In addition to providing world-class care for people living with neurological injuries and conditions, Shepherd Center also has a robust research and innovation program that aims to push the boundaries of what’s possible, improving the quality of life for people with disabilities at Shepherd and beyond. Hitesh Mehta, M.D., M.Tech, Ph.D., joined Shepherd Center in the spring as director of innovation and translation. We talked to him about fostering innovation at Shepherd and what drew him to the role.

What is your role at Shepherd Center?

My role is to take technologies and bring them to patients. Now, that could be technologies that we are building in-house here from our research, or from our clinicians who are thinking differently, or our patients as well. … And it's not only technology, it could be small things like changes to workflow. My role is to see that and see if we can bring it, not just to Shepherd Center, but to others as well — to see how you can make it more adopted worldwide. So that is a key role, but there's also an element in the other direction, which is, if there are technologies that have been developed for other reasons, can we bring them into rehabilitation and use them for our patients to help them.

What made you want to work at Shepherd Center?

Time is of the essence in rehab medicine. And Shepherd does it so well that they bring patients while in the ICU. So, that's kind of what got me — it’s the only hospital that brings patients early on in the ICU and helps patients [through early rehabilitation]. And innovation is about timing … taking that little extra effort while there are so many unknowns and doing it early on.  

Your title is director of innovation and translation. Tell us about how you define innovation.

An idea is a “what-if” condition, an abstract thought. It's a concept. … An invention is when you enable it, you create a prototype or a solution, a method where now that “what if” is “what.” It is an asset. Someone can replicate or reproduce it and see it work. … But innovation is really the acceptance of it in the market where you have scaled it, the doctors, the hospitals are using it. … It has become an ecosystem. There is competition growing along with it.

Sometimes commercialization is frowned upon because you're trying to make it revenue-generating. But that is what drives technologies into systems. If you make it free, no one gets interested, and it doesn't actually get implemented or scaled. So, we do need to realize that part: innovation needs some level of support from the capitalist side of the system [to increase its chances of being implemented.]

What is the process of moving from idea to innovation?

Going from an idea to innovation has a lot of unknowns. These unknowns bring in risk, so it is inherently risky. And these risks cannot be removed. So, what do you do? To overcome the risk, you have to treat innovation as a process. And what that means really is you want to fail fast and build the right mindset. So, if you fail fast and you have the right mindset, you can innovate again and again or create new technologies as you move forward. … It’s not an inbuilt talent; it’s something that you can learn and do, a skill you can adopt … if you treat it as a process.  

How does the innovation program support innovation at Shepherd Center?

In three ways: we are a catalyst, a connector, and a facilitator. A catalyst, in the sense that if you have the idea, we can work with you to refine what that opportunity is, understand what the feasibility is, and create the solution to move forward. As a connector, if we identify those risks, can we get experts to help us overcome those risks? Maybe it's clinical, operational, regulatory, whoever that expert is, can he or she help us in facilitating from that idea to innovation? And finally, as a facilitator, it means getting the financial resources … guiding you through that end journey. … which can be a license or a startup. So, help in those parts. Innovation is actually an adoption. It could be in the form that it gets adopted here in the hospital itself, or outside the hospital. ... So, we want to broaden the scope, not just in research, but other places and implement it in clinical paths.

What are you most excited about in your new role?

I like technology, tinkering, and doing it. So, I like playing, and that's what is most exciting, bringing these different, out-of-this-world solutions. … I think that's the cool part — having these technologies and being able to play with them, and ... being able to get them here at Shepherd to help our patients.

What is the most fulfilling part of your role?

I [trained as] a physician academically, then I got into engineering. The goal was to help more patients, and how could I help do more, versus treating one patient at a time? So that's why I went into research and engineering. … The fulfilling part is helping patients, seeing them improve in whichever way [they] can.

Education: 

Hitesh Mehta possesses a rare interdisciplinary background bridging medicine and advanced engineering. He earned his Bachelor of Medicine and Bachelor of Surgery (M.B.B.S.) — equivalent to a Doctor of Medicine (M.D.) and license as a family physician from Seth G.S. Medical College, Mumbai, India. He then completed a Master of Technology (M.Tech.) in Biomedical Engineering at the Indian Institute of Technology (IIT) Bombay, followed by a Ph.D. in Biomedical Engineering from the University of Minnesota.

Fun Facts:

• Dr. Mehta has four siblings who live in various countries around the world.
• He and his wife, Vandana Ranka, recently moved from Cleveland to Atlanta.
• He likes to snow ski.
• Dr. Mehta likes to travel, and now that he lives in Atlanta (a gateway to the world), he’d like to travel south of the equator.

Responses have been edited for length and clarity.

Interview by Ruth Underwood

The event was born out of what used to be Research Day, an all-day affair that united researchers and clinicians for poster presentations, research updates, and a keynote address. The annual event was put on pause in 2020, and as leadership discussed how to revive it, the idea for Research Week was born.

“We wanted to create opportunities for more staff to engage with research without having to step away from their daily responsibilities,” says Shepherd Center’s Vice President of Research and Innovation Deborah Backus, PT, Ph.D., FACRM. “By offering sessions during lunchtime throughout the week, we were able to bring research directly into the flow of clinical care and make it more accessible to everyone.”

Dr. Backus kicked off the week by detailing the sessions attendees could look forward to: presentations from colleagues on their ongoing research, “lighting round” presentations from clinicians on their work, and a keynote address. Shepherd’s Chief Medical Officer, Michael Yochelson, M.D., MBA, also spoke at the kickoff, highlighting how research at Shepherd is a team effort and how research directly informs and influences clinical practice, as well as how gaps in clinical care can inform research questions and innovative strategies.

“At Shepherd Center, research is not something we do in addition to clinical care. It is part of how we care,” Dr. Yochelson says. “It is how we advance the field of rehabilitation, create better outcomes for our patients, and honor the trust our patients place in us.” 

Throughout the week, research scientists and clinicians alike presented their work and recent studies. On Wednesday, James S. Krause, Ph.D., a distinguished university professor in the Medical University of South Carolina (MUSC) College of Health Professions, the director of the Center for Rehabilitation Research in Neurologic Conditions, and a frequent Shepherd Center collaborator, gave the keynote address. In his presentation, "Surviving and Prospering After Physical Disability: 50 Years of Research, 20,040 Days of Survival," Dr. Krause discussed his own experience living with a spinal cord injury, as well as his research, a 50-year study regarding spinal cord injury (SCI), quality employment, and longevity.

To round out the week, on Friday, research leadership presented awards for research posters and presentations, recognizing work for its excellence, innovation, and applicability to the clinic space. And Dr. Backus and her team are already preparing for next year’s Research Week, with hopes to include more Shepherd staff members and community researchers alike.

“Research Week highlights what makes Shepherd Center unique — the close partnership between those asking important questions and those delivering exceptional care,” Dr. Backus says. “When research and clinical practice inform one another, we accelerate innovation and create better outcomes for the people we serve.”

Congratulations to this year’s award winners!

Posters

Best Overall: Affective Clinical Measures Correlate with Connectivity between Brain Regions Associated with Vestibular Function in Chronic Mild Traumatic Brain Injury. Piper Lashley; Joe Behnke; Jeremy Smith; Vishwadeep Ahluwalia; Ashwini Tulpule; Rachael Frank; Jason W. Allen; Russell K. Gore

Most Innovative: Standardizing Seating Clinic Patient Education Using AI-Supported Multimodal Tools: A Quality Improvement Initiative. Tori Fallgren, PT, D.P.T., NCS, ATP; Kashun Davis, BSIE, MBA, MSIT, LSSBB

Most Translational: Turning the Tide on Pressure Injuries: A Multidisciplinary Approach Through PDSA Cycles. Kimberly Levenson BSN, RN, CRRN, CWOCN, CFCN; Ethan Goff, RN; Anna Murdock, BS, LSSBB

Papers

Best Overall: Toward precision stroke rehabilitation: an integrated causal machine learning and clinician feedback approach. ​Aaron Baird, PhD; Houping Xiao, PhD; Yusen Xia, PhD; Chloe Sellers, MA; Katheryn Metzger, OTR/L, MBA; Karen Patterson, MS, CCC-SLP; Liv Nyankori, BSW, BSN, RN CRRN, CCM; Raeda Anderson, PhD

Most Innovative: Development of a Structured Interview for the American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury. ​Rael T. Lange; Kelly C. Gillow on behalf of ACRM Brain Injury Special Interest Group Mild TBI Task Force members: Noah D. Silverberg; Tracey Wallace; William J. Panenka; Amanda Rabinowitz; Jaclyn A.Stephens; Kristen Dams-O’Connor; Richard Delmonico; Min Jeong P. Graf; Alice Sau Han Kam; Quratulain Khan; Anthony H. Lequerica; Zainab AlLawati; Gary McKinney; Jacob I. McPherson; Drew Nagele; Deborah Snell; Josh Kamins; Jennifer Wethe

Most Translational: Exploring Integration of Support for Co-Occurring Substance Use-Related Needs in InterdisciplinaryTraumatic Brain Injury Treatment for Military Service Members and Veterans. ​Katherine L. McCauley, PhD; Tracey Wallace, MS,CCC-SLP; Timothy P. Moran, PhD; Javier Palacios, BS; Dina Forehand, MS, CCM; Jacquelyn Breitenstein,MS, CTRS, CCM; Shannon C. Miller, MD; Russell K.Gore, MD

Written by Erin Kenney

 “You can do rehab in a barn if you have the right people.” — David Apple, M.D.  

This “Apple-ism” often echoes off the walls at Shepherd Center, the hospital David Apple Jr., M.D. helped start five decades ago. It uniquely captures a key part of the hospital’s philosophy — with the best therapists, you can help patients achieve more, regardless of your facilities, financial resources, or access to high-tech equipment.  

In the years since Dr. Apple helped start Shepherd Center, it has transformed into a world-renowned rehabilitation center, with a multi-building main campus, large, well-equipped therapy gyms, state-of-the-art technology, and room to grow. Thanks to Dr. Apple and his leadership, Shepherd Center also boasts a one-of-a-kind staff of over 1,800 people, all dedicated to serving patients through hope, humor, and hard work.  

Dr. Apple took a chance on Shepherd Center as an early-career doctor, eager to help those experiencing a catastrophic injury or illness. For half a century, he served Shepherd Center’s patients, staff members, and visitors with his compassion, dedication, and medical expertise.  

On March 23, 2026, Dr. Apple died at home in Atlanta, surrounded by his loved ones. Shepherd Center is saddened to say goodbye and grateful for his service, which has helped define the hospital he helped start.  

“Walk or roll through our halls, and you’ll feel Dr. Apple’s presence everywhere: in our culture of compassion, in the courage of our patients, and in the dedication of every team member,” says Jamie Shepherd, MBA, MHA, FACHE, president and CEO of Shepherd Center. “Over more than 50 years of service, Dr. Apple changed the world of rehabilitative medicine — and he did it with heart, humor, and an unshakable belief in what is possible.”  

Taking a Chance on Shepherd Center  

When Harold and Alana Shepherd and their son, James, were working to start a new rehabilitation hospital in Atlanta, they approached Dr. Apple about being the founding medical director. While Dr. Apple was still early in his career as a doctor, he had quickly amassed clinical expertise and leadership abilities.  

After his graduation from medical school at the University of Pennsylvania in 1962, he came to Atlanta, working first as a medical intern at Emory University and then in a residency in surgery at the Morehouse School of Medicine. He also completed an internship at Grady Memorial Hospital. Working in the region’s foremost trauma center, he learned firsthand how to care for patients hurt by devastating falls, car crashes, gunshot wounds, pedestrian accidents, and other serious incidents. In 1964, he joined the Air Force for two years — the last of which he served as chief of surgery. Then he worked as an orthopedic resident at the University of Cincinnati Medical Center in late 1969. He completed two fellowships, one in orthopedic rehabilitation at Rancho Los Amigos Hospital in California and another in hand surgery in Louisville, Kentucky. Then, he was the medical director for Easter Seals, an experience he said gave him the foundation to be the medical director for a brand-new facility.  

By the time the Shepherds asked Dr. Apple to sign on as the medical director of their new rehab center, he already had ambitions to lead a hospital. Plus, he was familiar with James’ story — he had been peripherally involved with his care at Piedmont Hospital after James sustained a spinal cord injury in 1973. Helping start what was then Shepherd Spinal Center was a great opportunity, as well as a huge risk. One of his colleagues warned that starting the hospital would ruin his career. But luckily, Dr. Apple was willing to take the chance.  

“I’d been trying to start a rehab center in Atlanta, and this gave me the opportunity I’d been looking for,” Dr. Apple reflected in a video filmed for the hospital’s 50th anniversary. “It all came together as if by magic.”  

Looking back, Alana says that in hiring Dr. Apple, she, Harold, and James found the best medical director they could have had.  

“When we asked him if he would consider being medical director, he said yes right away because he said he knew [a rehabilitation hospital] was needed and he knew it would succeed,” says Alana Shepherd. “We were lucky that we got the right one. That's the best part of all, [he was] the best choice that we could have had. Because he certainly believed in research, and he believed in doing the best you could and giving it your all, and also being very relaxed, and eager to be a real person — not a doctor in a white coat that looked at the baseboards and could hardly speak to anyone. He wasn't that kind of a doctor. So, we were really lucky that we had picked him.”  

Dr. Apple was Shepherd’s first medical director, but he was also much more. As a co-founder of a brand-new hospital, he had to be a cheerleader, a fundraiser, a hiring manager, and a mentor.   

Stories from those early years are now cemented in Shepherd Center lore. For example, in 1975, he asked friends to donate to the hospital if he completed the Peachtree Road Race. He made it to the finish line, and a friend named George Johnson gave him a $100 check, the first donation to Shepherd Center from anyone not involved in the hospital’s founding.  

He also helped put together the hospital’s first staff, bringing in staff members like Tammy King, MSN, ET, CRRN, CCM, who worked at the hospital for 47 years, and Herndon Murray, M.D., who worked here for 50 years. Dr. Apple was able to recruit Dr. Murray even without guaranteed funding for his position, showcasing both physicians’ belief in Shepherd’s mission. 

Staff members and volunteers remember Dr. Apple as down-to-earth, a great listener, and a gentle leader and teacher whose influence helped shape Shepherd’s culture. He was a beloved mentor for staff, always eager to share his knowledge with them. 

“Dr. Apple never asserted that he was the doctor. He was always just someone who would roll up his sleeves with everybody else,” says Jill Koval, Ph.D., ABPP-Rp, rehabilitation psychologist and psychology supervisor who has worked at Shepherd for 36 years. “And one of the most important things that he taught me as a leader was the importance of really listening, and respecting different opinions, but also thinking about the patients that we serve as whole people.”  

Sarah Morrison, PT, MBA, MHA, former chief executive officer of Shepherd Center, remembers her first impressions of Dr. Apple when she started as a physical therapist in 1984. She says he had total faith in his team. 

“When I started working with him, what I saw was he totally trusted the staff,” she recalls. “Some physicians would say, ‘Okay, physical therapy, you're going to do X, Y, and Z three times a day.’ Now, Dr. Apple never did that. He would just say, ‘Hey, evaluate and treat this patient as appropriate.’ He understood the nuances of every position of the team. He just trusted the staff and said, ‘Do what you do best.’” 

Shari McDowell, PT, DPT, FASIA, FACHE, the hospital’s current chief operating officer, joined Shepherd as a physical therapist in 1992. She remembers Dr. Apple really listening to staff — an experience she hadn’t had with working as a doctor before. 

“He was somebody who listened to every single person's opinion, and valued everything equally," she says. “It was very unusual — especially then, there was a lot of hierarchy in medicine. I remember thinking, 'This is an amazing physician. This is going to be an amazing place to work.'”

Dr. Apple took his responsibilities as medical director seriously. But one responsibility — fostering a supportive culture for his patients and staff — often required him to be not-so-serious. Sara Chapman, longtime Shepherd supporter and Board of Directors’ corporate secretary, began volunteering with the hospital when it was still at its original location. She remembers Dr. Apple as doing whatever it took to bring a smile to his patients and staff, even if he was occasionally the butt of the joke. 

“He [created] a spirit of fun in our culture,” she says. “He was the one you could always dress up, you could always throw pies at. He was always up for something that added to the spirit of enjoyment and happiness at Shepherd Center.” 

Dr. Apple also helped lead the push to move Shepherd to its location on Peachtree Road. While the unit inside West Paces Ferry allowed Shepherd Spinal Center to get its start, Dr. Apple knew they needed more space — the rehabilitation facility had a waitlist almost immediately upon opening. Plus, he felt at odds with the owners of the leasing hospital, a for-profit operation.  

“They were interested in profit. We were interested in service,” he once reflected. “That got to be a problem.”   

Thanks to the vision of the Shepherd family and Dr. Apple, on May 13, 1982, Shepherd Center moved into its own building — growing to 40 beds and with a therapy gym nearly as big as the entire previous space.   

Pioneering Research & Recreation Therapy  

Dr. Apple leaves behind a tremendous mark on Shepherd’s history. But perhaps his most enduring legacies lay in Shepherd Center’s renowned clinical programs and research initiatives.  

Dr. Apple’s clinical expertise allowed Shepherd’s Spinal Cord Injury Rehabilitation Program to quickly become renowned nationally, and even globally. With his leadership, Shepherd Center was designated as one of only a handful of Spinal Cord Injury Model Systems (SCIMS) by the National Institute on Disability, Independent Living, and Rehabilitation Research, then a program through the U.S. Department of Education. The recognition came with a $246,000 grant, a boon to a hospital only seven years old, and it cemented Shepherd Center’s status as a leader in SCI research and rehabilitation. The hospital has continued its tenure as an SCIMS ever since, operating as the Southeastern Regional SCIMS Center. The hospital is also now recognized as a Traumatic Brain Injury Model System (TBIMS).  

Shepherd Center officially added research to its mission in 1985, and the program has been expanding ever since, with Dr. Apple serving at the helm for years.  

“Dr. Apple is such a legend in the SCI research community, and meeting him for the first time as I considered relocating my lab to Shepherd was a tremendous honor,” reflects Edelle Field-Fote, PT, Ph.D., FAPTA, FASIA, director of spinal cord injury research and the Hulse SCI Research Laboratory. “When I arrived, I learned that he had generously given me his own office and moved himself to another space. Because he had a key, I would often arrive back at the office to find a note, a flower, or an apple. These are the kinds of sweet gestures of support that made him so loved by everyone.” 

Dr. Apple also saw the value in inpatient services extending beyond the usual clinical setting. He started Shepherd’s Recreation Therapy Program, now the largest program of its kind in the country, by paying the first recreation therapist out of his own pocket. The recreation therapist, Barb (Leidheiser) Trader, took patients on outings to concerts, Atlanta Braves games, and even Dr. Apple’s property in North Georgia to fish and enjoy the outdoors. 

The program has since grown into a 30-plus-person department, coordinating everything from pottery clinics to adaptive hunting trips for inpatients, outpatients, and community members living with disabilities. Last fall, recreation therapists from across the decades at Shepherd made a visit to the hospital as part of 50th anniversary celebrations. Dr. Apple attended the reunion, where current and alumni recreation therapy staffers shared their favorite stories and thanked him for his vision.  

“That's one of Dr. Apple’s great legacies for Shepherd, is his understanding and vision for rec therapy, and how it was such a critical component of our patient care,” says Chapman, who volunteered on recreation therapy outings in the hospital’s early days. 

Dr. Apple believed in getting patients beyond the walls of their hospital room, and he practiced what he preached. Rarely found holed up in his office, Dr. Apple was a familiar face in the hallways during his tenure as medical director and beyond. Patients often reflect on seeing him across the center, from him meeting them upon their arrival at the ambulance entrance to taking a front-row seat at events like Project Rollway.  

“We talk a lot here … about culture and what that means,” says Cheryl Linden, MA, LPC;MS, OT/L, who has worked at Shepherd for 30 years. “And Dr. Apple portrayed that in such a way because he lived the culture. And it wasn't just about patient care and family care. The culture was about care of all. Care of community. Care of each other.”  

A Leader at Shepherd and Beyond  

Dr. Apple often encouraged his children and grandchildren to get involved in their community, beyond the responsibilities of their day jobs. And he modeled this for them constantly.  

In addition to his work at Shepherd, Dr. Apple brought his medical expertise to the global stage. In 1983, he became president of the American Spinal Injury Association, a professional organization he helped found. At that time the youngest member ever elected to serve as president, Dr. Apple led the organization's then 275 physician members. In 1997, he was awarded the organization’s Lifetime Achievement Award.  

“He really took his knowledge and tried to implant it in others, whether it was through the American Spinal Injury Association, whether it was through research, or one-on-one mentoring,” Morrison says. 

He also served as president of the Atlanta Clinical Society, the Atlanta Orthopedic Society, and the Georgia Orthopedic Society, receiving the F. J. Funk Award for outstanding service to the Society in 2017. For the 1996 Paralympics, he was the chief medical officer. For the ’96 Olympics, he co-chaired the doping committee. And for 30 years, he was a team physician for the NBA’s Atlanta Hawks.   

His history of community involvement has deep roots, reaching even before his time in medical school. Dr. Apple graduated from Highlands High School in Fort Thomas, Kentucky, in 1954 as valedictorian, class president, and an outstanding athlete with varsity letters in basketball, football, and track. While he was an undergraduate at the University of Virginia, studying as a Dupont Honor Scholar, he ran as a protest candidate and became student body president.   

He also found ways to give back to the community outside of the medical field. He donated his time to the Lovett School Board of Directors, the Community Foundation for Greater Atlanta, and the Cathedral of Saint Philip, where he was a devoted member for more than 55 years.  

“He was very beloved at the cathedral by our clergy,” says Chapman, who also attends St. Philip’s. “Whenever the church called on him, he answered. He was generous, he was present, and he was involved.” 

At Shepherd Center, he continued to serve on the board of directors even after his retirement, where he helped with strategic planning for the hospital’s future.  

“He was a very highly valued and respected board member whose insight and opinion were always persuasive,” says Jim Thompson, chairman of the board of directors. “When he chose to comment, it became quiet in [the boardroom] as each member listened intently to what Dr. Apple had to say. He was a giant influence to all of us.”  

At the core of Dr. Apple’s heart was his love for his family. He met his wife Jane in 1961 when she had a date with his roommate, and they were married one year later. They had four children together and 12 grandchildren.  

“Jane was the love of his life, and they had an incredible partnership,” says Jamie Shepherd, who grew up alongside Dr. Apple’s children. “He loved his kids, his grandkids. Everybody is partial to their grandkids — but he was exceptionally proud of his grandkids and all the great things that they are doing, and he really loved being a grandfather.”

Dr. Apple enjoyed spending as much time as possible with his family, always celebrating each birthday with dinner at a favorite restaurant and attending his children’s and grandchildren’s sporting events. He also always made time for yearly trips with his family. 

“[Those trips] are totally my best memories, and definitely our kids' best memories. And you could just tell that that was what gave him the most joy,” says John Stephenson, Jr., one of Dr. Apple’s sons-in-law and a member of the Shepherd Center Foundation Board of Directors. “They would just sit there and look around, smile at everybody, and be happy that everybody was there.” 

A Vision for the Future  

In a presentation Dr. Apple gave before his retirement in 2005, he outlined what he’d like to see in Shepherd’s future: an enlarged exercise facility, enhanced continuing education opportunities for staff, continued research emphasis, and continued focus on patients and their families.   

Over 20 years later, his vision continues to come to life. Renovations at the main hospital have allowed for expanded patient floors and bigger therapy gyms. The NeuroRehabilitation Learning Institute provides educational opportunities for clinicians at Shepherd and around the world. The new Marcus Center for Advanced Rehabilitation is bringing research at Shepherd Center to new heights. The Arthur M. Blank Family Residences allow families to fully participate in their loved ones’ rehab. And during the hospital’s 50th anniversary, celebrations showcased how hospital staff are more dedicated to their patients than ever.   

Even after stepping down from formal leadership, Dr. Apple continued to pour his time, talent, and passion into research, advocacy, and supporting Shepherd Center patients and staff. He frequently was at the hospital for Founders Meetings with fellow co-founder Alana Shepherd and hospital leadership. He also regularly attended events hosted by the Shepherd Center Foundation, including Derby Day, The Legendary Party, as well as groundbreakings and ribbon cuttings that coincided with Pursuing Possible: The Campaign for Shepherd Center, the hospital’s largest campaign and expansion effort to date.  

Dr. Apple accepting the position as Shepherd Center’s first medical director not only defined his medical career but impacted thousands of patients and their families, helping them rebuild their lives. His legacy, and the hospital he helped build, will continue to do so.  

“He was not a prideful person — he was quite humble, so he'd probably shudder at the concept of the legacy,” says Stephenson. “But I think he would want his legacy to be that of a man of strong faith, a dedicated husband and loving father and grandfather, and a gracious friend to anybody that he met. We all know that his legacy stretches far beyond that in scope and reach ... he was brave and pioneering in his field. His innovation, creativity, and entrepreneurial approach to that work has been a big factor in really changing the entire field around treatment of traumatic spinal injuries and complex neurological conditions worldwide."

March is Multiple Sclerosis (MS) Awareness Month, a time to promote understanding of the chronic neurological condition that impacts one million diagnosed Americans and their families, friends, and care partners. Thanks to the efforts of researchers at Shepherd Center and around the globe, outcomes for people with MS have never been better, and the prognosis for someone diagnosed with MS today looks completely different than it would have 20, 15, or even 10 years ago.

To learn more about the research driving improvements in MS care, we caught up with Brad Willingham, Ph.D., director of the Multiple Sclerosis Research Program at Shepherd Center.

First, can you tell me about MS research at Shepherd? How are we different from other institutions conducting MS research?

That's exactly why I'm here at Shepherd: because we are very different. And it’s why I'm so honored to be a part of this organization and working to advance our mission through research.

Although I started my career here as a clinician at Shepherd Center, my scientific training is in neuromuscular physiology . So, a lot of my work has been focused in basic science. I spent almost five years at NIH [National Institutes of Health] doing deeply cellular-level work. It was fun. The questions were interesting. The technology was cool, but I wanted to be focusing more on work that has an immediate impact on patients.

At Shepherd, our work must be immediately relevant to those we serve and the clinicians who provide their care. Meaningful research is a mandate. Every experiment, every outcome is someone's life. And we get to see the impact we are making through our research in real time.

Additionally, Shepherd just has a different culture. Our clinicians are curious, they're motivated, they're looking to push the status quo, they're open-minded, and they're always questioning how to advance things. This creates an environment where researchers are welcome in the clinical spaces. They consider us part of the team. They're excited to share their needs and problems and questions with us.

How do you ensure research is addressing patient needs?

We actually start with the patients and with the clinicians, and we meet with them. We meet with them on a quarterly basis, sometimes more frequently, in what we call knowledge translation meetings. And we ask, ‘What are your needs? What are your questions? What are your barriers?’ And then from that, we work backwards.

We design scientific research studies to address a knowledge gap, or create and innovate a tool or solution, or create a way to overcome barriers to access and care. It's wonderful because we do get research that's directly relevant to the real world. It's immediately tailored and catered towards the needs of the patients and clinicians.

Because we start with the clinicians and patients, we do end up with quite a wide range of studies. We have studies in employment, studies in fatigue management, and studies on technology development, developing tools to make care more accessible.

We also have studies that are directly integrated into care, and so we're empowering clinicians to use the data they collect as part of their routine job to extract meaning from that, extract insights from that, to help refine their care, and explore what care may be most effective for different folks living with MS.

Does your team conduct any research looking at potential cures for MS?

Yes. We are very active in research that moves the field toward better treatments and, ultimately, a cure for MS. 

We have a fantastic clinical trials team here, led by Issi Clesson, RN, MSCN, CCRP, Director of Clinical Trials. We partner with pharmaceutical industry collaborators to evaluate the most cutting-edge disease-modifying therapies aimed at slowing or preventing MS progression as early as possible.

In the wider medical community, we've come a long way with disease-modifying therapies for MS. We have made tremendous advancements in preventing relapses and preventing disease progression with pharmacologic treatments, but that's just part of the story.

When someone has MS, the initial damage from the disease cascades throughout the body. It causes mobility impairments and fatigue and cognitive disruptions, bowel and bladder dysfunction, all of these things that impact your daily life. It's important that we not solely focus on a cure, but also help those who have already been impacted by MS to sustain their function, get back to doing the things they love, and mitigate the severity of disability progression.

You mentioned how far MS research has progressed in terms of pharmacology. What are some other advancements we’re seeing now? 

The research we’re working on now — which is really paradigm-shifting — is addressing one of the most long-standing and pressing challenges in MS care: the heterogeneity, or variability, we see in our patients. No two folks living with MS are living the same experience. 

People with MS most commonly report impairments in mobility and fatigue as their most common and most impactful, debilitating symptoms. But the reason why someone may have challenges with mobility or walking, or the reason someone may feel fatigued, is different from person to person. So, what we’re doing now is leveraging our new infrastructure in the Human Performance Lab, that allows us to systematically evaluate different physiological systems at the same time. This allows us to determine what is causing mobility impairment or fatigue from patient to patient. Because if we know that, we can apply a very targeted treatment. A one-size-fits-all approach is not going to work. By treating the symptom, you may not be addressing its underlying cause.

One of our current studies is the PRISM study (Precision Rehabilitation through Integrated System Modeling). We use the Human Performance Lab to systematically evaluate the body, from brain activity, to biomechanical movement, to muscle activation, to metabolism and cardiopulmonary function. We can evaluate all of these systems at the same time, during the exact same conditions, to tease out the underlying cause of what a patient is experiencing. Modern pharmacology achieves precision by targeting specific biological pathways in the body. Our goal is to bring that same level of precision to rehabilitation by identifying the underlying physiological processes that cause symptoms and designing therapies that address them directly.

A lot of things are coming together to make this possible. Almost daily, we hear of some new technology being invented. But it’s not just for convenience, it’s not just for entertainment anymore. With advancements in computing, imaging, sensors, neurophysiologic measurement systems, and AI, we can now see further than ever before. And we now have technology to make all these precise measurements, and it’s fast enough, affordable enough, and mobile enough to use in a clinical research lab .

And so, on the clinical side, this precision rehab approach, this PRISM approach, is going to allow more targeted therapies, with the goal of improving outcomes for patients in a more personalized, efficient, and cost-effective way. On the research side, it's also going to accelerate scientific discovery because we can capture more meaningful data that are more sensitive to changes in health and function. This can make clinical studies more efficient and help promising therapies move more quickly from research into real-world care for the people who need them most.

Responses have been edited for length and clarity.

Interview by Erin Kenney

Allie leads the Best Health and Wellness Program’s weekly adaptive strength training course. One of three weekly in-person offerings from the Best Health and Wellness Program, the strength class is open to patients and community members, providing access to professional fitness and health and wellness support in a fully accessible setting.

Since sustaining a spinal cord injury in 2017, Patrick has completed a variety of rehabilitation programs at Shepherd Center and beyond: inpatient therapy, the Spinal Cord Injury Day Program, Beyond Therapy®, and rehab at the Veterans Affairs hospital in Augusta, Georgia. He discovered the Best Health and Wellness Program’s class listings online and has made them part of his routine.

“Even [with my background as a trainer], a lot of stuff Allie shows me makes me go, ‘Oh, I didn’t know that,’” says Patrick, who was an avid runner and personal trainer prior to his injury. “The classes are fun, and I enjoy it. And I learn something new every time.”

The program also offers weekly inpatient classes. These classes are offered in-person as well as pre-recorded and can be streamed anytime, anywhere around the hospital. Marina Moldavskiy, ACRP-CP, Shepherd’s tele-wellness program manager and exercise physiologist, says this allows patients across injury levels and programs to participate in class together. The pre-recorded classes offer another accessibility benefit — subtitles allow patients who are hard of hearing or who don’t speak English to engage in real time, without delays from using an interpreter.

“These classes allow patients with a variety of needs to participate in a real-time fitness class with other patients from around the hospital,” Moldavskiy says. “And because the courses are pre-recorded and available on demand, patients off-site at the SHARE Military Initiative or Shepherd Pathways can also engage. Patients who aren’t able to leave their rooms can engage.  Patients can then transition to participating in these classes upon returning home, which is really great!”

Classes recorded through the Best Health and Wellness Program are available on demand via an online platform. Access is free for Shepherd Center patients, ensuring that even once they return home, they have access to high-quality, expert-led classes. Anyone can subscribe to the platform to access the virtual content. For assistance signing up, please email marina.moldavskiy@shepherd.org.

Written by Erin Kenney

Eight years earlier, Michael Gore, a maintenance technician at a vinyl siding plant in Whiteville, North Carolina, had sustained a T-10 spinal cord injury after falling at work. Since going through rehabilitation at Shepherd Center, he had returned home to his wife and new life. But in 2010, he got a call from Shepherd, asking if he was interested and available to take part in clinical trials for the Indego® exoskeleton. He was all in. 

“I wanted to see how this thing works,” Michael says. “But the main reason I agreed to be part of the trials is to see how this could help people.” 

What followed was a marathon of trial and error, with technological advancements fueling this new partnership between Vanderbilt and Shepherd. Clare Hartigan, PT, MPT, was project manager, eventually spending almost 10 of her 33 years at Shepherd on the Indego project. “It was an incredible opportunity for us, but also for the patients,” she says. “The device allowed them to stand up and walk and exercise. It was such a thrill.” 

The concept sounds a little like the movie “RoboCop,” but the technology is more akin to the Segway® scooter. Essentially, the Indego is a lightweight modular device with components for the lower legs, upper legs, and hips/waist. Electric motors drive the hip and knee joints, while gyroscopes and accelerators anticipate a patient’s steps by subtle upper body motion—similar to how a Segway works: Lean forward, go forward; lean back, stop or sit down.

Every month, Michael Goldfarb, Ph.D., who invented the Indego technology, and his engineering team from Vanderbilt would come to Shepherd, and Michael Gore would travel from North Carolina for a week of intensive testing. “We would spend all day with Michael, from 9 a.m. to 5 p.m.,” Clare recalls. “Then the engineers would be up until 3 a.m. recoding things. Sometimes they would sleep in the gym. It was a tremendous amount of work.”

Within two years, the team had a fully functional prototype. In 2013, Parker Hannifin, a global leader in motion technologies, bought the Indego and began the extensive process of bringing it to the market, first in Europe and, in 2016, the U.S. Initially, the FDA approved Indego for people with paraplegia or tetraplegia and, two years later, approved it for people recovering from strokes. In 2022, a company called Ekso Bionics bought Indego from Parker Hannifin and continues to market it for personal and therapy use. 

Ultimately, about 50 patients at Shepherd took part in the Indego clinical trials, along with hundreds of other people across the country. Shepherd Center was in the national and international spotlight during the research, and Clare and Michael were in demand all over the world to demonstrate how Indego works. 

“This was my heart, this project,” Clare says. “It was eight years of hard work, but we had such a good time and learned so much. In the end—the whole team would say this—the motivation was to do this for the patients. The fact that we were able to succeed meant everything.”

Success may be best measured in the real-life moments that follow clinical trials, like when Will Hutchins, who sustained a T-7 spinal cord injury in 2013 in a vehicle crash, was able to walk into the football stadium at Heard County High School in Franklin, Georgia, two years later to receive his diploma. Using forearm crutches and wearing the Indego, with Clare walking a half-step behind, Will was able to make the long walk into the stadium, up a ramp, across the stage, and down another ramp. “I was very emotional that day,” Clare says. “There have been a lot of incredible, amazing firsts with this device.”

David Carter, who has used a wheelchair for mobility since sustaining a T-7 injury in a motorcycle crash in 2010 and works now in Peer Support at Shepherd, was able to walk down the aisle at his wedding while wearing the Indego. The device cannot heal a spinal cord injury, of course, but it allows people to experience these moments—celebratory and mundane—in a different way. 

At home in North Carolina, Michael Gore doesn’t wear his Indego every day. “Just when I want to get up and walk around a little,” he says, quietly acknowledging what a remarkable option that is.

Written by Teresa Weaver

This story is an excerpt from “Mission Moments: 50 Years of Rebuilding Lives One Moment at a Time,” a book celebrating Shepherd’s 50th anniversary in 2025. 

The magazine highlights the Hulse Spinal Cord Injury Research Lab, as well as the new James M. Cox Innovation Institute.

This issue also features these stories, among other patient profiles, anniversary stories, honorariums, and memorials:

• Shepherd & The Peachtree: 40+ Years of Hope & Inclusion
• Going Beyond: Q&A With Exercise Physiologist Corey Gainey
• A Hero's Journey: Jacob Kennedy's Story of Strength, Support, and Starting Again

 Subscribe here for Shepherd Center's Spinal Column magazine print and/or e-newsletter versions.

“When they started talking about discharge, I got really frantic, like, ‘What do I do now? I'm not moving,” she remembers. “It was kind of a frantic time, but we tried to absorb everything they told us and taught us.”
 

Before discharge from Shepherd, she began to feel sensation in her lower back, prompting doctors to change her diagnosis from complete to incomplete SCI and opening a new world of possibilities for her recovery.

Once she was back home, she and her husband continued her physical therapy program while they worked through delays in finding a home care agency. They referred to handouts and flyers her therapists gave her before she left Shepherd. Over time, they started noticing progress. Robbyn had returned to Shepherd for the Spinal Cord Injury Day Program when she heard about a research opportunity in the Hulse Spinal Cord Injury Research Lab. The study aimed to reduce muscle spasticity through transcutaneous spinal stimulation (TSS).

Even though the study wasn’t aimed at improving motor function, after participating, Robbyn noticed changes in her ability to move. She heard about a study led by Shepherd’s SCI Research team, where TSS was used over the neck area to boost the effects of training with the goal of improving hand function. She brought a stimulator she’d been using at home to the SCI research team, where lab director Edelle Field-Fote, PT, Ph.D., FAPTA, FASIA, and the other research scientists adjusted the settings so the device could be used for TSS. Now, she uses the stimulator at home as part of her routine physical therapy practice.

“She’s really been a champion of translating the work that we're doing, not only from the lab to her home, but also from the spasticity study that she participated in to her home program for motor function,” Dr. Field-Fote says.

Robbyn says TSS has been a game-changer. It’s helped her build strength in several muscle groups, and it’s especially exciting because even her therapists who don’t know she’s using TSS are seeing the changes. 

“[Sometimes my therapists] will go, ‘Hey, we’re noticing a little more strength in this arm, what’s going on?’ and we laugh,” she says. “It’s great because they’re noticing the effects of the TSS and the exercise that goes along with it.’”

Electrical stimulation is nothing new, but the Hulse Lab has pioneered its application for TSS. The SCI research team is continuously finding new ways to use it to help people with spinal cord injuries, from reducing spasticity to improving motor function in the hands, to magnifying the effects of locomotor training for improved walking function.

Turning on the Stove: TSS & Neuromodulation

Dr. Field-Fote is an expert in spinal cord injuries. Her career weaves throughout all kinds of research in that field — from her Ph.D. thesis on turtles with complete SCIs to her work at the Miami Project to Cure Paralysis, a world-renowned research center. At the Miami Project, she worked alongside both basic and applied scientists — basic meaning foundational scientific research, like doing experiments with animal models or cells in a dish. She frequently reviews grant proposals and papers on the basic science of SCIs, and she’s received numerous distinctions for her work in the field.

In short, she knows a lot about spinal cord injuries. And she says that right now, despite all the attention the media gives to high-tech approaches, rehabilitation is key to helping people with SCIs regain function after injury.

“The research evidence shows that right now rehabilitation is the best approach we have for improving function in people with spinal cord injury,” Dr. Field-Fote says. “And when I say rehabilitation, I mean practice and training. The focus of my lab has acknowledged that physical and occupational therapy are the best ways to promote neuroplasticity.”

That’s why, as director of the Hulse Lab, Dr. Field-Fote has focused research efforts on how tools like TSS and other forms of neuromodulation can improve physical and occupational therapy outcomes. By applying stimulation to the spinal cord or the brain, the SCI researchers in the lab make the nervous system more receptive to therapy.

“These tools change the nervous system, but you still have to tell the nervous system what you want it to change,” Dr. Field-Fote says. “Think of a stove that has four burners. If you turn the stove on, it will heat up, but there’s no usefulness to it until you put a pot on the stove with the soup. Stimulation provides the system with energy, but it’s the training that tells the nervous system what to do with that energy.”

In addition to improving hand and walking function when combined with training, TSS can also help reduce spasticity — another focus for the Hulse Lab. The lab’s scientists also determine best practices, such as where to place the electrodes and whether to use the stimulation in bursts or as a continuous pulse.

“If you think about a spinal cord that is damaged, the signals are still coming down from the brain, but information is not making it out to the muscles,” Dr. Field-Fote says. “It's like a hose that has holes in it, and you might not be able to do anything about the holes in the hose, but if you turn up the spigot, more of it's going to get to the end.”

‘Ready to Find a Breakthrough’

Of course, none of the lab’s research would be possible without help from research participants. For research scientists Anastasia Zarkou, PT, MS, Ph.D., and Jennifer Iddings, Ph.D., their groundbreaking work in noninvasive brain stimulation to improve hand function in people with SCIs finds its true purpose in patient interactions.

“We love working with participants. It’s probably our favorite part of the job,” Dr. Iddings says. “Research seems to attract a very specific type of person who wants to benefit the spinal cord injury community in some way. They’ll say, ‘It doesn’t matter if it helps me, as long as we get knowledge out of it.’”

Research participant Hannah Johnston is one example of someone embracing this philosophy. Hannah’s experience with research is intertwined with her recovery journey — she started a clinical drug trial while in the hospital following an accident with an 18-wheeler. She sustained a C3-C4 level SCI and was taken to the University of Mississippi Medical Center. Once her condition stabilized, she transferred to Shepherd Center for rehabilitation, where she continued the drug trial and later participated in other studies.

“I've been the research girl for quite some time — for the entire length of my spinal cord injury, I've been participating in research of some sort,” she says.

Hannah has many reasons for participating in research. For starters, she says Shepherd Center is her home away from home. After her inpatient therapy, she went straight into the Spinal Cord Injury Day Program and later returned for another round of Day Program and Beyond Therapy.

"You don’t look the same as you used to, or you don’t feel the same, and your body’s definitely not the same, but there’s no judgment,” she says. “You’re just loved and appreciated and respected at the same time. I can’t imagine being anywhere else and being able to receive the same treatment.”

While continuing outpatient therapy, Hannah got involved with the Hulse Lab’s spasticity study, funded by a research grant from the National Institutes of Health, and also with a motor skill training study funded by the SCI Model Systems grant. She says working with research staff members like Drs. Zarkou and Iddings makes participating in research all the better.

“They’re just so eager. You know, a lot of people go to work and do their job and do the bare minimum,” she says. “But you don’t get that here, and you definitely don’t get that with research. They’re happy to be here, but they’re also ready to find something to help somebody — to find a new breakthrough.”

Hannah did experience some breakthroughs because of the research. For the spasticity study, she wore sensors on her body that connected to a computer monitor, showing her which muscles she was activating. She says she could see where she was overcompensating and where she wasn’t fully activating certain muscle groups. As a result, she learned how to better isolate certain muscles. Hannah also says she continues to visit with Drs. Iddings and Zarkou when she’s at the hospital, jokingly adding that she and Dr. Zarkou “are like best friends.” 

It’s not uncommon for research participants to feel this way — Drs. Iddings and Zarkou make it a point to build relationships with patients who might be interested in research starting when they’re inpatients. 

“We never want someone to be interested in research and verbalize this to someone and not meet one of us,” Dr. Zarkou says. “Even if they aren’t eligible for one of our research projects, we are more than happy to guide them through resources and other opportunities that are out there for them.”

“[They’re] more than a participant to us. We are there for them,” Dr. Zarkou says. “We want them to feel comfortable reaching out to us because that’s what establishes this relationship.”

Building a Better Study

Scientists in the Hulse Lab rely on participants to complete their studies, and they also need participants’ feedback to create better clinical trials. Dr. Zarkou says she often returns to participants after a study to learn what went well and what could’ve gone better. She says a participant’s perspective is equally important when working on proposals for new studies. Some grant funding even requires including participant perspectives in proposals, something scientists in the Hulse Lab are proponents of. 

“We might have the best idea in the world, right?” Dr. Zarkou says. “But I’m not the person who lives with spinal cord injury, so [we have] our participants come and say, ‘Yeah, that seems like a good idea, but what are you going to do about this?’”

For example, participants might flag that a clinical trial requires too many research sessions or that each session is too long. Participants living outside Atlanta may have to fight traffic just to make it in time for a research session — a concern that has eased slightly with the expansion of housing at Shepherd, which can sometimes accommodate an out-of-town participant to stay in the Irene and George Woodruff Family Residence Center, Dr. Iddings says. 

The lab prioritizes participants’ needs — from making the research process accessible to addressing problems for people living with SCIs. 

Although the research team can never promise a beneficial outcome to participants — the purpose of research is to test out new ideas, after all — this is no turnoff for Robbyn and Hannah. They say even if they hadn’t personally benefited from the research, they’d do it all over to help someone else down the line. 

“I already had my foot in the door with research when I got here, and of course, I was willing and ready to participate,” Hannah says. “But some people seem uninterested or hesitant, and I’ve been trying to encourage people to get involved or ask if there’s a good fit for them. It’s not going to hurt you in any way; it would only help you, or at least help somebody else in the future.” 

Robbyn shares this sentiment, adding that she encouraged a friend who had a stroke to look into brain injury research at Shepherd. 

“I am definitely an advocate of ‘You’ll never know until you try,’” she says. “Even if it doesn’t help me feel something, someone else could really benefit. They could get more data so they could see where they could help others.” 

At Shepherd, there are ongoing clinical trials in the Hulse Lab and other research areas throughout the hospital, including brain injury, multiple sclerosis, and accessibility and user research. To learn more about opportunities or how to get involved, you can visit shepherd.org/research. 

Written by Erin Kenney

Tech Hub

When you exit the elevators on Floor 11, you’re greeted by double doors bearing Shepherd’s logo. Pass through these doors, and you’ll find jaw-dropping views of the Atlanta skyline, as well as equally impressive displays of assistive technology. Home to the new Travis Roy Ability Bar and adjacent to the Center for Assistive Technologies, the MCAR Tech Hub is the future of patient access to technology, for everything from adaptive gaming to smart home controls. Backus says she hopes the Tech Hub will help people even outside of Shepherd’s walls. “Our mission is to break down barriers — the best care and quality of life. We want to have open houses and workshops so people with disabilities can learn new skills like 3D printing to develop their own solutions. We aim to have people from around the world come see and trial these technologies and solutions and decide what’s best for them to use at home.” 

Human Performance Lab

Down the hall from the Tech Hub, the Human Performance Lab combines state-of-the-art technology with clinician expertise to fully evaluate a patient’s motor and cognitive capabilities, as well as their behavioral attributes, to better understand what they need and to fully customize care. Equipped with a ZeroG 3D to provide body-weight support for balance and walking, an instrumented treadmill outfitted with a virtual reality projector screen, and two types of motion-tracking cameras, clinicians can evaluate and track their patients’ movement and develop personalized plans based on their needs. Plus, researchers and innovators will use this motion-capture technology to inform research, technology development, and future patient care at Shepherd. “We are collecting this data to do predictive analytics, and combine this new data with our huge existing database, to be able to understand a person’s characteristics, who they are, what their capabilities are, where they’re from, and better identify what they need while they’re at Shepherd or wherever they are in their recovery journey,” Backus says. 

She also hopes the data will be helpful when working with insurance companies, providing evidence for the care patients need, and technology developers to create the next generation of solutions for Shepherd patients. Care teams across the hospital will have more data to inform decisions about treatment, discharge, and continued rehabilitation. 

Best Health Suite

A couple of doors down from the performance lab, the Best Health Suite serves both patients at Shepherd and those back home in their communities who may not have access to a facility like Shepherd. The space is both a workout studio and recording studio, allowing exercise physiologists to lead group exercise classes and record them for use as future on-demand programming through burnalong®. The programming is free for Shepherd patients, so no matter where they travel, they have access to guided sessions from Shepherd clinicians. Dr. Backus says the new studio space also gives Shepherd’s tele-wellness programs room to grow. “People with disabilities from a spinal cord injury, brain injury, or multiple sclerosis face barriers to accessing experts for exercise and wellness,” Dr. Backus says. “Our Best Health Suite and burnalong® partnership break down these barriers for Shepherd patients and any person with these issues anywhere in the world.”

Research Teams

In addition to supporting new initiatives, the Cox Innovation Institute has brought all of Shepherd’s research programs onto one floor, giving researchers the opportunity to easily collaborate with other labs and departments. Dr. Backus says a collaboration room for researchers was a priority when planning the 11th floor. It’s already getting heavy use. “It gets used every single day. It’s different than a conference room — it has a lot of whiteboards and comfy seating — and people meet in there and have such energetic conversations. My office is down the hall, and I have to close my door and put on music, because it can get loud,” she says with a smile. “It’s been great.” 

Written by Erin Kenney

Kinemo, a wearable input controller, aims to combine controls for power wheelchairs and devices like phones, computers, tablets, and smart TVs into one easy-to-use device. The device allows people with limited upper body mobility, including those with high-level paralysis, to access digital devices and drive their power wheelchairs using small tracers that detect body gestures. These tracers can be worn anywhere on the body, from the back of the head to a finger, and translate subtle movements to move a cursor, send a mouse click, scroll through a document, drive a wheelchair, or even perform a weight shift in a wheelchair, among other capabilities. Kinemo’s core technology was developed with funding from the Georgia Research Alliance, National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), Georgia Tech Create-X, Biolocity, and with the support from the MIT’s The Engine Accelerator and TiE Atlanta.

For Earle, a lawyer who completed rehabilitation for a spinal cord injury at Shepherd Center, the device sounded like an upgrade from his current assistive technology device that relied on a bite switch.

“The idea that I wouldn’t have to have something in my mouth appealed to me. That immediately sparked my interest,” Earle says.

Earle, along with three other former Shepherd Center patients, signed up for a user study to test the Kinemo device with the AURC. This user testing, which was made possible by a Small Business Innovation Research grant funded by the NIDILRR, was done in collaboration with Kinemo’s co-founders: chief executive officer Nordine Sebkhi and chief technology officer Arpan Bhavsar. Both were previously research engineers at the Georgia Institute of Technology, but their decision to partner with Shepherd Center was more than just geographical.

“Shepherd is really good about having a holistic perspective on what a patient [with paralysis] should be going home with,” Bhavsar says. “They shouldn’t just be going home with a wheelchair, they should also be going home with personalized assistive technology solutions to help them become more independent. Shepherd is great about having access to the latest assistive technology to recommend to their patients.”

After an initial session to calibrate the device, Earle could use it for much of his digital activity at work — he says with the device, he can create a legal document from start to finish, check his calendar, and draft and respond to emails.

As the four-month testing neared its end, Earle used the Kinemo device in one of his cases during a court proceeding. The results were a game-changer. Earle says the device allowed him to freely move between his legal documents on his laptop while arguing his motion. Because he didn’t have a bite switch in his mouth to control his computer, Earle says he was able to argue his motion freely.

"I was able to argue my motion and respond to questions from the judge without having the bite switch in my mouth, which directly affected my ability to speak clearly, so that the judge and opposing counsel could hear me and understand what I was saying,” he says. “[The Kinemo device] allows me to be able to practice law — I’m grateful to have had the opportunity to be part of the user testing."

Other former Shepherd patients who tested the device had a similar experience — one participant in the study can now navigate his smart TV without assistance. Participants and clinicians alike enjoy the device because of its low profile and wearability — it doesn’t require as many adjustments as similar devices mounted to power wheelchairs. And because it doesn’t use a mouth switch, it’s more compatible with voice-activated assistants like Siri or Alexa.

“We don’t want to say that users should control all of their devices with our system — we want it to work with other types of alternative device controls,” Sebkhi says. “That’s the beauty of Kinemo. It works well with other systems to augment the user’s independence in device control.”

Earle continues to use the device, and Sebkhi and Bhavsar are set on making more improvements based on his feedback. They’ll need more rounds of testing, especially with using the Kinemo for wheelchair controls, but they’re hopeful about the future and making the device more widely available.

“Everything we learned from this user testing with Shepherd will be used to refine our device,” Sebkhi says. “This user testing showed us people love the system … there’s a value to it they haven’t found with other assistive technologies.”

By Erin Kenney

Building MCAR allows Shepherd to transition activities from the main hospital, which opens up space for a new Acquired Brain Injury Unit on the sixth floor of the main building in spring 2026 that will expand capacity from 152 to 175 beds. Additionally, all inpatient rooms will become private and be equipped with smart technology to enhance the patient experience and their ability to control their environment independently. There is room to eventually add another inpatient unit on the third floor of the main building, which will increase capacity to 210 beds—a plan that will ensure Shepherd Center is poised to care for generations to come.

Outpatient capacity grows as well. Moving the Dean Stroud Spine and Pain Institute to MCAR will allow for the expansion of both the Pain Institute and the Andrew C. Carlos Multiple Sclerosis Institute. The 2024 renovations at 80 Peachtree Park will expand capacity for the SHARE Military Initiative, making it possible to support more service members and first responders who struggle with traumatic brain injuries and mental health concerns. Also, new facilities in the Innovation Institute will more than double the space for the Center for Assistive Technologies, including adding the Travis Roy Ability Bar. This will enable community members with disabilities to learn about and access technologies that enhance their ability to perform daily activities such as accessing electronic devices, controlling their home environment, driving, and moving around.

Written by Teresa Weaver

This story is an excerpt from “Mission Moments: 50 Years of Rebuilding Lives One Moment at a Time,” a book celebrating Shepherd’s 50th anniversary in 2025. 

“I was very busy, working day and night, trying to open these stores and get them functioning,” said Bernie, who died Nov. 4, 2024. “I had no time, especially to go to a place where people were paralyzed. It was not uplifting, in my mind, and I needed to keep positive.”

But Max Rittenbaum, a neighbor of the Shepherds, persisted. “He just insisted that I go,” Bernie said. “And it was shocking to me that not only didn’t I find despair and people who were just morose, I found nothing but hope. Young people were talking about the fact that they were going to be able to go fishing again, swimming again, skiing again. It was incredible to me. How do you get people thinking so positively? The Shepherds did it.”

Bernie made a small donation after his first visit, then returned about a year later. “He remembered patients by name that he had talked to,” Alana Shepherd says. “Wow! Unbelievable!” Harold Shepherd was so impressed that he wanted Bernie on the hospital board.

As The Home Depot grew, so did Bernie’s support of Shepherd Center. 

Shepherd was one of the top recipients of Bernie’s philanthropy, but far from the only one. Bernie and his wife, Billi, were early signatories of The Giving Pledge and the Jewish Future Pledge, both commitments by some of the country’s wealthiest citizens to give away their money. Bernie pledged to give away 90% of his multi-billion-dollar holdings. 

Billi Marcus also has been a hands-on supporter of Shepherd Center. Among her efforts, Billi chaired a fundraising golf tournament for 16 years, raising more than $3.5 million. Shepherd Center, Billi says, “is the kind of place you hope you never have to go to, but you thank God it’s there if you need it.”

Bernie and Billi raised money for a building that opened in 1992, doubling the hospital’s square footage. Bernie named it after Billi as a birthday gift.

Bernie’s involvement with Shepherd went beyond donating money. The SHARE Military Initiative, which launched in 2008 to treat post-9/11 military personnel and later expanded to include first responders, was his idea. Afterward, he was instrumental in founding the Avalon Action Alliance, which includes centers across the country dedicated to treating military personnel and first responders with traumatic brain injuries and concurrent mental health conditions. Shepherd’s SHARE Military Initiative is a leading player.

One of the most recent gifts by The Marcus Foundation was an $80 million grant in 2022 to fund the Marcus Center for Advanced Rehabilitation, as well as the renovation and clinical expansion of the hospital. Once again, Bernie and Billi Marcus made it possible for more people to have the advantage of Shepherd’s top-of-the-line care, research, and innovation.

For those treated at Shepherd, Bernie said, “Your life has already changed. Now the question is: ‘How are you going to go forward?’ That’s what Shepherd is all about—the going forward.”

Written by Gayle White

This story is an excerpt from “Mission Moments: 50 Years of Rebuilding Lives One Moment at a Time,” a book celebrating Shepherd’s 50th anniversary in 2025. 

Ekso Bionics Holdings, Inc. (Nasdaq: EKSO) (the “Company” or “Ekso”), an industry leader in exoskeleton technology for medical and industrial use, today announced a research partnership with Shepherd Center, a renowned rehabilitation hospital in Atlanta, to incorporate EksoNR and Ekso Indego devices across its rehabilitation and community network. 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.

As part of the partnership, Ekso and Shepherd Center will work collaboratively to design a research and training program for the Ekso devices. The experience is expected to contribute to the evolving understanding of best practices for implementing Ekso training into a clinical program, as well as for individual use of the Ekso Indego Personal device.

Shepherd Center will also work with Ekso to design a training program for the Ekso Indego Personal device, which Ekso expects will offer individuals the opportunity to experience and explore exoskeleton technology, empowering those interested in purchasing a home device with the knowledge and skills needed for successful integration into their daily lives. Shepherd Center’s spinal cord injury (SCI) expertise and programming is uniquely positioned to investigate the clinical and quality of life benefits associated with incorporating exoskeleton technology throughout the continuum of care from hospital to home.

“We are thrilled to partner with Shepherd Center to advance the integration of our unique exoskeleton technology in the rehabilitation and community settings,” said Scott Davis, chief executive officer of Ekso Bionics. “This collaboration comes at a pivotal moment, following the recent decision by the Centers for Medicare & Medicaid Services to provide a reimbursement rate for Ekso Indego Personal, opening new avenues for accessibility and patient care to individuals living with SCI. Our research partnership with Shepherd aligns with our mission to empower individuals with mobility challenges and enhance their overall quality of life.”

“Shepherd Center is proud to be at the forefront of innovation in rehabilitation,” said Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation at Shepherd Center. “We expect that incorporating Ekso’s exoskeleton devices into our rehab center will not only benefit our patients across the continuum of care, but also contribute valuable insights to the broader medical community.”

About Ekso Bionics^®

Ekso Bionics® is a leading developer of exoskeleton solutions that amplify human potential by supporting or enhancing strength, endurance and mobility across medical and industrial applications. Founded in 2005, the Company continues to build upon its industry-leading expertise to design some of the most cutting-edge, innovative wearable robots available on the market. Ekso Bionics is the only known exoskeleton company to offer technologies that range from helping those with paralysis to stand up and walk, to enhancing human capabilities on job sites across the globe. The Company is headquartered in the San Francisco Bay Area and is listed on the Nasdaq Capital Market under the symbol “EKSO.” For more information, visit: www.eksobionics.com or follow @EksoBionics on X.

Forward-Looking Statements

Any statements contained in this press release that do not describe historical facts may constitute forward-looking statements. Forward-looking statements may include, without limitation, statements regarding (i) the potential benefits of EksoNR or Ekso Indego, (ii) the performance or effectiveness of the Company’s products, including the EksoNR or Ekso Indego, (iii) the details of and expected results from the Company’s research collaboration with Shepherd Center, including the expected benefits to patients and potential promotion of the Company’s devices, and (iv) the assumptions underlying or relating to any statement described in clauses (i), (ii) and (iii) above. Such forward-looking statements are not meant to predict or guarantee actual results, performance, events or circumstances and may not be realized because they are based upon the Company’s current projections, plans, objectives, beliefs, expectations, estimates and assumptions and are subject to a number of risks and uncertainties and other influences, many of which the Company has no control over. Actual results and the timing of certain events and circumstances may differ materially from those described by the forward-looking statements as a result of these risks and uncertainties. Factors that may influence or contribute to the inaccuracy of the forward-looking statements or cause actual results to differ materially from expected or desired results may include, without limitation, patient or therapist dissatisfaction with EksoNR, any delay or discontinuation of the research collaboration, or Ekso Indego and risks related to product liability, recall and warranty claims. These and other factors are identified and described in more detail in the Company’s filings with the U.S. Securities and Exchange Commission. To learn more about Ekso Bionics please visit the Company’s website at www.eksobionics.com or follow @EksoBionics on X. The Company does not undertake to update these forward-looking statements.

Participants had the opportunity to visit more than a dozen booths and learn from representatives of Shepherd Center departments and organizations outside the hospital working to make the world more accessible.

The event showcased three speakers from the accessibility advocacy community — corporate disability and diversity consultant at Your Invisible Disability Group, Yvette Pegues, Ed.D.; freelance writer, disability blogger, and accessibility consultant, Empish Thomas; and former Shepherd patient and founder of iAccess Life, Brandon Winfield.

Check out the links below for more information about Shepherd departments and outside organizations represented at the GAAD Resource Fair.

Shepherd Center Department Highlight: Assistive Technology

The Center for Assistive Technologies encompasses the Wheelchair Seating and Mobility Clinic, Driver Evaluation and Rehabilitation Program, and Access Technology Lab

Shepherd Center Research Department Highlight:  

Accessibility User Research Collective (AURC)

The Accessibility User Research Collective (AURC) is a U.S.-based national community of people with all types of disabilities interested in helping make technology, health, and consumer goods companies more accessible and usable. AURC has partnered with major companies to help them achieve their accessibility and usability goals for their products. They run full-scale research projects with people with disabilities so that they can develop a deep understanding of their customers, uncover hidden market share, or meet federal accessibility regulations.                           The AURC is organized and maintained by assistive technology and accessibility researchers at Shepherd Center. 

Call to Action: If you have a disability of any kind, sign up for the AURC today to qualify to participate in paid research studies! 

Shepherd Center Department Highlight: 

Recreation Therapy – Accessible Gaming  

Accessible gaming refers to the design and development of video games with features that allow people with disabilities to play and enjoy games comfortably and effectively. This includes incorporating options for various disabilities, such as customizable controls, visual and auditory aids, text-to-speech functionality, and alternative input methods. Accessible gaming aims to ensure that individuals with disabilities can fully participate in gaming experiences without facing unnecessary barriers or limitations. 

Shepherd Center Department Highlight: Emergency Preparedness 

Shepherd Center’s Recreation Therapy Program, along with other consultants, has cultivated resources for individuals with mobility impairments to prepare for emergencies, including fires and natural disasters. Due to the unique needs and challenges faced by individuals with mobility impairments, being adequately prepared for emergencies can be a matter of life and death. In times of crisis, access to necessary medical equipment, evacuation assistance, and specialized care can significantly impact outcomes for individuals with disabilities. Come learn about how you can be more prepared to stay safe during an emergency.

Burnalong is a digital health and wellness platform with the mission to change lives by giving people the health and wellbeing programming and social support they need. Shepherd Center has partnered with Burnalong to develop specialized content for both live-stream and on-demand classes for wellness activities such as exercise and education content, that can be utilized by various disability groups for accessible wellness. The Shepherd team introduces the platform to our clients while they are here as patients, and they can continue participating and accessing content curated by Shepherd clinicians when they go home.  

Makers Making Change is an organization focused on connecting makers to people in need, providing affordable open-source assistive technology, and enabling community-based development.

Since 2000, Side by Side has advanced the long-term well-being of Georgia's brain injury community, offering an adult day program that provides a supportive environment where adults suffering from brain injuries can redevelop social and work-related skills at their own pace in a meaningful, productive way. People with brain injuries come from every walk of life – a business executive, a teacher, an athlete, or a returning veteran. After they come home from the hospital, they face a big unknown: “Will I need non-stop caregiving from my family? Will I be able to work again? Will I have friends, colleagues and live a productive life?” Side by Side answers these unknowns for hundreds of people in Georgia’s brain injury community.

iAccess Innovations has developed and released a lifestyle application that will allow its users to rate and review locations they visit based on their accessibility. Users will be able to rate places like restaurants, stores, and hotels based on the accessibility of the parking, entrance, interior space, and bathrooms. They plan to build strategic partnerships with booking agencies and exciting brands to empower the community to seek new adventures, stress-free. Prospective versions of the application will expand to other forms of disabilities like vision impairments, hearing impairments, and autism and allow users to interact and keep up with their friends, through a social feed. 

The ultimate goal of iAccess Life is to develop a platform that will assist in shining a light on accessibility flaws. 

Tools for Life, Georgia's Assistive Technology Act Program, is dedicated to increasing access to and acquisition of assistive technology (AT) devices and services for Georgians of all ages and disabilities so they can live, learn, work and play independently and with greater freedom in communities of their choice. Individuals can visit an assistive technology resource center (ATRC) to learn more about assistive technology devices and to try before they buy! They offer AT device demonstrations, individual and group AT trainings, and AT device loans.  

Georgia Tech Center for Inclusive Design and Innovation (CIDI) is recognized as a leader for services and research in accessibility. We are dedicated to an inclusive society through innovations in assistive and universally designed technologies, with a goal of addressing the full range of needs for accessibility. We are committed to the promotion of technological innovation and development of user-centered research, products, and services for individuals with disabilities. Ranging from braille to digital compliance, CIDI is your one-stop shop for affordable accessibility. 

The Georgia Library Service for the Blind and Print Disabled (GLS) promotes assistive technology and accessible reading materials for individuals who are blind or have physical disabilities, offering "talking book" and large-print library services with over 450,000 annual circulations. Materials can be obtained freely by mail for those unable to visit a library. GLS collaborates with state library systems to provide access to the national library program by the Library of Congress and the National Library Service for the Blind & Print Disabled. Borrowers can search the online catalog for materials and receive assistance from reader advisers in person or via phone. GLS also offers consulting, training, and serves as a liaison between local libraries and the National Library Service. 

Centers for Independent Living are community-based, cross-disability, non-profit organizations that are designed and operated by people with disabilities. CILs are unique in that they operate according to a strict philosophy of consumer control, wherein people with all types of disabilities directly govern and staff the organization. Centers for Independent Living Provide: Peer support, information and referrals, individual and systems advocacy, independent living skills training, and transition services.  disABILITY LINK is a center for independent living led by and for people with disabilities and promotes choice and full participation in community life.  

NFB-NEWSLINE® is a free audio news service for anyone who is blind, low-vision, deafblind, or otherwise print-disabled that offers access to more than 500 publications, emergency weather alerts, job listings, and more.   

The Georgia Radio Reading Service, or GaRRS for short, is Georgia’s premier provider of information for individuals who are visually-impaired or otherwise print-impaired. Every month, we broadcast and stream hundreds of programs including local and national newspapers, books, magazines, events, employment opportunities, and shopping ads. We invite you to access our expansive program library or sign up to listen to our live broadcast. 

Friends of Disabled Adults and Children (FODAC) in the Atlanta area provides essential services and support to individuals with disabilities. They offer a wide range of assistance, including providing medical equipment such as wheelchairs, walkers, and hospital beds at little to no cost to those in need. Additionally, FODAC offers home modifications and vehicle adaptations to improve accessibility and mobility for individuals with disabilities. Their mission is to enhance the quality of life for people with disabilities and their families by providing access to necessary equipment and resources. FODAC plays a crucial role in the Atlanta community by promoting independence, dignity, and inclusion for individuals living with disabilities. 

The Center for Puppetry Arts is deeply committed to fostering Diversity, Equity, Inclusion, and Belonging in our local and global community. The Center realizes the unique ability of puppetry to tell diverse stories with diverse characters that relate to people from all cultures. We celebrate and embrace diverse voices, perspectives, backgrounds, and stories to inspire each other. Our conscious intention is to promote these principles in our programs, events, outreach, education and development opportunities, and communications, and to create safe spaces for groups and individuals to feel comfortable sharing their authentic selves. Accessible programs include Sensory Friendly Sundays, ASL-Interpreted Performances, Audio-Described Performances, and more.  

Not in Georgia? No problem. You can visit the links below to find resources near you.

Find your Assistive Technology Act program

Find your Center for Independent Living

Find your local Developmental Disabilities Council

Learn more about AbleGamers Foundation

Visit the National Library Service for the Blind and Print Disabled

Learn about/sign up for the National Federation of the Blind’s NFB Newsline

Explore vision technology through Palmer Vision

Find a Telecommunications Equipment Distribution Program for people with hearing loss/deafness near you

Learn more about the National Deaf-Blind Equipment Distribution Program

“We're positioned as an innovation hub because we are leaders in the field. The Innovation Institute is a natural extension of that – giving us more capabilities, space, and resources to foster ingenuity,” says Deborah Backus, PT, Ph.D., FACRM, Shepherd Center’s vice president of research and innovation. “We collaborate with like-minded partners to advance rehabilitation medicine and find better, more efficient ways of delivering care to improve the lives of the people we serve.”

The new 30,000-square-foot Innovation Institute, which will occupy the top floor of the Marcus Center for Advanced Rehabilitation on Shepherd Center’s main campus and is slated to open in 2025, will be a hub for collaboration, allowing Shepherd researchers to form more of these robust partnerships to advance patient care. The following are just a few of Shepherd’s partnerships that are improving patients’ and their families’ lives.

Virtual Visits

In 2020, Shepherd Center’s Recreation Therapy Program partnered with Aetos Imaging, a technology company that takes scans of real-world locations such as restaurants, stores, and stadiums. Then, they create a 3D digital replica of the location. Shepherd’s recreation therapists label the scans, flagging potential barriers that people using wheelchairs, for instance, may need to consider when visiting the venue — including locations of accessible entrances, table or counter height, or type of flooring. The scans are invaluable for patients and care partners who are anxious about navigating life outside Shepherd. Therapists also use the images as a follow-up after an outing to cover anything a patient or caregiver might have missed during training sessions.

Kelly Edens, CTRS, recreation therapy manager at Shepherd, compares the experience to playing a video game.

“It's a tool to provide education for patients and families to get from A to B on outings to places like a doctor's office, a library, a church, or a stadium. Reviewing the scans lets patients sharpen problem-solving skills, prepare for outings, and even advocate for themselves. We never want a former patient to avoid going somewhere just because they use a wheelchair. We want them to have access to their community,” she explains.

Connor Offutt, CEO of Aetos Imaging, says that working with Shepherd Center to help patients rebuild their lives resonates with the company’s core values and allows Aetos to explore a different application of the technology.

“People are increasingly using the Aetos Operate platform to reintegrate within their communities and gain confidence in the real world. Like Shepherd Center, it’s our hope — and responsibility — to utilize technology in ways that benefit our neighbors,” he says.

Accessible Wellness Content

Another innovative partnership that builds community and allows Shepherd clinicians to reach patients after they return home is Shepherd’s partnership with burnalong®, an online platform that offers on-demand health and wellness tools. The hospital and online wellness platform are collaborating to create and distribute specialty programming that makes wellness accessible to all.

Shepherd’s highly trained specialists are developing live and on-demand content geared toward people with spinal cord injury, brain injury, stroke, spine and chronic pain, multiple sclerosis, and other neurological conditions. Currently, Shepherd patients, staff, and Burnalong users can access the classes.

“The great thing is that these classes span across all our specialties and are appropriate for many neurological diagnoses and patients who we serve at Shepherd,” says Marina Moldavskiy, ACRP-CP, Shepherd Center’s tele-wellness program manager and exercise physiologist.

Among the more than 50,000 classes are yoga, exercise, and financial wellness courses, among others, for people of all abilities.

“Alongside the unparalleled range of classes and programs, one of the biggest things that sets Burnalong apart is the social experience. You can see and hear each other live. You can join communities. It ensures people get the support they need,” says Daniel Freedman, president of commercial health and fitness, Tivity Health, and co-founder of Burnalong. 

“We are always thinking of ways to empower our patients before they return home,” Moldavskiy says. “When our patients are at Shepherd, there’s always a rehabilitation professional there to guide them or give them information. We hope this platform can help them feel empowered to continue when they leave our walls.” 

While Burnalong™ is creating an inclusive community, it also opens opportunities for further research. Shepherd Center’s Virginia C. Crawford Research Institute is piloting two studies to better understand the program’s benefits. One focuses on people with multiple sclerosis (MS). If you are interested in participating in MS research, scan the QR code for more information.  

A second study focuses on people who have sustained an acquired brain injury (ABI) and have been discharged from a hospital-based ABI program. The purpose of the study, conducted in collaboration with Moody Neurorehabilitation Institute in Texas, is to evaluate the potential efficacy of tele-wellness delivered through Burnalong™. For more information on ABI research or to volunteer, contact Erica Sutton at 404-367-1305 or erica.sutton@shepherd.org.

Written by Lindsey Rieben and Ruth Underwood

Shepherd Center's Accessibility User Research Collective (AURC) teammate Kelsey Koupal, M.A., CCC-SLP, is a lead user experience researcher. She has led numerous usability and user needs studies for retail clients through the AURC, and also maintains her speech-language pathologist license, having experience in both pediatrics in schools and adults in rehabilitation programs.

We spoke with Kelsey to get her thoughts on the current state of the retail experience for people with disabilities.

1. Why is the retail experience important for people with disabilities?

Retail experience is important for everyone, but it is not always accessible. People with disabilities are often excluded from simple day-to-day retail experiences, whether that be for lack of accessible stores, websites and apps, transportation, or other factors – the list is endless when you think of all the factors that might be barriers if they are not designed and implemented with accessibility not only in mind, but with intention. The retail experience is an essential aspect of individual autonomy, community participation, and economic growth – and that includes people with disabilities.

2. When we talk about the retail experience, what does that include?

There are so many retail experiences that come to mind right away, but I think this is a great opportunity for people to think about how they interact with retail environments (both physical and virtual) and then consider how accessible those are for people who are blind or have low vision, are hard of hearing, Deaf, mobility impaired, and/or neurodivergent.

For example, I think back to a recent morning of errands – I started by picking up coffee to get my day started. Even swinging through the drive-through might pose considerable barriers for someone who can’t access the menu, pay window, or use the retailer’s rewards app. Depositing a check on my banking app, returning a shirt at the department store, and picking up a new read at the library with their kiosk were next on my to-do list. I ended by getting a gift for an expecting friend, ordering and picking up my week of groceries, and driving through the car wash. Now, all of those are day-to-day retail experiences that should be available for everyone – and accessible. It is a privilege to complete these, but it shouldn’t be.

There are endless potential barriers in each of these experiences if they are not designed with accessibility in mind, limiting the options for people with disabilities to get what they need done for their daily living. I used a variety of means to get my errands done (apps, websites, kiosks, brick and mortar stores) just in that brief time frame. With technological advances, many of these tasks are theoretically possible to do with many companies having websites, apps, voice assistants, and AI chatbots. This sounds great, but those are not always easier. Making sure those are also accessible and enjoyable is one of the things I and my AURC teammates dedicate ourselves to improving.

3. What are some of the specific accessibility/usability concerns that you have observed as a user experience researcher and clinical specialist in speech-language pathology?

This is a fun one! Yes, my journey to user experience (UX) research is one that is a bit nontraditional with my background in speech-language pathology. However, a reason I wanted to transition into a field that focused on asking more questions and making more strides toward accessibility was the common thread of intersectionality of disability and advocacy. Both of these roles allow me to amplify the voices of people who face struggles that are not always heeded and champion their experiences while encouraging them to share their likes, dislikes, and ideas.

One usability concern that I have observed both as a UX researcher and a clinician in school and hospital settings is the lack of affordable, attainable technology that is designed for easy use and true accessibility. People with disabilities statistically have lower socioeconomic status, but the products that might be more accessible or allow them to have more autonomy in their day-to-day are increasingly expensive. I would say a specific frustration that I have encountered in both careers is products that were not designed to be accessible from the start, and now that piece is either being worked on from the back end or ignored completely. Equal access is so important, but we need to continue to ask and learn from those with the lived experience to be truly great.

I look forward to seeing companies that have the resources to make their products and environments more inclusive with full ADA and WCAG 2.0 compliance, less harsh lighting and sounds, screen-reader-friendly apps, sign language options, and staff who are trained and diverse in disability fully embrace accessibility from these user stories and experiences.

4. What efforts or progress have you observed in your work as a UX researcher in terms of improving the retail experience for people with disabilities?

Most retailers today have a dedicated team or programs in diverse sectors with varied product and service offerings, each with experience in specific retail challenges for accessibility/usability. There have been great strides taken toward diversity, equity, and inclusion (DEI) but sometimes the “A” is left out: accessibility! Again, intersectionality here is key. People have so many identities that weave together, and taking disability into account is incredibly important. It is no secret that the economy and retailers face new challenges with the growth of online shopping and skyrocketing technology, and I have seen progress in making retail websites and apps more accessible with better chatbots, accessible buttons, screen reader compliance, etc. However, this is not yet a widespread norm, and DEIA practices, while aided by wonderful programs, should truly be in the design of every retailer’s environment, whether it is a small business, nonprofit, or a Fortune 500 company. After all, they serve customers – and we are all, in some way or another, customers.

Learn more about the AURC on their website here.

Brandon grew up in Johns Creek, Georgia, just outside Atlanta. As a child, he dreamed of being a professional motocross rider. He traveled for motocross competitions and even switched to home-schooling to allow more flexibility and time to focus on the sport. But when he was 14, he sustained a T-7-T-8 spinal cord injury in a crash at a motocross event in Tennessee, which resulted in paralysis from his chest down.

After spending time in a hospital in Memphis, Brandon transferred to Shepherd Center for rehabilitation, but as soon as he arrived, he wanted to leave.

“I couldn't wait to get out of there at first. I had been hurt racing motocross plenty of times, which helped me wrap my head around the injury,” he recalls. “But my time at Shepherd was great. My therapists were amazing, and as soon as I got home, I missed Shepherd Center. Everything was so easy and accessible there.”  

As Brandon returned to life as an active teenager, including re-connecting with his motocross community, he realized that finding accessible parking spaces, bathrooms, restaurants, and venues could be challenging.

“I felt like a burden to the people I was traveling with. We’d go someplace, and I either couldn't get in, or I couldn't access the bathroom, and I’d have to go home, or we'd have to try someplace new. I felt like it was my fault,” he says. “For somebody who's adventurous and likes to do new things, I got tired of going places and not knowing if I'd be able to access those new things. So that was the catalyst for my idea,” he explains.

The idea that Brandon is referring to is his brainchild and now business — where he focuses much of his attention and energy — a mobile app called iAccess Life. The app uses crowdsourcing to collect information about accessibility at restaurants, stores, and other venues in cities across the United States and worldwide. Users can rate a venue’s parking, entrance, interior, and bathroom accessibility and have the option to leave a review as well.

“I wanted you to open the app and feel like everybody else looking for a place to have dinner, drinks, coffee, or go shopping. Whatever you wanted to do, I wanted to find a way for people to leave feedback on their experience and then hopefully travel confidently as we gather more ratings and feedback from people in the application,” he says.

Of course, it wasn’t a straight line from idea to app. Along the way, Brandon got into competitive go-kart racing, which included traveling and filming for a TV show featuring his experience, “Dreams to Champions,” that aired on Fox Sports 1. He also worked in information technology (IT), including quality assurance testing for websites and mobile apps. He eventually met Sayeed Mehrjerdian, now iAccess Life co-founder and head of product, who helped him develop the app and raise funding.

In 2019, they launched the app and are working on building their user base so the app will have more reviews of more places. They also want to expand the breadth of the app to address accessibility for people with a broader range of disabilities. They recently launched a product in partnership with a parking company to allow for feedback on accessibility issues by scanning a QR code on a street sign. They hope to provide restaurants, retail spaces, and sports venues input on ways they can improve accessibility.

Brandon lives the life of an entrepreneur — always with his eye on what is next — and works to support other start-ups through his role at Atlanta Tech Village, managing the pre-accelerator program, a four-month program designed to help underrepresented tech entrepreneurs get their products to market.

Through every venture, Brandon recognizes the experience he had at Shepherd as one of the major influences in his life.

“After getting back into normal life and meeting other wheelchair users who didn't get to go to Shepherd, I got to see the quality of life that I have because of the therapy and education I got there,” he says. “I'm forever grateful for Shepherd because it made me who I am today. It made me feel comfortable being in a wheelchair.”
 

Written by Ruth Underwood

Shepherd Center, an Atlanta hospital that 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, is ranked among the top rehabilitation hospitals in the nation by U.S. News. Ninety percent of Shepherd’s patients return to their communities after receiving care at Shepherd Center, which exceeds the national average by more than 30%. In addition to patient care, Shepherd Center has a robust research program, typically participating in 20 grants and 75 research projects concurrently. It is also one of the few institutions recognized as both a Spinal Cord Injury and Traumatic Brain Injury Model System by the National Institute on Disability, Independent Living, and Rehabilitation Research.

“Shepherd and Georgia Tech will build upon Shepherd’s expertise to conduct and integrate research and technology throughout the entire continuum of care and Georgia Tech’s research and technology development to create new solutions for the people Shepherd serves and beyond,” said Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation at Shepherd Center. “Potential collaborative research and development efforts can occur in many disciplines – from developing new devices and technologies to fellowships and training for the next generation.”

Leaders from Georgia Tech and Shepherd Center met recently to celebrate the partnership.

“Shepherd Center leads the world in treating brain and spinal cord injuries with an innovative research program that implements technology throughout inpatient and outpatient programs to get patients back to leading active, independent lives,” said Julia Kubanek, Ph.D., vice president of interdisciplinary research at Georgia Tech.

Dr. Kubanek was joined by Andrés García, Ph.D., executive director of the Institute of Bioengineering and Bioscience at Georgia Tech, and Stephen Sprigle, Ph.D., PT, professor and researcher who directs the Rehabilitation Engineering and Applied Research Lab (REARLab), which focuses on applied disability research and development.

“We were inspired by our recent visit and tour, where we observed clinicians and researchers working directly with patients. Georgia Tech’s mission of using technology to improve the human condition is a perfect fit for our collaboration with Shepherd. I’m grateful for Dr. Stephen Sprigle and the Institute for Bioengineering and Bioscience for their goals of increasing the breadth and depth of our partnership,” Dr. García said. “There will be wonderful upcoming opportunities for Georgia Tech students and faculty to bring their expertise in data science, AI, robotics, cell therapies, exercise physiology, and neuroscience, among many strengths, to join with Shepherd clinicians to help patients.”

Driven by a shared vision for transforming healthcare, the two institutions will utilize their complementary capabilities to provide technical solutions for clinical needs. The teams are identifying challenges to tackle and will establish a series of workshops to bring researchers and clinicians together.

Shepherd Center’s Smart Technology Education for Carryover at Home (SmartTECH) project began when Chris Maurer, PT, MPT, ATP, assistive technology program manager, and Tracey Wallace, MS, CCC-SLP, Shepherd’s SHARE Military Initiative project and education coordinator, saw an opportunity to extend the reach of everyday technology to more patients through the education and training of therapists in departments throughout Shepherd Center.

“We went through a discovery process and found that not only are patients unaware of how to use or uncomfortable with using some smart devices, but some of our therapists also aren’t as comfortable training and using those types of technology as others,” explains Maurer. “So, we wanted to create a program where we would train therapists as well as patients in using everyday consumer technology to enhance patient health, safety, and wellness at home.”

Examples of applications of smart tech solutions include a person using a wheelchair adding smart plugs for lamp switches that were previously out of reach, a person with memory issues using a smart speaker to create a digital grocery list accessible from their phone, or a caregiver concerned about leaving their loved one unsupervised for even a brief period using the “drop-in” feature on a smart speaker with a video screen.

“I think what's exciting — and daunting — about these types of technologies is that they can do so many things,” Wallace says. “Smart home technology can support communication, planning, leisure, and control of your environment. It’s endless. And the way that you set up your technology can be customized. We’re using things that exist, but it's the creative way that our therapists put them together in partnership with the people that they're serving that is innovative."

Maurer and Wallace saw the greatest opportunity to start with outpatients.

“Many outpatients are already living at home, and those who are not at home live in a home-like environment,” Wallace says. “They've had an opportunity to return to life outside the hospital. Before you’ve left the hospital, you can only do so much prediction of what you’re going to need, and sometimes people don't realize something will be a challenge until they actually try it.”

Danny Housley, Shepherd Center’s Assistive Technology Center equipment case manager, is the project coordinator.

“This training is important for individuals with disabilities because they will have more access, control, and freedom, but it is also useful for caregivers. It gives everybody peace of mind and helps with care,” Housley says.

Wallace and Maurer have recruited champions – staff members from outpatient departments — to help identify the tools most helpful for their patient populations and pass on their knowledge to members of their teams.

“These champions are building their skills and knowledge and becoming leaders in this area. We have monthly meetings where they exchange information, ideas, and experience, and it's been exciting to see staff helping one another develop,” Wallace says.

They are also developing an assessment to establish a uniform way of measuring needs and interests in using smart home technology — and training materials. The next steps are to obtain equipment and set up a smart home space in each clinic. The team will implement the program in one clinic at a time.

“We hope to provide people more independence and confidence when they go home by using this type of technology,” Maurer explains. “We want to create a program that will give the therapists confidence and awareness of the available tools and how to train the patients. We want to provide patients with training materials that they can use as a resource in the future to use these technologies.”

Maurer says the program will have to evolve as technology changes.

“We will continue to update the program as technology advances to keep everybody updated on what's out there and how we can use everyday technology to help our patients further,” she explains.

The Innovation Institute in the Marcus Center for Advanced Rehabilitation, under construction on Shepherd’s main campus, will further facilitate Shepherd’s ability to connect users and technology. The Innovation Institute will house an assistive and rehabilitation technology showroom, a dedicated space for people with disabilities to test and try technologies and smart home solutions before they invest in them. The Innovation Institute is set to open summer of 2025.

Written by Ruth Underwood.

In this issue of Spinal Column, we celebrate the universal language of hope that exists at Shepherd Center. We hear from patients from across the country and around the globe about why they chose Shepherd Center for rehabilitation. Sachin Chamaria traveled to Shepherd from New Delhi, India, and recaptured his love of sports during rehabilitation. Daniel Hund found that the progress he made at Shepherd Center and the sincere staff investment in his well-being helped him focus on new possibilities in his life. Finally, after sustaining a traumatic brain injury, Rachel Foster of Oklahoma was determined to return to running. She started with daily laps around Shepherd Center’s track and went on to complete the Boston Marathon.

The magazine also features these stories, among other patient profiles, staff highlights, honorariums, and memorials:

Breaking Barriers

From speech to music, speech-language pathologist Deborah A. Vega, MS, CCC-SLP, HC, champions the universal power of communication to connect.

Reclaiming Her Wings

Tiffany Vinson credits Shepherd Center’s Wheelchair Seating Clinic with helping her find the right chair to fit her lifestyle of travel.

Igniting Creativity and Advancing Innovation

At the Innovation Institute in the new Marcus Center for Advanced Rehabilitation, researchers, engineers, clinical scientists, and designers will explore real-world applications of research and technology to provide extraordinary care to more people.

Finding His Center

After a stroke, JR Reid embraced innovative treatments at Shepherd Center.

Subscribe here for print and/or e-newsletter versions of Shepherd Center's magazine.

“I was really struggling,” Felicia explains. “My right knee was always hurting and stiff. I would try to push through, but that’s when I realized there was something else going on.”

In 2018, Felicia and her neurologist identified the source of her symptoms: multiple sclerosis (MS). Her diagnosis led her to Shepherd Center’s Andrew C. Carlos Multiple Sclerosis Institute and the Ensemble Research Study, which focused on newly diagnosed relapsing-remitting multiple sclerosis (RRMS) and the medication ocrelizumab, an infusion therapy used to slow the progression of MS. “By the grace of God”, Felicia says, she filled the final available spot for the study, under the care of Sherrill Loring, M.D., a neurologist at the MS Institute, and the clinic staff.

“They treated me like a queen!” Felicia says. “There were long days, especially when I first got there. So, they would get me breakfast and get me all set up on the pump. They were always so kind, attentive, and willing to do anything to make me more comfortable.”

As the study continued, Felicia’s days at Shepherd Center got shorter, and her symptoms slowly began to wane. Today, Felicia still visits Shepherd Center and Dr. Loring for follow-up appointments every six months, with a virtual visit in between.

“Now when Dr. Loring asks me to put my legs on the table, I can swing ‘em on up there,” she laughs. “Before, I wasn’t able to lift my legs or stand correctly, but now, I can get up and go! This medication has been a lifesaver for me.”

Four-year safety and efficacy data results for the Ensemble Research Study were presented at the 2023 American Academy of Neurology Conference in Boston.

“Ensemble clinical trial assessed Ocrevus in patients with early-stage relapsing remitting MS and with no prior treatment,” says Dr. Loring. “It showed stable or improved disability progression in majority patients up to the four years studied, no new safety concerns were seen and over two-thirds of patients showed no evidence of any disease activity. This emphasizes the extreme importance to treat early in course of disease with effective treatment to have the best outcome.”

While Felicia was unable to return to her active job in insurance, she has found new ways to get back on her feet. She runs a small business with her family called Quality by Khool Kustoms. Felicia creates crafts to sell online, including her very first t-shirt design for MS Awareness Month, displaying MS and “multiple strengths” complete with the MS awareness ribbon and trademark orange color.

“When people hear multiple sclerosis, they tend to cringe,” Felicia explains. “I wanted everyone to see MS not as a weakness, but as multiple strengths.”

You can check out more of Felicia’s designs on TikTok by using her handle: @khoolkustoms_merchlady.

Written by Lindsey Rieben. 

“We're positioned as an innovation hub because we are leaders in the field. We collaborate with like-minded partners to advance rehabilitation medicine and find better, more efficient ways of delivering care to improve the lives of the people we serve,” says Deborah Backus, PT, Ph.D., FACRM, Shepherd Center’s vice president of research and innovation. “The Innovation Institute is a natural extension of that — giving us more capabilities, space, and resources to foster our ingenuity.”

The vision for the institute is to integrate rigorous research, data science, groundbreaking rehabilitation and assistive technologies, and revolutionary care models to restore, sustain, and protect the lives of people requiring neurorehabilitation worldwide.  At its core, the institute will use data to develop and guide point-of-care precision rehabilitation and the creation of new technology solutions.

Once completed, the Innovation Institute will bring existing research and technology teams throughout the hospital into one space, inspiring even more collaboration. Human-centered designers, biomedical and rehabilitation engineers, data scientists, clinical scientists and coordinators, people with disabilities, and other partners will gather around tables and whiteboards, brainstorming and creating solutions. The Innovation Institute will be a home for even more robust data analytics. Data will continue to drive clinical care, helping Shepherd Center experts identify the most meaningful and effective solutions for patients.

Here’s a look at some of the programs, labs, and workshops the new facility will house:

Virginia C. Crawford Research Institute

In the Crawford Research Institute, researchers develop, refine, and evaluate new treatments, medications, diagnostic tools, and therapeutic interventions in spinal cord injury, brain injury, multiple sclerosis, and chronic pain. The expansion will allow the Hulse Spinal Cord Injury Research Lab, an integral part of the Crawford Research Institute, to be in the same space. The Hulse Lab pioneers the development of rehabilitation interventions that optimize the functional abilities of people impacted by spinal cord injury.

Travis Roy Ability Bar

The Travis Roy Ability Bar will provide mainstream as well as innovative devices created through co-innovation by our patients, clinicians, and academic and industry partners, for patients to try before they buy, to help them learn what is possible, and help them return to a fully, integrated, productive life. 

An Innovative Design Workshop

In this workshop and training space, dedicated staff will use advanced 3D printing and other advanced technologies to create prototypes for small-batch production of adaptive technology solutions. Team members will also train people with disabilities and students on how to develop affordable solutions.

An Assistive and Rehabilitation Technology Showroom

The showroom will connect users and product developers, allowing people with disabilities to test and try technologies and smart home solutions before they buy them. It will also allow product developers to learn first-hand from people with disabilities about what they need to live the fullest life possible.  

Highest Performance Lab

A fully outfitted assessment and evaluation suite will allow motion analysis and behavioral data collection for people with disabilities to identify their needs for health, wellness, function, and the best quality of life in their homes and communities.

Best Health Suite

Partnering with health and wellness solution generators and technology companies, Shepherd will offer on-demand and live wellness and fitness classes to Shepherd patients, partners, and people worldwide, at Shepherd and in their homes and communities, with the goal of breaking down barriers to care for the people Shepherd serves.

Together, all these exciting initiatives mean the Innovation Institute will provide an opportunity to deliver Shepherd’s extraordinary care to more people at a larger scale.

“Our clinical care is cutting edge, and we want to keep it that way,” Backus says. “The Innovation Institute will enable us to be more effective and efficient in delivering individualized solutions, helping the people we serve, and increasing accessibility to our world-class care.”

For more information on Shepherd’s research and innovation programs, please visit ExpandingShepherd.org.

Written by Leslie Jackson and Ruth Underwood

“Neuroplasticity refers to the nervous system’s potential to change with learning,” explains Deborah Backus, PT, Ph.D., FACRM, Shepherd Center’s vice president of research and innovation and a member of the team who developed the program. “After an injury or when someone has a disease like multiple sclerosis (MS), neural pathways are altered or damaged. We're trying to train the nervous system to complete tasks in a way that's effective and efficient.”

As its name suggests, the program goes beyond what traditional therapy offers. While standard therapy focuses on the critical goal of helping people develop strategies to become as independent as possible after injury or illness, Beyond Therapy serves clients who have already participated in traditional rehabilitation. It combines exercise science and rehabilitation science to drive the nervous system, focusing on weaker muscles and nerve connections that may not have gotten much attention in the initial stages of therapy. The goal is to improve functional recovery and reduce the likelihood of secondary health issues.

“One of the unique pieces of this program is that each client is assigned a physical therapist and an exercise physiologist, and they develop a treatment plan based on the patient’s goals,” explains Becky Washburn, manager of Beyond Therapy and a member of the team who launched the program.

Today, it’s a well-established program, but this innovative idea started with conversations between patients and care teams around Shepherd Center. It gained traction through the collaboration of exercise physiologists, physical therapists, and other clinical, research, and administrative staff.

One patient with a high-level spinal cord injury (SCI) was looking for intense activity-based therapy to follow an experimental procedure she had abroad. Her goal was to improve her arm and hand use. Another patient with a lower-level SCI was participating in a study led by Dr. Backus using Functional Electrical Stimulation (FES) bicycles. He was pleased with his progress but wanted to do more.

“I love that it started with a conversation between a patient and a researcher from one angle and a patient and a clinical manager from the other,” Dr. Backus reflects.

One conversation led to another, and members of several departments formed a team. The team mapped out what they thought the therapeutic intervention should look like and wrote a business plan.

“Within six months, I had a waitlist of 30 people to get into the program,” Washburn explains.

Today, Beyond Therapy serves 40-45 clients at any given time. Therapists employ a variety of high-tech equipment — a Lokomat®, an Indego® exoskeleton, FES bikes, dynamic zero gravity (DZG) equipment, a multi-channel electronic stimulation unit, as well as aquatic therapy and equipment that you might see in any gym that can be adapted for patients to use.

“We’re really lucky Shepherd keeps us on the cutting edge of technology, but even with the best equipment, it is truly the staff’s innovation that helps clients reach their goals,” Washburn says.

The activity-based therapy at the heart of Beyond Therapy has influenced inpatient programs at Shepherd, including introducing inpatient classes like FES cycling and Shepherd’s locomotor training clinic.

Beyond Therapy is not covered by insurance, but Dr. Backus hopes that might change in the future.

“We want to provide the evidence that Beyond Therapy helps people achieve their greatest function and lead more productive, healthier lives. Helping people return to school or work and reducing their need for medical services for secondary health conditions will reduce the load on them and the healthcare system."

To be evaluated for enrollment in Beyond Therapy®, download our enrollment form and follow the directions for returning the completed forms to us. All information submitted is personal and confidential. For assistance with filling out this form, please call 404-350-7787.

Written by Ruth Underwood

Inspiring Innovation

Marcus Center for Advanced Rehabilitation 

Pursuing Possible, the most ambitious campaign in the history of Shepherd Center, will create so many more opportunities to do what Shepherd does best: help patients begin again. Of the many initiatives and growth opportunities the campaign will enable, few are as significant as the development of the Marcus Center for Advanced Rehabilitation.

This state-of-the-art facility will allow Shepherd to increase patient access and improve the patient and family experience in several ways, including growing Shepherd’s day programs and outpatient services, as well as creating space for a new 30,000-square-foot Innovation Institute. This adds to enhanced, fully integrated innovation across Shepherd’s entire rehabilitation continuum.

Growing the Heart of Shepherd  

Enhancements to the Main Campus

Since its founding in 1975, Shepherd Center has set the standard for what is possible in transformation after injury or illness and the field of neurorehabilitation. The main campus at 2020 Peachtree Road has been at the heart of this work for the past 47 years.

But to satisfy unmet patient needs, Shepherd Center is poised to make key enhancements to the main campus that improve patient access. The Pursuing Possible campaign will allow Shepherd to expand inpatient capacity and modernize patient rooms, increase capacity for day programs and outpatient services, and centralize and expand the Andrew C. Carlos Multiple Sclerosis Institute. 

Family Matters

The Arthur M. Blank Family Residences at 1860 Peachtree Road

It is not only psychologically crucial for families to be together during rehabilitation but also therapeutically imperative for them to be on-site as part of the care team. Shepherd Center’s industry-leading patient outcomes reflect the benefits of involving families in care.

Through the Pursuing Possible campaign, Shepherd will further improve the patient and family experience by building a new family housing tower just down the street from Shepherd's main campus.

Written by Leslie Jackson

Pursuing Possible with Shepherd Center

To support the continuation and expansion of Shepherd's world-class care, please consider contributing to Shepherd Center's Pursuing Possible campaign.         

Today, some of society’s greatest needs are more equity, inclusion, and accessibility for people with disabilities. Shepherd Center employee Danny Housley, who joined Shepherd Center in February 2021, is determined to do his part to address that need by using his unique perspective to teach the community a new way to think about disabilities. Appropriately, he works in one of Shepherd’s innovation hubs, the Assistive Technology Center (ATC).  

As assistive technology equipment case manager, Danny connects patients with community resources and services that can assist them with accessing, paying for, using, and optimizing assistive equipment they need to live independently. He is also part of Shepherd Center’s Diversity, Equity, Inclusion, and Accessibility (DEIA) Council, where he educates colleagues about how these issues affect the disability community. There are three common threads in everything Housley does: outreach, education, and advocacy.

“I’ve been passionate about advocating for the disability community my entire career,” Housley says. “This is a topic that affects all of us because anyone can become part of the disability community at any point in their lives. You can be born with it, like me, or become that way.”

Housley, who was born blind, presents to a variety of audiences about DEIA and the disability community. To illustrate his point, he uses his experiences as concrete examples of daily barriers he faces. But awareness is only half the battle.

“Of course, you want to be aware of the issues,” Housley explains, “but the next step is asking how you can be an active participant and help break down barriers.”

To help that cause, Housley co-led a training with Liz Persaud, program and outreach manager at Tools for Life, Georgia’s Assistive Technology Act Program based out of Georgia Tech, for staff at the Center for Puppetry Arts in Atlanta, Georgia. The training covered topics like disability awareness, culture, history, and best practices for respectfully interacting with patrons with disabilities.

“We want to reframe how people perceive disability,” Housley says. “I’m not a ‘broken person’ because I have a disability; it’s the environment I’m in. When we design public spaces and interact with patrons, we need to make sure the environment allows everyone equal access to participate.”

He also emphasizes that making mistakes is human.

“If you say or do something to a person with a disability unintentionally, the biggest thing is that we identify it so we can fix it in the future,” Housley says.

The Center for Puppetry Arts took these lessons to heart and is already integrating Housley and Persaud’s presentation into their employee onboarding, as well as including accessible practices into their business, like incorporating audio-described performances for people with visual disabilities and including an American Sign Language interpreter for people who are deaf or hard of hearing.

Housley continues his efforts, most recently leading a presentation on behalf of the DEIA Council for Shepherd Center employees during the anniversary of the Americans with Disabilities Act that discussed the legislation’s impact and the work yet to be done. He also provides tours of Shepherd Center’s ATC to donors, students, staff, and guests to demonstrate what assistive technology is and how Shepherd Center uses it for patients.

“Shepherd specializes in helping people with disabilities thrive,” Housley says. “It is nice to work at a place where this kind of outreach is supported. If we all work together, we can normalize disabilities and break down barriers.”

Written by Damjana Alverson

On August 10, 2021, Clevance was driving from his home in Franklin, Georgia, to his job at a plant where he helps make tractors. Every weekday, he leaves the house before the sun rises and clocks in between 5:45 and 6 a.m. This day was like any other until the unexpected happened.

“My pickup truck rolled over four times and hit a tree,” Clevance says. “To this day, I have no idea exactly what happened. Two weeks of my life, from that morning to the first hospital room I was in, to my operation, are gone.”

In addition to breaking both his shoulders, sustaining injuries to his hips and having significant wounds, Clevance also had sustained a T-11 spinal cord injury (SCI).

When he arrived at Shepherd Center’s Spinal Cord Injury Rehabilitation Program on August 24, his therapy team got to work to help him achieve his goals, including returning to the piano. The team affectionately calls Clevance by his last name, Weekes.

“While Weekes could lift and drop his foot, he wasn’t able to move his toes or his ankle to press a standard piano pedal. This was frustrating to him because it made a difference in the sound,” says Katie Murphy, CTRS, recreational therapist at Shepherd Center.

Clevance adds, “When you play the piano, it sings. When I couldn’t press the pedals anymore, I couldn’t make it sing the way I wanted to, and it was devastating.”

Murphy teamed with Clevance’s physical therapist, Lindsay Brinker, PT, DPT, to use common items around the hospital to craft a makeshift extension that attached to the piano pedal.

“With a longer pedal, Weekes could use more of the heel of his foot where a majority of the weight was being applied when he dropped his leg onto the pedal instead of relying on his toes or ankle,” Brinker explains. “After testing it with him, we realized it could work! Unfortunately, our mock device wasn’t sturdy enough, and there was really nothing out there we could buy for pianos. That’s when we decided to contact Jared.”

Jared Grier is a rehabilitation engineer in Shepherd Center’s Assistive Technology Center (ATC). Grier, who was a patient at Shepherd in 2015 after sustaining a spinal cord injury, began working at Shepherd Center in 2021. Since then, he has combined his engineering background and expertise in 3D printing to help Shepherd Center patients.

“I found how much of a useful tool 3D printing was for myself personally,” he says, “For example, for a while, it was hard for me to open the gas cap on my car, so I 3D printed a handle like a wrench to help myself get it off and put it back on.”

His work changes daily, but he sums up his role this way: “A rehab engineer utilizes engineering principles in the clinical environment to enhance patient care. I work with my colleagues in the ATC and therapy teams across the hospital on a variety of projects.”

“Using specialized software, I am able to custom design parts that patients need after I consult with the patient and their therapy team,” Grier says.

In Clevance’s case, Murphy and Brinker asked for a sustainable solution for the piano pedal extension. After some back-and-forth, Grier figured out he needed a rigid design that wouldn’t flex, long enough to accommodate the way Clevance’s heel hit the pedal, and a size that could fit different pedals on whichever piano Clevance was using.

Clevance will never forget the day he got to play the piano the way he envisioned again using Grier’s device.

“For the first time since my accident, I heard a sustained sound when I pressed the pedals, and I just cried,” he says. “I realized that the piano was no longer taken away from me. The accident took it, but the team at Shepherd gave it back. That for me is life – I dream and compose music.”

Clevance graduated from Shepherd Center’s outpatient Day Program on January 14, 2022. His wife created a music studio for him at their home, where he’s busy using his 3D printed pedal adapter to compose music, which he hopes to release in the future. He also looks forward to playing at his church.

“What the team at Shepherd did for me is show me nothing is out of reach,” Clevance says. “I’ll never say I won’t be able to do this or that anymore. You can do anything – just don’t stop.” 

By Damjana Alverson

But researchers at Shepherd Center are.

Fortunately, even with the unpredictable nature of spinal cord injuries, Shepherd Center has long had collaborations with trauma centers and industry partners in place to connect newly injured patients with clinical trials to participate in and advance research – even weeks or months before a patient arrives at Shepherd Center for rehabilitation. In two recent studies, Shepherd Center is partnering with trauma centers and industry sponsors to advance research that aims to catch patients early in their recovery from spinal cord injury.

Elezanumab

AbbVie, Inc. sponsored and launched one such study in 2020, “A Randomized, Double-Blind, Placebo-Controlled Proof of Concept Study to Assess the Safety and Efficacy of Elezanumab in Acute Traumatic Cervical Spinal Cord Injury.” Shepherd Center is one of 30+ institutions participating worldwide in this Phase 2 clinical trial using the drug Elezanumab – a monoclonal antibody – in people with acute (new/recent) traumatic cervical (neck region of the spine) spinal cord injury. Monoclonal antibodies are human-made proteins that behave like human antibodies. In previous studies in animals, Elezanumab was shown to promote neurorestoration and regeneration.

The goal is to enroll 54 newly injured people with spinal cord injury in the trial at trauma centers. Once deemed eligible, participants will receive their first intravenous (IV) infusion of Elezanumab or placebo within 24 hours of injury. Participants then receive monthly doses of Elezanumab or placebo every four weeks for a total of 13 doses. Shepherd Center recently provided this study’s first participant with three study infusions and ongoing research follow-up. Shepherd Center is uniquely suited to participate in studies like this because of its ability to provide a high level of rehabilitation care for patients in the earliest stages of recovery, including those who are still using a ventilator to breathe.

“Partnerships with trauma centers are critical because they allow us to enroll patients in acute SCI studies in those critical early hours and days after injury,” says Michael Yochelson, M.D., MBA, chief medical officer of Shepherd Center and principal investigator for the study. “Not only can Shepherd Center provide highly specialized rehabilitation for patients, but we also offer patients the opportunity to participate in cutting-edge research that we hope will make a difference in patients’ lives earlier in their course of rehabilitation and provide treatment options for generations to come.”

Participants will be followed for approximately one and half years post-injury to assess for the safety and effectiveness of Elezanumab.

MT-3921

Launched in 2021, “A Phase 2a, Randomized, Double-blind, Placebo-controlled Study to Assess the Efficacy and Safety of MT-3921 in Subjects with Acute Traumatic Cervical Spinal Cord Injury,” sponsored by Mitsubishi, is evaluating the use of MT-3921, a humanized monoclonal antibody to repulsive guidance molecule A (RGMa). Animal studies of MT-3921 demonstrated improved locomotor function and increased recovery of manual dexterity.

Participating trauma centers will enroll people who meet eligibility criteria, including having an acute, traumatic C4-C7 spinal cord injury, AIS A-C and being able to receive the first infusion of MT-3921 or a placebo within 48 hours of sustaining a spinal cord injury. After the first dose within 48 hours of injury, participants receive infusions of the study drug or placebo on day 15 post-injury, and then monthly through month six. Once a study participant transfers to Shepherd Center from their referring trauma center, Shepherd Center provides acute inpatient rehabilitation and administers the study medication according to the research schedule. Shepherd research staff also monitor the safety and function of the participant for the duration of their care at Shepherd Center.

“While Shepherd Center is known for our life-restoring rehabilitation for spinal cord injuries, through partnerships with our colleagues at trauma centers and industry sponsors, we’re setting the stage now for therapies that have the possibility to change the course of acute spinal cord injuries,” says Yochelson.

Participants will be followed for nine months post-injury to assess for the safety and effectiveness of MT-3921.

When patients are enrolled in these research studies at the time of injury at participating trauma centers, they have the option of selecting Shepherd Center for both world-class rehabilitation, if they meet eligibility criteria for admission, and ongoing research participation.

You can learn more about research at Shepherd Center here.

By Kerry Ludlam

When we see a tennis ball, most of us likely think of hitting it over a net with a racquet. But that same tennis ball can be fitted to the bottom of a walker for traction and stability. Poke a spoon or a pen through it, and it makes eating or writing much easier for people with weakened grip strength. In this context, a tennis ball is among the simplest examples of assistive technologies, which are invaluable to people living with disabilities.

Assistive technologies, by definition, include any item, device or piece of equipment, off the shelf, modified or customized, that can be used to maintain or improve function to help a person learn, work or play in the community of their choice. August 19, 2021, marks the 33^rd anniversary of the Assistive Technology (AT) Act, key legislation that provides people with disabilities access to a wide array of tools to help them more fully participate and thrive across different settings and activities. The AT Act intentionally set forth a broad definition of assistive technology to include anything that might give more independence.

At Shepherd Center, assistive technologies are an integral part of rehabilitation plans from the moment patients arrive, across the continuum of their care and as they return to the community.

“These technologies make a world of difference in the life of an individual,” says Danny Housley, case manager in Shepherd Center’s Assistive Technology Center, who, as a blind person, has been using assistive technologies since he could walk. “At Shepherd, we get to know each patient, their circumstances and condition, and work together to find solutions that meet their specific needs. Ultimately, they decide which technology is most helpful as they are the ones who will use it.”

For Ryan Carter, 27, of Senoia, Georgia, eye gaze technology that interfaces with his computer has given him a voice and an easier way to communicate. Ryan, who was born with cerebral palsy, tried many communication solutions before coming to Shepherd Center, including alphabet boards to point to letters to spell out words. He says his device, which allows him to control his computer with his eye movements and verbalize his thoughts through speech-generated software, has changed his whole world. It even allows him to control the TV and other things in his environment.

“The word that comes to mind is freedom. I feel free not having to rely on my family and friends to hold an alphabetical board in front of me and do word prediction to figure out what I was saying,” Ryan says. “I’m a very outgoing person. It’s given me the ability to say what I want when I want, and that’s just awesome. I can call and text just like everyone else.”

He adds that Shepherd Center has a special place in his heart, crediting his speech pathologist for helping him choose the right device and the right access method – even adjusting the device so that it sits lower and to the right to accommodate his movements.

For his mom, Jo Carter, it’s more than she could have hoped for.

“He just didn’t say very much – not that he didn’t have thoughts or feelings or desires, but it was just too much, and it was exhausting. Now he’s able to share what he needs and, although we knew it all along, it turns out he’s pretty funny too!” Jo shares with a smile. “With this technology and his power wheelchair, he has independence, and I have independence, which is a beautiful thing. It’s what every parent wants for their kids, to be able to do things for themselves and spread their wings as much as possible.”

Elizabeth Zweigel, 38, a quadruple amputee, says that assistive technologies have given her confidence and peace of mind. Elizabeth was diagnosed with sepsis in 2016, several months after having her second child. She was put into a two-week coma and had her limbs amputated to save her life.

“I feel like Northside Hospital saved my life, and Shepherd gave me life,” Elizabeth says. “I was super independent before this happened, so any level of independence that I could gain back [during my recovery] was huge.”

The team at Shepherd Center listened to her needs and taught her how to use her smartphone again, control her TV and tablet using different apps, and get back to driving. More recently, she worked with the Wheelchair Seating Clinic to find a portable electronic wheelchair that folds down and isn’t as bulky so she can take it to the zoo with her kids or on vacations, including a recent girls’ trip to St. Thomas.

“It’s given me a lot of freedom. I used to have to crawl around the hotel floor if I didn’t have a van big enough to bring my big, power wheelchair,” she says. “Anything I can do for myself makes me feel better. Just knowing that these assistive technologies are available, even if you’re not going to use them now, is empowering.”

For more information about Shepherd Center’s Assistive Technology Center, click here.

Written by Amanda Crowe

By Deborah Backus, PT, Ph.D., FACRM  
Vice President of Research and Innovation at Shepherd Center 

One does not have to go far or search too hard to find references to “innovation” these days. To some, “innovation” has become a buzzword thrown around to gain recognition or attention, just a new way to package old ideas. 

This is why in my new role as Vice President of Research and Innovation at Shepherd Center, it is important to me to go beyond the buzzword and focus our innovation efforts on what truly matters – the patients and families we serve.  

Shepherd Center was founded based on an innovative spirit driven to fill the need for a top-tier rehabilitation hospital in the Southeast. Since then, our clinicians, researchers, staff and leadership have worked relentlessly to develop new or improved approaches to care for people with spinal cord injury, brain injury, multiple sclerosis, spine and chronic pain, and other related conditions.  

Now, I’m excited to take it a step further and define what mission-driven innovation means to us: advancing the field of rehabilitation to improve the quality of life for people with disabilities at Shepherd Center and around the world – today and for generations to come.  

We will do this in a few ways. First, we will cultivate a culture that is prepared to discover and innovate, in which we nurture and reward those who think boldly and creatively. We will take a strategic approach and ensure our work is closely integrated with our clinical programs’ priorities. This will involve creating a product development strategy and defining processes for bringing ideas to reality. Finally, we will leverage Shepherd Center’s clinical and research expertise, collaborate with our patients and like-minded external partners, and educate and train future researchers and innovators. 

Since I began my career at Shepherd Center in 1989, I have witnessed first-hand how innovation can make a true impact on peoples’ lives. From a young man with a high-level cervical injury able to control his computer and TV through a smartphone, to a woman with no limbs empowered to drive because of the innovative solution created for her vehicle, to a veteran with post-traumatic stress syndrome now able to work because he has a new app to help manage his anxiety – there are so many examples of how we have helped people live fuller lives through innovation.  

Mission-driven innovation at Shepherd Center will lead to new and better ways to change “I can’t” moments into “I can” realities. I am excited about the future for Shepherd Center and the rehabilitation field, in general. Join us on our journey to being the preeminent innovation institute in rehabilitation medicine. Learn more at shepherd.org and in our recent research and innovation feature story at this link. 

We shine a light on how Shepherd Center innovates to improve clinical outcomes and quality of life for patients and the community. You’ll learn about a clinical study to restore hand and arm function in people with spinal cord injury, life-enhancing mobile apps, big data's potential impact on healthcare, our unique partnerships and more.

The magazine also features these stories among other patient profiles, staff highlights, honorariums and memorials:

Calling an Audible After sustaining a traumatic brain injury while playing football in 2018, Christion Abercrombie finds new purpose beyond the gridiron.

Virtual Connections Fill Gaps in Patient and Family Care Shepherd Center innovates virtual options to effectively treat patients and support families.

Anything but Idle With help from Shepherd Center, Tommy Knight navigates multiple sclerosis to return to his love of working with his hands.

Shepherd Center Welcomes New Members to Board of Directors Shepherd Center has named five new members to its Board of Directors who are uniquely qualified to help guide Shepherd Center into the future.

You can subscribe to the print and/or e-newsletter versions of Shepherd Center's magazine here.

“Providing consistent care is critical to our patients’ rehabilitation,” says Sarah Morrison, PT, MBA, MHA, president and CEO of Shepherd Center. “COVID-19 forced us to innovate quickly and find a way to continue that care virtually where it was needed.”

Within three weeks of the pandemic’s start, every Shepherd Center department contributed to making virtual services possible. Telehealth, online wellness clinics and other virtual services are now a regular part of the hospital’s operations and have broader applications. For example, people who don’t live near the hospital can now participate in programs they previously could not access.

Shepherd Center’s peer support program, which connects injured individuals and their families with mentors, also offers virtual platforms. It has been so successful that the acquired brain injury (ABI) family peer support groups have seen a 32% increase in meeting attendance.

“Instead of having to miss a peer support dinner or one-on-one support session because they are out of state or it’s inconvenient, they can tune in from anywhere,” says Claire Holley, acquired brain injury family peer support coordinator.

The spinal cord injury (SCI) peer support groups have had another unexpected benefit: patients can now get a glimpse into the lives of their mentors in their home environments through virtual sessions. This allows them to see how their mentors live day-to-day, which ultimately boosts their confidence to manage life when they return home.

To help navigate their loved one’s injury, families of inpatients with a brain injury can participate in therapy. Shatavia Thomas, DMFT, LMFT, an ABI family therapist, launched telehealth services in March 2020. Since then, she has met with 34 families across the 10 states where she is licensed or has provisions during the state of emergency.

“Personally, it’s been a rewarding experience in my career to be part of this effort to adapt quickly to serve the needs of families,” Dr. Thomas says.

The Eula C. and Andrew C. Carlos Multiple Sclerosis Rehabilitation and Wellness Program aims to help patients slow disease progression and improve quality of life. In August 2020, it began offering its wellness program virtually, including 10 group exercise classes, yoga, Pilates, meditation, individual coaching sessions and social hours.

“Managing multiple sclerosis (MS) involves a combination of medical treatment, specific rehabilitation such as physical or speech therapy, and overall wellness,” says Anna Berry, PT, DPT, program manager of the MS Institute. “With the virtual wellness classes, we’ve been able to increase our class sizes and are looking to increase the number of classes we offer, as well.”

In the early days of the pandemic, Shepherd Center’s Spinal Cord Injury Rehabilitation Program received an emergency grant from the Craig H. Neilsen Foundation to provide a virtual solution to help people with spinal cord injuries stay physically active. They have trialed it in three cohorts.

The first cohort completed an eight-week trial core curriculum for seated yoga classes and upper-body strengthening classes in September 2020. The second cohort included a leisure skill art class, art and relaxation class, upper-body strengthening, and yoga. Due to high demand, a third cohort was added, incorporating an updated strengthening and cardio class called Shepherd Moves and a weekly theme that teaches a new area of wellness to participants.

“The cohorts have been going really well,” says Jenny Dilaura, MA, CCLS, CTRS, lead therapist in Shepherd Center’s health and wellness clinics. “Participants have even continued to exercise on their own with the videos we recorded over Zoom. I am excited to see how we can continue to develop this program.”

To prevent a gap in care for its clients, Shepherd Center’s SHARE Military Initiative, a comprehensive rehabilitation program for post-9/11 veterans and service members with brain injury, began offering telehealth in Georgia during July 2020 and has since become licensed in North Carolina, South Carolina, Virginia and Florida. The team is working to become licensed in other states, as well.

“The goal of the telehealth program is to help our clients develop sustainable activities of wellness,” says Jackie Breitenstein, MS, CTRS, CCM, the SHARE program manager. “We still offer our full spectrum of therapy including recreational therapy, virtual exercise groups and virtual peer support groups for clients who are currently in the program or clients who have graduated.”

With tenacity and ingenuity, Shepherd Center quickly launched a variety of virtual wellness and telehealth offerings.

“The foundation built since last March will allow the hospital to continue to evolve, even as we move past the pandemic,” Morrison says. “While virtual solutions may not always be the appropriate choice, having the resource as part of Shepherd Center’s comprehensive rehabilitation program helps elevate the patient and family experience.”

Written by Damjana Alverson

“Our ‘why’ has been clear from the start,” says Mike Jones, Ph.D., FACRM, who recently retired as vice president of research and technology after 25 years at Shepherd Center. “We focus on improving clinical outcomes and quality of life for our patients with disabilities. At the end of the day, impressive technology and clinical trials are only meaningful if they have practical, sustainable applications for the people we serve.”

Shepherd Center’s research efforts began in 1982 with funding of the Southeastern Spinal Cord Injury Model System, which continues to this day. In 1996, the Virginia C. Crawford Research Institute was founded with the aim of broadening Shepherd’s research program and supporting the integration of research into clinical practice. During the past 25 years, researchers and clinicians at Shepherd Center have participated in many studies and clinical trials that have changed the care landscape for people with spinal cord injury, brain injury, stroke, multiple sclerosis, and spine and chronic pain. Today, Shepherd Center’s research and innovation initiatives focus on therapy augmentation, assistive technology, big data and partnerships.

BOOSTING THE SIGNAL: THERAPY AUGMENTATION

Anyone who has been through rehabilitation for spinal cord injury (SCI), brain injury or a neurological condition, such as multiple sclerosis (MS), will tell you it is hard work. There are physical challenges in occupational therapy, physical therapy and speech therapy sessions and unseen psychological hurdles. While a person’s dedication to old-fashioned hard work is necessary to experience progress, there are specific ways to enhance – or augment – conventional therapies to produce even greater results. 

That’s what Edelle Field-Fote, PT, Ph.D., FAPTA, FASIA, director of spinal cord injury (SCI) research and the Hulse Spinal Cord Injury Lab at Shepherd Center, is hoping to accomplish as co-principal investigator in the Up-LIFT clinical study, a multi-center clinical trial of cervical spinal stimulation using ARC Therapy™. Sponsored by the medical technology company ONWARD (formerly GTX Medical), the Up-LIFT trial aims to restore hand and arm function in people with SCI who have minimal ability to move their hands. Shepherd Center enrolled the first participant in the study in January 2021.

Here’s how it works: A spinal cord injury disrupts the transmission of signals from the brain that activate the muscles someone wants to move. In most people with SCI, there are still some remaining spinal pathways, but the damage to the spinal cord means that only a fraction of the signals get through. The result is limited ability to move. The goal of spinal stimulation with ONWARD’s ARC Therapy™ is to “boost” the signal transmission so that more of it reaches the areas of the spinal cord that activate the muscles. The research team hopes to show this technology improves movement and strength in the hands and upper extremities of people with SCI when combined with daily functional task practice training.

“For individuals with impaired arm and hand function due to spinal cord injury, improved hand function directly translates into meaningful gains in terms of quality of life – being able to eat, dress and perform other day-to-day activities,” Dr. Field-Fote says.

Shepherd Center plans to recruit at least eight participants in this clinical trial. This trial is registered on clinicaltrials.gov (#NCT04697472). Click here for more information and to be considered for participation.

TECH THAT HELPS: ASSISTIVE TECHNOLOGY

Ranging from low-tech to high-tech with a wide variety of applications, assistive technology is any item, equipment, software or product used to increase, maintain or improve the functional capabilities of people with disabilities. Shepherd Center’s Assistive Technology Center focuses on addressing these needs.

“A lot of times, new assistive technology innovations come out of one person solving for one specific need,” says Chris Maurer, MPT, ATP, program manager of Shepherd Center’s Assistive Technology Center. “At Shepherd, our diverse patient population allows us to test these innovations and offer feedback so we can see how a piece of technology can apply to more people who may benefit from it.”

This was certainly the case for the LUCI™ autonomous driving system for power wheelchairs. Inspired by his daughter who was born with cerebral palsy, Grammy-nominated songwriter Barry Dean wanted to create a smart wheelchair that could  prevent tips, collisions and falls. Barry and his brother, Jered, partnered to develop LUCI, a system of cloud-connected software and hardware mounted to a wheelchair that uses sensors to detect potential dangers in the environment. Last year, they approached experts at Shepherd Center to test it.

“So often, typical research remains theoretical, focusing on the narrowest data sets,” Dean says. “Shepherd Center gave us the opposite – and much more valuable – view. Their expert team examined our new technology and tested it with their patients. There was immediate and direct feedback, and this incredible team allowed us as a company to observe reactions to our new product in real time.”

That direct feedback inspired the LUCI team to completely redesign the mobile app used to set up the technology on a wheelchair, making the technology more accessible. Now, they are working to build their distribution network to make LUCI available to more people who may need it. You can learn more about LUCI at luci.com.

In 2018, Matt Kubota’s loved one was referred to Shepherd Center after being diagnosed with Guillain Barré syndrome (GBS). Anastasia Soule was temporarily non-verbal and lacked motor function, making it difficult for Matt to effectively and affordably communicate with her. Fortunately, Matt is a software designer and decided to create a free mobile communications app called Vocable with help from others at his company. The app uses built-in technology to track the user’s head movements. When the user stops moving their head, the item on the screen is selected. The app features pre-programmed phrases that speak when selected so the patient can communicate with caregivers and loved ones. 

After Anastasia was discharged, Matt contacted Adina Bradshaw, MS, CCC-SLP, ATP, a speech-language pathologist in the Assistive Technology Center, for help testing and developing this new idea.

“Adina offered her expertise to us to improve the app,” Matt says. “She was one of the people who tested the beta version. We worked with her to understand the ideal use cases for an app like this, how we could improve the phrases users can select from and more.”

To date, the app has more than 4,000 downloads and is used in 49 countries. Matt and his team have kept the app free and open source so anybody can access the code and adapt it to their specific use cases. 

“At Shepherd Center, we regularly use Vocable with our patients,” Bradshaw says. “It’s made an incredible impact on them.”

Shepherd Center also produces assistive technology through its collaboration with Duke University and Northeastern University called the LiveWell Rehabilitation Engineering Research Center (RERC). The LiveWell RERC promotes access to existing and emerging technologies for all people, regardless of ability, through various research and development projects. A key project is the App Factory, a technology development initiative started in 2011 and pioneered under the Wireless RERC grant by Dr. Jones. It brings together rehabilitation experts and app developers with people living with disabilities at the center of all efforts. To date, the App Factory has funded or directly produced 46 mobile apps which have generated nearly 1 million downloads.

“With the advent of the iPhone and other smart devices that followed, we now have platforms to support mobile apps, and it’s opened tremendous opportunities for our patients and others with disabilities,” Dr. Jones says. “But amid the explosive growth of mobile healthcare apps, technologies must evolve and/or be adapted so that people with disabilities can use them.”

One example is SwapMyMood, a free app that assists people with brain injury in using evidence-based tools to support problem-solving and emotion regulation. Clinicians can use it to guide patients through recognizing when they have a problem, what caused it, and how to resolve the issue and cope with their emotions in a thoughtful, constructive way.

SwapMyMood was born out of Shepherd Center’s SHARE Military Initiative, a comprehensive rehabilitation program focusing on assessment and treatment for service members who have served in the U.S. military since September 11, 2001, regardless of discharge status.

“We traditionally teach these problem-solving and emotion regulation techniques from a paper manual, but it occurred to me that it might be more effective if we could provide an electronic version that our SHARE clients could use no matter where they are,” says Tracey Wallace, MS, CCC-SLP, the SHARE Military Initiative’s projects and education coordinator.

Wallace teamed up with John Morris, Ph.D., FACRM, a senior clinical research scientist at Shepherd Center, in 2016 to create the app. They received positive feedback from SHARE clients. Like all technology, the app is continually evolving, and developers released the latest version in spring 2020. The team plans to launch a clinical trial comparing the outcomes from clients who use only the paper manual version with outcomes from clients who use only the app. The results will inform how the app will evolve to help those who need it.

KNOWLEDGE IS POWER: BIG DATA

Big data may sound like an intimidating concept, but when it’s boiled down, it refers to large, diverse sets of information that are too complex to manage and process in traditional ways. For example, think of all the information you store each day in your smartphone, like photos, texts, web searches, social media interactions and more. Now, multiply that by the more than 2.8 billion smartphone users in the world, and your head may start spinning. This is what the tech industry refers to as big data.

“Big data can have a huge impact on healthcare and patient quality of life,” Dr. Jones says. “Shepherd Center has about 23 years of electronic medical record data that is nearly impossible to analyze manually. Thanks to big data analytics, we have a much more efficient way to dig into that information to help reveal which interventions and treatments are most effective for our patients.” 

At Shepherd Center, big data is making an impact through the concept of mobile rehabilitation (mRehab). That concept involves the delivery of services and support for home-based rehabilitation using mobile apps, sensor-based activity tracking and gamified exercises. The goal of mRehab is two-fold: keep patients interested in their therapy so they continue training at home and provide a low-cost, accessible way for people to continue rehabilitation once they leave the clinic.

Dr. Jones’ extensive work with wireless technology helped him realize mobile devices generate vast sets of clinically valuable data. For example, data can reveal whether people stick to their at-home rehabilitation plan and what motivates them to stay consistent. He recruited George Collier, Ph.D., as a Shepherd Center senior data scientist tasked with creating a big data system to  handle the amount of information recorded by patients using apps and sensor technology to track their therapy.

Dr. Collier works with Raeda Anderson, Ph.D., a research scientist at Shepherd Center, and a team of collaborators at the University of California, Irvine, including David Reinkensmeyer, Ph.D., Edgar de Jesus Ramos Munoz, Ph.D., and Veronica Swanson, to explore factors that determine whether people continue their rehabilitation exercises at home and when they are likely to drop off.

“Clinicians can use the results from this data analysis to makes mRehab more engaging and adjust the programs accordingly,” Dr. Collier explains. “That way, the users are more likely to participate and stay as healthy as possible once they leave Shepherd Center.”

This work is funded by a $4.25 million, five-year grant from the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) to help advance the mRehab field and test how clinicians can embed these technologies into practice. Two of the key collaborators in implementing mRehab are Pt Pal and Flint Rehab.

Pt Pal is a HIPAA-compliant, secure app that allows a patient’s care team to send exercise routines, activities of daily living, diet recommendations, surveys and educational materials to the patient’s or caregiver’s mobile device. Clinicians use data collected from the app to monitor patients’ adherence to treatment regimens.

Flint Rehab is a digital health company that develops rehabilitation tools using the latest clinical research and gamification. Two of their popular products are fitness games that use sensors that track users’ movements and help them regain mobility and function with real-time feedback. 

The team is working to integrate the Pt Pal app with Flint Rehab’s sensor technology so the app can store sensor data while patients exercise at home and in clinic. This information provides a clearer picture of the patient’s lifestyle and motivation, allowing clinicians to determine the best treatment plan for each individual. So far, Shepherd Center has accumulated one year’s worth of Pt Pal app data from patients, resulting in a data set of about 4.8 million observations. They have also begun collecting information from the Flint Rehab sensor devices.

“What happens in the clinic is important, but the data from these mobile devices will give us a window into what happens after the patient returns home to their community,” Dr. Collier says. “That’s what is really telling about someone’s long-term success. With this wealth of information, we hope to personalize at-home rehabilitation to make that success even more achievable.”

INNOVATING THROUGH CONNECTIONS: PARTNERSHIPS

Sharing knowledge is a cornerstone of making progress, which is why Shepherd Center has more than 200 industry and academic partnerships to advance research and innovation.

“We have to share knowledge, energy and resources with our partners to maximize the impact we can have for our patients and all people with disabilities,” Dr. Morris says. 

One such partnership began between Microsoft and Shepherd Center in 2017. It is the Accessibility User Research Collective (AURC), which connects Microsoft product engineering teams directly with people with disabilities. Microsoft partnered with Shepherd Center for its expertise in accessibility and usability testing, as well as rehabilitation research in areas like assistive technology. AURC staff at Shepherd Center design study protocols, recruit research participants, and collect and analyze data to ensure that ongoing product development at Microsoft meets the needs of people with disabilities.

“By working with the Shepherd Center AURC, we have built a scalable system that brings the voice of people with disabilities into our company, helps us better understand how they use our products and provides feedback to engineers to make our tools more accessible,” says Megan Lawrence, Ph.D., Microsoft senior accessibility evangelist.

Since AURC’s inception, Shepherd Center and Microsoft have completed more than 75 usability and user-needs research projects to make Microsoft’s consumer technologies more accessible and useful. There are about 1,000 participants in the studies selected based on the type of disability they have to test specific features of Microsoft’s products.

“A lot of times, research and innovative ideas can take a long time to go to market,” says Nicole Thompson, MPH, director of operations for the Accessibility User Research Collective (AURC) at Shepherd Center. “The beauty of this type of data collection model is that we can gather consumers’ feedback and implement their suggestions quickly in order to match the needs of the fast-paced technology sector.”

To learn more about the AURC, visit accessibilityuserresearchcollective.org and sign up to join.

--SIDE BAR--

Shepherd Center Welcomes a New Vice President of Research and Innovation

Deborah Backus, PT, Ph.D., FACRM, assumed the new role of vice president of research and innovation on March 1. Dr. Backus began her career at Shepherd Center in 1989 as a physical therapist. Through her tenure, she has demonstrated strong collaborative skills and the ability to deliver innovative solutions to meet patient care needs, most recently as director of multiple sclerosis research. In her new role, Dr. Backus will expand Shepherd Center’s existing programs to ensure the hospital continues to be at the forefront of treatment and technological advances.

“Dr. Backus’ passion, dedication and hard work perfectly position her to be successful in this new role,” says Sarah Morrison, PT, MBA, MHA, president and CEO of Shepherd Center. “Through her leadership, we will continue to transform patient care for years to come.”

Dr. Backus assumed the role following Michael L. Jones, Ph.D., FACRM, who is retiring as vice president of research and technology after a distinguished 25-year career with the hospital, yet will continue participating in research at Shepherd Center in  other capacities.

His contributions have been immeasurable. In addition to serving as a founding director of the Center’s Virginia C. Crawford Research Institute, he oversaw Shepherd’s Assistive Technology Center and Noble Learning Resource Center. After joining Shepherd Center in 1996, Dr. Jones served in various management roles, including chair of the Research Review Committee, ex-officio member of the Board of Directors and director of information systems from 2000-2017.

“Dr. Jones and his team’s impact have transformed Shepherd Center over the past 25 years,” Morrison says. “Shepherd Center patient programs like our successful Beyond Therapy® outpatient program started as research projects. We have Dr. Jones’ leadership to thank for that.”

Written by Damjana Alverson

Deborah Backus, PT, Ph.D., FACRM, assumed the role of vice president of research and innovation on March 1, 2021. Dr. Backus is a grant-funded researcher, physical therapist and educator with more than 30 years of experience in the neurorehabilitation field, most recently as director of multiple sclerosis research at Shepherd Center. At Shepherd, she has been instrumental in facilitating clinician involvement in research activities, translation of evidence into clinical practice and uptake of technology into clinical programs.

Q: How did your career get started? 

I actually began my career as a physical therapist. I graduated from physical therapy school in 1986 and began working at Shepherd Center in 1989. While I loved my work as a PT, I felt like I wanted to continue to learn. My passion was finding new ways to improve our patients’ function, health and quality of life. So, I made the decision to leave Shepherd Center to pursue my Ph.D. in neuroscience. Through the years of pursuing my doctorate, I also had my three wonderful kids, moved to New Jersey and then moved back to Atlanta in 2004.

When I returned to Atlanta, I knew I wanted to apply what I had learned through my doctoral training to directly impact our patients at Shepherd Center. I began working at the hospital again and officially started my career in research. Initially, I worked on spinal cord injury research. After holding various roles, I became director of multiple sclerosis research in 2012 after the MS Rehabilitation and Wellness Research Program began as part of the Eula C. and Andrew C. Carlos MS Rehabilitation and Wellness Program at Shepherd Center.

Q: What are your main responsibilities as vice president of research and innovation?

My job is to expand Shepherd Center’s already innovative clinical and research programs to ensure the hospital continues to be at the forefront of treatment and technological advances for spinal cord injury, brain injury, stroke, multiple sclerosis, and spine and chronic pain.

Q: Why are research and innovation important at Shepherd Center?

We know that healthcare is changing, and we want to be at the forefront of finding new ways to work smarter and more effectively in neurorehabilitation to improve patients’ lives. At Shepherd Center, we are well-positioned to do that through research and innovation. Our experienced clinical experts, successful research directors, enthusiastic academic and industry partners, and diverse patient population are willing to work together to improve clinical outcomes through research trials, technological advances and analytics. When we work together, the opportunities are endless.

Q: What are you most excited about in the next five years at Shepherd Center?

I’m really excited to work with our clinicians, leadership and patients to build the innovation culture at Shepherd Center. This hospital was built on bold, innovative practice, and now I look forward to continuing in that spirit. We never say we can’t do something, and that’s one of the things I love most about working here.

I’m also excited about building our data analytics capacity. We have collected a robust set of patient data through the years that can inform how we care for patients in the future to drive better clinical efficiencies and outcomes.

Finally, we have an opportunity to develop our research program and Assistive Technology Center (ATC) as the hospital plans to expand over the next several years. This expansion will allow us to build and validate more innovative solutions that can help our patients and the rehabilitation field in general.

EDUCATION

• Sargent College at Boston University – Bachelor of Science in Physical Therapy
• Emory University – Ph.D. in Neuroscience

FUN FACTS

• In her spare time, Dr. Backus loves to exercise, cook and spend time outside enjoying a glass of wine with family and friends.
• Dr. Backus has three kids who all attend the University of Tennessee, Knoxville. The kids grew up in Connecticut and New Jersey, so it is quite a coincidence that they all chose that school for college!
• Dr. Backus is grateful to her husband and kids for being supportive throughout her career. She says, “If I didn’t have such an awesome husband and kids, I would not be able to take on this new role at Shepherd Center.”