Physical therapists provide treatments for people having had a stroke to restore movement and walking ability, decrease disability, and improve function. Physical therapy programs work on balance, walking, task-oriented functional training, and exercises, among other things. They teach how to use devices, including orthotic braces, canes, walkers, wheelchairs, and perhaps even robotics, and training for families and caregivers. Over the past 50-60 years, therapists have endeavored to identify and specialize in the approach and fundamental philosophy they believe is best, and all have had favorable outcomes. More recent research strongly encouraged clinicians to embrace the newest high-intensity gait training (HIGT) approach, and Sunnyview’s heavy emphasis on extensive walking aligns with this recommendation.

Every day, secured in the Rifton Tram, Matt continued to slowly walk past all of the patient rooms, lining the square loop of the TBI wing with the nurse’s station and storage rooms in the center. In the past month, he had gradually progressed from walking 240 feet to 800 feet, then 1,200 feet, and finally 1,320 feet—the equivalent of a quarter of a mile—not significant in things of the world, but undoubtedly noteworthy for Matt. It was time to wean him off the Rifton Tram. The next big ask? Physical therapy challenged Matt to stand between rigid parallel bars.

They convened in the large therapy gym with open space for walking, three or four large mat tables, practice stairs, bikes, therapy balls, a table for arm activities, and the 10-foot-long parallel bars. With the help of three people, Matt was levered onto his feet, and his hands were placed to rest on each bar. His floppy body needed guidance and hands-on support to control his trunk and four extremities and stabilize various joints.  He stood for two or three minutes while the therapist appraised the next move. Was he ready to take steps? Yes, and off they went.  One person helped brace his right knee, another advanced his right leg and hand along the bar, and the third held him upright. So many components, once done unconsciously, now require a concerted effort. The staff allowed me to man a post on days I was available.