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Getting Closer Every Day


Shortly after 11 a.m. on the morning of April 2, 2016, Brian Rapp was pulling a small, fiberglass boat behind his pick-up truck on the way to his vacation home in Lake Anna, Virginia. Rapp had purchased the used, 898 Nitro Bass Boat at a good price, and was happily anticipating another season of bass fishing on the large freshwater lake.

But that carefree summer of fishing was not to be. Less than a mile from his house, a pick-up truck and Brian’s SUV collided head-on. The impact broke the tibia, fibia and femur of Brian’s left leg, and he suffered a compound fracture of his right femur. His left patella was shattered, along with 17 ribs.

The 49-year-old remodeling contractor was airlifted to UVA Medical Center in nearby Charlottesville, where he underwent three extensive surgeries. Initially unable to walk, lift his head, or raise his arms; Brian transferred to a long term care facility specializing in orthopaedic rehabilitation near his Frederick home just fourteen days after his accident. Several months later, he went home with the support of FMH home-based Rehabilitative Services.

After several weeks of home-based physical and occupational therapy, Brian turned to FMH Rehabilitation Services to continue his recovery. Since July, he has been working through a customized rehabilitation plan at the hospital’s Aspen Ridge location under the care of a multidisciplinary team of physical and occupational therapists. Overseen by one of Brian’s care team members, Physical Therapy Assistant Nick Harbaugh, his rehabilitation plan relies on evidence-based protocols, and the use of state-of-the-art equipment to strengthen his injured muscles, ligaments and tendons, increase his range of motion, and promote flexibility while decreasing stiffness.

On Mondays and Fridays, Brian works out with Nick using land-based equipment, including the AlterG treadmill. Recommended as the ideal way to exercise without impact or stress to joints, AlterG technology allows recovering patients to exercise “on a cushion of air,” taking considerable weight off compromised joints. Using technology developed by NASA, the AlterG® treadmill strengthens and improves Brian’s muscle coordination, enhances balance and gait, and promotes a full range of motion.

“I could feel dramatic improvements in the earliest stages of my rehabilitation,” says Brian. “During the time I went from using a wheelchair, to a walker, to crutches, I felt daily improvement. But once I got to a certain point, it was harder to recognize very much forward progress.”

All that changed for Brian in August, when his rehabilitation plan expanded to include aquatic therapy. Every Wednesday, Brian works with physical therapist Cindy Brendle for 60-70 minutes in the Aspen Ridge location’s SwimEx® pool. Also called a “resistance pool,” a SwimEx hydrotherapy pool allows Brian’s injured body to actively “rest” while he gains strength, stability, confidence, and range of motion.

“I do everything in the water that I do on land,” says Brian. “But the resistance of the water is a game changer. It makes the work-out more demanding, and I can feel a big difference the very next day—my legs, arms and core feel stronger and more flexible. It’s good for me physically, but it’s also a good motivator. The more I feel myself improving, the more motivated I am to do more—and the closer I feel to getting my life back to the way it was before the accident.”

Water is 600-700 times more resistant than air, allowing for significant strengthening of injured muscles, ligaments and tendons. Physical Therapy Assistant Cindy Brendle, Brian’s aquatic therapist, says that it’s the unique properties of water-- buoyancy, hydrostatic pressure, viscosity and fluid dynamics—that provide Brian with the extra support, additional pain and spasm relief, and decreased swelling he needs to execute the exercises comfortably and effectively.

The aquatic portion of Brian’s physical therapy uses the buoyancy, hydrostatic pressure, viscosity and fluid dynamics of water to help him gain strength, mobility and confidence while gradually increasing his weight-bearing ability. “The warm water—kept at a constant 94 degrees—relaxes Brian’s muscles and increases blood flow to the injured areas,” says Brendle. “The resistance builds strength, and the hydrostatic pressure of the water keeps the swelling down, takes the lactic acid out of the cells, and delivers it more efficiently to the muscle—that’s why muscles exercised underwater usually will not feel as sore.”

The SwimEx pool at Aspen Ridge has multiple water depths, a variety of workstations for stretching and core stabilization maneuvers, ledges for seated exercises, and variable settings for water speed and resistance. Brendle is able to program all the pool’s conditions from one session to the next to keep baseline levels consistent, and accurately monitor Brian’s progress over time. “The SwimEx pool is a very versatile piece of equipment,” she says. “It is extremely beneficial in helping patients like Brian recover from serious injuries, but it has many other uses as well. Aquatic therapy helps build muscle strength and flexibility following joint replacement surgery. And it’s an effective tool in managing medical conditions that affect joint or muscle integrity such as arthritis, fibromyalgia, amputation and other chronic conditions characterized by chronic pain.”

Brian gives a great deal of credit for his continued progress to the multidisciplinary team he has been seeing for the past six months. “I’m motivated to come all the way back from this,” says Brian. “I was always really active before, and I’m determined to get back to work and life as I knew it as soon as possible. And my therapists get that. They have taken their lead from me, and put together a plan for my treatment that I can feel working every day.”

Considering that just seven months ago Brian couldn’t walk at all, his progress has been remarkable. “Of course, I want to be 100% recovered yesterday,” says Brian, “But I realize that it takes a while to come all the way back. And my doctor is extremely pleased with my progress. When I go in for my follow-up appointment, he just says ‘Keep on doing what you’re doing, because you’re looking really good.’ I’m working hard to get my life back to how it was, and I couldn’t ask for better partners in doing that than the team at FMH Aspen Ridge.”

To learn more about FMH Rehabilitation, click here or call 240-566-3132 for more information.

Categories: RehabilitationTherapy