In May 2024, Jacob ‘Jake’ Martin had a post-surgical seizure a few months after an operation to remove a meningioma (slow-growing brain tumour). The seizure occurred while Jake was driving, and he was rushed to Bedford Hospital, where a combination of issues rendered him immobile, with poor muscle strength, cognitive impairment and a limited range of joint motion.
However, Jake was determined to regain mobility and find a way to walk again when he arrived at St. Neots Neurological Centre to begin his rehabilitation journey. In the weeks that followed, Jake and his specialist care team were able to achieve remarkable results as he fought to overcome severe physical challenges. Here, Therapy Lead Anand Kumar Annamalai shares Jake’s story of unwavering determination to get back on his feet.
Anand says: “When Jake arrived with us at St. Neots Neurological Centre, he was using a wheelchair and had a catheter in situ. From the outset, Jake’s goals were to be able to transfer and use the toilet independently, as well as to build the strength to walk again. Following a comprehensive assessment by his Multidisciplinary Team (MDT), a tailored treatment plan was devised across various disciplines.”
Finding the strength
As Jake was starting as wheelchair dependent, the team focused on helping him gain the physical strength needed to become more independent.
Anand says: “Jake’s physiotherapist, Sonia Stephen, created a comprehensive, individualised plan to address his needs and aspirations. The primary goal was to improve his lower limb strength, trunk control, and overall mobility, transitioning him from wheelchair dependence to walking with a frame. The exercises were focused on strengthening his lower limbs and core muscles, gradually advancing to standing transfers and gait training.
“Rebuilding this strength is no easy feat, with fatigue and physical weakness among the primary barriers to his recovery. Jake also faced a significant fear of falling and lacked confidence in his mobility. This fear, coupled with unsteadiness during weight-bearing tasks, required a careful balance of safety and encouragement from his therapy team.So, Jake had to dig deep to find the resilience to keep going when initially he struggled with standing transfers and weight-bearing activities.”
The answer was frequent but short therapy sessions designed by the team, which could work within Jake’s physical capacity while gradually building endurance. In addition, Jake’s cognitive impairments sometimes made following therapy instructions challenging, so therapists adapted their communication methods and used simplified instructions and visual demonstrations to ensure clarity. Jake also had a history of seizures, which meant every session was conducted under close supervision to ensure his safety. These measures were particularly critical when Jake was outdoors.
Despite the numerous challenges, with expert guidance from the physiotherapy team and his unwavering dedication and effort, Jake started to make notable progress.
Anand adds: “After three weeks of rehabilitation, Jake was able to transfer without assistance but instead using a walking frame. His increased lower body strength improved his weight-bearing ability and allowed Jake to do standing transfers independently. Having conquered standing again, Jake started to use the walking frame to move across short distances in his room. Within weeks, he had gained the confidence to push himself further and was now walking between his room and the lounge, showcasing his improved mobility.”
The next step towards independence
Reliance on support for personal care can limit independence, so Jake’s rehabilitation included strategies to eradicate the need for assistance in the bathroom.
Anand says: “From the off-set, Jake was determined to achieve toilet independence, and with the help of our Occupational Therapy team, he succeeded. The first step was finding a solution to Jake’s difficulty transferring from his wheelchair to the toilet commode. The issue was that the commode seat was low, making it hard for Jake to transfer successfully. The solution was found in a freestanding toilet frame, which was height adjustable, allowing Jake to set it at the right level for his needs. This new equipment made the difference, and Jake was soon empowered to use the toilet independently.
“Along with working with Jake on toilet independence, the Occupational Therapy team started looking at how to empower him in other daily living activities. Senior Occupational Therapist Farah Azam and I conducted a full assessment of his personal care routines to identify where Jake needed extra support to complete specific tasks such as showering. In addition, we looked at meal preparation and how to work towards Jake being able to use the kitchen again for himself. As the rehabilitation continued, Jake received personalised training to help him prepare small, manageable meals by himself. The impact on his confidence was significant as he enhanced his skills and ability to handle kitchen tasks.”
Milestones in Mobility
The time Jake spent working with the MDT at St. Neots was invaluable as he reached the end of his rehabilitation and prepared to return home.
Anand says: “At the end of Jake’s six-week rehabilitation programme, his progress was exceptional. His mobility had improved to the extent that he could walk outdoors if he wanted to, covering uneven garden surfaces and increasing his distance to 20 metres. His indoor mobility was significantly improved as he used both his walking frame and furniture support to move around his living space. He’d even started incorporating stair usage into his routine, demonstrating the ability to descend stairs with assistance after ascending a stairlift. Jake had made incredible progress towards his independence goals and started readying himself to return home.
“There was no doubt that leaving St. Neots would involve adjustment, but Farah and I had been working to ensure new measures were in place. We assessed Jake’s home and identified the key modifications needed for his newfound independence. A Mowbray toilet seat and frame were ordered for his second bathroom to ensure safe transfers, as well as a Zimmer frame for him to move comfortably around the house. These extra measures were in place alongside Jake’s attendant-propelled wheelchair and adapted wet room furniture. As he returned home, Jake could be confident that things were in place to enable him to build on the independence he’d already achieved.”
“A powerful testament to the human spirit.”
Reflecting on the clinical outcomes Jake and the team at St Neots achieved, Anand believes the combination of expertise and sheer determination was the key to Jake’s success.
Anand says: “Jake’s journey from wheelchair dependence to partial independence is a powerful testament to the impact of dedicated physiotherapy and the resilience of the human spirit. Through targeted interventions and relentless effort, Jake achieved key milestones that restored his mobility and enhanced his quality of life.
“His story underscores the crucial role of therapy in rehabilitation and exemplifies how personalised, patient-centred care can lead to remarkable recoveries. The team’s collaborative approach, where physiotherapy, occupational therapy and patient motivation intersected, achieved life-changing outcomes. Jake’s perseverance, combined with expert guidance, allowed him to overcome significant physical challenges and reclaim his independence.”
When he was preparing to leave Jake shared these words of gratitude to Sonia and the physio team at St Neots.
Jake said: “When I arrived at the hospital I couldn’t walk. With thanks to Sonia and all the support she has given me through intensive leg and muscle exercise I am now able to transfer from my wheelchair to my bed or another chair with ease, and I am also walking with a Zimmer frame very confidently. ”
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Adderley Green, Staffordshire
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St Neots, Cambridgeshire
Stanley House, Herefordshire
The Avalon Centre, Wiltshire
The Bridge, Middlesbrough, Wiltshire
The Dean, Gloucestershire
