Kenneth Cook Sr.: Testing the Limit

[caption id="" align="alignnone" width="300"] Cook, center, with his wife and Hogan. Photographs courtesy of Al Hogan.[/caption] Kenneth Cook Sr. was able to park his wheelchair and walk hand in hand with his wife for the first time in eight years when he was fit with bilateral stance control orthoses in 2009 (Ottobock Sensor Walk). Last November, he was fit with bilateral Ottobock C-Braces and is now able to dance with his wife for the first time in about 11 years. "[Cook] has incomplete paraplegia," says Al Hogan, Cooks' orthotist at the Edward Hines Jr. Veterans Affairs (VA) Hospital, Hines, Illinois. But the first time he tried on C-Braces, Cooks says, "We were sitting around joking, and I did this little jig. I was just kind of like, 'Wow, this is so cool. I can actually do a little wiggle.'" And there's more: Cook says he can walk at his normal 30-inch pace again. He uses hand controls in his car, but he says he can drive comfortably from his home in Chicago to Milwaukee, "run around all day," and then drive back home. He can descend and ascend stairs with a typical step-over-step gait. He can get up in the morning, get dressed, and find something to do, whether it is helping with chores around the house like vacuuming, baking, or making dinner. He is reclaiming his life, which, he says, is now 150 percent better because of his new orthoses. Cook, 53, is a Marine—there is no such thing as an ex-Marine unless you have a dishonorable discharge, he explains. He joined the U.S. Marine Corps in 1978 and served for two years at Camp Pendleton, California, where he was an administrative clerk. Cook injured his back during his service and says the injury was diagnosed as a strained muscle. While he had problems with his back on and off through the years, it wasn't until 2000 that things took a turn for the worse. Cook was working as a delivery truck driver, hauling packages and climbing into and jumping out of the truck many times a day. On one particular delivery, Cook jumped out of the truck, and both of his legs buckled underneath him. "I was lying on the ground in the street," he recalls. "My partner helped me get back in the truck...and he took me to Westside VA [Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois]." The tests and MRIs the physician ran showed that what Cook had originally been told was a strained muscle were pinched nerves at the L3, L4, and L5 levels and two or three herniated discs, he says. For the next 18 months, he went to physical therapy and received spinal injections—neither of which worked well. The VA provided him with a manual wheelchair in 2001, later upgrading him to a manual-assist wheelchair as his mobility challenges progressed. In 2003 he underwent back surgery. "I lay on that table for six-and-a-half hours, and believe it or not I was in better shape when I went in then when I came out," he says of the surgery. "That was how I ended up in a wheelchair... for about eight years." [caption id="" align="alignnone" width="250"] Hogan makes some minor adjustments to Cook's C-Brace.[/caption] Cook began seeing Hogan in 2007. The men have different memories about how they met and started working together. Hogan recalls seeing Cook for the first time outside of the bank where they both held accounts. Cook was in a wheelchair and was trying to transfer into his vehicle with the aid of Canadian crutches when he started to fall. Hogan rushed to help him, and the two started talking. When he found out that Cook was a veteran, he encouraged him to contact his physician and see if more could be done to help him. "And that is how I started with him," says Hogan. "I like to get patients out of wheelchairs." Cook remembers being at the prosthetics lab picking up some unloader knee braces, when Hogan commented about how well he got around with them and the Canadian crutches. Sometime after that, he was walking across the bank lobby with his crutches when Hogan entered; he again commented about Cook's ability to get around. The two got to talking, and Cook says Hogan mentioned another type of orthosis that might help him out. "So I set up an appointment...and he showed me pictures of the [Sensor Walk] braces and asked if I would be interested. I said, 'Sure I'll give it a try.'" Regardless of when and how they met, the patient/practitioner relationship that developed boded well for Cook because it led to him eventually being fit with C-Braces. "[T]hey hooked me up [with C-Braces], and I've been a happy man ever since," Cook says. Cook is one of the first veterans to be fit with C-Braces, says Curtis Kowalczyk, CO, clinical specialist, custom orthotics, at Ottobock, Minneapolis, Minnesota. But why Cook? "First and foremost, his attitude," Kowalczyk says. "He wanted to try this new technology not only for his own benefit but for the benefit of other veterans who might become more independent by using something like this." He also has the necessary clinical presentation: adequate muscle strength and core balance to "drive" the orthoses. He has better than grade-three hip flexors, abductors, and internal and external rotators-all of which are necessary for bilateral users because it indicates full hip control. C-Brace is a new class of device called an "orthotronic mobility system," Kowalczyk explains, meaning that it controls each phase of gait and automatically adjusts to prepare for the next movement as opposed to a stance control orthosis, which locks and unlocks. Kowalczyk assisted the Hines VA Hospital O&P staff while they fit Cook with Sensor Walks in 2007, and he provided training and technical assistance as Hogan and his colleagues fit Cook with C-Braces. Cook has progressed from being a limited community ambulator with the aid of bilateral Sensor Walks to being a full community ambulator with the aid of bilateral C-Braces. Cook takes his role as a tester of new technology to heart. "I don't think there's a whole lot of limitations with the C-Braces," he says, "but if there is I haven't reached that point yet. I'm giving them a good shot." In addition to the jig he did when he first tried them on, he also taught himself to walk backward while using them-even though he says he wasn't supposed to. "You wear them every day and you just try everything," he adds. "I've walked them down six flights of stairs; they did pretty good for me. I walked them back up three flights before...[I] got tired...." Cook's next goals, he says, are to see how far he can walk with C-Braces before the batteries run out and to ride a bike again. "That is my pet project this summer-I'm going to learn to ride a bike."

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Kenneth Cook Sr.: Testing the Limit

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