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Madonna Rehabilitation Hospitals

Four-sport athlete pushes herself to succeed in brain injury recovery

February 16, 2023

Fifteen-year-old Kinsley Provin has been playing sports ever since she can remember. When she’s not on the basketball or volleyball court, track or softball field, the sophomore from Williamsburg, Iowa, is hanging out with her friends or cheering on her brothers at their sporting events. It’s the grit and determination she learned as an athlete that has propelled her incredible brain injury recovery.

On September 21, 2022, Kinsley was in a car accident. She was t-boned in an intersection, then life-flighted to the University of Iowa Health Systems, where she spent a month in a minimally conscious state. Her family chose Madonna Rehabilitation Hospitals for the next step in her recovery because of its specialized pediatric disorders of consciousness program.

Arriving at Madonna on October 28, Kinsley wasn’t walking, talking or eating on her own, but her mom says they were ready for a long, hard recovery journey thanks to a Zoom call with Brooke Murtaugh, Madonna’s brain injury program manager.

“She laid it all out,” Amy Provin, Kinsley’s mom, said. “She was like, ‘Listen, Kinsley may do everything else before she ever talks again. It may be six months to three years before she ever talks again.’ That was so hard to hear, but we heard that upfront before we ever came here so our expectations were, ‘Ok, that’s where we’re at. We’re just going to keep on working.’”

From the moment they met her, Kinsley’s physician-led care team could tell there was a spark in her.

“I had a feeling that she was going to make some great progress, but I had no idea how quickly it would go and she surprised us all,” Cait Scott, MA, CCC-SLP, a Madonna speech-language pathologist, said.

Finding her voice

Just two weeks into her stay at Madonna, Kinsley spoke her first words.

“We were working on breathing and breath support in that session,” Scott said. “Then, I was like, ‘You know what. Let’s just try this.’ We started counting. So, I was like, ‘I want you to say one, two, three.’ And you could see her mouth move. She was moving her mouth to the words, and I was like, ‘Oh, my gosh. She has it. We have to do this.’ I held her hand, and I told her ‘I want you to pull me as hard as you can, and I want you to belt out that voice.’ I said hi, and then she did it. She had this little voice, and we were so excited. Mom was in tears. I was in tears.”

Kinsley’s talking didn’t stop there. Within the same session, she was able to say words like mom, dad, her brother’s names and even ‘I love you.’

As she rediscovered her voice, Kinsley also tackled other obstacles. Even before she could communicate her wants and needs, her care team could tell she had some vision deficits.

We could tell that she really liked to keep her head and her eyes turned toward the right side, which can then kind of indicate that her looking to her left is not something that’s natural,” Aubrey Janousek, MOT, OTR/L, Madonna’s vision program leader, said. “She lacked that awareness that she needed to move her eyes to the left.” Setting her sights on vision therapy Janousek worked closely with Madonna’s neuro-optometrist, Dr. Tanner Gates, to help Kinsley improve her fixation, or focus on a certain target for a period of time, as well as her double-vision and even her visual acuity.

“Kinsley really presented uniquely because she had difficulty with her clarity of sight,” Gates said. “Oftentimes, after traumatic brain injury, the eyes themselves aren’t impacted. It’s more of how the brain makes sense of what the eyes take in, but she had a pretty significant shift in her ability to see things clearly, so potentially requiring some glasses.”

Utilizing specialized technology like the DynaVision or BITS Bioness Integrated Therapy Systems touchscreen, Kinsley completed mass repetitions of saccades, or shifting her eyes from one place to another, strengthening her eye coordination and creating smooth visual scanning motion.

“Those coordinated eye movements are necessary for reading, school-based tasks, driving, just about everything we do every day,” Janousek said. “Being able to do those mass repetitions harnesses that neuroplasticity for the brain to continue to heal and promote that recovery.”

As Kinsley’s vision improved, Janousek continued to challenge her with more complex tasks. She tried out Madonna’s new BITS Balance System, helping Kinsley regain her proprioceptive awareness and where her body was in space.

“We’re blessed in that we have a great vision rehab program at Madonna, so we can pick up on a lot of these visual issues and treat them effectively,” Gates said. “I think that’s a wonderful component that helps to tie in that multidisciplinary approach to the other therapies and it makes other therapies more effective if we’re addressing those visual issues. If those go undiagnosed, it can impact the physical and occupational therapy and slow progress overall.”

Taking her first steps

With her improved vision and cognition, standing and walking became easier. Kinsley progressed from using the Lokomat robotic gait trainer to the LiteGait body weight support system, to finally using only a walker to navigate the hallways of Madonna. Aquatic therapy in the warm water pool helped further refine her balance and coordination.

Strong family support only compounded the incredible progress Kinsley was making.

“Amy was such a rock star,” Scott said. “She asked me, ‘What can we do next? What homework can you give me?’ I was printing worksheets off for them all the time. The fact that Kinsley was getting therapy in therapy and also outside of therapy made a big difference.”

As a final test of every skill she mastered during her time at Madonna, Kinsley went on a patient outing to pick out a new pair of glasses and prepare herself for a return to her community. She was able to show off improvements in her walking balance, her visual scanning and her ability to communicate her wants and needs.

On her last day at Madonna, Kinsley’s care team presented her with a Madonna Spirit Award and applauded loudly as she walked unassisted out the doors. The moment was filled with laughs, tears and cheers.

“The people at Madonna who have been part of her journey, they want it as much as we do,” Amy said. “I think that’s what probably means the most. I don’t think at any point we’ve ever felt like we’re alone in this. They are our biggest fans and they are that way for everyone that’s here. I think that’s pretty incredible.”

Although her hometown is more than three hours away, Kinsley returns to Madonna weekly for the outpatient Rehabilitation Day Program. Her mom said the choice was an easy one.

“This is where she’s made consistent, amazing progress, and we want to keep her somewhere she’s going to continue to make incredible progress,” Amy said.

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