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Physical therapy students work with stroke
survivors to minimize paralyzing effects

Physical therapy students Marie Bernal and Greg Stewart help Rosey Ramsey scale the step outside Solano Hall.

On the steps outside of Solano Hall, stroke survivor Rosey Ramsey is being ushered up a step and down, up the same step and down again, repeatedly. It may not look like she is going anywhere, but in fact she is taking giant leaps.
           
Two Sacramento State physical therapy students stay close to Ramsey.

 “She began with eight steps and now she is up to 15,” says student Marie Bernal. It has taken Ramsey three weeks to work up to those additional seven steps.

“It is a huge achievement,” says Bernal. “Her balance is better and she is stronger.”

On August 15, 2002 at the age of 52, a blood clot in the left side of Ramsey's brain left her paralyzed. She credits Sacramento State’s Physical Therapy Neurologic Evaluation and Treatment course with her recent physical progress.

“It really helps a lot,” says Ramsey. “I have not fallen since I began the program at Sac State.”

It is not only the patients whose lives are being changed here. For many of the students, this is the first time they have been directly responsible for a patient’s care.

Patients from throughout northern California are referred to Sacramento State’s College of Health and Human Services from Sutter Hospital and UC Davis Medical Center. Currently 15 stroke survivors are moving, bending, and, yes, struggling all under the watchful eye of physical therapy professor Michael McKeough.

Professor Michael McKeough

As a physical therapist, McKeough has helped patients come back from crippling paralysis for 32 years. He is now teaching graduate physical therapy students what he learned so well in three decades as a professional: physical therapy is not a patient’s favorite part of getting well.  

“Physical therapy causes pain,” McKeough says. “Physical therapists have to ask patients to do what they can’t do and sometimes it causes physical and emotional pain.”

The students, work under the watchful eyes of McKeough and Bryan Coleman-Salgado, another physical therapy professor.

As McKeough works the room he asks student after student what they are doing and why they are doing it as they work with their patients.

“What is the patient having difficulty with?” McKeough asks. “And what are you going to do about it?”

The students respond to the professor’s questions as they work the patients’ muscles, forcing the stroke survivors to re-learn simple tasks. McKeough is working the student’s brains.

The course in which the patients are being seen, Neurologic Evaluation and Treatment I, is part of a three-course sequence in which students learn to help rehabilitate adult patients with neurologic damage. For eight weeks during the laboratory section of the course, students provide free physical therapy under the direct supervision of a licensed physical therapist. The patients are volunteers from the community who no longer have insurance coverage. Patients with diagnoses ranging from stroke and brain injury to spinal cord injury, multiple sclerosis and Parkinson's disease are seen in this and other courses.  The eight weeks include initial examination, seven weeks of treatment, a home exercise program, and a home visit. During the home visit, students inspect the patient’s home and suggest possible improvements and observe as the patient takes them through his or her daily routine.  Information learned during the home visit is incorporated into the weekly treatment and home exercise program to make the patient more functional in daily life. The goal is to mend and revitalize muscles and give patients back a piece of their former physical lives.

On the mats—Lita Lappin is escorted down the hall by physical therapy students David Clewett (left) and Jeff Blankenship (right)

“Breathe out, breathe, breathe,” says physical therapy student David Clewett.

He and his physical therapy student partner, Jeff Blankenship, are working with Lita Lappin, a stroke survivor. Lappin is working on keeping her balance as she tries to climb a small, yellow 12-by-12 inch square sponge. Lappin’s stroke happened five years ago, in July 2002. There was extensive bleeding in her cerebellum, she was in a coma for 10 days and when she regained consciousness she had lost the hearing in one ear and was paralyzed on her left side.

She remains unsteady on her feet; the stroke robbed her of her sense of balance but not her sense of humor. As she attempts to take a step up, she waivers, but laughs.       

“This is really rewarding,” says Blankenship. “To see the progress the patients make, I really love it.” 

Lappin is in pain as she and the students ask her muscles to do what they have long forgotten. It is through the repeated efforts to learn new ways to strengthen weak muscles, balance on unsteady legs and perform the activities of daily living that patients are regaining control of their lives.

But at this moment she is glowing from her victory over the sponge.

“I love it. I love it,” says Lappin, a member of the Sacramento Stroke Support group. "Every stroke is different, it was the therapist who saved me."

for more information on Sacramento State's Department of Physical Threrapy vist www.hhs.csus.edu/pt/.