HOUSTON U.S. Representative Gabrielle Giffords was moved on Wednesday from an intensive-care ward to a long-term rehabilitation facility to begin her first full round of therapy since she was shot through the head 17 days ago.
Doctors also said they planned soon to insert a special valve in the breathing tube connected to Giffords' windpipe that would allow her to speak, though her medical team was vague about the extent of her capacity to form words.
Her transfer to The Institute for Rehabilitation and Research (TIRR) came a day after doctors upgraded Giffords' medical condition from serious to good, following removal of a stent from her skull on Monday that had been draining excess fluid around her brain.
Since arriving in Houston from Tucson, Arizona, last Friday, the stent, and the elevated risk of infection it posed, had forced Giffords to remain in the ICU, limiting the range of rehab activities she could pursue.
Even under those circumstances, doctors said on Wednesday, the pace of the congresswoman's recovery as remarkable.
"Since Gabby arrived we have continued to see daily improvement," Dr. Dong Kim, one of her neurosurgeons, told a news conference. He described her progress as proceeding with "lightning speed."
With the stent now removed, her transition into the TIRR went smoothly, according to Dr. John Holcomb, a trauma surgeon at Memorial Hermann-Texas Medical Center, the nearby complex where Giffords was in intensive care.
"It couldn't have been better," he told reporters.
By Wednesday afternoon, she was undergoing her first full round of rehabilitation, including physical, speech and occupational therapy. The sessions last as long as the patient can tolerate, said Dr. Gerard Francisco, chief medical officer for TIRR.
"We've already increased the amount of her therapy because her tolerance has improved in the last few days," he said.
For the time being, her therapy will focus on conditioning, balance, strengthening and maintaining range of motion with activities such as sitting and standing up.
Giffords, 40, suffered a gunshot wound to the head at close range on January 8 when a gunman opened fire outside a Tucson supermarket where she was meeting with constituents. Doctors have described her progress so far as akin to a miracle.
Jared Lee Loughner, a 22-year-old college dropout, is charged with the shooting. Six bystanders including a federal judge and a 9-year-old girl were killed in the incident, and 13 others were wounded, Giffords among them.
Giffords has not spoken since the shooting. The presence of a breathing tube that first ran down her throat, and was later attached through a hole in her neck to her windpipe, has prevented her voicebox from functioning.
Dr. Imoigele Aisiku, director of neurocritical care at Memorial Hermann-Texas Medical Center, said doctors would soon fit her breathing tube with a valve designed to let tracheostomy patients speak. But he was vague about whether she possessed the neurological capacity for speech.
Her vision has not yet been tested and she still shows some muscle weakness. While upbeat about her condition overall, her medical team remained vague on details, such as how long Giffords is sitting up at a time or whether her communication seems purposeful.
"I've seen her be interactive, appropriate with her family and the staff round her," Kim said. "She's just making great progress."
(Editing by Steve Gorman and Peter Bohan)