Patient Case Study: Functional Quadriplegic Walks Again After Aquatic Therapy

Patient Case Study: Functional Quadriplegic Walks Again After Aquatic Therapy

When Keith McCrate, PT began the process of developing an aquatic therapy program for his team, he admittedly was not enthused, stating,

“I had to be pulled into this hydrotherapy kicking and screaming…”

However, in the same interview, he also passionately claimed he would absolutely recommend a pool to a friend or colleague.

We’ve seen nothing but tremendous success and growth since implementing it…”

Keith went on to share, “What success has surprised us is the elevation of the overall program: the quality of therapists we’ve been able to attract and the patient mix are better.”

Why did his feelings about aquatic therapy change so drastically?


Specifically, the incredible successes they never would have experienced without utilizing aquatic therapy.

In this interview, Keith shared an astounding recovery story about a functional quadriplegic who learned to walk again using their HydroWorx pool.

HW:      Before we dive into the story, tell us a little about why you felt hesitant about starting an aquatic therapy program and why your feelings changed.

KM:      Sometimes PTs don’t want to admit they need help from someone or something else, like an aquatics program, thinking they are skilled enough to help any patient. And a lot of therapists don’t want to get in a bathing suit in the water—they’ve never had that experience. They’ve never actually seen the benefit of it, so as the director of therapy, you have to begin by just saying, “You’re getting this person in, and let’s see how it goes.” Once the therapist starts seeing results, then the floodgates will open.

And open they did. The following patient story is one of many, many incredible successes that he has been able to be part of.

HW: What can you tell us about this patient’s history? What was her condition upon arrival at the facility?

KM: She had been involved in a major car crash. She was in her 60s, active, strong, still working and very, very motivated to improve. She ended up having four orthopedic surgeries; a left shoulder replacement, right hand reconstruction, and reconstruction of bi-lateral, multiple fractures all along her tibia and fibula as well as her femurs.

She came to the facility when she was in a very basic condition—non-weight bearing on all four extremities. When the team felt she could tolerate the water, we asked her surgeons if we could get her in the HydroWorx pool. They let us be pretty aggressive with it.

HW: What was it like for her to start aquatic therapy?

KM: When we started, she was a functional quadriplegic, she could not do anything for herself. Gradually, she started to make good progress in the water: sitting balance, slide board transfers, those kinds of things started to take off. When we got toe-touch weight bearing, we requested the physician to allow us to actually walk her in the water. So for the next 30 days, we did walking on the treadmill every day, a lot of aggressive strengthening underwater.  We saw just remarkable progress from that.  Seeing her face light up the first couple steps in the water was amazing. Watching her legs work underwater was just tremendous.

HW: The HydroWorx pool you used for her rehab has underwater cameras. What added benefit did that system provide for her recovery?

KM: There’s something with seeing yourself on video that is different that when you take 10 steps across the gym.  We’ve all been on film and thought, “Ooooh, do I really look like that? Do I really sound like that?”  What we have in our mental picture is very different from the external picture. Looking at the external picture for her on-screen, in real-time watching her legs working, that was different than perceiving your legs walking with your internal picture. That was a break-down moment when she saw herself walking again.

HW: What was it like for the rehab team to help someone recover from such a traumatic event?

KM: We spent about 80 days total with her. And to take somebody from no weight-bearing quadriplegic to walking? It was special. And it was the therapist and all the loving people around here that really made the difference for her. We celebrated her birthday on campus. During the time she was here, she really became like family.

HW: After she completed her rehab program, what did she do?

KM: She went back to her home state, working and doing everything she used to. She flew to Dallas once a month to reconstruct her hand to get that full function. She came and visited us, walking without a walker and you wouldn’t have ever guessed what she has been through.

Sometimes all it takes to go from kicking and screaming to applauding and cheering is a change in perspective. What once caused anxiety and hesitation is now a recovery and rehab method that Keith heavily relies on for improved patient outcomes and success.

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