Exciting time in stroke rehabilitation

Cory Smith

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

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.

Kevin Brown and Dr. Teasell walking in hallway

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 Health Care London’s Parkwood Institute to begin his long climb back to health. 

“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.”  

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 St. Joseph’s Health Care London’s 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.

“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.” 

Kevin with Parkwood Institute team

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. 

“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.

Kevin working on a planter

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 his new life.

“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. 

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