Santa Clara Valley Medical Center takes health care quality to another level with research and innovation
A man whose leg was amputated can be fitted into a zero-gravity gait trainer while receiving his new prosthesis without risking weight-bearing injury to his other leg. A woman with a spinal cord injury can be supported by the same zerogravity harness system to reach a standing posture and practice weight shifting and taking steps — without the fear of falling. Her family will cheer when seeing her in a standing position for the first time.
In the nearby therapy pool, physical therapists using an underwater treadmill system can help a patient relearn how to take steps at varying resistance levels. On a screen placed above water, he’ll watch in amazement the difference in his gait each time his therapist corrects his posture and alignment.
In another area, a woman with minimal consciousness following a traumatic brain injury can receive noninvasive magnetic stimulation to her brain. The treatments are part of a study investigating how such stimulation can accelerate recovery. And, with the help of a robotic exoskeleton bodysuit, a man with paralysis can re-experience the feeling of moving his extremities by maximizing movement he already has.
None of these scenarios is futuristic. Each is happening regularly at Santa Clara Valley Medical Center (SCVMC), where trailblazing research and innovations are the norm. In 2011, physicians at SCVMC successfully implanted 2 million stem cells into the spinal cords of two patients who had suffered severe spinal cord injuries. In partnership with Stanford Medicine, those two patients were among the first five in the country to take part in a groundbreaking trial measuring how human embryonic stem cell therapy can positively affect rates of recovery.
Dr. Stephen McKenna is director of the Rehabilitation Trauma Center at SCVMC, where these studies and advancements are taking place. From cutting-edge research and trials to innovations around medical devices and technology, SCVMC is advancing patient care. In another example explained by Dr. McKenna, SCVMC achieved one of the highest rates of ventilator weaning ever published in a peer-reviewed journal. Through the study, they demonstrated a remarkable rate of successful removal of patients from ventilators following certain catastrophic spinal cord injuries. “These are patients who were assumed to be incapable of liberation from ventilators,” said Dr. McKenna. It is yet another example of how SCVMC is a place that conceives of unique rationales for treatments to reach recovery outcomes previously considered unachievable.
Also in the Sobrato Pavilion, Dr. Thao Duong and her team are researching the use of receptive transcranial magnetic stimulation (rTMS) on the brains of patients who have experienced severe traumatic brain injury. The noninvasive treatment uses foil and a magnet to stimulate specific areas of the brain. “We are one of very few centers on the West Coast that have been able to convince insurance providers that allowing us to work with severe brain injury patients from the beginning can improve their recovery and chances of returning directly home,” said Dr. Duong, vice chair of the Physical Medicine and Rehabilitation Department.
Meanwhile, underwater treadmills, electrical stimulation bicycles and the HydroWorx underwater treadmill system are everyday items in the toolkit of longtime SCVMC team members such as Shonna Moran, MPT. There’s also the exoskeleton — essentially a robotic bodysuit — which fits on a person who has recently experienced a stroke or spinal cord injury and has some ability to move their extremities. Using the exoskeleton to move with and for them, the patient can simulate natural movements.
“The ZeroG gait trainer,” explains Moran, “is a dynamic bodyweight support system that allows people to get vertical or on their feet a lot earlier than they normally would be able to.” For many people, a session on the ZeroG gait trainer is the first time they have been upright or walking since their injury or stroke. Moran feels privileged to experience the improvement of patients she and others treat with these devices. She’s not alone in her excitement.
Dr. McKenna, for instance, described a recent conversation with a physician at another facility whose patient was transferring to SCVMC. “The patient’s case was extraordinary,” Dr. McKenna said of the woman’s injuries. She had experienced a brain aneurysm complicated by a coma and seizures. The condition was made more difficult by her inability to tolerate a breathing tube due to an anxiety disorder. The other physician described the situation almost apologetically to Dr. McKenna. “He said, ‘So you’re the lucky one who gets to pick up the pieces on this case.’ But I thought to myself, ‘I actually do feel lucky to be able to help a person who has survived this many complications. This is the day-to-day water we swim in.’ ” SCVMC has the capacity to manage the most complex care. “We’ve been doing it for more than 40 years; our staff are comfortable working with people in these complicated medical, physical, emotional and rehabilitation situations. I feel very grateful knowing we provide the highly technical and compassionate care that will allow this woman to return to a meaningful life.”
Only a center that already provides excellent comprehensive care can add research and trials like these to its existing clinical burden and still deliver excellent care, he added. “Not all medical centers are able to do the types of studies we’re doing.” SCVMC already has the patient population, the care providers and the experience in place. Because of this, the Center is home to one of the nation’s largest databases on traumatic brain injury and spinal cord injury.
In the process of taking part in these studies, research and trials, the Center elevates the knowledge and the passion of the staff members who are on the cutting edge of understanding the potential for advancements. Rehabilitative care, ultimately, can reach its full potential in a setting such as this. “There’s a special component to what we do here,” said Dr. McKenna, describing the ongoing, collaborative work of nurses, therapists, social workers, case managers and physicians. “SCVMC has provided ‘world class’ rehabilitation care and services for decades. We are grateful that we now have a world class facility in which to deliver those services.”