Mobile Therapy : Have Bus, Will Travel to the Aid of People in Need of Exercise, Massage, Other Treatments

Sally Stevens begins the day at 9:15 a.m., leaving her Simi Valley home in a blue-and-white bus with the words Physical Therapy in Motion emblazoned on the side. She heads for Moorpark and Thousand Oaks, making the rounds of her patients’ homes and workplaces.

During an average day, Stevens visits 10 disabled patients--quadriplegics and paraplegics, people who are suffering from strokes or back injuries. She spends up to an hour with each.

Unlike most traveling physical therapists, Stevens treats these people in the street. She exercises them, massages them and applies therapies within the confines of her bus.

Two physical therapy experts in the San Fernando Valley said they knew of no other self-contained, mobile treatment unit.

“You have to give her credit for taking the initiative,” said Richard Katz, director of rehabilitation services at Granada Hills Community Hospital and a member of the American Physical Therapy Assn.

Range of Equipment

Stevens differs from other house-call therapists because the bus allows her to take a broader range of equipment to patients’ homes, said Doreen Grindler, rehabilitation coordinator of the Valley office of the Visiting Nurses Assn.

That equipment includes $15,000 worth of machines: mechanical traction, ultrasound (which bombards tissues with sound waves to ease pain and control inflammation), a neuromuscular stimulator, electrical stimulators (which contract muscles to tone and strengthen), galvanic stimulators to decrease edema and pain, an acuscope (“I use it under the theory of acupuncture, with energy rather than needles”) and transcutaneous electrical nerve stimulation units.

All of this is contained in a bus that Stevens took out a $40,000 loan to buy. Her husband, Rich, 46, extensively remodeled the bus, adding electrical outlets, insulation and carpeting. He removed seats and installed a table and cabinets.

Sally Stevens also bought cervical and pelvic traction units and Velcro weights for the bus.

But there is more to the work than just equipment, she said. Stevens, who graduated with a bachelor of science degree in physical therapy from California State University, Long Beach and later worked in supervisory capacities at several hospitals in the San Fernando and Simi valleys, said she must listen to, soothe and encourage her patients.

“As the patient is lying there, there is a lot of counseling, a lot of uplifting,” said Stevens, 42.

2 Herniated Discs

One of Stevens’ patients, Debbie Holden, was eight months pregnant when she was in a car accident in 1981. The Simi Valley woman suffered two herniated discs. Seven years later, Holden, 37, still requires therapy.

Stevens visits Holden’s home three time each week. On a recent day, Holden climbed into the bus and lay on her back on a padded examination table.

Stevens placed a foam cushion under Holden’s calves and a moist heat pack under her back. She applied a galvanic stimulator to Holden’s lower back and legs. After a timer went off, Holden turned on her stomach. Stevens moved the ultrasound wand in a circular motion across her back. She finished with a massage.

Holden had been seeing another physical therapist, but, she said, “I wasn’t getting any relief at all. It was a meat-market-type therapy. They even hung me upside down.”

Stevens shows care and compassion, Holden said.

“She knew I was suffering physically and mentally,” Holden said. “She started treating me, and I had never gotten so much pain relief.”

After many years of not being fit to work, Holden is now an assistant director of the Family Connection, an employer-supported child-care center.

“It means a lot to me to be able to be back at work and be a mother and wife again,” she said.

Before Stevens left, Holden hugged the therapist.

Former Mechanic

The bus traveled next to Moorpark, where Stevens worked with Steve Canterbury, 41, who was left a quadriplegic in a car accident two years ago.

Canterbury, formerly an auto mechanic for the city of Thousand Oaks, was driving on a two-lane highway near Ojai when an oncoming car drifted into his lane. Canterbury swerved and his sports car rolled over. He awoke in a Ventura hospital.

“I could not move a thing,” he recalled. “I was completely paralyzed.”

He underwent neck-stabilization surgery at St. John’s Regional Medical Center in Oxnard and began daily therapy there.

Today Canterbury--stretching his 6-foot-1 frame in a recliner while watching a football game on TV--said neurosurgeons “don’t really know what’s going to come back and what’s not.”

Stevens started treating Canterbury late last summer. His program includes stretching and exercising his arms, legs and trunk using progressive resistance. Stevens also uses an electrical stimulator to force muscles to contract.

Canterbury now can walk with a walker and has some use of his left hand. He rides a stationary bicycle 1 mile a day.

“When Sally started treating me, I couldn’t move this right leg at all,” Canterbury said, lifting his leg. “I have areas that were useless to me that I’m getting to be able to use again.”

Canterbury’s insurance coverage does not cover the entire cost of his therapy.

“Fortunately, Sally told us she would give me therapy, and we could only pay what we could afford,” he said.

Constant Pain

Another stop this day was at the Simi Valley home of Claire Buchanan, 49, a former data-processing project coordinator. Buchanan, a bespectacled, heavy-set mother of seven, emerged from her door supported by a cane.

She told of constant back and leg pain resulting from a 1984 incident when she ruptured a disc while lifting four personal computers into a car.

The injury required five back surgeries. Painful scar tissue still surrounds the nerves in her lower back, but she can’t risk more surgery. She relies on physical therapy and two Percodan a day to ease her pain.

Buchanan said driving to a therapist’s office brought on so much pain that it undid the benefits of therapy. Then Buchanan found Stevens, someone who “feels for us,” she said.

For the last 1 1/2 years, Stevens has treated Buchanan with a combination of galvanic stimulation, ultrasound, acupuncture-like acuscope, moist heat, massage and exercise.

Spiritual Life

But Buchanan credits Stevens with giving more than physical therapy; she credits the therapist with redirecting her spiritual life. Buchanan’s existence had become so pain-ridden that it drove her to a back room where, she said, “many times I picked up that cold gun in my hands.”

Stevens, she said, instilled a lot of “learning and discipline” into her life. On this day, the woman is in a joyful mood.

At Stevens’ home, one bedroom has been converted into a crowded office. Two desks, a copier and many medical books fill the room.

Stevens acquired a second bus earlier this year, equipped it and hired a registered physical therapist, Jodi Proud, 27, of Simi Valley, to staff the vehicle. Proud’s patient load is already nine a day. And there are so many new referrals that Stevens must hire at least one more therapist.

She also employs an assistant to work in the office during the week.

With vehicle, equipment and insurance costs, a physical therapy business is not among the most profitable, Stevens said. But the therapist said she finds her mobile work more satisfying than previous, hospital-bound jobs.

“When you are working for someone else, they want you to do as many patients in the shortest amount of time,” said Stevens. “I was often doing four to six patients at a time, whereas this is 100% one-on-one--as long as you want to be with the patient, as long as they need you.”