Patrick’s Journey: Overcoming Paralysis and Rebuilding Life After a Devastating Dive
On July 29, 2023, Patrick Hoey, a 20-year-old rising junior at Penn State University, was vacationing in the Finger Lakes with his friends. A former diver for Conestoga High School’s swim team, Patrick took one look at the sparkling blue water and dove in. But the minute he hit the water, something was wrong – he couldn’t move.
His friend rescued him from the water and Patrick was rushed to a hospital in Rochester, NY, where he underwent a complex, four-hour spinal surgery to remove his fractured C-5 vertebra.
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The surgery was successful, but Patrick was paralyzed from the chest down.
“We weren’t sure if Patrick would be able to move again. We were terrified,” says Patrick’s mom, Diane. “But when they took him off the ventilator and he was able to move his upper arms and shoulders, we were so thankful.”
Patrick would need months of rehabilitation, but as two former Jefferson Health nurses, Patrick’s parents – Ed and Diane – knew exactly where they wanted their son to receive treatment. After a week’s stay in the acute care hospital, Patrick took a seven-hour ambulance ride to Jefferson Moss-Magee Rehabilitation Hospital –Center City (formerly Magee Rehabilitation).
“We wanted to be near our home base, and we knew we wanted Patrick there,” added Diane. “When my husband and I worked at Jefferson together, I cared for many of the rehab patients, so I know how exceptional the care is.”
When Patrick arrived for his sixweek stay, he started physical and occupational therapy immediately.
“I wanted to start making progress right away,” says Patrick. “I went from an ICU bed right to the gym.”
I wanted to start making progress right away. I went from an ICU bed right to the gym.
therapies, Patrick also participated in art and music therapies. Both have brought him a lot of joy, giving him new hobbies and allowing him to connect with others his age with similar injuries. In music therapy, Patrick creates motivational playlists of songs to listen to while exercising and studying.
New Cognitive Community Rehabilitation Program Helps Patients Lead Productive Lives
Patrick also resumed his education at Penn State, enrolling in virtual classes this past January.
With the help of his care team, Patrick quickly made progress in relearning how to do daily tasks, like feeding and dressing himself. Patrick can also now transfer from his wheelchair to his bed with assistance.
Patrick’s therapists also helped his family make household adjustments, installing smart devices around the house so Patrick could operate the lights and televisions hands-free.
Patrick feels his years as an athlete helped his recovery. “I had a good understanding of how to do some of the exercises and target specific muscles. I was really motivated to do the work, which was exciting for my therapists.”
In the fall, Patrick was discharged to the Jefferson Moss-Magee Rehabilitation –Day Rehab program. In addition to physical, occupational and recreational
Patrick recalls that adjusting to the injury was a shock, but not something he wanted to dwell on. “You get thrown into it. One day you’re fully functional and the next day you can barely move your arms,” he commented. “It was a significant change but having clinicians with expertise around my specific problems was extremely valuable –I had amazing therapists.”
While Patrick’s injury has been emotionally difficult for his parents, Diane is hopeful as she watches her son regain his independence. “I’m very grateful for my nursing education because I understood his treatment plan and how to care for him, but it’s so different when it’s your son,” she shares.
“I never dreamed I would need my training in this way, but it’s incredible to see him make progress.”
Soon, Patrick will undergo a nerve transfer surgery to improve his upper extremity and hand function. Afterward, he will return to Jefferson Moss-Magee Rehabilitation to continue his therapies, like using the Lokomat, a roboticassisted device that simulates walking.
“It’s all still a work in progress,” says Patrick. “It’s a journey – learning to live with the abilities you have and be the most functional you can in your world.”
Patrick thanks his therapists and says they’ve helped him keep fighting and take every day one day at a time.
The Moss Traumatic Brain Injury Model System and NIDILRR Invite You to Our Event– Discovering a New Path after Brain Injury
Keynote Speaker: Jennifer Lynn Robinson
Date: Saturday, October 12, 2024
Time: 9 a.m. to 4 p.m.
Cost: $15 per person
JeffersonHealth.org/TBIconference
At Jefferson Moss-Magee Rehabilitation –Riverfront, patients who had a stroke or Traumatic Brain Injury (TBI) – including those with aphasia (a loss of language skills from an acquired brain insult) –now have the opportunity to receive outpatient cognitive rehabilitation services for a two-month period. These services facilitate strategies to work around their deficit area and help them return to meaningful and satisfying activity – whether it be work, school or a more satisfactory life.
Sarah Lantz, MA, CCC-SLP, was tasked with starting the outpatient Cognitive Community Rehab Program that had been conceived of prior to the pandemic and put on hold.
“I call it ‘Real Life Therapy’ because it is personalized to what our patients need to increase their involvement in the community and day-to-day productivity,” says Lantz.
During the first month, patients meet with Lantz twice a week for an hour in her office to establish goals, develop cognitive strategies and train in a quiet, one-on-one session. The second month consists of weekly outings. Depending on a patient’s individual goals, this may include exploring volunteer opportunities, taking public transportation, ordering at their favorite coffee shop, using a shopping list and self-checkout at a local store, or even visiting a former workplace.
“A 6th grade math teacher with a TBI prepared a math lesson and had volunteers from the Day Rehabilitation program be his ‘students’ so he could practice doing his former job,” recalls Lantz.
“These real-life activities also have a big effect on caregivers,” she says. “This program can also give caregivers a new perspective on what their loved ones are capable of in the community and ways to support their increased independence – things like ordering their own coffee, taking a ride share on their own, or completing shopping trips independently.”
“I had a patient with non-fluent aphasia practice ordering over the counter, something he was able to do for the first time since his stroke. We went to the mall and Reading Terminal Market, giving him the opportunity for repetitive practice. It allowed him to face his fears and boost his confidence in what he could do. After those outings, his wife told me she saw a huge shift in his confidence level and a light in him she hadn’t seen since before his stroke,” says Lantz.
The Cognitive Community Rehabilitation Program is not covered by commercial health insurance. Partially funded by proceeds from the Jerry Segal Golf Classic that supports patient programs and services at Jefferson Moss-Magee Rehabilitation Hospital – Center City, it was created to fill a gap in care for patients who have cognitive/community goals, have exhausted their insurance benefits for therapy and do not have other alternative funding sources. For additional information about this program, call Sarah Lantz at 215-218-3900.
Activity-Based Therapy: Revolutionizing Rehabilitation
Activity-based therapy (ABT) is a dynamic and progressive approach to rehabilitation that emphasizes active participation in functional tasks to improve neurological function and physical capabilities.
Unlike traditional physical therapy, which often focuses on performing slow and controlled movements, ABT engages patients in moderate to intense workouts and activities that are meaningful and goal-oriented, promoting neural recovery and overall physical well-being.
What is Activity-Based Therapy?
ABT is rooted in the principle that engaging the body in functional activities can stimulate and retrain the nervous system. “The goal is to promote neuroplasticity – the brain’s ability to reorganize itself by forming new neural connections – to enhance the recovery of motor and sensory functions,” says physical therapist Elizabeth Watson. “We choose workouts and activities that will activate and wake up the nervous system.”
A variety of exercises and activities designed to engage the entire body, ABT often uses specialized equipment, such as functional electrical stimulation (FES) bikes, body-weight support systems and robotic-assisted devices. These activities aim to mimic real-life movements and tasks, providing meaningful and purposeful exercise that directly relates to daily living.
How Does Activity-Based Therapy Differ from Traditional Physical Therapy?
ABT stands out from traditional physical therapy and other rehabilitation methods due to its focus on active participation, intensity and specificity of training. Here are some key differences:
Task-Specific Training
ABT focuses on exercises related to everyday activities, helping patients relearn essential skills for daily living. Physical therapists like Watson focus on practicing specific activities the patient wants to improve, such as walking, rather than isolated leg exercises.
Intensity and Frequency
ABT involves intense or high-repetition exercises performed frequently to drive neuroplastic changes and improve function. “For example, we use highintensity gait training to challenge the cardiovascular system,” Watson explains. “For patients with some walking capacity, we use treadmills, increasing speed and incline to elevate their heart rate. This approach can have tremendous outcomes for people following a stroke or incomplete spinal cord injury.”
Use of Advanced Technology
ABT often incorporates advanced technologies, such as FES, robotics and virtual reality to enhance training. These tools provide additional sensory input and feedback, which can accelerate recovery and improve outcomes.
Holistic Well-being
ABT doesn’t only improve function, but also health, wellness and quality of life. “Even if we can’t get a patient walking completely, with ABT, we see reduced pain and spasticity, as well as improvements in associated health conditions,” Watson explains.
Who is the Best Candidate for Activity-Based Therapy?
ABT is particularly beneficial for individuals with spinal cord injuries (SCI), traumatic brain injuries (TBI), stroke survivors and those with other neurological conditions, such as multiple sclerosis (MS) or cerebral palsy.
“This therapy is suitable for patients at various stages of recovery, from those who are newly injured to those who have been living with a neurological condition for an extended period,” says Watson.
Due to the intensity of some of the activities, patients who are committed to a rigorous and intensive rehabilitation program that requires a high level of participation tend to see the best results with ABT.
The Jefferson Moss-Magee Rehabilitation Difference
Neurological recovery can take a long time, with progress often coming in spurts. “ABT offers a promising pathway to recovery and enhanced quality of life, but it might require a combination of rehabilitation techniques for a patient to see improvement,” says Watson. “At Jefferson Moss-Magee Rehabilitation, our staff collaborates with other providers to create and facilitate a holistic rehabilitation experience for each patient.”
Happenings
Wheelchair Rugby Tournament Recognized Jefferson Moss-Magee Rehabilitation received the “Event of the Year” award for our “Beast of the East” Wheelchair Rugby Tournament. Presented by the United States Wheelchair Rugby Association during the national tournament, held May 4, 2024, Jefferson Moss-Magee Rehabilitation was selected by league membership among more than 30 tournaments.
Tennis
Jefferson Moss-Magee Rehabilitation’s Wheelchair Tennis Team members –Travis Nock, Aaron Boggs, Community Program Coordinator Keith Newerla, Amanda Parezo and Frank Ganther – gather at Ron Jaworski’s tennis and golf club in West Deptford, NJ, during the annual Jefferson Moss-Magee Rehabilitation Wheelchair Tennis Tournament.
Trip to Mount Southington Ski Area in Connecticut
Joseline Castillo enjoys a ski trip at Mount Southington in Connecticut. She is using 4 tracking with outriggers as adaptive equipment.
In The News
Jefferson Moss-Magee’s sports program partnered with Leaps of Faith adaptive skiers. Steve Seibert (shown here) is bi-skiing at Mount Southington for the first time.
Dr. Jaclyn Barcikowski wins the 2024 Lynne and Abelardo Lechter Award for Physician Excellence.
Research, Publications & Presentations
• Spinal Cord Injury Model Systems Study: We want to remind current participants who signed up for this study at time of injury that we will be contacting them at 5-year intervals. If you receive a call from 610-608-4383 or 267-571-7358, it will be for this study. If you are a participant and your contact information has changed since the last interview, please contact either number to let us know.
• Mul tiple spinal cord injury (SCI) studies are taking place at the Jefferson College of Rehabilitation Sciences. Studies include remote SCI assessments, coaching, upper extremity screening/intervention studies, pediatric spinal cord imaging (MRI) and more. If you are interested in hearing more, please contact us at CenterforOutcomes Measurement@ jefferson.edu or call 215-503-2849.
• Jefferson Moss-Magee Rehabilitation wrapped up its inaugural cohort of the Moss-Magee Program in Advanced Application of Clinical Technologies for the Lower Extremity (MMPAACT for LE) at the beginning of June. This 7-week program provided 25 hours of continuing education to a group of physical therapists and clinician scientists in a combined remote and in-person experience. The program was developed over the preceding year by a dedicated group of PT clinicians at Jefferson Moss-Magee Rehabilitation led by Andrew Packel, PT, NCS, Amanda Charles, PT, DPT, Erika Dixon, PT, DPT, NCS, Colleen Johnson, PT, NCS, Kimberly Miczak, PT, NCS, Kelly Sprik, PT, DPT, Elizabeth Watson, PT, DPT, NCS, and Unique Williamston, PTA, BS. This group undertook an enormous effort to organize and develop content, hone their on-line presentation skills including the use of polls, breakout rooms and other interactive features, and then offer a live, experiential 1.5-day portion featuring assessments and treatments with live patients.
PUBLICATIONS:
• Canori A, Lak shminarayanan R, Nunn M, Schmidt-Read M, Intille SS, Hiremath SV. Potential of social engagement for overcoming barriers to physical activity in individuals with spinal cord injury. J Rehabil Assist Technol Eng. 2023 Jun 26;10:20556683231185755. doi: 10.1177/20556683231185755. PMID: 37426039; PMCID: PMC10327411.
• Solinsky R, Park K, Betancourt L, Schmidt-Read M, Owens M, Schwab JM, Dusseau NB 2nd, Szlachcic Y, Sutherland L, Taylor JA, Nash MS. Patient Perceptions and Clinical Assessments of Cardiometabolic Disease After Subacute Spinal Cord Injury. Arch Phys Med Rehabil. 2023 Dec 7:S0003-9993(23)00692-5. doi: 10.1016/j.apmr.2023.12.001. Epub ahead of print. PMID: 38065229.
• Carey RL, Le H, Coffman DL, NahumShani I, Thirumalai M, Hagen C, Baehr LA, Schmidt-Read M, Lamboy MSR, Kolakowsky-Hayner SA, Marino RJ, Intille SS, Hiremath SV. Health-Based Just-in-Time Adaptive Intervention to Improve the Physical Activity Levels of Individuals With Spinal Cord Injury: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2024;13:e57699
PRESENTATIONS:
• Johnson TC, Hagen C, Coffman DL, Carlson ESR, Vaid A, Nunn M, Schmidt-Read M, Heath KM, Marino RJ, Hiremath SV. Evaluating sensorderived features as indicators of upper extremity function in cervical spinal cord injury. Paper presented at: American Society of Biomechanics East Coast Meeting; April 27, 2024; Rochester, NY.
• Schmidt Read M, Snyder B, Walden K. “Do I do the ISNCSCI correctly? –Pitfalls and common mistakes performing the ISNCSCI exam” Platform presentation (repeated twice) at the American Spinal Injury
Association Annual conference, May 2024, San Juan Puerto Rico.
• Johnson C, Freimuth E, Trudell E, and Tyrell, C were accepted to present a poster at the Academy of Neurologic Physical Therapy conference in September 2024.
• Addressing educa tional needs in the use of technology in neurorehabilitation: Strategies and perspectives from three distinct programs by Andrew Packel, PT, NCS, Locomotor Clinical Program Leader, Jefferson Moss-Magee Rehabilitation, World Congress of Neurorehabilitation, Vancouver, Canada 5/24
• The Rehabilitation Treatment Specification System: Unpacking the Active Ingredients of Neurorehabilitation by Andrew Packel, PT, NCS, Locomotor Clinical Program Leader, Jefferson Moss-Magee Rehabilitation – Elkins Park and John Whyte, MD, PhD, Institute Scientist Emeritus, Jefferson Moss-Magee Rehabilitation Research Institute, World Congress of Neurorehabilitation, Vancouver, Canada 5/24
• From the Bedside to Home, Robotics and Technology for Rehabilitation, by Dylan Edwards, PhD, Director, Jefferson Moss Rehabilitation Research Institute and Alberto Esquenazi, The John Otto Haas Chair and Professor, PM&R, Chief Clinical Officer Jefferson Moss-Magee Rehabilitation, Jefferson SVP for Rehabilitation and Post Acute services. World Congress of Neurorehabilitation, Vancouver, Canada 5/24
• Robotics: Innovation for Neurological Rehabilitation, Serving People, by Alberto Esquenazi, The John Otto Haas Chair and Professor, PM&R, Chief Clinical Officer Jefferson Moss-Magee Rehabilitation, Jefferson SVP for Rehabilitation and Post Acute services. World Congress of Neurorehabilitation, Vancouver, Canada 5/25
