Joe's Story

Joseph Robles stands against a mural of a road outside of UF Health Rehabilitation Hosptial.

Retired art teacher Joseph “Joe” Robles was enjoying an active, creative retirement in South Florida with his wife of 55 years, Carol, and his adult children. Joe enjoyed building ocean kayaks and making scale 17th and 18th century model ships.

Joe’s hobbies helped take his mind off of his health issues. The 76-year-old had struggled with diabetes and kidney stones for years, ultimately losing both kidneys. Dialysis became a regular part of his life while he waited on a transplant list, hoping for a call. He and Carol had also moved to Gainesville to be closer to their hospital when the call came in.

During that wait, Joe’s health took another slide. He was diagnosed with spinal stenosis, a narrowing of the spinal canal narrows that puts pressure on the spinal cord and nerves, causing pain, numbness and weakness. When his legs and arms became even weaker and the numbness intensified and spread to his face, Joe visited his physician again. Initially, the doctor said his stenosis was worsening and compounded by COVID-19. Two weeks later, when his condition worsened, Joe was taken to the emergency room. Tests there showed Joe had lacunar stroke – an artery supplying blood to the deeper portions of his brain had become blocked.

Joe’s left side was severely impacted; he struggled to feel and use the left side of his body, making it difficult for him to stand, much less walk. His medical team recommended inpatient rehabilitation and explained the types of therapy that would be provided, Joe agreed to head to UF Health Rehabilitation Hospital for his recovery.

Upon admission, Joe couldn’t do anything without help – getting out of his wheelchair, dressing, using the bathroom. While his care team assessed him, Joe said he’d simply like to walk again and regain the use of his left arm and hand so he could get back to the hobbies he loved. His physician-led team of nurses, physical therapists and occupational therapists worked with Joe to devise a plan that would help him reach those goals.

Occupational therapists had Joe participate in constraint-induced movement therapy (CIMT) therapy to improve the control and coordination of his left hand. Group and individual therapy sessions involved constraining the movements of Joe’s less affected arm while intensively inducing use of his more affected arm. Joe regularly participated in exercises that made him repeatedly open and close his hand, touch his thumb to each finger and bend and extend his the elbow. He also did an array of weight bearing exercises to build his strength, balance and endurance. As he grew stronger and more balanced, he learned how to manage other daily activities like toileting, dressing, transferring from bed to wheelchair using a transfer board—a small plank that allowed him to safely slide from one surface to the other.

The care team also helped Joe address the pain he was experiencing in his left thumb. They fit him with a custom orthosis, a brace worn on his hand to provide support, reduce pain and get a better grip on objects. Therapists worked with Joe on his fine motor skills and balance, and he didn’t need much prompting – they asked him to stand at the window and paint. Armed with adaptive paint brushes that were easy to grasp, painting became Joe’s turning point. “Standing up when I was painting on the glass – I didn’t know I stood up for that long,” he said. “At some points I didn’t even touch the rail and rolling walker.”

Meantime, physical therapists (PT) worked to continuously improve Joe’s balance and mobility, focusing on exercises to build muscle strength, which allowed him move from a sitting to standing position. Gradually, he took steps using a rolling walker.

PTs also took Joe for a home evaluation where they assessed the environment, including his art studio, and made recommendations on how to make it safer and reduce the risk of falls.

Back at the hospital, therapists worked with Joe to improve his stability by stepping forwards and sideways to Q-pads – floor pads that light up to provide visual feedback. As Joe’s walking improved, he ventured outdoors with his therapists to practice walking over different surfaces and various obstacle courses.

Throughout Joe’s stay at UF Health Rehabilitation Hospital, his wife and daughter were a constant presence. Both underwent family training to learn how to help Joe remain safe at home.

After 16 days in rehab, Joe was able to walk 400 feet using a rolling walker. Carol was nearby if he needed her assistance. Joe’s balance had also improved, he could transfer positions without assistance, and he needed only minor assistance with his personal care tasks. He plans to continue his recovery with outpatient therapy.

Joe embraced his rehabilitation sessions. “I enjoyed the games and activities where I had to manipulate small objects with my affected arm. The more I worked on that, the better I was able to use my hand. I will use my left hand probably a lot more than I did before the stroke…I think I will be back to where I was before,” he said.

The rehabilitation process taught Joe that he was stronger than he thought. “I didn’t think I would have the stamina to rehabilitate this way because there was therapy every day,” he admits. “But I found that I did develop that stamina to go on and do it every day.”