DEFYING THE ODDS

INTERVIEW

When Rolf Zartner was given a slim chance of survival after four strokes, his determination not to be written off - coupled with his background in extreme fitness - saw him begin his punishing rehabilitation while still in his hospital bed. Here, Rolf shares his amazing story of survival, defying expectations and overcoming the biggest challenge of his life

Defying the odds

When Rolf Zartner experienced three strokes in March last year, followed by a devastating fourth after lifesaving surgery, he was given - at best - a five per cent chance of survival. But Rolf, a managing director at Deutsche Bank in London and lover of extreme fitness challenges, would not be written off so easily. From the point of him waking from more than three weeks in a coma, he resolved this would not be the reality for him, and began to plan for a future as full as his life was until March 21, 2020. And on March 21 this year - a year to the day that stroke struck - he ran a half-marathon, having pursued a punishing neurorehabilitation and training regime which begun even while he was still in hospital. “I knew they expected me to die, so that made me become very, very determined. I got out of my hospital bed and began to walk around the aisles on the ward, and then over the days and weeks, I started to jog. “I saw the doctor who felt I may not recover. I got out of bed and walked over to him - ‘Don’t write me off, doctor’, I said to him. He was amazed. “And from when I got home, my training began again, gradually, but my determination since I woke from my coma has not decreased. “I know doctors say I’m a medical miracle, but for me, it was about setting targets and working towards them.” It was while training for an Iron Man extreme fitness challenge - only shortly after securing a promotion at work - that Rolf sustained the injury that would lead to his strokes. While completing his swimming training in Fuerteventura on March 7, unbeknown to him at that time, he sustained a double artery dissection in his neck. “I swam 4,000 metres and sprinted the last part when my neck made a weird twist,” recalls Rolf. “I was in quite a bit of pain afterwards, particularly in my jaw, but I didn’t pay too much attention to it. The pain became stronger in the two weeks afterwards, so I went to see my GP. “She didn’t recognise anything was seriously wrong, except a muscle spasm, and told me to take ibuprofen. But while I didn’t realise it, the clots had been building up, and that same night, 12 hours later, was when I had my strokes.”

INTERVIEW

Rolf’s wife was the first to know something was terribly wrong, after her husband woke during the night. “She asked what was wrong and I said something, but she asked me to repeat it. I was slurring my words and she couldn’t understand what I was saying,” he recalls. “I was in much more pain and then realised I didn’t have feeling in my left side. She called an ambulance.” Rushed to St George’s Hospital in London from their Twickenham home, it was established that Rolf had experienced three strokes as a result of the dissection two weeks earlier. Having underwent surgery which was to save his life, Rolf then had a further stroke which caused complications through lung and kidney infections, which meant his outlook looked bleak. More than three weeks in a coma and eight weeks in intensive care took its toll on Rolf, to the point where thinking about the future was his only salvation. “I had my surgery two days before the UK went into lockdown and after that time I couldn’t see anyone. I wasn’t able to see my wife and daughter. It was very boring, very difficult being in hospital, and many weeks passed by somehow,” he says. “I woke from my coma like a toddler. I couldn’t do basic things like brush my teeth, it was shocking, my life had been turned upside down. “I didn’t really know what to do, so began to think about getting back to running. I began jogging while still on the hospital ward, but a week after I got home, my training began again. “While I had problems with my left shoulder, arm and hand, and they continue even now, I never had paralysis in my legs - so although it probably looked a bit funny, my ability to run was never hindered by what had happened. “A lot of effort went into my training, it was very important to me that I could do this. I started with 400 metres, then went to one kilometre, then three kilometres, then five, ten and finally the half marathon.” But for Rolf, the accomplishment does not end there, and plans for the next stage of recovery are already in motion with him set to undergo stem cell therapy in Bratislava. “I was getting to the point where I thought ‘Should I stop here? Should I accept the recovery that I have made?’ But that’s not something I want to do,” he says. “From my body point of view, my hand hasn’t recovered although I have done well otherwise, but my brain is my concern. I have a job which needs a lot of brain input, and while I can live with how my hand is, I want to have the best possible chance of processing thoughts and facts. “I am very lucky that I am able financially to have stem cell therapy, so I thought why not? It’s a fact that 99 per cent of people who had an injury like I did are dead and because I survived, I want to do all I can. “I’m not allowed to swim anymore and can’t go to a higher altitude than 4,000m - which means no more mountain climbing, I have climbed Kilimanjaro before my strokes, but that can’t happen now - although that feels a small price to pay for the fact I am alive.” And while Rolf’s phenomenal determination has been key in getting him through the trauma of the past year, he credits the support of those around him as helping him to reach this point. “My wife has been amazing and I could not have got through this without her. She saw me in a coma when I was at the very bottom and has been there all the way,” says Rolf. “The bank have stood by me too, they have displayed role model behaviour. Of course you worry what will happen with your job, how can you afford a life in London if you no longer have that, but they supported me from the start, enabling me to do my job while also having time for therapy. “This past year has been very difficult, of course, but reminds me of how lucky I am in what I have and what I have overcome.” Rolf has been supported in his incredible recovery by the Neuro Rehab Practice, based in Teddington, with consultant neurophysiotherapist Richard Sealy overseeing his therapy sessions.

CASE STUDY

Successful Launch of a Unique NeuroBall™ TeleRehab Program for Upper Limb Rehabilitation

By Jon Graham BA Bsc MSc MCSP HCPC reg, Clinic Director, PhysioFunction, Northampton, UK

Background

The coronavirus pandemic severely impacted rehab therapy for countless clients and therapists worldwide. As was the case at many care delivery sites, PhysioFunction (a private outpatient rehab facility) experienced a significant impact to its business when it had to close during the first lockdown. As a result, clients were given no choice but to stay at home and perform exercises on their own with the remote support of the therapy team.

To compliment the remote support and allow their clients to continue having e ective therapy at home, PhysioFunction expanded their o ering of home use innovative rehabilitation technology devices, including implementing a TeleRehab program using Neurofenix’s NeuroBall™ for clients needing upper limb rehab.

The NeuroBall Home Program

Neurofenix trained PhysioFunction sta on the NeuroBall and its suite of tablet-based activities and games, and also how to incorporate the device into their TeleRehab sessions. PhysioFunction then o ered the new NeuroBall Home Program to their existing and any new clients with upper limb impairment. The NeuroBall device and tablet preloaded with proprietary software were then delivered directly to the client’s home. Neurofenix supported PhysioFunction on the first TeleRehab session using the device. PhysioFunction then arranged regular TeleRehab sessions with their clients where the therapist evaluated progress, provided advice and adapted the program to the client’s needs.

O ering this innovative new teletherapy program has benefited both PhysioFunction and its clients:

For PhysioFunction: The clinic is now able to o er an additional e ective therapy program that can be accessed from the comfort of home. Clients pay for the NeuroBall Home Program, and appreciate its added value compared to phone calls alone, as it helps them develop movements they want to recover. PhysioFunction is able to o er this new program beyond its immediate local community, unlocking a new customer base. Furthermore,

– Therapists are able to see more clients in a single day, as there is no need for extensive sanitation between clients; they can move easily from client to client using video-calls. – Therapists working from home can now deliver teletherapy sessions.

The NeuroBall Home Program creates a new revenue source, and enables the clinic to di erentiate itself from other rehab facilities that do not o er this unique service. The first month of launching the NeuroBall Home Program:

– 6 clients subscribed and paid for the use of the

NeuroBall at home. – Each client booked 1-2 teletherapy sessions per week, increasing PhysioFunction’s revenue. – New clients from outside the local area accessed remote therapy due to PhysioFunction’s promotional e orts using client testimonials over social media and via its website. For Clients: PhysioFunction saw strong engagement with NeuroBall; clients enjoyed the activities and games and consistently and frequently performed the exercises independently at home, which helped them work towards their therapeutic goals.

Using NeuroBall, clients: – Trained on their own between 2 and 6 days a week; – Trained between 18 to 45 minutes per day; – Engaged with their upper limb 1 to 4 hours more per week vs. simply performing exercises at home alone.

Clients reported: – NeuroBall was lightweight, and easy to set up and use; – They enjoyed the wide variety of activities and games; – Using NeuroBall helped to reduce wrist sti ness and improved wrist movement. – NeuroBall helped to increase concentration and enabled more natural arm movements.

What’s Next

As pandemic lockdowns have eased and clients are able to come to the clinic for rehab, PhysioFunction has begun o ering a “blended” approach. Clients are able to use NeuroBall in the clinic but can also participate in the NeuroBall Home Program to continue exercising at home. PhysioFunction has found this blended program to be an e ective way to extend therapy beyond the clinic, motivate clients and achieve high dose, high repetition therapy.

These results demonstrated that the NeuroBall Home Program is an e ective tool to grow clinic revenues, enhance client engagement and further therapeutic goals from the comfort and convenience of the client’s home.

The NeuroBall Home Program was a huge benefit to the clinic and our therapists during this di cult time. Moreover, the NeuroBall program has been popular with clients. Even after restrictions are lifted, I know we will continue o ering this program.

Claire Everett BSc MCSP HCPC reg, Clinical Operations Manager and Senior Neurological Physiotherapist at PhysioFunction