From surgery to strength: The rehabilitation journey of Diana Hoy
By Asham Rehab
When 75-year-old Diana Hoy was admitted for planned spinal surgery on May 1, 2025, doctors discovered she had lost mobility from her knees to her feet and from her fourth and fifth fingers to her elbows, along with saddle paresthesia.
Despite this, Diana was determined that it would not mark the end of her independence. For years, she had lived with gradually worsening weakness, pain, and fatigue that had quietly limited her once-active lifestyle.
Following a posterior cervical decompressive laminectomy at C5/6/7 at Addenbrooke’s Hospital for degenerative cervical myelopathy, Diana awoke to find she could not feel her legs at all and she could not mobilise.
Although imaging confirmed successful decompression, she faced the challenge of restoring proprioception, gait, balance, confidence and endurance — a process requiring intensive, multidisciplinary neuro-rehabilitation.
She was unable to go home.
Inpatient Rehab Phase – Rebuilding Foundations
At Askham Rehab, Lead Neuro Physiotherapists Caroline Stoneham, Neuro Physiotherapist Jeff Hammel and Lead Occupational therapist Bethany Miller created an individualised programme targeting strength, sensory re-education, and safe functional mobility.
Key interventions
- Robotic-assisted therapy (Omego, Myro, Pablo) to re-establish reciprocal limb movement and motor control.
- Hydrotherapy for graded weight-bearing, gait patterning, and sensory stimulation.
- Task-specific training: sit-to-stand, stair climbing, balance on unstable surfaces.
- Core stabilisation and Pilates principles to reduce lumbar loading.
- Fatigue and pacing education to enhance self-management and prevent over-use.
“Diana came in saying, ‘Tell me what to do, and I’ll do it.’ That attitude shaped everything that followed,” recalls Lead Physiotherapist Caroline Stoneham.
“Her willingness to push herself safely meant we could progress faster than most people would expect after this type of surgery.”
Within three weeks she could climb a full flight of stairs with one handrail, mobilise with a stick indoors, and complete personal care independently.
Outcome measures on discharge (Mid June 2025)
| Measure | Result |
| Berg Balance Scale | 51 / 56 |
| Timed Up & Go | 7.5 s |
| 10 Metre Walk Test | 14 s (with stick) |
| 6 Minute Walk Test | 211 m |
| Sit-to-Stand (60 s) | 23 with hands / 12 unaided |
(Figure 1: Initial outcomes after inpatient phase)
Outpatient & Hydrotherapy Phase – Extending the Gains
Diana continued outpatient therapy through July to October 2025, combining land-based gym work and hydrotherapy to consolidate neural and muscular adaptations.
Clinical focus
- Core endurance and pelvic control to address residual lumbar stenosis.
- Dual-task balance training using the Pablo Tymo system and visual feedback to reduce visual over-reliance.
- Hydrotherapy progression: buoyancy-resisted walking, turbulence challenges, functional games for anticipatory balance.
- Vestibular and gaze-stabilisation drills for night-time steadiness.
By late summer she walked unaided indoors and used her stick outdoors only.
By October she was driving short distances, (attending community pilates classes – no not yet waiting the end of nhs therapy sessions, which continue), and exercising independently in water.
“Diana’s journey shows that recovery isn’t just about walking again — it’s about rebuilding identity,”says OT Bethany Miller.
“Her motivation and engagement made all the difference.”
Measured outcomes – June → October 2025
| Measure | June 2025 | October 2025 | Improvement |
| Berg Balance Score | 51 / 56 | 54 / 56 | ↑ Dynamic stability |
| Timed Up and Go | 7.5 s | 6.2 s | ↑ Gait efficiency |
| 10 Metre Walk Test | 14 s (with stick) | 9.5 s (stick) / 10.8 s (unaided) | ↑ Fluency |
| 6 Minute Walk Test | 211 m | 340 m | ↑ Endurance |
| Sit-to-Stand (unaided 60 s) | 12 | 18 | ↑ Strength & control |
| Mobility Level | Stick indoors/outdoors | Unaided indoors / stick outdoors | ↑ Functional independence |
(Figure 2 – Functional Gains (June → October 2025)
Interpreting the data
Whilst Diana presented with individual impairments of reduced proprioception, back pain and saddle anaesthesia, some of which were long standing, her progress aligns with expected recovery trajectories.
These are described in NICE NG220 and recent evidence supporting combined robotic and aquatic therapy after cervical myelopathy.
Her gains in endurance (61 per cent increase in 6MWT) and speed (22 per cent faster TUG) demonstrate restoration of both aerobic and neuromotor capacity.
The close correlation between Berg Balance and Sit-to-Stand improvements suggests re-established proprioceptive control and quadriceps endurance — key predictors of community re-integration.
Reflections
By October 2025, Diana had not only regained physical function but also renewed self-efficacy.
“Rehab gave me my life back — not just my legs,” she said in her patient interview.
Watch her discuss her experience here: Watch Diana’s story https://youtu.be/oLTIie40g9g
Clinical insight
- Seamless continuity across inpatient, outpatient and community phases prevents plateauing.
- Hydrotherapy provides safe sensory re-education and graded load.
- Technology-supported feedback (Pablo Tymo) accelerates postural control.
- Education in fatigue management supports sustainable independence.
- Goal-centred collaboration maintains motivation and real-world relevance
Summary
Diana Hoy’s story exemplifies evidence-based, person-centred neuro-rehabilitation.
From surgery to strength, her recovery illustrates how structured multidisciplinary input, coupled with patient determination, can convert surgical success into lifelong independence.
Following cervical decompression, she faced the classic challenges of impaired proprioception, weakness and fear of falling.
Through multidisciplinary coordination, graded exposure and consistent follow-up, she not only achieved independence but exceeded expectations for her age and presentation.
Her pathway illustrates several broader lessons for clinical teams:
- Early engagement and psychological readiness accelerate progress — Diana’s motivation and trust in her team allowed for earlier task intensity and reduced length of stay.
- Integrated treatment technologies (robotics, hydrotherapy and functional retraining) deliver synergy: robotic therapy refined precision, water-based therapy rebuilt confidence, and land-based practice transferred skills to daily life.
- Quantifiable, meaningful outcomes such as Berg Balance, TUG and 6MWT enable both patient motivation and service evaluation.
- Continuity and communication between acute, inpatient, and outpatient services are vital. Seamless handovers ensured no interruption to learning or conditioning.
- Patient-centred identity restoration is as important as biomechanics. The transition from patient to independent adult, able to drive, cook, and plan social activities again, marks the true success of neuro-rehabilitation.
In essence, Diana’s recovery showcases what modern rehabilitation strives for: evidence-driven practice anchored in empathy and personalised goals.
Her outcome — full indoor independence, community mobility, and renewed self-confidence — is a testament to teamwork, persistence and the transformative power of therapeutic continuity.
For clinicians, her journey is a reminder that progress after spinal surgery is not linear but layered — each phase building on the last. #
Through creative, data-informed and compassionate practice, “from surgery to strength” becomes more than a headline: it becomes a measurable and repeatable outcome for patients everywhere.
Find out more about Askham Rehab at askhamrehab.com
