We all arrive today with anticipation of what this week will hold for Queena.
Monday was a day of preparing Queena for the week and for the onslaught of media who will be attending TheraSuit Sessions on Tuesday and Wed.
Sit to standing was emphasized with assisted pivoting for transfers. While pivoting, Queena is beginning to assist with greater control on the loaded leg when given tapping manual cues. Today after transferring to sitting in a regular chair, vertical poles were added on each side for Queena to place her hands around. It was at first difficult to reduce the tightness/tone in Queena’s hands to get around the poles. Once her hands were placed, Queena gradually reduced the tightness in her arms and was able to allow her arms to open to the sides of her body and at her elbows. The walker was re-introduced with Queena having greater difficulty getting the left hand on the grip. On the first trial ,when she was holding on to the walker she was excited and when commanded to “STAND” she over recruited her muscles lifting the walker from the floor . On the 2nd trial she controlled the stand for approximately 1 ½ to 2 minutes and the walker remained grounded to the surface. By the third trial, Queena was tiring.
On Tuesday, we began our session almost 30 minutes early to begin movement of Queena’s body. We returned to upright sitting on the plinth table with the therapy team assisting work at the abdominals, neck flexors and back extensors. As we progressed with our assistive movements, Queena was asked to initiate the movement and take it over and she did by moving her head and body towards the left and beginning to return it to upright. The media had arrived by this time and we had already put Queena in the TheraSuit. Cameras flashed repeatedly and microphones were placed close by to capture our conversation and to interview family and friends. Queena did not falter in her concentration even with all of the activity. She was transferred to stand then, to sitting and then, to arm slings to open and close her arms. Following, increased repetitions were done from sit to stand, with Queena maintaining “STAND” for 2 minutes. The team felt and discussed that possibly the use of a platform walker might be good for Queena to better control her arm position.
Wed, was the 2nd media day and much more relaxed as there were only two different groups. Both were low key and very aware of our teams work and needs. Queena maintained her focus. The team noted that Queena’s body now had more contours particularly through the abdominal and back. A Neoprene wrap was now used at the waist to reduce the padding bulk needed for the TheraSuit. Today Queena used the spider apparatus in addition to the TheraSuit. Queena was able to stand for extended periods . She made many positive adjustments with her head and shoulders. She did not require a constant verbal reminder/adjusting position on her own.
Thursday, the team was back on the plinth working with Queena on first her left side and then, on her right. Queena further learned how to “call up” her leg muscles to simulate how to bring her entire leg up and then down as if taking a step, but, on her side, thus eliminating the force of gravity. Initially, Queena required the therapists to give the muscles frequent cues. She also took a very long time while concentrating to “find” the muscle. As we progressed with repetitions, Queena was able to activate the muscle with fewer assistance. Queena had a very strong “release” while assisted in standing with the walker. She initially was unable to release her arms to come down to the handles on the walker. When , her hands finally connected to the hand grips, she was able to flex partially at her hips and then, return to standing. She continued to have difficulty grading her movements. At this point, Queena was ready to advance to the next step in her treatment, by not only controlling more of her movements, but, taking responsibility for them. However, when, the therapist told her to “take responsibility for her body , and said to Queena “it is your body”, she became very upset. She cried out and continued to vocally express distress/anguish. When she settled, the therapist talked with her and discussed what she had accomplished these 3 weeks and where she needed to go next. ….what her next challenge needed to be.
On Friday, Queena arrived ready to work and stood from the chair multiple times. She was able to rest her arms on an elevated walker and bring her body up to full standing with control. She activated the muscles needed to work her hips and knees while on the plinth and finished her 3rd week strong with improved control over her head, back, abdominal and leg muscles. Queena’s face was beautiful with color in her cheeks and relaxed facial muscles. Her smile brightened the room as did her spirit throughout this challenge.
DENISE KILBURN, PT
Denise Kilburn is Queena’s Physical Therapist and is co-owner of Pediatric Therapy Services, Inc. in Lakeland, Fl.
