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Exciting time in stroke rehabilitation

For many stroke survivors, resuming life takes a team of support as well as determination and internal fortitude. Kevin Brown and Cora King are two individuals whose recovery has been propelled by advances in rehabilitation and sheer determination to reclaim their lives.

Kevin Brown – The Power of Rehabilitation

It was a horrifying injury that shook the hockey world and changed regulations on mandatory safety gear for officials.

hockey game

Kevin Brown was 25 and a linesman in an Ontario Hockey Association game when his neck was slashed by a skate blade while breaking up a fight. The injury led to a devastating stroke, which damaged approximately one third of Kevin’s brain. But his remarkable recovery since the 2009 incident is a testament to the power of long-term stroke rehabilitation, the support of family and friends, and a young man’s focused determination to get his life back.

Photo courtesy of Cory Smith/Postmedia News: Kevin Brown, left, a millisecond before a skate blade sliced his neck, which led to a devastating stroke. As a result of his injury, neck guards became mandatory for all Ontario Hockey Association officials. 

On the ice that night, quick action by a trainer and a nurse in the crowd stemmed the flow of blood pumping out of Kevin’s carotid artery. He was rushed to hospital where the artery was repaired, he was put into an induced coma, and a hemicraniectomy was performed to give Kevin’s brain room to swell. After three weeks in acute care, Kevin was transferred to the Stroke Rehabilitation Program at St. Joseph’s Parkwood Institute to begin his long climb back to health.

“The therapy started first thing in the morning and went pretty much non-stop all day.”

Kevin Brown

“Rehabilitation was intensive,” says Kevin, who spent three months as an inpatient at Parkwood Institute. “The therapy started first thing in the morning and went pretty much non-stop all day.”

Photo right: Kevin Brown and Dr. Robert Teasell have explored many technological devices, such as the peroneal nerve stimulator that helps normalize his walking.

Once discharged home, Kevin received care from the Huron Perth Community Stroke Rehabilitation Team (CSRT) which came to his home for several months. Kevin supplemented this therapy with his own workouts, which he continues to this day, along with private therapy to sustain the gains he has made through the years.

Dr. Robert Teasell, Medical Director of the Stroke Rehabilitation Unit at Parkwood Institute and Associate Scientist, Lawson Health Research Institute, says there is a growing evidence of the value of long-term stroke rehabilitation. He would like to see formalized stroke rehabilitation extend much longer.

“The longer the therapy the better people become at relearning how to walk, regaining their independence, and performing higher level skills.”

Dr. Robert Teasell

“Research shows the brain can continue to recover and improve for a long period of time after a stroke – longer than the typical three to four months of therapy most patients receive,” he says. “The longer the therapy the better people become at relearning how to walk, regaining their independence, and performing higher level skills such as banking and grocery shopping.”

The CSRT, adds Dr. Teasell, is an excellent example of extending rehabilitation beyond the hospital. The CSRTs bring therapy to the homes of often older, more frail patients and to those who live in rural areas, who have greater challenges in accessing outpatient therapy away from home. There are three CSRTs in the South West LHIN that are located in the Grey Bruce, Huron Perth, and Thames Valley areas.

Kevin Brown’s recovery from stroke began with three months of intensive inpatient stroke rehabilitation at Parkwood Institute. Among members of his inpatient stroke rehabilitation team were, from left, physiotherapist Karen O’Neil, Kevin, Dr. Robert Teasell, and occupational therapist Trish Shoniker. 

“Our research shows the CSRTs have levelled the playing field for urban and rural stroke patients, with both recovering equally as well when they have the same access to post-hospital rehabilitation,” says Dr. Teasell.

Photo right, Despite having a stroke in 2009 that damaged one third of his brain, Kevin Brown has made a remarkable recovery and today is a contract farmer.

New technology is also helping Kevin on his recovery journey. He and Dr. Teasell have explored many new technologies including the peroneal nerve stimulator, which helps normalize his walking, functional electrical stimulation to help retrain the nerves in his arm, and repetitive transcranial magnetic stimulation to help ease the depression that arose with his transition to a life different than before.

“I’m happy to be a guinea pig,” says Kevin with his dry sense of humour.

“It’s an exciting time in stroke rehabilitation with many new technologies, including robotics and electrical stimulating orthotic devices, coming on the market that hold promise for improving motor function of people with stroke,” adds Dr. Teasell.

Kevin has progressed by leaps and bounds since he came to Parkwood Institute eight years ago unable to walk and requiring assistance with the most basic tasks. Today he works with his father in contract farming, taking pride in his knowledge of the intricacies of the massive planter he operates. In addition to the crops that flourish under his care, Kevin has also influenced the hockey world, making it a safer place. In January 2010, less than two weeks after his injury, neck guards were made mandatory for all Ontario Hockey Association officials.

Cora King – Making Her World Right Again

In 2014, a series of medical events turned Cora King’s world upside down, but the Community Stroke Rehabilitation Team (CRST) helped make her world right again.

Cora King, left, is helped by occupational therapist Martha Scott, to learn new ways to do tasks such as washing dishes.

Cora, then 37, was living in a tranquil rural setting in Middlesex County, leading a busy life caring for her husband and two young boys and working at a community health centre. She had the first inkling something might be wrong when she started dropping things and had trouble moving her legs.

After many diagnostic tests, Cora was given devastating news – she had a brain tumour. In the weeks following, she had a seizure, then pneumonia, and finally a stroke. She was gravely ill, however quality medical care, the love and support of her husband, and her steely determination have carried her through.

“We take a very holistic approach to care, so clients can become more independent and reintegrate into their community.”

Occupational therapist Martha Scott

Once Cora’s health stabilized, she continued her recovery at Parkwood Institute. When she was discharged home in January 2016 the CSRT swung into action.

“The health care professionals on the CSRT provide intensive rehabilitation in clients’ homes so they can achieve their rehabilitation goals,” explains occupational therapist (OT) Martha Scott. “We take a very holistic approach to care, so clients can become more independent and reintegrate into their community.”

Cora in her garden

The CRST is made up of health care professionals from various disciplines. As an OT, Martha helped Cora relearn activities of daily living such as dressing and showering. The team’s physiotherapist helped Cora learn to walk again, and the speech language pathologist and Martha assisted her with thinking skills such as memory and scheduling. The therapeutic recreation specialist taught her activities such as colouring and knitting to help retrain hand dominance. The social worker supported Cora and her husband in addressing their new family roles, and the nurse provided education about medications and healthy lifestyle choices. Finally, the rehabilitation therapist practiced therapy plans with Cora so she could meet her goals.

“I believe one of the reasons Cora had an incredible recovery is because she is so motivated,” says Martha.

“My desire to be independent outweighed my frustration with my physical limitations,” says Cora.

Members of Cora’s church were supportive and offered to alter a pew to fit her wheelchair. “I said no thank you; they were amazed when I walked into church with just a quad cane.”

“Never stop trying – if you think you can, you will.”

Cora King

These days Cora is once again living a full life managing household chores, attending a day program, going to her children’s activities and socializing with friends and family. With her can-do attitude, Cora’s advice to others who have had a stroke is, “Never stop trying – if you think you can, you will.”

Stroke rehabilitation has helped Cora King get back to tending her garden.

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