Part II: Straining to Progress, as Family Challenges Mount

Reeve's workout regime included a bicycle that uses electrical stimulation to contract the leg muscles and help them to pedal, a treadmill that simulates walking, and underwater resistance training in a pool. A research team, led by neurologist John McDonald, published a paper crediting the activity-based therapy with much of Reeve's improvement. The actor died in 2004.

The underlying premise is that even quadriplegics have to "use it or lose it." If a paralyzed person never tries to move, any neural connections remaining between the brain and the spinal cord atrophy and essentially get turned off. Exercise those limbs, and the connections may be restored.

Some researchers believe the spinal circuitry alone can be retrained to control walking through "sensory patterned feedback" — using treadmills or other devices to break down walking movements and repeat them again and again.

A quarter million people in the United States live with a spinal cord injury, and there are some 11,000 new injuries each year. It is a desperate population, often unwilling to go along with the standard treatment: learning to live with the injury.

They hear about the idea of using human stem cells to stimulate regrowth of damaged spinal cord connections, but that's still in research. Some go to great lengths and expense to find a magic bullet, heading abroad to have shark embryo cells transplanted into their bodies or trying other unproven treatments.

But activity-based therapy "is not some kind of miraculous pie-in-the-sky thing. This is real stuff," says a leading spinal cord injury researcher, Dr. Wise Young.

Reeve's former doctor started such a program at the Kennedy Krieger Institute in Baltimore. A few other centers focus on exercise therapy — some affiliated with respected treatment facilities, such as Beyond Therapy at the Shepherd Center in Atlanta, others privately run.

Insurance won't cover it, and many doctors remain reluctant to recommend it, seeing it as still unproven by independent studies. That leaves folks like the Pous to fend for themselves.

Project Walk was founded in 1999 by Ted and Tammy Dardzinski. Ted, a former triathlete, and his wife Tammy, previously in marketing, were personal trainers running an athletic performance center in the San Diego area when a quadriplegic came in. He wanted to get back on his feet.

Using trial and error, Ted developed a workout routine. Less than two years later, the client, Mike Thomas, took his first steps, using crutches.

Through Thomas, other paralyzed clients sought out the Dardzinskis — and Project Walk was born. It started as a for-profit business, but has gone not-for-profit in recent years.

By the time the Pous arrived, the center had about 65 clients on site and many more who had visited, learned the premise and returned home to tackle the therapy.

Project Walk has its critics. The founders' lack of medical expertise has raised questions, and some quadriplegics conversing in chat rooms have wondered if the program instills false hope, using words like "pipe dream" and "Holy Grail."

"All I can say is, I can't believe it until I see hard, scientific evidence," wrote one man.