At most hospitals and recovery centers, when a spinal cord injury ( SCI) patient regains motor function and/or the ability to walk, it is considered a miracle. At Project Walk , it's considered the expected result of hard work and dedication.
For licensed acupuncturists and Pacific College of Oriental Medicine graduates Mike Akong, Donna McAdams and Anna Michelle Casco, being a part of the process of spinal cord injury treatment that helps patients walk again is a miracle in itself.
Using the same principles of athletic conditioning, Project Walk is a program that helps San Diego spinal cord injury patients condition their nervous systems to regain mobility.
Project Walk began in 1999 when its first patient came in with less than a 5 percent chance of recovery. Since that patient walked out of its facility, Project Walk has grown in both clientele and popularity. In the course of a year, one patient grew to 30, and one SCI recovery specialist grew to seven.
At the time of this writing, Project Walk had a staff of 21 and was treating about 50 patients, some of whom come from all over the world to be a part of this unique program in San Diego .
Spinal cord injury is damage to the spinal cord that results in a loss of function such as mobility or feeling. The nerves that lie within and branch out of the spinal cord are motor neurons that carry messages to the brain and other parts of the body; therefore, damage to the spinal cord results in loss of function and/or paralysis to specific parts of the body.
Besides a loss of sensation or motor functioning, individuals may also experience any spinal cord injury symptom such as dysfunction of the bowel and bladder, difficulty breathing, low blood pressure, reduced control of body temperature and chronic pain.
Another common side effect or spinal cord injury symptom is muscle spasms. Spasticity is an exaggeration of normal body reflexes that occur when the body is stimulated below the injury. Most recovery protocols prescribe medications to calm the nervous system and reduce spasms.
Project Walk , however, takes a different approach to these involuntary reactions. Because muscle spasms indicate activity in the nervous system, Project Walk encourages SCI patients to use each spinal cord injury symptom to create muscle strength and control. As a result, the recovery method created by Project Walk first produces joint stabilization, then eccentric contractions and load bearing strength. At that point, patients learn to develop movement, which finally leads to muscle coordination.
Because Project Walk makes use of spasticity , patients are usually encouraged not to take medication.
"[Normally, SCI] patients are given anti-spasmotics and painkillers [to stop the spasms]," said Suzzy Sale, director of operations at Project Walk . "That will just put the nervous system to sleep."
Project Walk also differs from other San Diego spinal cord injury recovery programs because it was founded by exercise physiologists who don't have a traditional medical background. Because they had never been told it was impossible to do so, the staff at Project Walk works to retrain the nervous system of SCI patients.
According to McAdams, what truly sets Project Walk apart from other SCI recovery models is the fact that it doesn't give up hope that SCI patients can walk again. Spinal cord injury treatment can be very slow and frustrating, leading to a sense of lost hope.
"There's no medical approach to dealing with [ SCI outside of Project Walk ]," McAdams said. "It just gets to the point of just learning to deal with their disability."
Akong agreed that the results Project Walk is able to achieve with its SCI patients is truly cutting edge.
"It's really quite revolutionary because if you ask any MD what the prospects are for [an SCI patient] getting back motor function, it's not good, unfortunately," Akong said.
By contrast, Project Walk expects and demands that patients recover - and it does so successfully. Of the clients who had been at Project Walk for at least seven months in 2003, 86 percent began to move their legs. Since April of 2003, part of that success has been the result of acupuncture treatments given by Akong, McAdams and Casco.
Before working with Project Walk , Akong had been privately treating a quadriplegic friend of his for two years when the patient was finally able to walk again. Akong was then referred to another quadriplegic patient who also attended Project Walk . When the patient told him about the Project Walk program, Akong decided to get involved.
With over 50 patients at Project Walk who could potentially benefit from acupuncture , Akong realized that more than one acupuncturist was needed.
"I had already seen that the clinic could be really big, and I knew that I couldn't treat everyone on my own," Akong said.
Akong called in McAdams and Casco, who graduated from Pacific College of Oriental Medicine with him in August of 2001. Together, they leased space at Project Walk and started offering their services to the clients there.
Though the SCI patients at Project Walk have to voluntarily sign up for the acupuncture services and also pay a separate fee, McAdams estimates that approximately 30 Project Walk patients have received acupuncture since April of 2003, 15 of whom are currently getting acupuncture in conjunction with the exercises Project Walk prescribes. This type of spinal cord injury treatment shows major promise.
"When we add our acupuncture to what they're already doing [at Project Walk ], we're enhancing their results," McAdams said. "It enables [ SCI patients] to make faster gains. So far, we've seen improvement with all the patients we've worked with."
In addition to body point acupuncture , Akong, McAdams and Casco apply Dr. Zhu Ming-Qing's scalp acupuncture to the patients at Project Walk . Not only is Dr. Zhu's scalp acupuncture less painful than traditional Shanghai scalp acupuncture , but it is especially helpful for problems in the nervous system.
"[Scalp acupuncture ] focuses the energy of the patient and practitioner on the problem to be solved," McAdams said. "It's very beneficial for neurological disorders - it helps to stimulate the nervous system and the brain."
Akong said that one reason scalp acupuncture is so effective as a spinal cord injury treatment is that it accesses the pathways closest to the brain, which allow for faster and more potent neurological results.
By seeing their SCI patients twice a week, the acupuncturists at Project Walk have gotten amazing results.
"Patients who were having very slow progress will come in [to see us] and suddenly be able to do things they couldn't do before," McAdams said.
Though it's hard to distinguish between the results of Project Walk 's nervous system reconstruction method and the acupuncture in terms of treating each spinal cord injury symptom , Sale believes that the optional service is helpful.
"I think there's more nerve excitation with acupuncture ," Sale said.
Akong expanded, "[ Acupuncture ] adds a whole dimension of energetic medicine that affects the entire body."
Casco said that in addition to stimulating the nervous system, acupuncture helps SCI patients actually rebuild the neurological pathways.
"It helps [ SCI patients] to strengthen their core," Casco said. "It especially helps them with their bladder function - it helps them recreate the nerve pathways so that they know if they even need to go to the bathroom."
McAdams said that one of the reasons she loves working at Project Walk is because she is able to see the miracles that acupuncture can do.
"When someone says, 'OK, I haven't been able to feel my left foot in three years and I just felt you put that needle in,' that is amazing," McAdams said.
Akong agreed that working with SCI patients is an incredible experience.
"There is so much we take for granted," Akong said. "Helping patients regain their senses makes me appreciate my own more."