Dancing Down the Road of Rehabilitation

B.A. was unable to talk, walk, breathe, or eat independently. This was not the charismatic leader who had been involved in dance, art, theatre and was an honor roll student at a premier performing arts middle school. Suddenly, at only 14 years of age, her dreams of dancing professionally were shattered and no longer a guaranteed opportunity. B.A. was in a car with her cousin on her way to Spring Break vacation when she was involved in a rollover motor vehicle accident outside of Houston, Texas. She was given a Glasgow Coma Score (GCS) of 5, which indicated a severely impaired level of consciousness. B.A. was intubated and sedated upon arrival to a trauma center.

Upon initial examination and CT findings, B.A. was diagnosed with a diffuse axonal injury, subdural hematoma, right trapezium fracture, second metacarpal fracture, thoracic compression fractures from T5 to T9, and right hemiparesis.

Approximately, three weeks after B.A.'s injury, she was admitted to an acute children's rehabilitation center for further treatment of her severe brain injury. Upon admission, she was moving all extremities, had begun to follow one step commands on occasion, was incontinent of bowel and bladder, was unable to communicate without moderate prompts, had dysphagia, was confined to a wheelchair, and had limited facial expressions. Throughout her course of stay, complications included pseudomonas, MRSA (an infection), trachetitis with TPBI breathing treatments, continued splinting of her right arm due to an unresolved fracture and hemiparesis.

After five weeks of acute rehabilitation, B.A. was admitted to Centre for Neuro Skills® (CNS), a post-acute brain injury rehabilitation center in Irving (Dallas), TX. B.A.'s unwavering goals upon entering CNS-Irving were to go to a performing arts high school, dance, write, walk and remember things. At admission, she continued to have swallowing difficulties, required moderate cues to perform at the 5th grade level, was unable to write, self-correct her errors, sequence or organize her thoughts or daily life events, walk without a walker, and continued to have a PEG (feeding) tube. Therefore, her treatment program emphasized visual deficits, cognitive skills, speech and language skills, adjustment to disability, endurance, balance, and coordination. Dance lessons and instruction were a key component of her therapy routine in order to include something she loved so much, while focusing on improving her physical movements and cognitive skills to recall the sequences. In accordance with this, B.A. was involved in therapy six hours each day in the areas of occupational, physical cognitive/speech, educational and counseling therapies.

However, B.A.'s rehabilitation was complicated due to severe weight loss, inability to use her right extremities (especially her right arm and hand), visual deficits, distractibility, moderate to severe cognitive impairments including memory, attention, speed of processing, executive functioning, awareness and decreased ability to sequence a series of steps in a task. B.A. also has a pre-morbid personality characteristic of being an "over-achiever." These factors may delay progress in rehabilitation and had the potential to affect B.A.'s ability to achieve her goals.

B.A. continued to push herself to overcome any challenge in her path to return to dance and school. In fact, she needed encouragement to take a break from her homework and exercise routine because her drive was incredibly strong before her injury and even stronger after. After seven months of participating in the Day Neuro Program and receiving homebound instruction through the school district, B.A. was able to set foot on campus at the performing arts high school she had dreamed of attending. Over the next four months, B.A. continued to receive therapy support to reintegrate into the school setting while tapering the frequency of participation in therapy.

B.A.'s next goal is to graduate as an honors student from the performing arts high school that she attends and to go to college to study Neuroscience. She would like to pursue a career as a physical therapist. B.A. continues to dance five days per week in school and at additional dance classes at a private studio. She maintains her place on the honor roll and continues to have a small group of close friends. Dance will always be a part of her life, but through her injury and rehabilitation experiences, she wants to use dancing not just to entertain others, but to help them through rehabilitation, just as dancing helped her.