U.S. Rep. Gabrielle Giffords is walking with assistance, mouthing the words to songs, and speaking simple sentences as she recovers after being shot through the head at a public event on Jan. 8, according to reports from friends, family, and the congresswoman's staff.
Although doctors have not provided an update on Giffords' condition since she began full-time rehabilitation on Jan. 26 at The Institute for Rehabilitation and Research (TIRR) Memorial Hermann in Houston, a report in the New York Times noted that she has lip-synched words to several songs and is walking the halls with assistance.
A spokesman from the congresswoman's office confirmed the information from the Times report for MedPage Today.
Experts contacted by ABC News and MedPage Today said reports of her progress are about what would be expected for someone with a good recovery pattern.
"Her overall recovery seems good but perhaps not overly surprising for someone who regained consciousness so quickly after her injury," according to Dr. Shari Wade, of the division of physical medicine and rehabilitation at Cincinnati Children's Hospital Medical Center.
Giffords was reportedly able to respond to requests immediately after the shooting and shortly before undergoing surgery at University Medical Center in Tucson, Ariz., where she was treated before moving to Houston for rehabilitation.
"Duration of unconsciousness is the single best predictor of recovery," Wade explained in an e-mail, "and someone who is unconscious for a few hours or a few days will recover much more rapidly and more completely than someone who is unconscious for a month or more."
According to Dr. Gregory O'Shanick, chair of the board of directors of the Brain Injury Association of America, "her recovery curve is somewhat rapid but is what we expect to see when someone has the benefit of a comprehensive inpatient rehab program immediately after their brain injury and receives therapies from an experienced team in an aggressive program."
Singing during rehabilitation is often used as a way to stimulate language functions, which are largely located in the left hemisphere. The ability to sing is largely located in the right hemisphere. Giffords was shot through the left side of the brain, leaving the right side untouched.
"The intonation or inflection in speech, called prosody, is a function of the right hemisphere of the brain and has regions analogous to propositional language ... in the left hemisphere," O'Shanick wrote in an e-mail. "When working with patients like [Congresswoman] Giffords, the use of melodic intonation to sing or speak is used to stimulate both regions."
Dr. Joel Stein, chair of the department of rehabilitation and regenerative medicine at Columbia University, said the "essential idea is to sing the intended statement, rather than merely say it. It has some value, but provides only limited benefit to most individuals with this condition."
The fact that Giffords is singing is a hopeful sign, added Dr. Paul Schulz, a neurologist at the University of Texas Health Science Center, "but would be less significant than the degree to which she is talking."
The report in the New York Times stated that Giffords has lip-synched to "Twinkle, Twinkle, Little Star" and "I Can't Give You Anything but Love, Baby" as friends and family members sang. She has also been videotaped mouthing "Happy Birthday to You" for her husband, astronaut Mark Kelly.
According to Giffords' chief of staff Pia Carusone, the congresswoman recently spoke with Kelly's twin brother Scott, an astronaut aboard the International Space Station, saying "Hi, I'm good." "It's not like she's speaking the way she spoke, but she is vocalizing and making progress every day," Carusone was quoted as saying by the Times.
Giffords is also walking through the halls of the rehabilitation center with the assistance of a shopping cart, according to an e-mail written by her mother to friends.
Several experts agreed that reports of Giffords' progress can give other patients with traumatic brain injuries hope for their own recoveries, but Schulz noted that patients should be counseled on how injuries and brain plasticity differ between patients.
"Each person's improvement will differ and expectations should be tempered by their individual circumstances," Schulz wrote in an e-mail.
O'Shanick pointed out, too, that the intensity of services and length of inpatient rehabilitation Giffords is receiving is not what the average patient would receive.
Dr. Brian Greenwald, from Mount Sinai School of Medicine's department of rehabilitation medicine, cautioned that, even with such a high level of care, Giffords will have a protracted recovery from her wound.
The singing, the walking, and the speaking "are all good things on the road to recovery," he wrote in an e-mail.
But, he added, "The road back after this type of injury is long to get to independence. The road to being a congresswoman again is much longer.
