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Shepherd Center Offers Benefits Beyond Therapy®

Research finds activity-based therapy can help promote long-term recovery following brain injury.

Like most young newlyweds, Becky and Jairo Cortes were filled with high hopes, eager to start their life together. Becky was about to begin her third year of nursing school, just two years away from beginning a career that would fulfill her dream of caring for others. Jairo had a growing business as a subcontractor installing kitchen cabinets in Dunwoody, Ga., where they lived.

But just a few short months after exchanging their vows, their lives were turned upside down – their plans for the future sidelined by tragedy when a truck came barreling through a four-way intersection and slammed into their car. Becky sustained a severe brain injury in the accident and remained in a coma for two months.

Fast forward six years, and she is making tremendous strides in regaining function thanks, in large part, to Beyond Therapy®, Shepherd Center’s rigorous, activity-based outpatient program.

“She is walking better, can hold conversations and is realistic about the goals we set to be more independent,” says Becky’s physical therapist, Katie Fitzgerald, PT, DPT. Becky’s husband says her mobility has improved dramatically: She can get in and out of their SUV (they used to need a minivan with a ramp), shower by herself and walk around the house with minimal assistance.

Clinicians know little about the effectiveness of activity-based therapy in individuals recovering from brain injury. But Nick Evans, MHS, ACSM-HFS, a lead exercise specialist, and the team at Beyond Therapy are working to change this by collecting outcomes data on these patients.

“The time it takes to recover from brain injury is unknown, but it seems there is potential for recovery well beyond what was traditionally thought of as the cut-off point,” Evans says.

He believes programs like Beyond Therapy that are patient-driven and offer comprehensive activity-based training may be the key to helping individuals continue to progress long after the onset of their injury and inpatient rehabilitation.

In November 2013, the research team presented a case study, “Long-term activity-based therapy may restore walking ability in chronic traumatic brain injury,” at the American Congress of Rehabilitation Medicine. It demonstrated how the program helped a 30-year-old with a brain injury walk again with a rolling walker and minimal assistance after being unable to walk or stand without two people providing maximum support.

“They see their disability and deficits, and they think this is as good as it gets,” Evans says. “But when they are in a program like this, that challenges them with different activities and state-of-the-art rehabilitation equipment, I hear them say, ‘Wow, I didn’t know I could do that.’”

Patients also benefit from the social interaction Beyond Therapy provides, and there is an obvious emotional change as they gain confidence and become more independent. Fitzgerald is most concerned with what Becky and other patients are able to do away from their therapy sessions.

“It’s not just that she does better on a test with a therapist in therapy, but that she can go home and try new things and be a part of her community again,” Fitzgerald explains. “This is a protected, safe and controlled environment, so what we do here has to translate into the real world.”

It seems Becky’s hard work and determination – fueled by her family’s steadfast love and support – is paying off. Fitzgerald recently received a video clip of Becky walking with her family along the beach for the first time since her injury. Becky has also returned to volunteering at Project Pathfinder, a program she directed the year she was injured. It helps kids with their physical, mental and spiritual growth. 

“It’s been a blessing,” Becky says.

People need to understand there are options beyond inpatient rehabilitation, and some patients will need more rehabilitative care to see functional improvements, Evans says. He hopes that more data and research will document the value of outpatient therapy and, ultimately, convince insurers to reimburse for these services.

Keys to Beyond Therapy’s success?

  • It combines lots of different disciplines, including exercise physiology, physical therapy and more.
  • Services are offered over a much longer period of time compared to traditional therapy, and recovery takes time. The program typically involves nine hours of therapy a week.
  • It provides access to technology and state-of-the-art rehabilitation equipment and proven interventions.

Beyond Therapy® at Shepherd Center is a rigorous, activity-based therapy program designed to help people with a variety of neurological disorders, including spinal cord and brain injury, improve their lifelong health, minimize secondary complications and get the most out of any new neural links to their muscles. Since opening its doors in 2005, the program has helped more than 250 patients and families. For more information, visit

Written by Amanda Crowe, MA, MPH
Photography by Gary Meek

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.