Fell from bike during the British Triathlon Championship race in August 2021, fracturing C1-3. Requiring resuscitation at the scene, managed acutely at Aberdeen hospital before being repatriated to Cardiff then his local spinal unit in Wales. Fractures of C1 and 2 were managed surgically but due to surgeons being unsatisfied with the fixation he was also managed in a Halo then external bracing for approximately 6 months leading to lots of secondary changes. He was discharged from the spinal unit in March 2022 and started with us at Hobbs Rehabilitation Intensive Neurotherapy Centre in Bristol in April.
Complex presentation with all 4 limbs affected differently.
• Core and Respiratory muscle weakness but able to manage respiratory function independently by the time he was discharged
• Bilateral lower limb weakness, with right being more affected than left
• Bilateral upper limb weakness, with right being more affected than left, very minimal active movement in right upper limb
• Spasticity throughout all 4 limbs, with right being more affected than left
• Impaired sensation in all 4 limbs, significantly impaired to light touch and proprioception in left upper and lower limb
• Significant secondary changes at neck, glenohumeral and scapulars from prolonged immobilisation
• Mobile up to 10m with wheeled zimmer frame and close supervision indoors only
• Reliant on assistance from 1 person for sit to stand from bed a ordinary height chair
• Fully reliant on his wife for all activities of daily living, unable to reach head/ face for washing and dressing due to secondary changes at shoulders and weakness
• Unable to complete functional tasks in standing
• Not able to do any dexterous tasks with either upper limbs
• Intensive outpatient therapy in Bristol, including physiotherapy and occupational therapy
• 3x 80 hour packages, 3 hours per day, 3-5 days per week
• Used a wide range of neurotechnology in addition to conventional therapy
• Walk indoors independently with 1x elbow crutch or hiking pole and FES
• Walk outdoors with supervision, 1x elbow crutch and FES 500m +
• Reach left UL to head and independently wash and dress upper and lower body
• Able to complete functional tasks in standing
• Able to use left hand dexterously and right hand as a stabiliser
Back working as triathlon coach
It turned my life upside down, going from the fittest I have ever been, to paralysed from the neck down. Having to learn to breath again for myself, talk again, walk again. Day-to-day tasks take a lot of effort and concentration. From getting dressed, to making a simple meal. I worked on a lot of different goals. Finger dexterity, hand function, core stability,
walking, balance, proprioception, spacticity management, meal prep, strength,
return to work, dressing. The outcomes have had a huge impact on my independence. I am now pretty much fully independent with improvement on all areas I have worked on. I am now mentally in a much better place and I have some sort of my ‘normal’ life again.
