Project Walk is a world leading non-pharmaceutical exercise-based facility for spinal cord injured individuals. They are a non-profit organization located in Carlsbad, California. Project Walk was founded by Ted and Tammy Dardzinski and has been in operation for over 10 years. Programming at Project Walk is based on the 5 Phases of Recovery, also referred to as The Dardzinski Method™. The training methods employed at Project Walk have been proven to show dramatic improvements in nervous system regeneration in spinal cord injuries. More information can be obtained from Project Walk’s website: http://www.projectwalk.org

Project Walk’s success is noted world-wide with 9 international provider facilities to go along with the 4 facilities located in the United States.

First Steps Wellness Centre (FSWC) signed a Provider Agreement with Project Walk, making us the first, and only, provider facility in Canada. As such, FSWC utilizes the training methods designed by Project Walk. Trainers employed at FSWC are trained and certified by Project Walk.

2. Who can participate in programming at FSWC and what is the application criteria?

Programming at FSWC is appropriate for individuals that have sustained a spinal cord injury and are not ventilator dependent. Individuals can apply once they have been released from hospital. There is no time limit post injury. An application form must be submitted to FSWC, along with a doctor’s letter clearing the individual, based on past and present overall health, to participate in an intense exercise-based recovery program. Many times the doctor may request a bone density scan just to be sure that the bones are strong enough to support load bearing. An initial consultation will then be set up to obtain additional information and answer questions.

3. Why do I need more than my current traditional rehabilitation?

There are over 12,000 American and 4,000 Canadian spinal cord injuries each year, and only a small percentage regain the ability to walk. The reason is not always the injury, but the lack of treatment. It has been speculated that our new clients would be getting better without our program because they are less than a year post injury and, in most cases, incompletes. If such is the case, why are the majority of our clients regaining function beyond what the traditional model states possible for the injury level? Why are thousands of other injuries each year not progressing past their perceived level of recovery? It’s the treatment.

If you place an able-bodied person in a reduced gravity environment; tell them they can’t move for a year; heavily medicate them; and give them no hope; what will be the outcome? Bone density, muscle mass, and nervous system activity would begin to shut down and disappear. That able- bodied person would have the same symptoms of a paralyzed person. So, is it just the injury or the treatment that keeps some SCI paralyzed? We know that not every new injury will regain their desired function, but since 1999, a significant number of Project Walks clients have regained greater function than believed possible based on the injury level.

4. What will FSWC provide that is not already offered at local rehabilitation centres?

FSWC will not replace inpatient rehabilitation services provided at facilities such as Wascana Rehabilitation Centre, etc. FSWC is a community based centre for those who have been discharged from inpatient care. The exercise methods used at FSWC are intended to compliment outpatient occupational and physical therapy at a more frequent and consistent pace. Moreover, FSWC specializes in spinal cord injury exercise programs with staff trained/certified as Project Walk Certified SCI Recovery Specialists. FSWC also utilizes specialized and adaptive exercise equipment. Trained staff and specialized equipment will provide full body weight bearing activities intended to stimulate the nervous system. Further, the integration of education and supportive services including massage therapy, acupuncture and chiropractic care will address the holistic needs of those with a spinal cord injury.

5. What are the benefits of First Steps Wellness Centre?

Clients can expect support at FSWC through dedicated staff, information, education and encouragement. Outcomes will vary for each individual as many factors impact recovery such as personal attitudes, financial issues, nutrition, etc. There are many individual success stories for those that have utilized The Dardzinski Method™ for SCI. The different areas that have shown improvement include:

• Increased muscle mass
• Increased circulation
• Increased central nervous system activity
• Increased health and well-being
• Increased sensation including hot and cold, pain, touch, etc.
• Increased function below level of injury
• Increased occupational skills
• Decreased drug dependence
• Decreased pain
• Decreased health problems associated with a spinal cord injury
• Prevent pressure sores

Remember, exercise is vital for everyone, regardless of physical ability.

6. What are the qualifications of your trainers?

First Steps Wellness Centre is the first Project Walk provider facility in Canada committed to providing the best possible SCI recovery care possible. As such, the professional staff at FSWC are specially trained as Project Walk Certified SCI Recovery Specialists. Project Walk has developed the world’s only Trainer Certification Program for SCI’s which enables FSWC staff to specialize and learn about SCI’s including the recovery methods through Project Walk’s exercise-based recovery program, The Dardzinski Method™, as well as participate in SCI recovery research. By participating in this certification process, First Steps Wellness Centre will be able to offer the program methods used by Project Walk with our clients. The certification process is extensive and requires in-house training at Project Walk in California followed by continual supervision through the trainer exchange program. Project Walk requires trainers to take mandatory courses, engage in a minimum of 450 hours of practical experience and track client recovery using Project Walk methods.

Trainers employed at First Steps will have a Bachelor of Kinesiology (or related field) accompanied with a Certified Exercise Physiologist (CEP) designation from the Canadian Society of Exercise Physiology (CSEP) or a Certified Exercise Specialist (CES) designation from the American College of Sports Medicine (ACSM).

7. What other services and programs are accessible through FSWC?

To meet our values of accessible and client centered services, First Steps Wellness Centre provides additional health care services in conjunction with exercise. It is our intention to provide registered massage therapy, acupuncture, and chiropractor services all under one roof. In addition to this, FSWC partners with professionals in the community to offer educational and networking opportunities to our clients. Clients will have the opportunity to lend support and share experiences with one another. The latest information and research regarding SCI will also be made accessible to our clients such as nutritional information, alternative therapies (laser, stem cell, etc.), and more.

8. Is there research behind the exercise-based recovery methods being used at FSWC?

As a certified Project Walk provider facility, FSWC will use the training methods developed by Ted Dardzinski (The Dardzinski Method™). Project Walk has their own Research and Development Department in which they conduct and publish their own research projects as well as provide their client’s with the latest on SCI research. Further, Project Walk is geared to developing new rehabilitative equipment for SCI. One particular research project published by Project Walk and the University of California studied the effects of intense exercise in chronic spinal cord injuries. This study concluded that, “Multimodal IE (intensive exercise) can significantly improve motor function in subjects with chronic SCI. An organized program may provide greater motor benefits than a self-regulated program; load bearing might be of particular value. IE might have therapeutic value in chronic SCI, and as an adjunct to other restorative therapies.” (Spinal Cord (2008) 46, 733-737). This research can be viewed at: http://www.nature.com/sc/journal/v46/n11/abs/sc200856a.html

FSWC benefits immensely from the dedication and research of Project Walk. The training methods used have been in place for a decade and have been proven effective. It is a part of our mission and values to stay current with the latest research and developments related to SCI. Further, the trainers at FSWC will be specially trained and certified using methods developed and researched by Project Walk. More research SCI recovery methods can be found on Project Walk’s research page: http://www.projectwalk.org/research/

Recovery from a Spinal Cord Injury:

9. Will I walk again?

Nothing in life is guaranteed, but if you do nothing to promote recovery, you are almost guaranteed a life without it. Taking care of yourself and taking control of your future is what makes life worth living. At First Steps Wellness Centre we can’t promise that you will walk again. We do promise the best facility in Canada, a positive environment for healing, the best and most highly trained and skilled staff in the world in the field of exercise-based recovery and a long-term, realistic plan that fits your needs as an individual.

10. What is the timeline to regain function?

There is no timeline or deadline for regaining function. Each person and injury is different. It’s only when someone actually regains function that we know they are healing. We have had clients regain function below the level of injury at a wide variety of intervals from two weeks to numerous months. Think of recovery as a lifetime process; it only stops when you stop trying.

11. My doctor said I have two years to recover. Is this true?

The doctors are correct in one aspect of the two-year window theory–your body is trying to recover and most people see the majority of their gains in the first two-years. If your body is trying to regain function, why not do everything in your power to increase your chances. The nervous system won’t improve without external stimulation and traditional treatment doesn’t work the paralyzed body. Without stimulation, your body will deteriorate. You will lose muscle mass, bone density and central nervous system activity. Increase your chances of recovering by changing your environment and increasing your nervous system stimulation. You can still recover function well past the two-year mark. The magic two-year mark is based on the assumption you do nothing to improve during that time. And, over the last 50 years or so, most people have not gotten better after the two year mark. The longer one waits to try to recover, the harder it becomes, but it is not impossible. We have worked with people five plus years post injury who are still regaining function. Our message to you is don’t wait. Take advantage of your body’s desire to heal before it is too late.

12. Do I require clearance from my doctor?

An application form must be submitted to FSWC, along with a doctor’s letter clearing the individual, based on past and present overall health, to participate in an intense exercise-based recovery program. Many times the doctor may request a bone density scan just to be sure that the bones are strong enough to support load bearing. FSWC recommends all individuals have bone density scan before attending FSWC

13. Should I give up everything and try to recover?

No, you cannot give up your life, family and friends, etc. to pursue recovery. Too often we meet someone who has moved across the country with the determination and mindset that they are going to get better and return home walking, only to fail. Add in undue stress and unattainable recovery timelines and you have an unhappy ending for everyone involved.

Clients who keep their support network and continue on with life are recovering. Recovery is a long process and isn’t all about walking; it is also about your life and how you live it. Outside of training, be active, play sports, go skiing and horseback riding, go back to school or work. In life, the most successful, happy people are well-rounded.

14. How can I stimulate my body to help it recover?

Humans don’t work as individual parts, the body is one unit and the nervous system has multiple complex jobs. One of its primary functions, however, is to deal with gravity by creating a stable upright posture. When you introduce gravity to the postural skeletal muscles, you stimulate the nervous system creating a demand on this primary function. Since the muscles of the legs have the longest and strongest levers they are the easiest to stimulate. As the muscles of the legs regain strength, they create a demand on the muscles within the pelvis to help with stabilization. This in turn helps to stimulate the muscles of the abdomen and low back to further assist with stabilization.

Unless you treat the body with load bearing and closed chain exercises using developmental movement patterns, you will achieve very little improvement.

Your recovery program:

15. How long should I wait to start my recovery program?

Once you are no longer in ICU and transfer to rehab, are healthy, and have your doctor’s clearance, you should start. Every day, every month, and every year that you sit in your wheelchair without nervous system stimulation, the harder it will become to regain function. With this injury your body is like newly poured concrete–in the beginning you can mold it, but once it sets, it is extremely difficult to work with. We have seen incomplete clients two or more years post injury struggle tremendously with tone and spasm because they did not receive the proper stimulation early on. The unfortunate thing is that these individuals are not alone. Each year hundreds of people wiggle their toes, get return of sensation down their bodies, some can even create movement, but they are told these occurrences are common and don’t mean anything. But it does mean something; it means everything. Your future depends on nervous system stimulation to improve.

Educate yourself, determine your goals, and try everything in your power to regain function. During this time, you will be improving physically and mentally, proactively increasing your quality of life.

16. How long is a recovery program?

There is no set standard on how long it will take to regain function. Every person has their own goals and desired outcomes and works towards their needs. Each person and the damage they have sustained are different; therefore, you can’t compare yourself to others because each person regains function differently.

Recovery is a lifetime program and includes all aspects of your life. What you do outside of FSWC is equally as important as what you do inside. Successful clients who are regaining function become independent, go back to school or work, and are surrounded by supportive family and friends. Because there is no timeline for recovery, you must develop and implement a life plan.

17. What are the costs and is anything covered by Saskatchewan Health or private insurance companies?

FSWC offers a 1:1 individualized exercise program. You will be working with a trainer who is certified in the Dardzinski Method™. Most of your workout will take place with you out of your chair. Full-time programs generally include 6-12 hours/week, with the amount of work-out time dependent on your injury level and individual goals. The rate for this program is $80 per hour.

FSWC aims to form partnerships within the healthcare system and private insurance companies to offer the best service to our clients at affordable rates. Clients are encouraged to discuss coverage with their individual insurer as applicable. Presently, Saskatchewan Health does not cover the training costs at FSCW. If your injury was work related, you should contact Worker’s Compensation.

18. Are programs made just for me?

At FSWC we create programs that are specific for the individual that combine their goals for recovery and our objectives for achieving those goals. These programs are constantly changing as the individual progresses through their recovery.

19. How long should my visit be?

All visits are a minimum of 1 week in length. However, we may recommend you stay much longer depending on your level of injury, budget, and schedule. For our out-of-province clients, a 1 month visit is pretty normal. The initial length of your stay will be determined by you and FSWC senior staff during the application process.

20. Do I need my own trainer?

If you are unable to attend First Steps on a consistent basis then you will probably need someone to assists you in your exercise program. This person can be a friend or family member that does not have prior experience working in a rehabilitation or exercise setting. He/she would be able to assist you in some basic exercises at home to continue your recovery when you are not at FSWC.

21. What if I cannot come to Regina?

FSWC highly recommends that you visit our facility in Regina. If you are unable to do this then you can purchase the Home Program Manual and DVD from Project Walk and it will be shipped to you.

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