Rehabilitation Journey of Aucha

Introduction

  • Aucha's Goal: To live an independent life after a cycling accident in New Zealand.

  • Initial Prognosis: Doctors doubted she would speak again.

  • Current Status: Determined to progress beyond medical expectations after rehab.

The Accident and Initial Assessment

  • Accident details: Hit and run incident while cycling.

  • Glasgow Coma Scale: Used to assess brain injury severity.

    • Aucha's initial score was the lowest survivable rate.

Rehabilitation Process

  • Early stages: Significant change within the first six months, followed by a plateau.

  • Current focus: Independent effort for future improvements.

  • Time since accident: Sixteen months.

  • Rehab timeline:

    • ABI Rehab: Half a year.

    • Slow stream rehab: Seven months.

    • Move to Cambridge: Present location.

Daily Routine and Challenges

  • Sleep: Uses sleeping pills and antidepressants for a good sleep.

  • Daily activities: Focused on mental and physical challenges to stimulate brain learning.

  • Example: Trying to hit a cup to train the brain.

  • Independence: Maintains minimal support from friends or carers.

  • Recent setback: Broke her wrist during exercise.

Morning Exercises

  • Core exercises: To wake up and aid walking.

  • Physio exercises: Tummy exercises to lift hips off the ground.

  • Controlled movements: For balance and coordination.

Ataxia and Vision Problems

  • Right sided ataxia: Nervous system sends wrong messages to muscles, causing erratic movement.

  • Double vision: Brain gives the eye the wrong information.

  • Surgery planned: To align the two images.

Importance of Routine

  • Daily schedule: Essential to manage appointments and exercises.

  • Consequences of change: Gets flustered easily if routine is disrupted.

Walking Route Exercise

  • Grounding exercise: Thirty seconds to start.

  • Same route: Repeated for recall and eventual independence.

  • Walking bike: Enables community access and longer distances.

  • Assistance levels:

    • Total assistance initially.

    • Gradual reduction to independent navigation.

Neuroplasticity

  • Brain's ability: To create new neural pathways for learning.

  • Learning routes: Creates new pathways to aid memory.

  • Goal: Independent trips to supermarket, gym, cafe, etc.

Physiotherapy Background

  • Former career: 15 years in New Zealand, 8 years in Germany.

  • Current physio: Less experienced but collaborative.

Current Physio Session & Exercises

  • Exercises:

    • Lower limb strength exercises

  • Client Motivation: Aucha is highly motivated and hard working.

  • Energy is focused on: Shaping exercises, ensuring safety, and promoting progress.

Former Physio Passion

  • The good feedback that Aucha misses from when she used to practice physiotherapy.

  • Possible future work: Consulting type role in physiotherapy.

Eating Habits

  • Loss of hunger/appetite: Requires reminders to eat.

  • Awkwardness: Difficulty in handling food.

  • Food choices: Prefers easy-to-handle options like toast and salmon.

  • Reasoning: Believes her body is letting her down.

  • Eating is a chore: Just feeds her body because she has to.

Initial Post-Accident Period

  • First six weeks: Overwhelmed with assessments and information.

  • Current state: Settled routine.

Fatigue

  • Mental vs. Physical: Mental fatigue is easier to handle.

  • Importance of rest: Cannot delay breaks; everything breaks down without rest.

Support System

  • Caroline: Support worker who helps with housework and conserves Aucha's energy.

  • John: Cycling buddy and advocate who was crucial in the initial stages.

Independent Living

  • Transition: From heavy support to more independent living with assistance.

  • John's role: Reduced involvement as Aucha gains independence.

Future Goals

  • Paralympics: Aiming to compete after starting with a trike.

    • Trike acceptance: Initially unwanted but now appreciated for enabling activity

  • Independent, happy life: Includes going for rides.

  • Courage and perseverance: Never gives up.

  • Relief and happiness: Post-ride feelings.

Cycling is very important to Aucha's recovery and future, fitting into the Occupational Performance Model Australia (OPMA) in several key ways:

  1. Occupational Role: Cycling fulfills multiple roles for Aucha. It's a form of rehabilitation, a leisure activity, and a potential path to competitive sports (Paralympics). As cycling progresses, it allows Aucha to redefine her identity and purpose post-accident. It rebuilds her role as an athlete and an active member of her community. For example, the video shows her planning her routes and expressing excitement about future cycling goals.

  2. Performance Components:

Physical: Cycling enhances her physical abilities, including lower limb strength, balance, and coordination. It directly addresses the challenges posed by her ataxia and helps improve motor skills. In the video, we see her doing core exercises in the morning to help with balance needed for cycling, as well as demonstrating controlled movements.

Cognitive: Planning routes, remembering directions, and navigating require cognitive effort, supporting neuroplasticity and memory improvement. The video shows her engaging in mental practices to recall her route.

Affective: Cycling provides emotional benefits such as relief, happiness, and a sense of accomplishment. It combats feelings of frustration and helplessness associated with her physical limitations. The video concludes with positive feelings after a ride, such as relief and happiness.

  1. Areas of Occupation:

Leisure: Cycling is a recreational activity that provides enjoyment and relaxation, contributing to Aucha's overall well-being. The video presents cycling as a fun activity to socialize with friends.

Health Management: Regular cycling is integral to her rehabilitation and health maintenance, helping her to overcome physical challenges and prevent secondary complications. The video displays her disciplined approach to daily exercises to manage and improve her physical condition.

Social Participation: Cycling facilitates social interaction and community engagement, illustrated by her cycling with friends like John and her goal of independently accessing local amenities (supermarket, gym, cafe). The video exhibits her engagement to socialize with members from her community.

The integration of cycling into Aucha's life addresses her physical and emotional needs and supports her journey toward independence and a fulfilling life, aligning with the holistic approach of the OPMA.

Aucha's occupational narrative is deeply interwoven with her experiences of doing, being, becoming, and belonging, reflecting her journey before and after the cycling accident.

Doing

  • Pre-Accident: Aucha was a practicing physiotherapist with 15 years of experience in New Zealand and 8 years in Germany, actively engaging in her profession and helping others regain their physical well-being.

  • Post-Accident: Her ability to 'do' was severelyChallenge, she had to relearn basic motor skills. Cycling became a crucial 'doing' activity, serving as both rehabilitation and a means to regain physical strength and coordination.

Being

  • Pre-Accident: Aucha identified as a capable and independent healthcare professional, valued for her expertise and empathy in patient care.

  • Post-Accident: Her sense of 'being' was profoundly impacted as she grappled with physical limitations and a changed identity. Cycling aids her in redefining her 'being' as a resilient, determined athlete and an active participant in life, rather than a patient defined by her injuries. She is seen in the video determined to push beyond her limitations.

Becoming

  • Pre-Accident: Aucha's career as a physiotherapist indicated a path of continuous professional growth and mastery in her field.

  • Post-Accident: The accident redirected her path, necessitating a process of 'becoming' someone new. Her goals now include competing in the Paralympics and achieving independent living. Cycling is pivotal in this transformation, providing a tangible way to pursue these aspirations and redefine her future. The video captures her setting goals and working towards them.

Belonging

  • Pre-Accident: Aucha had established connections within her professional community and personal networks in New Zealand and Germany.

  • Post-Accident: Her ability to 'belong' was threatened as she faced social isolation due to her physical limitations. Cycling helps her to reconnect with her community through activities like cycling with friends (e.g., John) and working towards independent access to local amenities. Participation in cycling clubs or events could further enhance her sense of belonging.

Through cycling, Aucha integrates these elements of doing, being, becoming, and belonging, piecing together a new occupational narrative that highlights