Ask Bill Scelza, M.D. (Residency 2002), to describe himself and he’ll say he’s “just an ordinary person living an everyday life.” The most important thing right now, he’ll tell you, is that he and his wife, Beatriz, are the proud new parents of a baby boy named Dominik William.

David Gater, Bill Scelza, and Denise Tate Photo: Gregory Fox

Keep him talking and you’ll learn that Scelza is a physician who graduated from Case Western Reserve Medical School in 1998, and then moved to Ann Arbor and the U-M Health System for his residency in physical medicine and rehabilitation. Next fall, after completing a fellowship at the Kessler Institute for Rehabilitation in New Jersey, he’s returning to the U-M to focus on the care of patients with spinal cord injuries. Athletics, especially basketball, have been a major part of his life since high school, and he encourages all his patients to exercise regularly to maintain health and fitness.

Oh, and by the way … Scelza uses a wheelchair, because a car crash at age 17 left him with a spinal cord injury and no function in his legs. In fact, his injury was the reason he decided to become a doctor. “I wanted to use my personal experience to take care of other people with spinal cord injuries,” he says.

By the time he started medical school in 1994, Scelza had developed self-confidence, a positive attitude and the skills required to negotiate his way through a world that’s not designed for people in wheelchairs. “You have to speak up and advocate for yourself,” he says. “If barriers come up, you have to be flexible, patient and creative on how to get around them. And you just keep going. You don’t let things hold you back. You figure out what needs to be done and then you do it.”

When he started treating patients, Scelza was careful to approach people with spinal cord injuries no differently than patients with other medical conditions. “We deal with patients with serious disabilities after major traumatic life events. Often they are in the early stages of adapting to the changes. It’s a difficult time and there’s a lot of anger. I don’t want to force myself on them, but I want them to see that injuries don’t have to hold you back.”

Scelza was introduced to the intense, competitive world of wheelchair basketball while he was at the Edwin Shaw Hospital for Rehabilitation in Akron, Ohio, recovering from his injuries. “I met some of the guys on the hospital team and they sort of took me under their wing,” he says. Before long, he was playing with the Cleveland Wheelchair Cavs competing all over the country. “There’s a misconception that it’s just people moving around slowly in wheelchairs, but it’s an active and aggressive game,” says Scelza. “We take it very seriously.”

People with complete spinal cord injuries like Scelza’s often have little or no leg function, so aerobic workouts can be difficult, because they cannot work the large muscles in their legs. That rules out treadmills and stair-climbing machines, but Scelza says basketball, swimming and upper extremity machines are good alternatives.

Some people with a spinal cord injury can benefit from new technology, which uses electrical stimulation of leg muscles as an exercise aid. When muscles aren’t used, they tend to atrophy, but electrical impulses cause the muscle to contract, building bulk and increasing metabolic activity.

“It looks very positive in terms of building aerobic and cardiovascular capacity, because it allows people who have no use of their legs to actually pedal a recumbent bicycle,” adds Scelza. “But it’s important to work with people who are familiar with this technology and know how to use it safely.”

During his U-M residency, Scelza led a study to identify barriers to physical fitness for patients with spinal cord injuries. The study was part of the Wellness with Spinal Cord Injury Project, a two-year clinical trial started in 2001 by Denise Tate, Ph.D., a professor and director of research in the U-M Medical School’s Department of Physical Medicine and Rehabilitation. Funded by the U-M Investment Venture Fund, the project is designed to determine the most effective methods of helping people with spinal cord injuries improve their health with nutrition, exercise and lifestyle changes.

The study surveyed 72 spinal cord injury patients participating in the wellness program in the U-M Health System. “We found that most people want to exercise, but things get in their way. They are afraid of getting hurt or don’t know what to do and how to start,” says Scelza. “Often, there is a lack of motivation or energy. Lack of accessibility to facilities with proper equipment or knowledgeable people who can help them develop a directed exercise program are additional barriers. And less than half the patients we surveyed said their physician encouraged them to exercise.”

Scelza’s bottom line message is that exercise and physical fitness are important whether you walk or roll through life. “People with spinal cord injuries are just as susceptible to heart disease and diabetes as everyone else,” he says. “Regular exercise improves their overall health and quality of life, and leaves them in better condition to benefit from new treatments for their injury.”

—SFP