper care, a spinal cord injury survivor can live a normal life span, but the cost of the necessary care during that time can exceed an estimated $1.35 million with therapy costing more than $100,000 annually. A quadriplegic survivor’s necessary care can exceed even that.

Even with these costs, the actual rehabilitation available to quadriplegics is minimal. Physical therapists target only those muscles not affected by the injury, typically shoulders and/or upper arms. Although this is a necessity to facilitate use of electric wheelchairs, it is not enough. With the loss of movement, quadriplegics are immediately presented with health problems such as bone loss, muscle loss, and a decrease in cardiopulmonary function. Emerging research shows that by exercising all of the muscles, these health problems can be reversed.

There are various exercise treatments available at this time. Perhaps the most widely publicized is Functional Electrical Stimulation (FES). FES has been used extensively at the Spinal Cord Injury Restorative Treatment and Research Program in St. Louis with over 900 people benefiting. This therapy sends electrical messages via a computer (acting as the brain) to the leg muscles, stimulating them to contract and move, typically in order to pedal a specially designed bicycle, such as the ERGYS. Christopher Reeve, himself, endorsed this therapy. The pressure of pushing the pedal aids in increasing bone density, resulting in a decrease in bone breakage and osteoporosis. In addition to these obvious health benefits, research suggests that by simulating this pedaling or walking motion, spinal cord cells may be able to “remember” involvement in movement, taking us one step closer to a cure for paralysis.

San Diego County does not currently utilize an FES bike in either SCI rehabilitation facility. Historically, California Insurance Providers have not supported any type of ongoing therapy or rehabilitation for quadriplegic individuals. The FES bike has been shown in clinical trials to be very beneficial in treating quadriplegia with regard to increased circulation, respiration, muscle mass, bone density and possible improvements to sensory and motor aptitude.

At the QUAD Foundation, we understand the critical importance of aggressive therapy to maintain fundamental physical attributes of quadriplegic individuals in order to attain a maximum state of health and to have a strong, healthy body for when the imminent cure for paralysis is discovered.

We have the renowned ERGYS-2 FES bicycle; it is the first one in San Diego. We want to share it with quadriplegic individuals so that they can reap the many health benefits of using it. However, one of the most difficult things for a quadriplegic individual is transportation. Not only must they have a specialized van to travel in, but it takes a good deal of time to get prepared to go. They must collect all of the supplies that they might need while out; they must plan to have someone with them to drive and be available in an emergency situation; plus it takes extra time to get into the van and strapped in. Therefore, it would be very difficult for these individuals to come to us. At the QUAD Foundation, we acknowledge these difficulties.

Hope On Wheels (H.O.W.) is our mobile gym. We have a special trailer that carries the ERGYS-2 bike to the individual homes of these people, so that they can participate in this physical therapy without the stress of transportation. In addition to the ERGYS-2 FES bicycle, we also use a standing frame to increase bone density, UpperTone weight training equipment which can be used by quads without assistance to increase upper body strength, and handheld FES units for contracting and strengthening lower arm, wrist, and abdominal muscles. By using this assortment of therapy equipment in our mobile gym, these quadriplegic individuals will improve their quality of life, and most importantly, improved health, strength and attitude while awaiting scientific breakthroughs for spinal cord injuries. We wish to continue providing this therapeutic opportunity at no charge to the client.

Our clients are evaluated by their personal physicians and undergo several standard lab tests, including a bone-density scan, to determine a safe and healthy qualification. Custom program cartridges are donated by Therapeutic Alliance Inc., the creator of the ERGYS-2 bike. Our client then schedules available time for H.O.W. deployment to their home. We monitor each individual’s progress through quarterly physician evaluation, increased bike time and performance, and the client’s anecdotal reporting. We expect to see improvement within one year of H.O.W. therapy onset. Our primary client who has been riding the bike consistently has undergone tremendous improvement, measured by his increased endurance as well as muscle tone. Our other two clients have not been riding the bike consistently enough to justify an evaluation.

Hope on Wheels (H.O.W.) was launched in April 2005 with the purchase of our trailer, but finding a suitable driver for our project proved to be a daunting task. Until 2007, our Board of Directors volunteered their time, vehicles, and gas money to drive the H.O.W. trailer to our clients. In January 2007, we were able to purchase a heavy duty truck whose sole job is to drive our H.O.W. trailer to our clients. Finally, we found a driver, and Hope On Wheels has been on the road ever since!

If you or someone you know would benefit from Hope On Wheels, please let us know!