IN SHORT: After a devastating car accident and traumatic brain injury, Rose needed extensive assistance with nearly every aspect of daily life. Since 2010, Tandem Strength & Balance® has worked with her to rebuild strength, regain important abilities, and help her live the best life possible. For years, her family continued to push for progress and challenge what Rose could do. For the past five years, the focus has been on maintaining her mobility at her assisted living community. Today, she transfers with the assistance of one person and remains pain-free without pain medication. Her story shows why long-term physical therapy can remain valuable long after major improvements have been made.
A Devastating Accident Changed Everything
In 2005, a car accident changed the course of Rose's life. She sustained a traumatic brain injury (TBI), a severe pelvic fracture, a left scapular fracture, and multiple fractures of her thoracic and lumbar spine. During rehabilitation, she also fractured her left hip and required a hip replacement.
When Tandem Strength & Balance® began working with Rose in 2010, she was living at home with 24-hour caregivers and needed extensive assistance with nearly every aspect of daily life.
Rose relied on a Hoyer lift for all transfers and used a tilt-in-space wheelchair. She spoke only three or four words and had significant difficulty managing secretions. She could stand only with total assistance from a physical therapist and was unable to walk.
Even sitting on the edge of her bed required moderate to total assistance. She had difficulty recognizing where her body was in space and could not reliably catch herself when she lost her balance. Her caregivers helped her eat, and she needed total assistance to reposition herself in bed.
Her family was deeply involved in her care and continually looked for ways to improve her memory, reduce muscle tightness, and support her quality of life. Her caregivers were already spending close to an hour each day helping her with stretches and exercises.
Her family understood that Rose would always need assistance. Their goal was to help her achieve the best life possible, continuing to pursue meaningful improvements while recognizing her lasting limitations.
The Work Behind Every Movement
At her family's request, TandemSB began working with Rose five days a week. Sessions soon increased from 45 to 90 minutes because so much preparation was needed before functional activities could begin. We continue to work with Rose five days a week for 90 minutes per session.
Rose's caregivers were already providing consistent, dedicated care. Yet she still needed a physical therapist's hands-on help to maintain her range of motion and address muscle tightness before she could work on sitting, standing, and transferring. Nearly half of some therapy sessions focused on maintaining range of motion alone.
Rebuilding strength was equally important. Despite being relatively young, Rose had lost significant strength after years of limited movement and inactivity. Rebuilding her leg strength became an important part of helping her regain the ability to stand, participate in transfers, and take part in everyday activities.
TandemSB also helped the family obtain a standing frame, which caregivers used twice daily for 60 minutes, as well as ankle braces to improve ankle control during standing practice.
Progress took time. It was approximately six months before significant functional changes became apparent.
Regaining Abilities - And Opportunities
Within the first year, Rose could sit in a standard wheelchair, transfer with her physical therapist, and stand with moderate assistance for up to five minutes. She became more alert, spoke more, and began interacting more with the world around her.
Over time, she progressed to pivot transfers with one person's assistance, learned to roll independently in bed, and became more involved in her daily personal care.
She also practiced walking with her therapist and worked on getting in and out of a car.
Her family continued to push for rehabilitation and encourage further progress. Over the years, Rose gained abilities that opened doors beyond daily care.
She attended the Minnesota State Fair and enjoyed two rides that required assisted transfers. She also took five trips with her husband and children, navigating airplanes, hotels, and the challenges of traveling together.
These experiences were about more than physical ability. They gave Rose opportunities to participate in family life and enjoy meaningful experiences with the people she loves.
When The Goal Changes From Progress To Maintenance
For many years, the goal was to keep challenging Rose and help her gain as much function as possible. About five years ago, the focus shifted.
Rather than continuing to pursue major functional gains, the priority became maintaining the abilities Rose had worked so hard to achieve.
TandemSB continues to work with Rose at her assisted living community. The focus is no longer simply on gaining new abilities but on continually challenging her to maintain her current level of function. Maintaining mobility, strength, and range of motion requires ongoing effort.
Today, Rose transfers with the assistance of one person. She needs very little physical help but substantial verbal direction to guide her through each step. This is a remarkable change from relying on a Hoyer lift for every transfer. The goal is to preserve this ability and continue helping Rose transfer without relying on a mechanical lift.
Despite her history of a traumatic brain injury, multiple spinal and pelvic fractures, and a hip replacement, Rose is pain-free and takes no pain medication. Given the extent of her injuries, this is a remarkable part of her quality of life.
When we first met Rose, she spoke only three or four words and relied on a Hoyer lift for every transfer. Today, she is constantly talking and interacting with those around her, enjoys playing Scrabble with her caregivers, and participates in music and brain games at her assisted living community. She continues to engage with others, share experiences, and enjoy time with her family. She still needs significant support, but her abilities and opportunities to participate in life have changed tremendously.
Progress Doesn't Always Mean Independence
Families sometimes wonder why someone continues physical therapy for years after making progress, especially when it requires an ongoing private-pay investment. Rose's story offers a personal answer.
Her family isn't expecting a cure or complete independence. They continue investing in exercise because Rose's abilities matter. They want her to remain comfortable, preserve her mobility, participate in daily life, and enjoy time with her family.
For some people, physical therapy focuses on recovering from an injury. For others living with significant, lasting disabilities, the goal eventually shifts toward maintaining strength and range of motion, supporting transfers, and preserving the abilities that make everyday life more manageable.
For Rose and her family, success isn't measured by independence. It's measured by maintaining the abilities she has worked so hard to gain, remaining pain-free, and continuing to live the best life possible.
Private-pay physical therapy is an ongoing financial commitment, and every family's circumstances are different. Rose's story illustrates why her family has continued to make that investment: the goal isn't simply to exercise. It's to help preserve her abilities, comfort, opportunities to participate in life, and time with the people she loves.
Her story reminds us that long-term physical therapy isn't always about reaching a finish line. Sometimes, the most meaningful progress is preserving what matters most.