[Detroit Rehab IS the place to go]

A CHANCE TO WALK AGAIN

Cost of rehab puts limits on patients
CORTNEY HOFFMAN'S CHALLENGE: She pushes for independence
January 22, 2007

BY PATRICIA ANSTETT

FREE PRESS MEDICAL WRITER

Whether she's tired or not, Cortney Hoffman wakes up before dawn,
three days a week, to make the one-hour trip to the Rehabilitation
Institute of Michigan in Detroit for therapy meant to coax her
damaged body to move.

Hoffman, paralyzed from her shoulders down in an auto accident in
2002, still does not walk unassisted, but she is stronger and has
made gains that make her healthier and more independent.

Two years ago this month, Hoffman, 20, of Riga underwent experimental
stem-cell surgery in Portugal in an attempt to regain mobility. The
surgery, not approved in the United States, involved using her own
stem cells from nasal tissue.

In therapy, Hoffman can walk 134 feet around a track with leg braces
and an upright walker, with help from her athletic trainer, Kerrie
Walker. Hoffman can do 100 push-ups, kneeling forward on an exercise
ball, and pedal for a half-hour or more on an upright bicycle-like
device, once she is strapped to it.

At home, she can get in and out of bed on her own, using a wooden
slant board. She can take off her pants in 2 minutes, not the 15 it
took a year ago. Last year, she got her driver's license.

Last week, she began attending classes at Monroe Community College.

"Everything' s easier," she said.

While Hoffman has been undergoing therapy, the Rehabilitation
Institute has become a leading center in aggressive rehabilitation
after a spinal cord injury, attracting patients come from all over
the world.

"More than 160 spinal cord patients have enrolled in the Detroit
program in the last two years," said Paula Denison, administrative
director for specialty services at the institute, which has added an
aggressive-rehabili tation program in Grand Rapids.

With a formal collaboration with the team from Lisbon, Portugal, the
institute hopes to become the first U.S. site of the stem-cell
procedure for spinal cord injury. But first, it must analyze outcomes
of patients having the surgery abroad, to convince the federal Food
and Drug Administration that the surgery is safe and effective.

The Lisbon team has performed the operation on more than 60 patients.
A report on the first seven of those patients, published last year in
the Journal of Spinal Cord Medicine, said all have had "a modest
amount of improvement in function."

Many are taking a wait-and-see approach to the surgery.

Hoffman's newest challenge is more typical of those her age: She will
test herself to see how she adapts to a college environment where
buildings aren't as wheelchair accessible. She has other worries,
too, including making friends.

"I don't want everyone to stare at me and wonder, 'What happened to
that girl?' " she said.

She wants to be a speech therapist.

And she still wants to walk someday at her own wedding.

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