'Where I'm supposed to be': Manitobans head to Saskatchewan for spinal cord rehabilitation

Three months after a snowmobile accident left her paralyzed from the chest down, Danique Dupuis left Winnipeg's Health Sciences Centre rehabilitation facility with a modified wheelchair, some functional movement in her upper body and a large backrest she thought she'd need her whole life.

It wasn't until she went to a rehabilitation centre in Saskatchewan that she realized she had moremovement to gain, she said.

"I used to need a big backrest that would hold me up, and now I barely have any support," said Dupuis, who's 19, referring to the reduced backrest on her current wheelchair.

In summer 2017, Dupuis started therapy at First Steps Wellness Centre, a charitable not-for-profit facility in Regina that focuseson spinal cord injury rehabilitation. Her family pays for the expensive therapy, which is not covered by medicare.

When Dupuis rolled into the facility with her high backrest, the therapists immediately recommended cutting the backrest down and focusing on developing her core muscles.

"I kind of feel like that's where I'm supposed to be," she said, "or it's like the best place to be after something like a spinal cord injury."

In Manitoba, patients with spinal cord injuries go to Health Sciences Centre, which has the province's only publicly funded rehabilitation facility. After they're discharged, most continue to get a blend of physiotherapy, occupational therapy and nursing care on an outpatient basis, usually with two or three hours of physiotherapy per week.

But Danique is one of several Manitobans with spinal cord injuries who have goneto the clinic in Saskatchewanfor services they feel they aren't receiving in their home province.

Executive director Owen Carlson said a steadystream of Manitoba clients has increased over the past three years.

This year, he's typically hadaround five or six patients from Manitoba at a time, he said.The majority of them, including Danique, receive about 15 hours a week of exercise-based therapy.

"We had had a few one-off people [before that]," Carlson said. "But when you have your first person, that sort of reaches back to all of the people that they were going to rehab with and starts telling them and that chain has never been broken."

'Less alone'

First Steps offers exercise-based therapy led bykinesiologistswho have done extra training to become exercise physiologists, Carlson said.

The facility uses therapies such as pneumatic training and gait training that assist the body with movement and help it relearn movement patterns.

Other therapies, such as vibration therapy and functional electrical stimulation, cause muscles in the body to relax and contract, encouraging muscle development and helping the nervous system grow and reconnect to different parts of the body.

The centre's focus is on neuroplasticity, which he described as the ability of the brain to rewire itself after an injury.

The centre isn't a replacement for inpatient care in a hospital setting, he said.

He'd like to see the provincial governments in Saskatchewan and Manitoba fund two or three months of care at the centre following discharge from hospitals, and to work with hospitals to more fullyintegrate the therapies into outpatient plans.

An entrepreneur in Winnipeg hopes to open a centre in the city in the future, Carlson said.

When Danique left the hospital in Winnipeg, she was offered two hours a week of physiotherapy. Itfocused on the mobility she still had using her arms to transfer in and out of her wheelchair, for example rather than working on her lower body,she and her mom, Gatane, said.

ButGatanesaid her family had researched other people with spinal cord injuries who improved their quality of life by working on muscles below their level of injury, even if it didn't mean walking.

"That's what we were looking for a bit more than just, 'OK, well you're confined to your chair for the rest of your life, get used to it,'"Gatanesaid. "Those were the exact words that they were using for us."

Danique'swork at First Steps has included strengthening hercore muscles to improve stability, time on an exercise bicycle and workon crawling. She's also continued to strengthen her arm muscles.

She's hit a series of small milestones that add up to major progress, including the ability to pedal on a spin bike, her mom said.

Whilemany of her fellow patients in Winnipeg were elderly or recovering from amputations, at First Steps, Danique has met people like her with spinal cord injuries.

"I didn't really get to meet people my age, or people that were going through, like, similar things as much as I do here," she said.

"It means a lot. I guess you feel a little less alone."

'Much more than walking'

Rudy Niebuhr, clinical advisor in physiotherapy at Health Sciences Centre's Rehabilitation Hospital, said outpatient services for patients in the program are determined based on patients' individual needs. There's no cap on how many hours a patient may get.

The Rehabilitation Hospital sees roughly 50 to 60 patients a year, with inpatient stays averaging from three to six months, he said.