Center plays role in woman’s recovery

It looked like the end when Nancy Lieberman slipped into a coma after undergoing surgery to remove part of her skull. But it was just the beginning of a story of hope and persistence infused with help from an innovative rehabilitation team.

Lieberman, 52, had a severe stroke followed by seizures in 2007. After she had surgery to remove the right part of her skull, doctors told her family that she probably would not walk again and would remain in a vegetative state.

But they did not give up.

“We were told the worst that could happen, and I wouldn’t go with that,” said Lieberman’s son, Sam. “I knew she had to pull through.”

After three months in a coma, when the doctors removed Lieberman’s breathing tube because it looked like she wasn’t going to wake up, she said, “Ouch,” recalled Lieberman’s daughter, Lisa.

The memory is still vivid to Sam, Lisa and their father, Mark.

A week later, Lieberman was able to recognize her family.

“She was laughing with us,” Lisa said. Unfortunately, Lieberman had complications and ended up needing kidney dialysis for several months.

“We took it one day at a time, and we kept hoping,” Sam said.

When the family felt that her rehabilitation was not progressing, they looked for a different approach. Four months ago, they took Lieberman to the Medical Rehabilitation & Kinematics Lab in the Miramar area that was founded by Del Mar resident Bradley Marcus and his brother Hank Marcus.

Bradley Marcus is an osteopathic medical physician who is certified by The American Board of Medical Specialties in the field of physical medicine and rehabilitation.

Based on his research, Marcus said, he set out to create one of the most modern facilities in the world for motor and gait training. His team includes a licensed physical therapist certified in brain injuries, a licensed occupational therapist and two rehabilitation technicians.

He started practicing in San Diego four years ago, providing inpatient rehabilitation, outpatient sports medicine, pain management and physiatry (physical medicine and rehabilitation). When he opened the new facility, he installed state-of-the-art computerized exercise machines, which give immediate patient feedback.

His approach is to educate patients — who range in age from 1 1/2 to 96 — on their condition and what they are trying to accomplish, so patients understand why they’re doing certain exercises and how it helps them.

The equipment is decidedly high-tech: computer screens, cameras and wireless devices fill the Trade Street facility.

Among the devices is the latest generation Ariel Computerized Exercise Machine, which monitors and selects the amount of force, velocity, acceleration and other variables for a patient’s exercise program based on continuous performance measurements. Older models are often used at Olympic Training Centers and have been used by NASA.

Marcus also utilizes the Lokomat, which has robotic legs that adjust to the patient’s efforts and allows the individual to work on strength, timing and coordination in a video-walking simulator. It’s been the key piece of equipment for Lieberman, who generally goes to the center five days a week and works out for 90 minutes,

“The goal is to get people moving who previously weren’t moving,” Marcus said.

He also can utilize a robotic elbow if a patient is unable to move an arm that can listen to the smallest signals reaching the muscle from the brain. It will move the arm almost as well as the unaffected arm, Marcus said.

And last week he and a salesman for Tibioin Bionic Technologies talked about the prospects for a robotic leg that is being used to help patients recover a normal gait.

The center also has computers with virtual reality programs that, for example, can simulate a racecar and help a patient work his or her “core muscles” by leaning right or left to steer the car, Marcus said.

Research is starting to show that with the right environment, patients who once were considered by the medical community to be lost causes can now be helped, he added.

Lieberman has made strides at MKR Labs. Doctors told her family that her left side might be paralyzed, but now she is able to move her left leg. At this point, she is able to scoot around in a wheelchair and sit up on her own.

“She is more in tune to her surroundings,” Marcus said. “At first, she went though most of the sessions with her eyes closed, but now she watches a movie while she exercises and makes comments about it.”

One of the biggest improvements has been in her communication.

When she first came to the center, Lieberman did not talk much, but now she is able to say simple sentences. She’s able to tell her children that she loves them and appreciates what they’re doing.