Motor skills clinic helps rehab patients get moving on wheels and on land

The Canadian Press ~ The News
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TORONTO - A short distance from a bustling east-end street where pedestrians amble along sidewalks and cars and buses zoom by in either direction lies a tranquil little slice of roadway heaven.
A gleaming sedan sits parked mere steps from a cosy, inviting wooden bench. The crosswalk lines are freshly painted, the lawn neatly trimmed.
There are no traffic jams or wailing horns. And you won't ever need a car brush or umbrella - or to check the forecast for that matter - since it never rains or snows.
Within the confines of this streetscape, rehabilitation patients at Providence Healthcare are able to get ready for life beyond the facility's walls by readapting to everyday activities.
The Toyota Canada Motor Skills Clinic recreates central elements of the outside world, including a wheelchair accessible ramp, crosswalk, traffic light and a mix of outdoor surfaces in a controlled indoor environment.
Amputee patients, orthopedic and geriatric rehab patients and individuals recovering from neurological disorders, usually strokes, are among those who use the clinic, said Shawn Brady, director of interprofessional practice at Providence Healthcare.
Brady said the idea for the facility stemmed from a clinical need identified by patients, therapists and clinicians to practise things like getting into and out of a vehicle in a safe manner, which can pose a challenge during inclement weather.
"(For) a lot of our patients, their ultimate goal is to go home," said Brady. "Not only do we want them to go home, we want them to go home feeling confident and having a really high quality of life, and for a lot of people, that involves outings."
Without the opportunity to practise getting in and out of a vehicle, for example, Brady said patients may be limited to using modes of transport like wheelchair taxis or buses, which can be expensive and not always the most convenient way to get around.
The clinic enables patients to practise repetitive acts in a safe, controlled environment, he added.
"If one patient is in the room using it, there's no one else there so they can build up that confidence and feel secure and feel at ease about practising these things that they might otherwise feel too shy or too timid to really try," said Brady.
One of Providence's foundation board members had worked for Toyota Canada, and the idea came up to present a proposal to the automaker for the motor skills clinic.
The company donated $300,000 to build the clinic, which measures more than 80 square metres, to provide equipment and operate it for the first year. In addition, a car was donated.
Since opening nearly three years ago, it has served more than 700 people.
After a neurosurgical procedure in March, Kathe Akbar said she could hardly move her legs when she arrived at Providence in April. Six months ago, the whole left side of her body had been numb and she had a broken foot.
While she still needs someone nearby, the wife and mother of two said she can now get out of bed and transfer in and out of a wheelchair, and has been using a walker for a couple of weeks.
Many people likely don't think twice about the ease with which they can transfer in and out of a vehicle. But for Akbar, 47, such movement and the ability to be more active and independent marks significant progress.
In the past month, she's been out to a movie, gone shopping and had her first haircut in six months.
And under the care and guidance of physiotherapist Angela Gliatta, Akbar said she's been able to better improve her car transition technique.
"Basically, my husband was almost helping me out there, but when I did it myself the way Angela showed me, it made more sense, and I can do it better now. I can almost do it myself as long as there's a person standing near me."
While every case might be slightly different, Gliatta said the best way to help someone getting into a vehicle is to stand facing the individual while the person holds onto the car if necessary for support.
"Generally, we think about sitting down first on the seat and then bringing the legs over, swivelling your bottom so the legs kind of go in," she said. "Getting out is just the opposite."
The clinic also gives patients the chance to test out walking on different surfaces, including interlocking brick, typically found in parking lots and driveways, and gravel.
A crosswalk with a working stoplight helps patients practise reaction times, while the walking path features slight inclines and declines allowing them to learn to adjust to such subtleties. Dimming lights help to simulate nighttime.
"It builds up their confidence so when they do this outdoors they feel more comfortable," said Brady.
"It's almost like a snowball effect: as they become more confident in their abilities, they'll reach higher levels of independence."

Organizations: Providence Healthcare, Toyota Canada

Geographic location: TORONTO

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