Photo: Recent ABI panel: senior physiotherapist Tanja Spencer (a prior Epworth staff member), Prof John Olver, former patient Tom Smyth with Prof Gavin Williams.

Determined is an understated way to describe Tom, a former Epworth patient. Tom is gearing up for his third half marathon event. Just five years ago, he was in a hospital bed fighting for his life and had never been a runner.

In 2019, Tom, 21 at the time, was coming home from a long weekend at Greens Lake, travelling on a gravel, country road.

“I was driving back with my brother when kangaroos jumped out in front of the vehicle,” Tom said.

“There were about four of them. I tried to avoid them, lost traction and lost control.

“I was driving an old 70’s ute, which was light on the back end. I got knocked out and thrown out the window. Luckily my brother was there or I would not be here today.

“Both my lungs collapsed, my collarbone was broken due to the old seat belt and I had hairline fractures throughout my head. My brother had experience with roadside accidents through the SES so knew what to do.”

Tom also sustained an acute brain injury. He spent two-three weeks in a coma and then six months at Epworth Richmond in rehabilitation.

At that time, a large research study, led by Epworth Rehabilitation, was in progress. Physiotherapists were giving patients with traumatic brain injury strengthening exercises that are performed quickly (termed ballistic) to improve mobility.

Study lead, Prof Gavin Williams, Professor of Physiotherapy Rehabilitation at Epworth, says the aim was to determine the best exercises needed to perform basic daily tasks.

“After a brain injury, balance, coordination, weakness and spasticity are the areas affected,” Prof Williams said.

“Twenty years ago, we were concerned about spasticity and worried that strength training would make the muscles worse. We have realised that the main problem is weakness. Ballistic training is more suited to the real world, helping you get stronger but also teaching the muscles to contract more quickly and replicate how the muscles work when you walk, for example. Conventional strength training, which is performed slowly, has limited impact on mobility.”

Tom was one of the trial participants who had a very good outcome.

“He had three hours physiotherapy each day, which included work to help him stand up and practice balancing,” Prof Williams said.

“It took six months for Tom to be able to walk by himself. He’s always been pretty determined.”

Amazingly, Tom found joy in running as he recovered. He began with a half marathon (21km) in May (in 3 hours, 2 mins), another in Run Melbourne recently (2 hours, 30 mins) and is signed up for his local Shepparton event in August.

“When I was still in hospital my goal was to do a parkrun (5km) in sub 30 minutes. That took 18-19 months to achieve,” Tom said.

“I love the feeling you get at the end of a long run, knowing you’ve pushed yourself and you succeeded. It feels awesome. You can’t beat it.”

Tom still has a few goals on his ‘to do’ list. Battling the daily “killer” fatigue that is a result of the accident is one hurdle.

“I recently moved out of home and I’m learning to cook, through occupational therapy. I’d like to improve my speech and improve my balance – it’s shocking after losing hearing in my right ear. I want to ride a push bike again. I also work three day a week and would like to get to the point where I can add another day.”

*The clinical trial, of which Epworth was the lead site, ran at five different Traumatic Brain Injury Centres throughout Australia with 144 patients. The results were published in the Journal of Physiotherapy.


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