The look of determination on Nick Malafronte’s face as he methodically pulled on the handle of his machine during a recent indoor rowing competition told the story of the young man’s life over the past two and a half years.
That determination is what gets him through each day since he was seriously injured in July 2011. And it’s what spurred the quadriplegic to compete in the adaptive division of this year’s Charles River All Star Has-Beens Sprints World Indoor Rowing Championships at Boston University.
Malafronte was just 19 when he was paralyzed in a fall into a shallow swimming hole while working at a summer camp in Abington, his hometown. After hitting his head on the sandy bottom, he lay motionless face-down in the water until he was pulled out by lifeguards. Conscious but unable to move, he was med-flighted to Massachusetts General Hospital. An accomplished high school athlete who had just completed his freshman year at Westfield State University, he was given a grim prognosis by doctors, who told him he would never walk again and would have very limited use of his arms.
But after meeting other quadriplegics and paraplegics who defied their own odds through intense rehabilitation and made progress in their recovery, Malafronte decided he would take control of his own fate and do whatever he had to do to improve. He set a goal for himself and told his tearful mom, Diane, that summer: “It’s going to be OK, Mom. I will walk again.”
Today, Malafronte — who can work a stylus for his phone and iPad with good control, feed himself, move his arms up, down, and side to side, and balance in his chair — still has that goal, but he’s working on other targets on a path to get there. Those small accomplishments he has made take a great deal of time, he said.
“It’s sometimes frustrating how slow the progress is. You don’t see results day by day, or even week by week,” he said. “Progress is measured month by month, and through the little things I do at home, like balance in my chair, feed myself without my arms getting as tired — basic stuff” that others take for granted.
Malafronte set a goal for the rowing competition at BU’s Agganis Arena: He wanted to better his time from last year, the first time he was strong enough to compete in a similar contest with the “Exercise for Persons With Disability” program at Spaulding Rehabilitation Hospital. On Feb. 16, as he looked around the arena populated with sections of rowing machines, he smiled and said: “I’m pumped. I’m ready for this.”
After cheering on the first heat of adaptive rowers, Malafronte’s mother and trainer moved him from his wheelchair to the rower, strapped him in, and he took several warm-up strokes. When the announcer counted down to begin, he focused as any athlete does when it counts.
For 7 minutes, 13 seconds, he pushed and pulled with every working muscle he has, racing against his own clock but also against his Spaulding Rehab buddies, until he reached 1,000 meters. His parents, Vic and Diane, cheered him and other competitors on along with trainers, spectators, and other Spaulding rowers.
Arms tired and looking relieved after the exhaustive effort, Malafronte said: “Last year I finished last in my division with a time of 8:37. I just wanted to beat that this time. I’m happy.” He did beat it, shaving more than 1 minute and 20 seconds off. Placing ninth of 11 competitors, he said he wasn’t disappointed because his was the second-highest injury level of anyone there.
The performance is impressive and shows significant improvement, said Glen Picard, director of the Spaulding exercise program, who says the competition gets patients excited about working hard and has tremendous health benefits for them.
“The rowing brings in the arms and legs for excellent cardiovascular exercise, which is so important with these guys,” said Picard. With the help of functional electrical stimulation that sends electric “messages” to the leg muscles, patients are able to work their legs, contracting muscles that they can’t contract on their own. This also helps to increase bone density and muscle mass, helping to prevent atrophy, Picard said.
Considering that doctors had told him he would “never get his arms back” fully, Malafronte said it’s incredible he’s able to row at all. But he commits five days a week to rehab, with one day at Spaulding and four days at Journey Forward, a privately run rehabilitation facility in Canton. He has also spent many weeks of intensive therapy at the Shepherd Center in Atlanta, one of the top rehab centers for spinal cord injuries in the country. While at home he wears weights on his wrists to strengthen them during normal activity.
He said the rowing helps improve his upper body and arm strength, getting him closer to his goal of using a manual wheelchair and becoming more self-sufficient. “I really want to get my shoulders strong enough to push myself around in a manual wheelchair,” he said. Although he is enrolled in online classes, he said he eventually wants to go back to college and live there to pursue his degree in communications.
His Journey Forward trainer, John Walters, said Malafronte’s attitude and willingness to work hard have contributed to his great strides in regaining overall strength and function. When he works out on the Lokomat, a computerized machine that uses robotic technology to walk paralyzed individuals with a harness and pulley system, because of the many repetitions and the length of time he has committed to it, Malafronte’s body is starting to respond better and is assisting in the movements, he said. The computer collects data and lets the trainer know if the user’s muscles are doing any of the work.
“We’ve noticed an increase in his neuro-activity” — the way his body responds to the electrical stimulation — “and that’s exactly what we look for,” said Walters, the program director at the rehabilitation facility founded nearly eight years ago by Dan Cummings, himself paralyzed from the chest down at age 19.
“Nick is incredible,” Walters said. “Like everyone, he has his ups and downs, but he has an overwhelming sense of wanting to succeed. He’s always moving forward through the emotional setbacks rather than dwelling on them.”
Walters said Journey Forward focuses on helping its clients improve their quality of life and independence, and through Malafronte’s hard work, both patient and trainer have definitely achieved those goals. “He is becoming more independent,” said Walters. “Enough that he can now visit his friends at college and stay overnight without his parents worrying as much as they used to.”
At the Agganis Arena, watching the oldest of his three sons among the other adaptive rowing competitors, Vic Malafronte couldn’t help getting emotional.
“Nick doesn’t like it when I get choked up, but I can’t help it. He’s come so far, and he works so hard with such a positive attitude,” the father said. “He amazes me.”
The young patient said a positive attitude helps him stay focused.
“It’s easy to get frustrated,” he said. “My mental attitude is a lot different now than it was three years ago. I know now how tough and slow progress is, but there’s nothing I can do to change that except work my hardest every day. I’m doing all I can to help myself . . . and going to therapy reminds me that someone always has it worse than me.”
According to the National Spinal Cord Injury Statistical Center in Birmingham, Ala., about 12,000 people suffer spinal cord injuries in the United States each year. Those injuries are categorized by severity; Malafronte suffered damage to both the low and high cervical nerve, the most serious range of injury, which severely limits or completely prevents use of the arms and legs.
“Nick can use his arms even though the doctor said he wouldn’t be able to even move them,” said Diane Malafronte. “That shows you where hard work and determination get you.”