Free Clinic Boosts Quality of Life for Stroke and Parkinson's Patients

University of Michigan
Cindy and Craig Hawkins visit the HEART Clinic every week to meet with physical therapy and occupational therapy graduate students from UM-Flint. Image credit:  Eric Bronson, Michigan Photography
Cindy and Craig Hawkins visit the HEART Clinic every week to meet with physical therapy and occupational therapy graduate students from UM-Flint. Image credit: Eric Bronson, Michigan Photography

This is Michigan

FLINT-The first time Craig Hawkins arrived at the free physical therapy clinic, the aftereffects of his stroke weighed heavy. He rolled up in a wheelchair with a tracheotomy, and had already exhausted his medical benefits.

Elizabeth
Elizabeth "Libby" Yost, who earned her doctorate in occupational therapy in 2018, helped Craig Hawkins regain some independence at the HEART Clinic. Image credit: Eric Bronson, Michigan Photography

"I didn't think he'd be out of a wheelchair," his wife, Cindy Hawkins, said. "I give a lot of credit to HEART clinic for getting him moving. He went from a wheelchair to walking without any assistance."

The HEART Clinic (Health Equity. Action. Research. Teaching.) is a no-cost student and faculty clinic that provides health care access to the uninsured and underinsured in Flint and Genesee County. Founded 13 years ago, the clinic has helped hundreds of people with services ranging from physical therapy, occupational therapy, nursing and rehab programs for stroke patients and those with Parkinson's disease.

Launched in 2010 as PT HEART at the North End Soup Kitchen, it offered physical therapy and health education; other disciplines have been integrated during the life of the program through UM-Flint's College of Health Sciences. The clinic is now staffed by UM-Flint graduate students in occupational therapy and physical therapy and undergraduate nursing students all supervised by licensed clinicians.

The services are offered every Friday at the Sylvester Broome Empowerment Village, a community gathering place. And a virtual exercise class for Parkinson's patients is offered every other Saturday.

Craig Hawkins, a former auto engineer, was at work five years ago when he had the stroke. Working with Libby Yost, who earned her doctorate in occupational therapy in 2018, was a turning point for him.

"I give a lot of credit to HEART clinic for getting him moving. He went from a wheelchair to walking without any assistance."

Cindy and Craig Hawkins visit the HEART Clinic every week to meet with physical therapy and occupational therapy graduate students from UM-Flint. Craig, who had a stroke, went from a wheelchair to walking again with their help.

"One of the first things Libby did with him is to teach him how to make his lunch again," Cindy said.

"Toast and bologna and cheese and mayonnaise," Craig said with a smile. "And a Mountain Dew."

Craig's self-sufficiency at home has meant a big improvement in their quality of life. "They've done a fantastic job. They give it their all-and it comes through with how they work with the patients," Cindy said.

Ronald Taylor, 83, right, participates in the weekly Parkinson's exercise class. Image credit: Eric Bronson, Michigan Photography
Ronald Taylor, 83, right, participates in the weekly Parkinson's exercise class. Image credit: Eric Bronson, Michigan Photography

Yost, who is now a clinical assistant professor of occupational therapy at UM-Flint, said the benefits go both ways.

"It's all learning by doing," she said. "It really teaches you on the fly how to work with people, how to collaborate, how to build relationships and how to show empathy, and not just talk about empathy."

In the gymnasium, the weekly Parkinson's exercise class begins. Nine participants are given hollow plastic tubes to hit against a chair "As loud as you can!" says the student leading the class. Each patient has a student or two working with them as they do chair exercises and then move to floor mats for core work.

On the sidelines, Agnes Taylor watches her husband Ronald Taylor, 83, a former middle school teacher, make some noise. He was diagnosed with Parkinson's disease in 2020. Agnes, who is a registered nurse, said she noticed tremoring and shuffling at first.

Students from the HEART Clinic help stroke patient Cynthia Cummings, center, with assisted mobility and heart rate monitoring. Emma DeBaake Brighton, second from the right, is a second-year physical therapy doctoral student, who heads Cummings' therapy. Image credit: Eric Bronson, Michigan Photography
Students from the HEART Clinic help stroke patient Cynthia Cummings, center, with assisted mobility and heart rate monitoring. Emma DeBaake Brighton, second from the right, is a second-year physical therapy doctoral student, who heads Cummings' therapy.

"His balance is a little off. He's not really self-motivated to exercise," she said. "That's why this is good for him. And also knowing there are other people in the community who are dealing with this."

Ronald Taylor said he likes the way the students create challenging yet attainable exercise goals for the group. "I feel like I'm more physically fit. I know I wouldn't do nearly as much on my own."

Meanwhile, three students are supporting a woman as she walks the perimeter of the gym as part of the MoveMore class, which features assisted mobility and heart rate monitoring to aid in getting people back on their feet.

Emma DeBaake Brighton, a second-year physical therapy doctoral student, encourages Cynthia Cummings as she concentrates: "Big steps. Look at stepping past that foot."

Cummings had a stroke in 2017 and couldn't walk. She tried other rehab programs, but said: "This is the only place that has gotten me mobile."

Amy Yorke is an associate professor of physical therapy at UM-Flint who is also board-certified in neurologic physical therapy and developed both of HEART's exercise classes. Image credit: Eric Bronson, Michigan Photography
Amy Yorke is an associate professor of physical therapy at UM-Flint who is also board-certified in neurologic physical therapy and developed both of HEART's exercise classes. Image credit: Eric Bronson, Michigan Photography

Cummings, who wanted to be able to walk again by her birthday last October, said the students helped her beat the goal. "(When I got here) I was afraid to stand but they helped rebuild my self-confidence."

Amy Yorke is an associate professor of physical therapy at UM-Flint who is also board-certified in neurologic physical therapy and developed both of HEART's exercise classes. She said that while the clinic specializes in stroke and Parkinson's patients, it targets anybody who requires skilled physical therapy or has trouble moving.

"Our patients come with goals. They want to be able to do something better. And as a physical therapist, students recognize that they have the chance to really make an impact in their life," she said.

"I think a lot of our patients keep coming because they benefit from it and they realize they're helping a student grow and learn. I think when you-particularly for these patients that have had a significant change in their life-give them a sense of purpose again, it's really meaningful for them."

Judy Mack says her husband, David Mack, who has Parkinson's, is helping to teach the students
Judy Mack says her husband, David Mack, who has Parkinson's, is helping to teach the students "that every Parkinson's person is different. They all have different struggles." Image credit: Eric Bronson, Michigan Photography

For David Mack, who was diagnosed with Parkinson's disease 20 years ago, the message then was to "go home, lay down and die." That was before it was known that vigorous exercise could slow down the progression of the disease.

"This program is essential. I'd shake like a leaf without it," he said.

Judy Mack said her husband has seen cognitive improvements on his neurological psychological testing that's attributed to the exercise he does at the clinic. "Without exercise, he'd be in a wheelchair or not here."

The students, she said, are "learning that every Parkinson's person is different. They all have different struggles."

And these are critical lessons for Yorke's students, who are used to practicing skills on each other, many of whom have no movement problems.

"And so seeing somebody who actually has a movement problem and then having to do a muscle strength test or check their posture, it really allows them to practice," Yorke said.

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