Just three years in, a partnership between Shepherd Center and the Sociology Department at Georgia State University (GSU) has yielded seven published studies, over 100 scientific outputs, and received the university’s prestigious Ignite Award for Faculty Research Partnership. 

The partnership began as another chapter was ending for Raeda Anderson, Ph.D. Dr. Anderson was preparing to come to Shepherd Center as a research scientist, leaving her role as a professor in the Department of Research and Engagement at Georgia State University. 

“Dr. Wright said something to the effect of, ‘So you think you’re leaving, but we’re actually going to make you an affiliate faculty member — so you can stay in the department as an Applied Sociologist as long as you’re willing,’” she remembers. “I wanted to be at Shepherd Center for a year before trying to build any bridges between the two institutions, because being a scientist is a hard profession. Being a scientist at a top-ranked non-profit hospital is even harder. So, I gave myself a year, and it was a year and one day when George Usmanov, my former graduate assistant at GSU, came over to Shepherd Center as a graduate assistant.” 

What started as one graduate student working at Shepherd Center grew into a formal partnership between the two institutions. The GSU department provided funding for two more of Dr. Anderson’s graduate research assistants from the university to come work with her at Shepherd. Dr. Anderson, along with Dr. Daniel Pasciuti, associate professor of Sociology at GSU, and Dr. Patricia Lawrence, research assistant professor of Public Health and Interim Associate Director for the Center for Leadership and Disability, co-founded and lead GSU’s Interdisciplinary Community Research on Disability Lab (iCORD Lab). The iCORD Lab focuses on actionable research grounded in the belief that people with disabilities should thrive, not just survive, in their communities. 

“Shepherd Center and GSU Sociology’s partnership has taken off.” Dr. Anderson says. “Social scientists are now making a real effect in clinical research. Our highly trained students work at Shepherd, contribute to publications, and excel at turning research into action. It’s a wonderful partnership that benefits everyone, most importantly our patients.” 

Ford Vox, M.D., a doctor in Shepherd’s Brain Injury Rehabilitation Program, was so impressed by the partnership that he approached Deborah Backus, PT, Ph.D., FACRM, the hospital’s vice president of research and innovation, about funding the partnership to work on a project with local brain injury day program, Side by Side Brain Injury Clubhouse. 

Side by Side is a member-led community providing growth opportunities for brain injury survivors. Dr. Anderson and her team have helped the program answer a myriad of questions about membership, participation, transportation, housing, and potential barriers to services. The multi-mode and multi-phase study is also helping prepare the program for Side by Side’s upcoming expansion.

In addition to the project for Side by Side, the partnership has helped drive quality improvements at Shepherd Center. In one recently published study, Madelief Tilder, a former GSU graduate research assistant, examined factors influencing telehealth appointment completion. The study, driven by questions from clinical leaders here at Shepherd Center, analyzed over one million Shepherd Center appointments to examine patterns of appointment completion, focusing on the role of insurance, appointment structure, and access barriers. 

“This experience helped me envision a future as an applied sociologist and showed me that interdisciplinary, collaborative research is not just possible — it’s powerful,” Tilder says. “The supportive environment fostered through the partnership helped me see that my voice matters, that I bring valuable insight and belong in research spaces. It gave me the confidence to ask questions, share my ideas, and meaningfully engage in scholarly conversations.” 

In another study, Melissa Treanor, the current GSU graduate research assistant, examined all Georgia State Parks for accessibility information and is in early stages with Rec Therapy to identify how to use the data here at Shepherd Center. 

“The GSU and Shepherd Center partnership has taught me that rigorous methods are most valuable when they are put in service of the community rather than kept inside the academy,” Treanor says. “Through this work, I have learned to ask not only whether a finding is significant, but what it means to the people the research is meant to help.” 

Another recent study, “Disabled and left behind: U.S. poor housing through a social determinant of health lens,” uses national data from the U.S. Census Bureau to examine social determinants of health for people with disabilities. Social determinants of health are conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks for people with disabilities. 

“We never say in science that we were the first ever, but to our knowledge, it is the first publication that has examined this many areas of social determinants of health for people with disabilities,” Dr. Anderson says. “So, we intentionally published it as open access, so more people could have access to it, and Drs. Lawrence and Pasciuti covered those fees for us.”

The partnership, while relatively new, has already made a tremendous effect on research at Shepherd Center and more widely in the field of rehabilitative medicine and disability advocacy. Fittingly, Georgia State recognized the partnership with its Ignite Award for The Faculty Research Partnership Award. The partnership was one of three chosen out of all partnerships across GSU’s seven campuses and hundreds of research areas. On top of the recognition, the award comes with a cash prize — enough to fund another graduate research assistant for the next academic year. 

“The GSU Sociology department has funded three years of students, however, with budget cuts they are not able to fund a graduate assistant this upcoming year,” Anderson says. “This will fund a student for the entire next academic year, so Shepherd Center will get another great research assistant, and a sociologist will get a full ride work-study position. All the money that we won from the award is going back into the partnership to help strengthen it even more.” 

Written by Erin Kenney & 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

In retrospect, Jodi Arminio, 70, says she started noticing her symptoms in 2010.

“I had periodic weakness and numbness in my left leg, but feeling would come back in 30 seconds. By the end of 2010, the weakness had virtually disappeared,” she explains.

The following year, Jodi began experiencing severe loss of vision in her left eye that a neuro-ophthalmologist discovered was due to inflammation of her optic nerve. She brought these issues to neurologist Yazan Houssami, M.D.

“He put all my symptoms together immediately and did a blood test to confirm that I had neuromyelitis optica [spectrum disorder] (NMOSD). I’m so thankful he recognized what I had so fast, or I wouldn’t have been so lucky.”

In late 2012, Dr. Houssami referred Jodi to receive specialized care at Shepherd Center’s Andrew C. Carlos Multiple Sclerosis Institute, which treats a variety of autoimmune diseases, under the guidance of Ben Thrower, M.D.

“Dr. Thrower is amazing. He was able to explain everything about my condition in terms I could understand,” Jodi says. “The entire team has been very helpful, including the infusion nurses. Not one of them there isn’t an angel.”

NMOSD is an autoimmune disease that causes inflammation of the spinal cord and optic nerves. It presents similarly to multiple sclerosis (MS) as it attacks the body’s nervous system.

“At one point, NMOSD was thought to be a variant of MS before they discovered the antibody in NMOSD. It mimics MS, and a lot of NMOSD patients were first diagnosed as having MS and treated with MS drugs that they didn’t respond to. Now, there are four FDA-approved treatments for NMOSD,” Jodi says.

While the severity of NMOSD symptoms can vary greatly from person to person, Jodi describes her NMOSD as an invisible disease. While she occasionally uses a cane for stability, has loss of peripheral vision in her left eye, and experiences pain and fatigue, she says that her symptoms are managed now. It took the right treatment and hard work to get to this point.

“I feel very blessed. In the early days, I didn’t know anybody else with NMOSD. The two big organizations for NMOSD patients are the Guthy-Jackson Foundation funding NMOSD research and the Siegel Rare Neuroimmune Association (SRNA). I started connecting with them, and it was eye-opening to see so many people out there like me,” Jodi says.

That’s why in 2014, Jodi decided to begin a support group hosted at Shepherd Center. Co-run with her right-hand person, Travis Edwards, the group has one primary focus.

“We want to help [others with neuroimmune diseases] recognize that they are not alone,” Jodi says. “Inviting anyone with a rare neuroimmune disorder, we gather monthly to welcome folks new to the disease, listen to members with questions or issues, celebrate milestones, and keep in touch with those experiencing setbacks or new attacks."

Jodi is optimistic that there will someday be a cure for NMOSD. She contributes to NMOSD research by participating in a study at Shepherd to determine the long-term cognitive and physical effects of the disease.

“I can't thank Shepherd enough,” Jodi says. “They've been wonderful about providing accessible space for our support group to meet. As a patient, I really appreciate the comprehensive care I receive and friendships I’ve made.”

Written by Damjana Alverson

Are you living with NMOSD?

Shepherd Center researchers are inviting volunteers to join a research study testing a new, non-invasive device designed to help improve walking for individuals with NMOSD who have difficulty walking. Read more about the research opportunity here.

Both Elizabeth and Paul learned some of these practices through their participation in a clinical trials pilot study at Shepherd Center. The study, funded by the Samsky Spine and Pain Research Fund, aimed to explore the feasibility and acceptability of a mindfulness meditation training program and to determine whether it could lead to improved ability to cope with pain and increased health-related quality of life outcomes. Having the tools to help manage frustrating calls and heavy traffic was a bonus.

Since breaking three vertebrae and sustaining other injuries in a fall about eight years ago, Elizabeth has experienced chronic pain. Her doctor’s warning to be careful, coupled with a fear of falling again, led her to stop many of her activities, which, in turn, led to isolation and depression at the loss of her socially and physically active life. She began coming to The Dean Stroud Spine and Pain Institute about a year ago, participating in physical therapy and adaptive yoga with great results. When she heard about the Mindfulness-Meditation Study, she knew she’d like to give it a try. 

“Because I want to get better. It's mindfulness and yoga, and I thought, ‘There's something here,’” she recalls. “I knew how much the yoga had helped, so I thought, ‘Well, more ways to look at something, more ways to move.’ It's just been incredible.”

Paul has been a patient at the Andrew C. Carlos Multiple Sclerosis Institute for about 20 years and has participated in research at Shepherd in the past. He was already curious about meditation, so when Erica Sutton, MA, CRC, clinical research coordinator at the Virginia Crawford Research Institute at Shepherd Center and principal investigator for the 12-week study, asked if he’d like to participate, he was in. 

“I have been on the fringes of trying to understand meditation and what it does,” says Paul. “Then Erica, out of the blue, called. ‘Hey, Paul, I was thinking about you. You said you always want to participate in things, and I think I have the right choice for you here — it's called mindful meditation.’”

Sutton, who practices meditation herself and holds two clinical meditation certifications, says she wanted to introduce people to its benefits. 

“I built a protocol based around meditation, and for people who are new to meditation and mindfulness, I wanted to show some of the different ways that people can engage in these mindful practices.”

Connecting and Reflecting

Participants in the program attended weekly classes at Shepherd Center and a weekly virtual support group session for eight weeks, followed by four weeks of practicing on their own, during which they could continue to attend virtual sessions. 

During each class, Sutton and her colleague, Alexandra Juarez, EP, RYT 200 HR, introduced participants to a variety of meditation and mindfulness practices, including visual meditation, sound baths, breathing techniques, guided body scans, and mindful eating.

Sutton and Juarez intentionally included time in each session for participants to catch up, share reflections on the tools they’d learned about, and connect with one another — a practice Elizabeth found especially meaningful. 

“Being able to talk to people … sharing how we handle it mentally, emotionally, and physically, even though all our stuff is different, has been a really important part of the mindfulness group,” she says.  

“Part of the benefit of having the study in person is that they get to have a social connection as well, and they really do enjoy that,” says Sutton. “Being able to see people with different diagnoses and to come together collectively with the same goal in mind has been a beautiful process.”

Between classes and during the four weeks of independent practice, participants kept journals documenting the mindful meditation they tried throughout the week and their reflections on the practice. 

“At the end of the study, we will use the diaries to collect those analyses to see if there were any improvements in areas of their overall well-being,” Sutton explains. “We're looking at any changes, primarily in the relationship to pain, so that's something that's important about this study. 

Although we targeted people with chronic neuropathic pain, it was not because we were looking to cure anything, but to build a better relationship with how they navigate and manage life with chronic pain. So, we're looking at their relationship with pain and overall quality of life. Was there any improvement with that? And then of course the safety and efficacy of the study.”

And Sutton hopes that this pilot study of 10 participants will lead to something bigger.

“It's a feasibility study. We're taking this hypothesis, and we're testing it in a small group with the hope that we can conduct more research on a larger scale, and thus translate that into clinical practice.” 

A Variety of Tools

Paul says he has noticed a change in his stress levels and energy.

“I'm like, ‘Am I really noticing that much of a difference that fast?’” he reflects. “My pain levels have gone down from like a six to a two. … I'm sleeping seven hours very easily. I'm in a deeper sleep. … I’m waking up with a lot of energy.”

And he’s even been able to use some of the relaxation techniques he’s learned instead of taking pain medication. 

“Through all the different techniques I've learned, I don't need it. When I feel that pain going across my shoulders or down my spine or my lower back or even on my leg, I'll just do a nervous system reset, and it's been working,” he says.

Elizabeth says learning so many different forms of meditation has been very helpful. 

“I might have known a bit of here and there, but to be very thoughtful, if I'm in pain, let me try this. And finding out which things work for me,” she explains. “Each class was a focus on a different way of meditating. I've known my whole life, ‘Oh, meditation is good,’ and I’d try it, and my mind gets too busy somewhere, and I just haven't been able to meditate. So, learning which ways to meditate has been so important — which ones work for me.”

“It's been very rewarding to hear the feedback and watch what tools they use,” Sutton says. “What we teach is that there's no right or wrong. It's a personal practice, and what's important is that they are making the space to carve out that time for themselves and to use whatever feels best for them in the moment.”

Paul also appreciates having a variety of tools to try. 

“I've used every single technique, and I found it very beneficial. It's a
healing of the soul, in my opinion,” Paul says. “I feel like when you're doing these things, you find yourself, you really get in touch with yourself, with your body, and it's been refreshing.”

Elizabeth says her daughter has noticed how she’s becoming more of her old self again, getting out, reconnecting with friends and family, and engaging in life.

“It's just progress every day,” Elizabeth says. “It has been life changing.” 

If you’d like to find out more about research at Shepherd Center, visit https://shepherd.org/research/redefining-rehab/find-studies/

Written by Ruth Underwood
 

 “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."

But psychological testing doesn’t always ensure fair and accurate results, especially for racially diverse patients.

“The primary issue is that most psychological tests were developed and normed on Caucasian populations, so they don’t really apply as well to non-Caucasians,” says Brick Johnstone, Ph.D., the O.Wayne Rollins Director of Brain Injury Research at Shepherd Center.

So, Johnstone, along with other researchers, worked on a study to show another way of evaluating patients, without relying on normed data. The study was published in the January 2026 edition of the journal Brain Injury. Working with the study’s lead author, Gary James, Ph.D., Johnstone and other researchers developed a method of evaluating patients’ severity of brain injury based on the individual’s estimated level of function pre-injury (such as their own reading score), rather than comparing results to normed data (i.e., a potentially inappropriate reference group).

Shepherd Pathways rehabilitation counselor Tim Riggins, LCSW, and brain injury research program manager Nicole Thompson, MPH, also worked on the study. Using data from 239 patients with brain injuries at Shepherd, the study examined the team’s method of neuropsychological evaluation. White patients and Black patients differed on some of the absolute scores (e.g.,IQ, memory, attention), but the study shows that when comparing someone’s post-injury function to their pre-injury function, the results were similar across the board (i.e., White and Black individuals had similar rates of mild, moderate, and severe impairment).

“These results further support the fact that people of different racial backgrounds — they all experience brain injury in a similar manner,” Johnstone says. “So, we’re really trying to indicate that there are different ways to look at data, to interpret it, and we think this is the most appropriate way to do it fairly.”

Riggins says that while neuropsychological testing doesn’t stand alone in the rehabilitation process, it can inform the treatment opportunities a patient receives. As a rehabilitation counselor, Riggins supports patients in managing the personal, social, and psychological effects of their brain injury on their goals of returning to employment, school, or independent living.

“When it comes to return to work potential, [patients] go through neuropsych testing to assess their readiness for return to work and potential accommodations that are necessary,” he says. “So, the outcomes of the testing directly influence their goals for their recovery ...[and] if they're not able to return to work, if the report doesn't support disability, it could make it more difficult for them to receive benefits they need to support themselves.”

Riggins says the research results were validating, acknowledging that while racial bias is often present in traditional testing, there are different ways to evaluate patients in order to help them achieve better outcomes. That philosophy — helping patients achieve the best possible recovery — drives much of brain injury research at Shepherd, Johnstone says.

“Our brain injury research is really focused on improving community outcomes. We want to make sure that the services we provide, the research we do, is helping people successfully reintegrate into their community or to get jobs ... we're just trying to help all of our patients from many diverse backgrounds.”

Written by Erin Kenney

Interested in participating in research at Shepherd Center? Find actively recruiting studies here.

VALENCIA, Calif., April 30, 2026 – SetPoint Medical, a medical technology company dedicated to improving care for people living with chronic autoimmune diseases, today announced that it has initiated enrollment in the pilot clinical study evaluating Setpoint System® as a potential pro-remyelination therapy for adults living with relapsing-remitting multiple sclerosis (RRMS). The study received Investigational Device Exemption (IDE) approval from the U.S. Food and Drug Administration (FDA) to evaluate SetPoint Medical’s proprietary neuroimmune modulation device. Additionally, the neuroimmune modulation device has received Breakthrough Device Designation and was accepted into the Total Product Life Cycle (TPCL) Advisory Program (TAP) by the FDA.

The primary purpose of this multicenter, randomized, sham-controlled, double-blind pilot study is to assess the safety and remyelinating effects of the SetPoint System as an adjunct to standard-of-care disease-modifying therapy (DMT) in adults with RRMS. The SetPoint System contains a miniaturized neurostimulator that is surgically implanted on the left vagus nerve and delivers electric stimulation to the nerve for one minute, once per day. The study will enroll up to 60 participants across the United States, with primary outcomes assessed at one year.

The study has enrolled patients at Shepherd Center’s Andrew C. Carlos Multiple Sclerosis Institute in Atlanta and UW Medicine Multiple Sclerosis Center in Seattle. Other centers participating in the study include Minnesota Center for Multiple Sclerosis in Plymouth, Minnesota; West Virginia University in Morgantown, West Virginia; Johns Hopkins University in Baltimore; UT Medicine Multiple Sclerosis and Neuroimmunology Center in Austin, Texas; and University of Texas Health Science Center in Houston.

“Remyelination is one of the most critical yet unmet clinical needs in the treatment of multiple sclerosis,” said Jacqueline Rosenthal, M.D., medical director of the MS Institute and principal investigator of the study at Shepherd Center, where the first patient was enrolled. “While current therapies focus largely on suppressing inflammation, restoring the damaged myelin sheath is essential for preserving neuronal function and preventing long-term disability. Neuroimmune modulation is hypothesized to recalibrate immune activity while supporting the conditions necessary for myelin repair, and offers an innovative avenue to evaluate whether meaningful remyelination can be achieved in patients living with MS.”

Multiple sclerosis affects nearly one million people in the United States and is an autoimmune disorder that damages the myelin sheath — the protective layer surrounding nerve fibers — disrupting signals between the brain and other parts of the body.

“Reaching this milestone of implanting the first patients in this RRMS pilot study is a meaningful step forward for us,” said David Chernoff, M.D., chief medical officer of SetPoint Medical. “Our approach to activating the body’s innate neuroimmune pathways offers a compelling and novel mechanism that could complement current standards of care of multiple sclerosis. We are deeply grateful to the investigators and patients participating in this study.”

For more information about the RRMS pilot study, visit clinicaltrials.gov (NCT06796504).

About SetPoint System
The SetPoint System is indicated for use in the treatment of adult patients with moderately to severely active rheumatoid arthritis (RA) who have had an inadequate response, loss of response, or intolerance to one or more biological or targeted synthetic disease modifying antirheumatic drugs. The use of SetPoint System for the treatment of multiple sclerosis is not approved, is considered investigational, and its safety and effectiveness for this indication have not been established. For full safety information, please see Instructions for Use and our Important Safety Information at spm.care/ISI.  Individual results may vary.

About SetPoint Medical
SetPoint Medical is a commercial-stage medical technology company dedicated to improving care for people living with chronic autoimmune diseases. The company’s FDA-approved SetPoint System is the first neuroimmune modulation therapy available for people living with rheumatoid arthritis (RA), offering a novel, device-based alternative for those who do not respond to or cannot tolerate biologic or targeted drug therapies. SetPoint’s proprietary integrated neurostimulation platform is designed to activate innate anti-inflammatory pathways in the vagus nerve to reduce inflammation and restore immunologic setpoint. With a vision to redefine the care of autoimmune conditions, SetPoint is also planning to evaluate its platform technology for other conditions including multiple sclerosis and Crohn’s disease. Learn more at setpointmedical.com.

Dr. Jacqueline Rosenthal is a study investigator for SetPoint Medical and has not been compensated in connection with this press release.

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.

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

McDonald’s kiosk design, developed in collaboration with Shepherd to make ordering easier for people who use wheelchairs and scooters, also makes the touch-screen menu reachable for little princesses and princes. Sasha Elizabeth’s mother, Sharon, says she noticed the accessibility prompt on the kiosk immediately. “And that’s a good thing,” she says. 

The McDonald’s connection is just one of many relationships between Shepherd Center’s Accessibility User Research Collective (AURC) and numerous name-brand corporations, including Samsung, Microsoft, Nike, Intel, LinkedIn, Roku, and the Tinder dating app. 

The AURC connects companies with consumers who live with various disabilities and who can provide feedback about products and services. The network of more than 1,500 consumers is not restricted to people who have conditions specific to Shepherd Center’s patient population. It also includes individuals with low vision, hearing loss, attention deficit disorder, autism, dyslexia, and other conditions. Their observations lead to improvements in accessibility that can benefit everyone.

The AURC research team works with companies to design studies, recruit participants, and collect and analyze results. When Microsoft wanted to develop a new process for providing testing accommodations, for instance, it turned to the AURC. Each time the company wanted to update the material, the AURC was there to advise. 

“Shepherd’s imprimatur provides confidence to research participants and AURC corporate partners that studies will be conducted with rigor and professionalism,” says AURC director John Morris, Ph.D., FACRM. 

The AURC was formally established in 2017, building on years of work providing research services to corporate partners. This work grew out of federally funded grants to support development of new assistive technology under the leadership of Mike Jones, founding director of Shepherd’s Virginia C. Crawford Research Institute and retired vice president of research and technology of Shepherd Center. 

Although much of the AURC’s work is proprietary and confidential, some businesses promote their Shepherd connection. Samsung, for instance, has regularly featured its partnership with the AURC and Shepherd Center at industry conferences and the company’s own events.

“The AURC provides an opportunity for us to help mainstream companies build better products,” says Ben Lippincott, project manager and consumer engagement strategist.

“We’ve done work for some big, big companies whose products touch the lives of literally tens of millions, even hundreds of millions of people,” says Delaney Cowart, AURC program manager. Sasha Elizabeth, leaving McDonald’s with drink in one hand and her mother’s hand in the other, is one of them.

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. 

Healthcare is constantly changing,” says Shari McDowell, PT, DPT, FASIA, Shepherd Center's chief operating officer. “If you’re still doing the same thing you were doing five years ago, you’re behind. You have to adapt. But technology and innovation for the sake of technology and innovation is not what it’s about. It has to make a difference in patients’ lives. We give our staff a lot of autonomy to be smart, and we don’t have a lot of bureaucracy here, so we’re able to move things forward pretty quickly when we have an idea. Most of our best ideas come from line staff, not managers. They’re in the trenches, and they’re really creative about what they do.”

Integrating research and technology into clinical practice — and sharing information freely with other institutions — ensures that more people benefit from every advance made. “Our research culture at Shepherd was consciously developed,” says Deborah Backus, PT, Ph.D., FACRM, who is vice president of research and innovation. “We weren’t setting out to make everybody a researcher, but we wanted everybody to understand the research process and help inform it—maybe bring us questions or know how to use evidence in a meaningful way.”

The result is that clinical staff are more fully invested in Shepherd’s research initiatives, and researchers are more attuned to patients’ needs. A sampling of recent or ongoing projects shows the breadth of Shepherd’s research. In spinal cord injury research, Edelle Field-Fote, PT, Ph.D., FAPTA, FASIA, leads the Hulse Spinal Cord Injury Lab and a team working on augmentation, combining strategies to modulate what’s happening in the nervous system to help it respond better to interventions. In brain injury research, George “Brick” Johnstone, Ph.D., ABPP, and his team are focusing on the patient’s return to employment, as well as the impact of spirituality on recovery. Through the SHARE Military Initiative, researchers are looking at ways to help manage substance abuse among veterans. “There’s some very exciting work there,” Dr. Backus says.

Shepherd is at the forefront of multiple sclerosis rehabilitation and wellness research, led by Brad Willingham, Ph.D., who is working on exercise interventions as well as the use of telehealth and remote monitoring. The findings will benefit not just people with multiple sclerosis, but patients in all Shepherd programs and beyond.

In addition, a team of specialists regularly lead clinical trials of pharmaceuticals and medical devices either to receive Food and Drug Administration approval or demonstrate market potential. These efforts, led by Ismari “Issi” Clesson, RN, BSN, CCRP, CIP, have included drugs that have revolutionized multiple sclerosis treatment over the past two decades and enabled people with multiple sclerosis to be healthier for longer.

Artificial intelligence (AI) offers exciting opportunities to build on what Shepherd already does well. With 25 years of solid data on patients, Shepherd researchers want to explore the use of pragmatic trials rather than randomized control trials (RCTs), which have long been the industry standard. In RCTs, data is gathered from an intervention group and a control group, and then comparisons are made. But, because the sample groups are small, it takes a lot of RCTs to reach broad conclusions.

“In pragmatic trials, information is collected as part of the regular clinical process, anonymized to protect patient privacy, and then added to our database,” Dr. Backus says. “With AI tools, we’ll be able to work through our data more efficiently and do more predictive analysis. We will be able to say, ‘OK, based on the thousands of patients who came before, this is what we think will work best for this patient.’ That may help them get better faster, maybe help them return to work or their lifestyle faster, give them a better quality of life, and decrease overall healthcare expenses. That would be the ultimate goal.”

The Cox Innovation Institute is designed to enable the team at Shepherd to be more effective and efficient in delivering individualized solutions for patients and increasing accessibility to world-class care and will include a wellness and telehealth suite, along with a fully equipped motion analysis lab, with the newest technologies to collect data on people’s cognitive and behavioral status.

In addition to more space for research, the Innovation Institute in the Marcus Center for Advanced Rehabilitation will have a smart tech hub where Shepherd can work with people with disabilities, industry partners, technology developers, data scientists, clinicians, and researchers to identify the most meaningful problems and solutions. “We’ll expand our 3D printing lab,” Dr. Backus says. “People can learn how to use 3D printing and come up with some of the tools they need in their everyday lives that otherwise would not be affordable.”

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. 

People who have multiple sclerosis (MS) often experience fatigue and reduced mobility. Measuring walking is part of MS care, but it can be extremely challenging to measure  walking  in everyday life.

So, a Shepherd Center research project is exploring new technology that can measure walking outside the clinic. At Shepherd Center's Andrew C. Carlos Multiple Sclerosis Institute, they’re using “smart socks” equipped with sensors, developed by Sensoria Health. The socks send important information to a patient’s healthcare provider – in real time.

Enter Georgia Research Alliance (GRA) Student Scholar Victory: In a clinical lab, she ensured the smart socks functioned as they should. She also helped process and analyze the data.

“And there was a LOT of data. It was especially enlightening to see how the smart socks data compared to how patients viewed their experiences walking. In some cases, the two measures were completely different." Victory says.

Early in her Georgia Tech career – Victory is a biology major – she was drawn to lab research. Particularly the kind involving patients. The GRA Student Scholar program gave her the chance to try out research, and in a clinical setting.

“I took a leap of faith when applying to become a GRA Student Scholar. I was amazed when I got the acceptance letter.”

 Victory was one of the first GRA Student Scholars to spend an entire academic year in the lab. And Shepherd Center kept her on for another two semesters!

 “I’d never thought about how people experience clinical studies. I came to understand that their participation in clinical research could really help them in the long run. And it could help others, too.”

September was officially recognized as Spinal Cord Injury Awareness Month just over a decade ago, so what better time to look at research advances over the past 10 years and promising avenues for the future? To learn more about spinal cord injury (SCI) rehabilitation research at Shepherd Center and advances in SCI research in general, we caught up with Edelle Field-Fote, PT, PhD, FAPTA, FASIA, director, Spinal Cord Injury Research and The Hulse SCI Research Laboratory at Shepherd Center.

Can you tell us about the focus of your research in the Hulse SCI Research Lab?

The field of SCI research can be divided into two paths. First, there's work focused on repairing the spinal cord, and second, there’s work focused on trying to reorganize the spinal cord so it can be more functional despite the damage. This second path is where the work of the Hulse SCI Research Lab is focused. Based on the research that is currently available, the best way to help the spinal cord reorganize in a way that allows people to move better is rehabilitation. Our studies compare rehabilitation approaches to determine which ones are most useful. We also study ways to amplify the effects of training using electrical and mechanical stimulation. This approach is called “neuromodulation,” where we use stimulation to activate the same circuits that are activated by training.

How has the approach to electrical stimulation evolved over the last decade?

One type of neuromodulation, transcutaneous spinal stimulation, is currently a top focus of the Hulse SCI Research Lab. There has been a lot of attention to this approach in recent years, and our lab has been a leader in these publications and advancements. We use stimulation over the spinal column to activate spinal circuits in a way that can make it easier for someone to move. So, when someone has even a little bit of voluntary movement, if you combine that with transcutaneous spinal stimulation, they can get more movement from the same amount of effort. Also, spasticity is a big problem for some people with SCI, and we are investigating the best transcutaneous spinal stimulation approaches to help manage spasticity.

What about research focusing on the repair of the spinal cord?

Beyond the research being done in my lab, Shepherd has a phenomenal clinical trials team. The clinical trials team works with outside investigators who want Shepherd to help them with research studies focused on the repair of the spinal cord. Most of the time, these involve recruiting research participants who have recently sustained an SCI, which we call the acute phase of injury. However, there have been times when outside investigators have partnered with Shepherd’s clinical trials team on repair strategies for participants with chronic SCI. 

What are other aspects of the mission of the Hulse SCI Research Laboratory?

In addition to research, the Hulse SCI Research Lab is very involved in training rehabilitation scientists. Training is integral to what we do because we need the next generation to pick up the baton and continue advancing research. Currently, we have three research scientists who joined the Hulse SCI Research Lab as scientific trainees. Jennifer Iddings, Ph.D., and Anastasia Zarkou, PT, Ph.D., completed their postdoctoral training with me, and Nick Evans, Ph.D., completed his Ph.D. training with me. While trainees generally move to another institution after their training, Shepherd is such a great environment that all three of them have stayed on as research scientists and are now submitting their own grants. In addition to our three research scientists, we have two PhD students, both of whom have clinical doctorates in physical therapy, Evan Sandler, PT, DPT, and Jake Creech, PT, DPT.

What are some other advancements in SCI research, and what are the challenges?

Stem Cells.

Stem cells are exciting because they have the opportunity to replace damaged cells, but there are some significant limitations. First, if you want to replace neurons, the cells that are implanted have to live, grow, and develop connections with other cells. Most of the time, the goal is to get the cells to cross the injury site and make connections with cells below the injury.  To date, no scientists have been able to accomplish this. So, there are a lot of steps that have to be successfully completed for stem cells to be useful, and this has been a real scientific challenge for many reasons.  

Brain-Computer Interfaces.

There is a lot of exciting work going on with brain-computer interfaces or BCI. Current work is centered on people with tetraplegia who are unable to move their hands and arms. The devices record brain signals and, with training, allow people to control a device like a computer cursor or a robotic arm using their brain signals. Other researchers are using brain signals to control stimulators that can activate muscles so people can use their hands and arms. This work is still in its early stages, but I can imagine that someday, it might be used to stimulate muscles in the arm to allow reaching and grasping for activities of daily living.

Exoskeletons for walking.

Exoskeletons for walking have come a long way. Shepherd was very involved in the development of the Indego exoskeleton device. One of the challenges that still needs to be addressed is the development of exoskeletons that can balance by themselves. This is important both to reduce the risk of falling while in the device and to eliminate the need to use crutches for balance so that the hands can be free. My vision for where it could eventually go is something like what we saw in the character RoboCop, where the person can strap themselves into the device and use the brain-computer interfaces we talked about earlier to control it — so the person thinks about walking and signals from the brain send commands to the exoskeleton.

How is Shepherd Center uniquely positioned to advance SCI research?

We have research in so many avenues. The Hulse SCI Research Lab team’s neuromodulation research has immediate applications for clinical practice. Our clinical trials team is involved in repair research that may have future potential. Importantly, we also have valuable device-related studies and interventions through Shepherd’s Center for Assistive Technologies.

One recent initiative that I’m especially excited about is SCI Ventures, for which Shepherd Center is a founding partner. This is an angel investment fund that was established to support the most promising SCI research around the world. They are taking a high-level view of the research and determining what approaches are most likely to have true value for people with SCI. They invest in these companies to help them reach the next level. For all the reasons I talked about earlier, Shepherd is very well-positioned to be part of the most promising research that comes out of this initiative.

How can people get involved?

People with spinal cord injuries who volunteer to be research participants are an important part of our study team. They help us answer questions that can affect the types of treatments available for people with SCI. We are so grateful to our participants because we couldn't do it without them — they're essential to the success of the studies in the Hulse SCI Research Lab.  There are opportunities to volunteer, so I encourage folks to visit Shepherd’s Research web pages at shepherd.org/research to learn about our studies.

Interview by Ruth Underwood

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

• Helius Medical and Shepherd Center partner on a study that aims at rehabilitating walking mobility in people recovering from stroke 
• Shepherd Center, a top neurorehabilitation hospital, is the third site in the registrational program in stroke
• The single-arm study will evaluate the Portable Neuromodulation Stimulator (PoNS®) in treating gait and balance deficits in chronic stroke survivors 
• Regulatory submission and marketing authorization for stroke expected in 2025

Helius Medical Technologies, Inc. (Nasdaq:HSDT) (“Helius” or the “Company”), a neurotech company focused on delivering a novel therapeutic neuromodulation approach for balance and gait deficits, today announced the expansion of its registrational program in stroke with the participation of Shepherd Center, under the direction of Michael Yochelson, M.D., MBA, FAAN, FAAPMR, chief medical officer. Shepherd Center joins Brooks Rehabilitation as a second site to the company-sponsored single-arm clinical study. As one of the nation’s top neurorehabilitation hospitals, Shepherd Center is known for its innovation, patient outcomes exceeding national averages, and expertise in providing world-class clinical care for people experiencing the most complex conditions, including stroke, spinal cord and brain injuries, multi-trauma, traumatic amputations, multiple sclerosis, and pain.

The study aims to evaluate the benefit of PoNS Therapy^® in treating gait and balance deficits in chronic stroke survivors. Shepherd Center has been an impactful participant in the PoNS Therapeutic Experience Program (“PoNSTEP”), a company-sponsored outcome research clinical trial designed to evaluate the impact of subjects’ adherence to PoNS Therapy in people with multiple sclerosis (MS), a trial led by Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation.

“Shepherd Center has been a valuable partner to Helius for almost two years. We are delighted Dr. Yochelson has agreed to contribute to the implementation of our registrational program and undertake the study at Shepherd Center,” said Antonella Favit-Van Pelt, M.D., Ph.D., Helius' chief medical officer. “Shepherd Center’s earlier involvement with the MS program is a testament to the strength of our clinical program. Dr. Backus and her research team have significantly contributed to further demonstrate PoNS Therapy’s ability to induce significant and clinically meaningful improvements in gait rehabilitation. Clinical evidence with PoNS Therapy in stroke patients, has led to a new indication for gait in Canada as well as highlighted the importance of this therapy in reducing the risk of falling in stroke survivors with gait and/or balance deficits. This study, as part of the broader registrational program, is an important step forward toward obtaining authorization in the U.S.”

“Innovation is at the core of what we do, and strategic collaboration is critical to advancing rehabilitation medicine and discovering better, more effective ways to deliver care,” said Dr. Backus. “From my experience with the therapy, PoNS has the potential to improve the lives of patients suffering from MS, and we believe it can have a meaningful therapeutic effect on chronic stroke survivors as well. I’m excited to bring this innovative treatment to Shepherd Center, where we take a patient-centric approach designed to promote the highest level of functioning possible.”

With recruitment starting in May 2024, Dr. Yochelson anticipates enrolling approximately 8-10 participants into the trial by the end of the year.

MS is a neurological disorder that can lead to significant mobility impairments. For example, people with MS often experience muscle weakness, spasticity, balance impairments, and fatigue, which may impair walking ability and can lead to an increased risk of falls. In fact, studies report that 50-70% of people with MS experience at least one fall over a six-month period. The consequences of falls can be significant, including physical injury, fear, and reduced independence.

“The current tools we have available to measure disability and walking function can only be used in the clinic,” says Brad Willingham, Ph.D., director of MS research at Shepherd Center's Virginia C. Crawford Research Institute. “This makes it difficult to measure changes that occur in patients between visits to the clinic, and it can take several months or years to detect changes in mobility associated with the progression of disability.”

To solve this challenge, Shepherd Center is partnering with Sensoria Health, a preeminent developer of innovative smart garments, software, and wearable systems, to develop and apply new technologies to advance the precision of care for people with MS.

“There are many wearable sensors on the market today that have greatly expanded our ability to evaluate patients in the home and the community,” Davide Vigano, Sensoria Health CEO and co-founder says, “What makes Sensoria’s approach to wearables particularly innovative and useful is the integration of microelectronics and textile sensors into comfortable garments and footwear such as shirts, socks, and other accessories that we wear every day. Our approach offers a truly wearable solution that seamlessly incorporates health monitoring technology into our everyday lives.”

Sensoria Health’s smart textile technology enables more accurate and precise measurement by allowing sensors to be placed nearly anywhere on the body. For example, Sensoria Health has recently created a system that measures walking function using smart socks that are infused with proprietary textile pressure sensors. These smart socks communicate wirelessly to a custom-developed mobile application, Sensoria® Walk, designed to measure gait impairments. While Sensoria smart socks feel and fit like regular socks, they can measure walking patterns in great detail and automatically send information to healthcare professionals via a privacy-compliant cloud software system.

“Measuring walking patterns, or gait, is an important part of assessing clinical disability in people with MS, but this measurement has been historically limited to in-clinic measurements that require direct supervision or the use of large, expensive equipment,” Willingham says. “Our partnership with Sensoria Health is focused on exploring how to leverage cutting-edge sensor technology, such as smart socks, to expand clinical evaluation into daily life. Such advancements may lead to more responsive treatment strategies and new scientific discoveries related to how MS impacts walking in real-world environments.”

In a research study recently published in Brain Injury, researchers from Shepherd Center’s mTBI Brain Health & Recovery Lab aimed to gain an understanding of evaluation practices, post-injury recommendations, and referrals to allied healthcare professionals by first-line healthcare professionals providing care for people with mild traumatic brain injuries (mTBI).

First-line healthcare professionals are often the first to diagnose and provide supportive care to children and adults with mTBI. While many people experiencing mTBI will recover within a few weeks or months without specialty care, others will continue to experience challenges with dizziness, balance, memory, visual perception, and sleep, among other disruptive symptoms.

“When a person has a prolonged recovery after a mild brain injury or concussion, they can benefit from a multidisciplinary approach involving specialized expertise of allied professionals,” said Tracey Wallace, MS, CCC-SLP, FACRM, projects and education coordinator for the SHARE Military Initiative at Shepherd Center and principal investigator of the study. “Our study showed that these professionals are often highly underutilized among family health practitioners for the management of mild traumatic brain injuries, which include concussions.”

The study consisted of an online survey completed by 126 first-line healthcare professionals, including physicians, physician assistants, nurses, nurse practitioners, and athletic trainers, on their practices related to mTBI evaluation, management, and referrals to allied health professionals. For the purposes of this study, allied health professionals included physical therapists, occupational therapists, speech-language pathologists, and behavioral health professionals such as neuropsychologists or counselors.

Reported rates of referrals to allied health professionals by first-line healthcare professionals were extremely low, as was the perceived knowledge of the roles allied health professionals can play in mTBI rehabilitation.

“Our findings suggest a need for collaboration across disciplines on research, education, and rehabilitation efforts to best care for people with mTBI,” Wallace said. “Programs like Shepherd Center’s Complex Concussion Clinic and SHARE Military Initiative pull experts from multiple allied health professions to care for patients who experience persistent symptoms after mTBI so they can return to their activities and enjoy life again.”

Shepherd Center researchers Tracey Wallace, MS, CCC-SLP, Amber Schwartz, MHS, OTR/L, CDRS, April Hodge, PT, DPT, NCS, Greg Brown, Psy.D., Russell Gore, M.D., collaborated with researchers Kelly Knollman-Porter Ph.D., CCC-SLP, and Jennifer Beardslee of Miami University, and Jessica Brown, Ph.D., CCC-SLP of Olentangy Schools.

Learn more about mild brain injury research at Shepherd Center.

In December 2023, Brad Willingham, Ph.D., a clinical research scientist at Shepherd Center's Virginia C. Crawford Research Institute, was named one of the International Progressive MS Alliance’s Innovations in Well-Being Award recipients. The highly competitive award funds the first phase of a large-scale program of research to identify and implement solutions to some of the most challenging symptoms that people with progressive MS experience, with the potential for further funding based on results to be reported in mid-2025.

Dr. Willingham is using data collected from wearable sensors to allow clinicians to monitor symptoms in people with progressive multiple sclerosis. Clinicians can use the data to improve treatment plans for patients remotely, in real-time.  

“All of our educational resources feature evidence-based guidance, but that’s not all we showcase,” says Diane Johnston, MSPT, director of professional education at Shepherd Center. “We also share how we collaborate across our different disciplines to create a unified, patient-centric focus in all we do because working with our patients is what creates the best possible outcomes.”

As of 2023, more than 9,000 healthcare professionals worldwide, including from 35 countries, have participated in proctored webinars, live virtual events, and online education courses hosted on the Institute’s site.

Christopher Hairie, PT, DPT, MBA, is the lead therapist of inpatient rehabilitation services at Atrium Health Navicent in Macon, Georgia. He’s one of the many clinicians who regularly use Shepherd Center’s resources for continuing education support.

Each quarter, Dr. Hairie picks a new webinar topic from the NRLI, reserves a room at his hospital, and invites staff therapists to come together and discuss what they learn.

“We’ve been doing this over three years now, and it’s such a helpful resource,” Dr. Hairie says. “We typically have 10-20 therapists attend each time, both established and new graduate therapists. They get some continuing education hours and gain new knowledge they can apply in their work.”

Most recently, he presented his staff with a bladder training course from Shepherd Center’s NRLI catalog.

“In an acute care setting like ours, we typically haven’t done bladder training,” Dr. Hairie says. “But we have patients staying longer in our hospital, and we have patients who don’t have the resources to get that training elsewhere. So, we’re having to do that more often here. That’s something that just wasn’t in our knowledge base before, so going through Shepherd Center’s course was hugely beneficial.”

The NRLI can benefit Shepherd Center patients, too, when they return to their hometowns after discharge.

“The NRLI allows us to influence the quality of care and provide guidance to other medical professionals who treat similar patient populations,” Johnston says. “Sometimes, that can include our former patients who need ongoing, locally based care back home. We’re building relationships with clinicians across the country, so when they have questions, they know they can come to us.”

Written by Phillip Jordan

Dr. Conklin was five years old when she, her brother, and her parents left their home in Guangzhou, China, to move to the United States. The family settled in Boston’s tight-knit Chinatown community, where most neighbors, shopkeepers, and family doctors could speak the Pan family’s Cantonese. While her parents never became proficient in English, Dr. Conklin did. As she grew older, she became her parents’ liaison to Western medicine when they were referred to specialists beyond Chinatown’s borders.

“What I noticed, even at that age, was that my parents were uncomfortable and hesitant about going to Western-style doctors,” Dr. Conklin recalls. “I think what it came down to was they just had very different understandings of what health is, what illness means — what symptoms can represent and how they can best be treated.

“They thought the tenets of traditional Chinese medicine matched their values and beliefs. Western medicine did not. So, when they needed specialized care, there was always this fundamental mismatch that put a barrier between them and the doctors — and the care they needed. And often, Western practitioners didn’t understand or appreciate my parents’ perspectives or the family dynamics at play.”

Those experiences stayed with Dr. Conklin as she grew older. They led to questions that guided her academic journey and professional career as a scientist-practitioner in neuropsychology. Those questions eventually led Dr. Conklin to create a research proposal at Shepherd Center exploring how culture impacts the rehabilitation and recovery of Asian people and Asian Americans following traumatic injury and illness. In the fall of 2022, she received a prestigious Switzer Research Fellowship for her work, one of just eight awarded nationwide.

Dr. Conklin’s research is both vital and timely. Asian Americans have some of the lowest service-seeking care rates in the U.S. and, simultaneously, are the fastest-growing ethnic group in the U.S. — yet one of the least studied.

“At its heart,” Dr. Conklin says, “this work was intended to make space for, and capture the stories of, patients and families at Shepherd Center who fit this identity and want to share what their experiences have been like navigating medical systems after their injury or illness.”

Dr. Conklin went into the research wondering if she would get more stories similar to her parents’. What she discovered was a much broader, more complex range of lived experiences, especially among younger generations of immigrants. Similar to Dr. Conklin’s parents, some families found comfort in receiving care from Asian or Asian American providers; others, more acclimated to American culture, had more nuanced concerns. Many families wanted to learn how to take care of their loved ones as quickly as possible — sometimes to help preserve their family member’s dignity and privacy when it came to more intimate care.

One of the most impactful findings was about the importance of Asian American family structures, where each family member often has a specific role  — and the disruption and guilt that can affect those family dynamics when a traumatic injury requires extended rehabilitation. Many patients Dr. Conklin interviewed worried they were weighing their families down instead of helping carry them forward.

“Now, we’re hoping to identify and understand the common elements of these family stories so that we can sharpen our skills as providers and offer more customized treatments for these families,” Dr. Conklin shares. “The goal is higher levels of care engagement and treatment adherence — sticking with the care they need.”

She cites the culture of learning and humility at Shepherd Center as a driver for constantly improving approaches to care.

“The nature of our work requires us to be curious,” Dr. Conklin says. “The best clinicians are the ones who have research questions, who want to better understand why we do what we do — and the way we do it. How we interact with patients, develop treatment plans, and prepare patients to return home.

“Asking questions is what allows Shepherd Center clinicians to be exceptional at what they do. You’re always thinking, ‘How do we do this better? How do we keep improving?"

Written by Phillip Jordan

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.

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.

The resulting items are the product of an innovative collaboration between Shepherd Center and Georgia Tech which is funded by a grant from the Craig H. Neilsen Foundation and led by Stephen Sprigle, Ph.D., PT, professor of bioengineering, industrial design, and mechanical engineering at Georgia Institute of Technology, director of Georgia Tech’s Rehabilitation Engineering and Applied Research Lab (REARLab), and director of assistive technology research and innovation at Shepherd Center.

To develop the challenges, Dr. Sprigle collects ideas from Shepherd patients and staff, including the Assistive Technology Center. He then presents teams of Georgia Tech seniors with challenges for their Capstone Design course. The students work with Shepherd patients and therapists to develop, test, and refine potential solutions to the challenges. One team created a roll-on tire scrubber to clean wheelchair tires, another, a hook and bag for adaptive cornhole, and a third, a postural support system for airline travel.

Throughout the semester, Dr. Sprigle coaches his students on everything from choosing a feasible project to time management. He also reminds them to seek simple solutions first.

“I tell students that if you get to a fork in the road and have simplicity or complexity, always start with simplicity. Prove that you have to go complex — don’t assume that you do,” he explains.

The 15-week course culminates with a design expo for students to present their solutions to attendees – but this summer, the hard work didn’t end there. Funding from the Craig H. Neilsen Foundation and the office of Georgia Tech’s Executive Vice President for Research allowed graduate students in the REARLab to assess how their products could help more people. 

“We wanted to figure out how to make these designs more available, and that could involve finding a manufacturer and a distributor. Not all these functional one-offs will graduate, but we're focusing on the process,” Dr. Sprigle explains.

Taylor Allen and Xavier Simonelli, graduate research assistants in the REARLab, spent their summer refining some of the prototypes and trying different production techniques to improve the final product while making it easier and more cost-effective to produce.

“We're taking these functional prototypes and investigating different manufacturing methods to figure out how to bring these assistive technology devices to market,” Simonelli explains.

Allen and Simonelli also researched whether similar products already exist to fill a need. For example, when they developed a deodorant holder, they found that an existing water bottle holder had many of the characteristics of the prototype and could double as a deodorant holder.

“Although we did design a nice deodorant holder, we found a similar product on the market that does exactly what we're trying to do, so there's no real value in making a small batch of this product. We posted our instructions on how to fabricate it on Instructables, so if anybody wants to make it, they can,” Allen explains.

They didn’t find products similar to the adaptive cornhole hook, so they sent prototypes to rehabilitation centers, including Shepherd, and plan to gather feedback from patients and staff.

“I'm happy that we collaborate with Shepherd because there's an endless number of ideas they bring us. It keeps us creative and happy to try something new,” Allen says.

According to Dr. Sprigle, the products are important, but equally important is the process, which involves input from Shepherd patients, expertise from Shepherd clinicians, and expertise from Georgia Tech students and faculty.

“We attend to market —how many people might this help?” Dr. Sprigle says. “The market analysis might involve interviewing the client who got the product and the clinicians involved. We deal with the technical side, the functional characteristics of the device, and the manufacturing.”

Even if the conclusion is that it doesn’t make sense to produce the product on a larger scale, the information gleaned is valuable.

“This is about developing an approach, a process,” Dr. Sprigle says.

Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation at Shepherd is enthusiastic about the future of this program and what it will bring to Shepherd Center.

“I am so excited about strengthening our collaboration with Dr. Sprigle and Georgia Tech,” Dr. Backus says. “Through these projects, we are learning what we need to do to not only design and develop new, innovative solutions for the people we serve, but also how to bring these solutions to market for others who might need them.”

Written by Ruth Underwood.

After graduating from high school, he attended and graduated from the University of Alabama. Aric continued his journey at Shepherd Center, where he discovered a new passion – adaptive water skiing. The sport allowed him to maintain an active lifestyle while connecting with others who shared his determination to overcome challenges. When he retired from waterskiing, Aric missed the physical activity and camaraderie of participating in a competitive sport. That's when he learned about Shepherd Center's Project Workout on Wheels Internet Intervention (WOWii).

“Since retiring from skiing, I felt myself getting lazy for lack of a better word,” Aric laughs. “I learned about the WOWii program at Shepherd Center and knew I had to join.”

Upon joining the program, Aric discovered he could modify workouts to suit his needs.

“I was pleasantly surprised at how easy it was to adapt some exercises from the fitness subscription I already had,” Aric says. “That was one of the biggest factors for me. I wanted to be open, be held accountable, and learn something new. It has really helped and energized me.”

But WOWii offered more than just a workout. Aric found a supportive network of peers and mentors, all facing similar challenges but determined to push forward together. The program became a platform for personal growth and creating a fulfilling and balanced lifestyle.

“It’s education to get stronger, reduce swelling, get cardio, negotiate priorities, and face obstacles. We work through common problems together,” Aric explains. “We’re all different ages, and we all have spinal cord injuries. We are all in the same boat.”

As Aric's WOWii journey nears its end, he reflects on the valuable lessons he has learned during this transformative experience.

“It’s not just physical, it’s mental,” he says. “It’s okay if you can’t work out one day. Just don’t let it get you down. I think the WOWii program is something everyone can learn and benefit from.”

Written by Lindsey Rieben.

The next Project WOWii group begins this October. If you are interested in signing up and learning more like Aric did, contact our clinical research coordinator, Amber Lopez, at Amber.Lopez@Shepherd.org or 404-350-7656 for more information. The deadline to sign up is September 1.

“You have people who understand where you’re coming from and your obstacles,” Katie explains. “As much as you love your family and friends, they can’t fully understand what you’re going through like someone with a spinal cord injury can.”

When Katie recently moved to Flowery Branch, Georgia, she had a difficult time finding the same feeling of connection. Then, she enrolled in Shepherd Center’s Project WOWii, a research study that examines how valuable and effective an online format is for helping individuals with spinal cord injuries stay active.

“One of the biggest reasons I wanted to start is because the older you get, the more bad habits can get in your way,” Katie says. “I found myself not having energy. Transfers are hard. This program made sense to be able to help me make a good lifestyle change.”

As Katie logged on to her first WOWii meeting, she was not sure what to expect, but she knew it would be beneficial. Equipped with her provided TheraBand and hand bike, she was prepared for her instructors to prescribe a list of mandatory exercises but was pleasantly surprised to find a personalized experience.  

“The cool thing is there is no set of exercises you’re given,” Katie recalls. They give you the tools, you find what works for you, and then we come together and talk about it. Some of the things people have shown me have been incredible. I thought, ‘How have I not thought about this for the past 30 years?’”

In the nine weeks since her program began, Katie has worked hard to meet her exercise goals, sneaking in 30 minutes of cardio on her hand bike before her morning coffee. Along with renewed energy and feeling physically healthier, Katie has finally found the community of spinal cord injury support she had been looking for.

“It’s gone beyond the exercise,” Katie says. “It’s really in the camaraderie. Being about to bounce ideas off people who understand and get their suggestions is priceless.  I’ve been lacking that for the past 10 years in Georgia.”

As Katie’s program ends, she is looking for new ways to raise awareness for Project WOWii.

“The important thing for me is getting people to know this program is out there,” Katie says. Even if you have a busy schedule, you can still do this program. It sounds overwhelming to fit in 150 minutes of exercise a week. It’s actually been super easy. Thirty minutes Monday through Friday, and you’ll feel 1000 times better doing it.”

Written by Lindsey Rieben.

If you’re interested in participating in our next Project WOWii group, please review the eligibility requirements on our website and contact Amber Lopez at amber.lopez@shepherd.org or by phone at 404-350-7656.

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

In 2021, one such solution took shape when Shepherd Center announced its partnership with Burnalong, a digital health solution offering live and on-demand health and wellness content. The hospital and online wellness platform are collaborating to create and distribute world-class, specialty programming that makes wellness accessible to all.

“As a non-disabled person, you can go online or choose any gym you want. The same is not necessarily true for those with disabilities,” says Deborah Backus, PT, Ph.D., FACRM, Shepherd Center vice president of research and innovation. “This partnership came from a desire to offer people choices while providing expertise, support, and community aspects as well.”

Burnalong is designed to meet users where they are by featuring more than 30,000 classes, including yoga, exercise, and financial wellness courses 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 Burnalong CEO Daniel Freedman. “You can do classes alone or with others, whether friends, family members, or people at a similar stage of life as you so you can find kindred spirits and social motivation.”

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.

Meg Stevenson is a physical therapist at Shepherd Center’s SHARE Military Initiative, a comprehensive rehabilitation program that delivers world-class treatment at no cost to veterans, service members, and first responders who are dealing with traumatic brain injuries (TBI) and mental health concerns. Every other Thursday, she leads a gentle yoga livestream class on the Burnalong platform. Her patients log on from home to attend the live class, which helps them stay in shape mentally and physically while also connecting with each other.

“Clients really enjoy being able to stay in touch with me,” she says. “We end up doing 45-50 minutes of yoga because we spend 15 minutes catching up. I think they honestly enjoy that piece as much as the yoga.”

Although not all of Stevenson’s SHARE clients can attend the live stream, they can access all the recorded classes on demand.

“I’ve recorded several guided meditation sessions,” Stevenson says. “They’ve been a game changer. I have one client that was so blown away by his experience, he uses it two to four times per night to help him sleep.”

All of Shepherd Center’s virtual fitness and wellness classes can be prescribed by rehabilitation experts to patients once they return home.

“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. Our hope is that 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 a multiple sclerosis (MS) study to better understand the program's benefits and if it changes a participant’s quality of life. If you are interested in participating in MS research, click here.

“We are incredibly grateful for Shepherd Center and their shared mission and values,” Freedman says. “We’re excited to explore new areas and bring on new content and programs, and together make an impact globally with Shepherd Center.  

Written by Lindsey Rieben

Shepherd Center has joined Helius Medical Technologies, Inc.’s Therapeutic Experience Program (TEP). The Atlanta-based neurorehabilitation hospital joins NYU Langone Health and the MGH Institute of Health Professions as the third Center of Excellence in this Helius-sponsored open-label observational trial designed to evaluate the impact of participants’ adherence to Portable Neuromodulation Stimulator (PoNS) therapy in patients with multiple sclerosis (MS). Led at Shepherd Center by Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation and director of multiple sclerosis research at the Virginia C. Crawford Research Institute at Shepherd Center, the collaboration aims to bring additional therapies to people with MS.

“Our Therapeutic Experience Program enables clinicians to evaluate the effectiveness of PoNS therapy for people with MS who have gait deficit in a real-world environment while providing important information about PoNS therapy to key opinion leaders in MS management.”, said Antonella Favit-Van Pelt, M.D., Ph.D., Helius' chief Medical officer. “The Virginia C. Crawford Research Institute at Shepherd Center is an important partner to the TEP, and we are thrilled with Dr. Backus’s contribution to our efforts of bringing innovative therapies to people with MS. Shepherd Center is one of the top 10 rehabilitation hospitals in the United States with a world-renowned Multiple Sclerosis Institute and integrated research program, and we look forward to a long-standing collaboration.” 

“Shepherd Center is dedicated to improving the function, health, and quality of life in all people with MS. We are excited to partner with Helius on this important study,” said Dr. Backus. “People with MS often have decreased mobility, leading to more disability and less participation in daily life activities. We believe PoNS therapy can be an effective therapeutic option for our patients.”

About the Therapeutic Experience Program

The Therapeutic Experience Program (“TEP”) is a Helius-sponsored, open label observational, interventional multi-center outcome research trial designed to assess adherence to on-label PoNS therapy for improvement in gait deficits for patients with multiple sclerosis (“MS”) in a real-world clinical setting. The study will rate subjects’ adherence to PoNS therapy, which combines the PoNS device with physical therapy, to better understand the relationship between adherence to the treatment regimen and therapeutic functional outcome. The primary endpoint of the study is maintenance of gait improvement from the end of supervised therapy (Phase 1) to the end of unsupervised therapy (Phase 2) in relation to the subject’s adherence to PoNS therapy. The secondary endpoint is improvement of gait and balance deficit over time and clinical global impression of change.

The study will be conducted at 10 to 12 Centers of Excellence across the United States, with an estimated four PoNS devices per site. Enrollment is expected to begin in the second quarter of 2022 and continue through late 2022. A total of 40 to 50 patients with MS are expected to take part in the program.

About the PoNS Device and PoNS Therapy

The Portable Neuromodulation Stimulator (PoNS) is an innovative non-surgical medical device, inclusive of a controller and mouthpiece, which delivers electrical stimulation to the surface of the tongue to improve balance and gait. The PoNS device is indicated for use in the United States as a short-term treatment of gait deficit due to mild-to-moderate symptoms from multiple sclerosis (“MS”) and is to be used as an adjunct to a supervised therapeutic exercise program in patients 22 years of age and over by prescription only. Helius is advancing PoNS post-approval research in MS through a recently launched Therapeutic Experience Program (TEP) designed to partner with neurologists and neurorehabilitation therapists at 10-12 US centers of excellence, who express an interest in becoming “early adopters” of PoNS therapy.

PoNS is also authorized for sale in Canada for two indications: (i) for use as a short-term treatment (14 weeks) of chronic balance deficit due to mild-to-moderate traumatic brain injury (“mmTBI”) and is to be used in conjunction with physical therapy; and (ii) for use as a short term treatment (14 weeks) of gait deficit due to mild and moderate symptoms from MS and is to be used in conjunction with physical therapy. PoNS is also authorized for sale in Australia for short-term use by healthcare professionals as an adjunct to a therapeutic exercise program to improve balance and gait.

About Helius Medical Technologies, Inc.

Helius Medical Technologies is a leading neurotech company in the medical device field focused on neurologic deficits using non-implantable platform technologies that amplify the brain’s ability to compensate and promotes neuroplasticity, aiming to improve the lives of people dealing with neurologic diseases. The Company’s first commercial product is the Portable Neuromodulation Stimulator (PoNS). For more information, visit heliusmedical.com.

“At Shepherd Center, we innovate to transform patient care at our hospital and around the world,” says Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation at Shepherd Center. “One way we do that is by encouraging employees to think outside of the box, whether that be using existing assistive technology in new ways or creating unique solutions to meet patients’ needs.”

In 2019, Shepherd Center did just that by becoming the host of the Atlanta Chapter of Makers Making Change (MMC), an organization that connects people with disabilities to volunteer makers who build affordable assistive technologies. Kristen Webber, MOT, OTR/L, BCPR, ATP, is a former Shepherd Center therapy manager who started the chapter, which now has 16 staff members from various backgrounds and disciplines, along with numerous outside volunteers. Webber passed the reins of the Atlanta Chapter over in October 2021 to Jasmin Brumby Smith, MOT, OTR/L, an occupational therapist in Shepherd’s Inpatient Spinal Cord Injury Rehabilitation Program, who will continue this exciting work.

In early 2021, the Atlanta Chapter of MMC hosted a virtual meeting where Webber spoke about using 3D printing to create assistive devices for patients. Emily Buchman, OTD, OTR/L, clinical assistant professor at Georgia State University and assistant director of the Doctor of Occupational Therapy (OTD) program, was one of the attendees.

“After the meeting, I chatted with Kristen about a joint project we could do that would combine academics and clinical practice,” Dr. Buchman explains. “We agreed to do a pilot study evaluating the effectiveness of using 3D-printed assistive devices for clients with disabilities, both in helping meet the clients’ needs and in providing OT students with real-world experience working with clients.” 

Students were divided into three groups, each with one client. Clients were patients at Shepherd Center who had sustained spinal cord injuries. The students consulted with the patients via telehealth sessions.

After sustaining a C-5 level spinal cord injury, one of the patients who Webber contacted to participate came to Shepherd Center for rehabilitation from January through July 2021. In the early days after his injury, he did not have the hand strength to clean his dentures independently and needed a denture cup to assist him. The 3D printer study offered a perfect opportunity to create one.

“The process working with the students was easy,” he says. “I only had to give them feedback to modify the denture cup once before it worked. It was good to give creative input that would help both of us. They got help practicing working with patients, and I got something that would help me day-to-day.”

Since then, the client's hand strength has improved, and he does not need the assistive device anymore.

“You always hope people will grow out of needing assistive technology as they progress in their rehabilitation,” Webber says. “It’s great that he doesn’t need the device anymore, and I’m glad we were able to help him get to that point.”

The students agree. As one student explained in their feedback of the course, “It was great to work with an actual client and see the impact the devices we made for them had on their functional ability!”

After the success of this pilot, the Atlanta Chapter of MMC is considering plans for even more extensive programming using 3D printers. The group partnered with the Georgia Rehabilitation Services Volunteer Partnership (RSVP), a free clinic hosted at Shepherd Center that provides outpatient rehabilitation care for people who are uninsured who have spinal cord injuries and/or brain injuries, including stroke.

Dr. Backus adds, “Innovative strategies like 3D printing have a lot of potential in rehabilitation, and Shepherd Center is uniquely positioned to test the possibilities. I look forward to continuing to explore this space.”

For more information on Shepherd Center’s research and innovation efforts, visit shepherd.org/research. To learn about Makers Making Change, visit makersmakingchange.com.

By Damjana Alverson

Deborah Backus, PT, Ph.D., FACRM, vice president of research and innovation at Shepherd Center, recently joined the board of trustees for the Georgia Research Alliance (GRA). This nonprofit organization brings together Georgia's research universities, business community and state government to create opportunities to grow Georgia's economy through scientific discovery.

As a grant-funded researcher, physical therapist and educator, Backus comes to the board of trustees with more than 35 years of experience in the neurorehabilitation field. Her research has been funded by the National Institutes of Health (NIH), the National Institute on Disability Independent Living and Rehabilitation Research (NIDILRR), the Patient-Centered Outcomes Research Institute (PCORI) and the National MS Society.

“I am honored to serve on the Board of Trustees for the Georgia Research Alliance,” Backus said. “GRA has been instrumental in establishing Georgia as a center of discovery and invention, and I look forward to working with my colleagues to further bolster research, science and innovation in Georgia and beyond.”

Backus is known for her innovative approaches to facilitating clinician involvement in research activities, translating meaningful evidence into practice, progressing technology uptake into clinical programs and incorporating standardized outcome assessment into routine clinical practice to better guide clinical care. In addition to serving on the GRA board, Dr. Backus is the immediate past president of the American Congress of Rehabilitation Medicine (ACRM) and serves as one of the founding editors for the Archives of Rehabilitation Research & Clinical Translation. In addition to serving as vice president of research and innovation at Shepherd Center, she is the director of MS research at Shepherd Center and of Shepherd Center’s Virginia C. Crawford Research Institute.

Established in 1996, Shepherd Center’s Virginia C. Crawford Research Institute is an internationally recognized neurological and neuromuscular research center. Researchers conduct federal- and industry-sponsored clinical studies in collaboration with leading experts at other hospitals, research centers, medical schools, and universities worldwide. Research activities primarily focus on spinal cord injury, brain injury, multiple sclerosis and neuromuscular disorders. 

Since 2016, Shepherd Center, an Atlanta-based neurorehabilitation hospital, has received more than $25,000,000 in extramural funding and another $300,000 from industry partners related to innovation. In 2021, Shepherd Center received approximately $1,000,000 generated from industry-sponsored trials. At any given time, Shepherd Center has approximately 20 active grants and 75 active research projects involving hundreds of participants with spinal cord injury, brain injury, MS and related conditions. You can learn more about research at Shepherd Center here. 

GRA, which expands research and commercialization capacity in Georgia’s universities to launch new companies, create high-value jobs and transform lives, appointed 10 new members, including Backus, to serve three-year terms and two new ex-officio members at a January 20, 2022 meeting. The Board of Trustees serves as the governing body of GRA and generates outside support for the organization.

About ONWARD

ONWARD is a medical technology company creating innovative therapies to restore movement, independence, and health in people with spinal cord injury. ONWARD’s work builds on more than a decade of basic science and preclinical research conducted at the world’s leading neuroscience laboratories. ONWARD’s ARC Therapy, which can be delivered by implantable (ARC^IM) or external (ARC^EX) systems, is designed to deliver targeted, programmed stimulation of the spinal cord to restore movement and other functions in people with spinal cord injury, ultimately improving their quality of life. ONWARD has received three Breakthrough Device Designations from the FDA encompassing both ARC^IM and ARC^EX. The company’s first FDA pivotal trial, called Up-LIFT, commenced in January 2021 and has now completed enrollment with 65 subjects worldwide.

ONWARD is headquartered at the High Tech Campus in Eindhoven, the Netherlands. It maintains an office at the EPFL Innovation Park in Lausanne, Switzerland and has a growing U.S. presence in Boston, Massachusetts, USA. For additional information about the company, please visit ONWD.com.

When the COVID-19 pandemic hit, SHARE, a comprehensive program that treats post-9/11 service members and veterans with traumatic brain injuries (TBI) and any co-occurring psychological or behavioral health concerns, was one of several outpatient programs to shut down to reduce the risk of spreading the virus.

Staff members sprung to action to continue to meet the needs of their SHARE clients, and within four weeks, SHARE began operating as a remote telemedicine program, with therapy sessions offered to SHARE clients virtually. Once COVID-19 testing was in place, a small group returned to the hospital, enabling the SHARE staff to switch to a hybrid model where clients spent a week at Shepherd Center and then returned to their homes to complete virtual treatment.

“We were forced to innovate using existing technology to offer speech, occupational and other therapies over a telemedicine platform,” says Russell Gore, M.D., medical director of SHARE. “As a treatment program we learned a lot from that effort. Now, we want to test the effectiveness of the hybrid treatment model.”

WWP’s funding will cover the cost of growing and assessing hybrid treatment, including a new neuropsychology research fellow, who will develop research protocols, collect and analyze data, and conduct literature reviews.

“We believe that no one organization can solve the significant challenges that wounded veterans face,” says WWP CEO Lt. Gen. (Ret.) Mike Linnington. “The investments we make into brain health research and partner organizations like Shepherd Center’s SHARE Military Initiative are critical to building strong, resilient veteran families and communities.”

“We are grateful for their support,” adds Jon Roxland, senior director of philanthropy and partnerships at Shepherd Center. “Any time we can partner with a leading organization like Wounded Warrior Project, it increases the credibility and visibility of our program.”

This two-year research study will look at two groups of 30 clients each (one group per year) and compare their outcomes with those who only did in-person therapy. Along with Dr. Gore, Brick Johnstone, Ph.D., ABPP, Shepherd Center’s O. Wayne Rollins Director of Brain Injury Research, will oversee the study. Jessica Pan Conklin, Ph.D., recently accepted the position of research fellow.

“This is an opportunity to gauge how hybrid care can affect patient outcomes,” Dr. Gore says. “We hope it will be equivalent at the very least. If we can establish that certain variables predict a better outcome with in-person versus hybrid care, we can make recommendations supported by our data.”

The researchers also hope to demonstrate how the hybrid model can improve access to care. While SHARE has the flexibility to create programs of varying lengths to meet individual clients’ needs, because of work and family commitments, it may not be feasible for clients to travel to Shepherd Center for treatment. With the hybrid model, SHARE can accommodate a greater number of clients, often regardless of their geographic location.

Because of the nature of SHARE clients’ injuries, they benefit greatly from being around each other, which is why the program is using a hybrid model combining telemedicine and in-person care.

“SHARE clients have complex histories and complex injuries,” Dr. Johnstone says. “They need to be here with other veterans, but if we can demonstrate they also benefit from telemedicine, it provides us with more options.”

The research also has implications for other similar programs across the country.

“SHARE has a reputation for effective, innovative clinical treatments for putting veterans’ needs first,” Dr. Johnstone says. “We can do more because we have a larger program. If we show the effectiveness of a hybrid model, it could be used in other places.”

To learn more about the SHARE Military Initiative, visit shepherd.org/share.

Written by Sara Baxter

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

It was diving that stuck. After being accepted to the biomedical engineering program at Georgia Tech, she made the diving team.

“I was so grateful to make the team,” Jordyn says. “I could transfer skills I learned in gymnastics like flipping and twisting into a new sport!”

Never one to shy away from a challenge, Jordyn pursued school and sport with determination. During a diving practice in the spring semester of her sophomore year, she jumped from the diving platform and, as Jordyn puts it, “hit the water wrong.”

“I got really nauseous, had trouble with lights and sounds, and couldn’t hold a conversation,” Jordyn recalls.

Jordyn had sustained a concussion. As her symptoms persisted, she decided to sit out of competitive diving until the end of that season. A study-abroad trip that summer gave her a break and time to recover. She returned to diving in the fall of her junior year, ready to start anew, but unfortunately, she would meet a similar fate.

“It was right before Thanksgiving in 2018,” Jordyn says. “I hit the water wrong again and was not feeling well. I had some trouble with visual tracking with my eyes, some vestibular symptoms and headaches that persisted too long. This is when I decided to go to the Complex Concussion Clinic.”

Shepherd Center’s Complex Concussion Clinic (CCC) serves patients ages 12 and up who are experiencing symptoms from a concussion or mild brain injury. Typically, concussions resolve within a week or two as headaches and other symptoms subside, but about 20% of cases present a more complex scenario with complications that fall beyond the scope of primary care physicians. In Jordyn’s case, she needed specialized care to handle the lingering symptoms she experienced.

“I received therapy for about two and a half months in early 2019,” Jordyn says. “I would go twice a week every week – once for physical therapy and the other for occupational therapy. They worked on tackling both my visual tracking and balance issues.”

At first, Jordyn had doubts about whether she was overthinking her symptoms. The results from her testing helped provide clarity.

“It’s like a light bulb went off,” Jordyn says. “They printed out my testing results and talked me through them. Now, I could understand my symptoms and have a plan of action to address them. By the time my treatments were done, I was feeling good, and my symptoms subsided.”

Jordyn was able to finish out her diving career at school by slowly easing back into it.

“I took a semester off from diving to pursue a co-op working on medical devices with Johnson & Johnson for my major,” Jordyn says. “When I came back, I wasn’t sure how my diving would be, so I got back into it slowly. I ended up having the best season of my career!”

She has also funneled her experience with concussion into several worthy pursuits. For her capstone project in biomedical engineering, she was accepted to a special project for the U.S. Army Rangers.

“Broadly, the project’s goal was to help mitigate traumatic brain injury among the Rangers,” Jordyn says. “I thought, hey, I have some familiarity with mild concussions, so that inspired me. It was nice to relate to the Rangers with my experience and work on how I can help service members prevent injury.”

Jordyn also became involved with Shepherd Center again, not as a patient, but as a mentor through the hospital’s SUCCESS program. SUCCESS, or Success in College after Concussion with Effective Student Supports, is a research and development project to develop a peer mentoring program for college students recovering from concussions. The program pairs newly injured college students (mentees) with students who have sustained concussions and successfully recovered like Jordyn.

“It’s been so rewarding to turn a negative of getting two concussions into a positive by mentoring,” Jordyn says. “I know I would have enjoyed having someone to talk to during that time in my life.”

Jordyn graduated from Georgia Tech in December 2020. Now, she’s pursuing her next challenge — hiking the entire 2,190-mile Appalachian Trail for six months.

“At first, I thought, oh, maybe I’m crazy!” Jordyn says jokingly. “But the more I looked into it, the more I fell in love with the challenge. I want to take time to enjoy every moment and every day.”

Written by Damjana Alverson

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. 

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.”

“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 or perform other day-to-day activities,” said Edelle Field-Fote, PT, PhD, FAPTA, FASIA, co-PI of the Up-LIFT trial and Director of Spinal Cord Injury Research and Professor of Rehabilitation Medicine at Emory University School of Medicine.

“The start of this trial marks a significant milestone in bringing non-invasive stimulation to people living with spinal cord injury, whose top priority is restoring hand and arm function,” said Chet Moritz, PhD, co-PI of the Up-LIFT trial and Associate Professor in the Departments of Electrical & Computer Engineering and Rehabilitation Medicine at the University of Washington in Seattle. ONWARD plans to enroll 65 subjects at up to 15 sites in the United States, Canada, UK, and Europe.

A study recently published by Chet Moritz and researchers at the University of Washington in Transactions on Neural Systems and Rehabilitation Engineering, a journal of the IEEE, the world’s largest technical professional organization for the advancement of technology, demonstrated ONWARD’s transcutaneous spinal cord stimulation leads to both rapid and sustained recovery of hand and arm function for people with both motor complete and incomplete cervical SCI. These findings further support the potential for non-invasive spinal cord stimulation technology in restoring hand and arm function in this population.

“The initiation of the Up-LIFT trial is an important first step toward delivering meaningful solutions to people living with the effects of spinal cord injury,” said Dave Marver, Chief Executive Officer of ONWARD. “We are deeply committed to our vision to use breakthrough science and pioneering technology to help the spinal cord injury community.”

An arc occurs when an electrical impulse bridges the gap between two conductors. ARC Therapy is designed to re-establish severed connections between spared neural networks and the brain by means of specific, targeted spinal cord stimulation.

To learn more about ONWARD’s ARC therapy technology and mission to restore movement, independence and health in people with spinal cord injury, please visit the newly launched ONWD.com.

CONTACTS

For general inquiries, please contact:

info@onwd.com

For media inquiries, please contact:

Laura Vinci, Finn Partners

laura.vinci@finnpartners.com

+14024998203

About ONWARD

ONWARD (@onwdempowered), formerly known as GTX Medical, is a medical technology company focused on the development and commercialization of innovative therapies to facilitate functional recovery of people with spinal cord injury. Driven by a mission to restore movement, independence, and health in people with spinal cord injury, ONWARD’s work builds on more than a decade of basic science and preclinical research conducted at the world’s leading neuroscience laboratories. ONWARD’s ARC Therapy, which can be delivered by implantable (ARC^IM) or external (ARC^EX) systems, is designed to deliver targeted, programmed stimulation of the spinal cord to restore movement and other functions in people with spinal cord injury, ultimately improving their quality of life. Both of ONWARD’s technology platforms have been awarded Breakthrough Device Designation by the FDA.

ONWARD is headquartered at the High Tech Campus in Eindhoven, the Netherlands and the EPFL Innovation Park in Lausanne, Switzerland, with a growing U.S. presence in Boston, Massachusetts, USA. For additional information about the company, please visit ONWD.com and follow us on Twitter and LinkedIn.

To better understand what exercise options are the safest and most effective for people with MS, Supervised versus Telerehab Exercise Program for People with MS (STEP for MS), a four-year study funded by the Patient-Centered Outcomes Research Institute (PCORI), was launched in 2017. Researchers from several sites, led by Deborah Backus, PT, Ph.D., director of multiple sclerosis (MS) research at Shepherd Center, and Robert Motl, Ph.D., a professor at the University of Alabama at Birmingham, hope to use findings from the study to develop tools and information for people with MS, caregivers, community providers, insurers and policymakers about different modes of exercise interventions to help them make educated choices.

STEP for MS will compare the outcomes of a 16-week exercise program conducted at home (“telerehab”) to a program conducted in a gym (“facility-based”). The exercise protocol in both programs is exactly the same; the only difference is where people will exercise.

In order to do this important work, researchers need volunteers who meet certain qualifications to participate in the study. Participating in a study like this may seem like a daunting task. To demystify the process, two former participants shared their experiences. Paul Fleming, 53, participated in the telerehab arm of the study while Christina Thompson, 36, participated in the exercise facility-based arm. You can learn more about the study and qualifications to participate on the STEP for MS website.

When were you diagnosed with MS?

Paul: I was diagnosed in 2004. I went to a neurologist because I was having seizures and didn’t realize it. They happened a couple of times a day and would last five to 10 seconds. My entire left side would just turn off. I was referred to Shepherd Center and have been under Dr. Ben Thrower’s care. I come to Shepherd Center two times per year now for infusions.

Christina: I was diagnosed in February 2018 after I started to have trouble walking and urinating. After being misdiagnosed a few times with UTI’s and bacterial infections, I finally went to my regular internist; she was the first one to say the words multiple sclerosis. I woke up the day I was scheduled to get an MRI unable to feel the right side of my body or see out of my right eye. After several hours in the ER, an MRI, blood work and a spinal tap, my MS diagnosis was confirmed. I now receive an Ocrevus® infusion every six months and have started to feel like my old self again.

How did you find out about the STEP for MS study?

Paul: I got a call from Erica Sutton at Shepherd Center and she asked if I wanted to participate. I told her I did and came in to do the evaluation. I participated in the study from August to September 2019.

Christina: I received a letter from my insurance company that mentioned the study, so I asked my doctor about it. He was very supportive and suggested I give it a shot. I used to run and exercise on a regular basis, but it’s been hard since my diagnosis. It’s hard even walking a mile without my legs getting tingly and numb. I submitted my name, took the survey and ended up participating in the study from October 2019 to January 2020.

Why did you sign up for the study?

Paul: A lot of times with MS, you can back slide. They caught me at the right time because I wasn’t exercising like I should be, and my MS was coming out of remission. Continuing to push to exercise through this study helped me.

Christina: I signed up for two reasons:

1. I wanted to contribute more to the MS community. I participated in Walk MS the past two years and donated money, but I wanted to do more. This is my way of helping.
2. I hadn’t been able to really exercise in almost two years. I don’t know if it was out of fear of falling or a lack of confidence. I thought this study could be an incentive to get me active because it was for a good reason – to help the MS community.

What was that like to participate in the study?

Paul: It was easy to sign up. You go into Shepherd Center and get evaluated. I was there a total of about three hours and was assigned to the home-based study. You are mailed your kit with a DVD and exercise guide that has visuals of each activity you’ll be doing. The kit also had various exercise bands and a pedometer. Every couple of weeks, you increase the level of exercises you do.

I thought the support I got was really great. I had a team leader who would call me every couple of weeks to check in on me. Each week, I’d also do a short evaluation that I’d submit with my results. Even though you are doing the exercises at home, you don’t feel alone. I felt free to call my team leader or Shepherd’s research team.

Christina: Before you start, you’re invited to Shepherd Center to go over your history with MS, symptoms and medicines you are on with a member of Shepherd’s staff. I also did a walking test and filled out some survey questions. All-in-all it was pretty simple – they are not judging you at all, but just seeing if you are right for the study.

I was then assigned to the facility-based training. I met with my trainer and we worked out the times I was available to meet. The beginning was rough. I hadn’t exercised in so long; walking around work and running errands is a lot different from using a treadmill and body weight exercises. I was really sore after the first couple of sessions and couldn’t walk on the treadmill at first. It got easier over time to where I could walk 50 minutes on the treadmill at a 2.5 to 3 miles per hour speed followed by a session of body weight exercises.

Was it worthwhile to participate in the study?

Paul: People with MS go through a lot of emotional swings, and exercise breathes life back into your body because it gets your endorphins going and makes you remember that, “Hey, I’m still here.” The more you can do through a program like this, the better. For me, everything has gotten better, and I asked myself why I had stopped exercising in the first place.

Doing the research also helps the next group of people. Whatever struggle you may have, the findings from your study help the next set of individuals who come into the study. I want to make life easier for the person behind me.

Christina: Personally, it gave me back the support and confidence I needed to exercise again. People feel it’s intimidating to go into a gym. You can lack the confidence you need, especially if you have something like MS. By working out with trainers, I had people who understood what I was going through. That helps tremendously. I now try to exercise three times a week, doing 30-40 minutes of cardio and then some body weight exercises.

Since the beginning of the study to present date, I’ve lost almost 50 pounds! I had gained weight due to all the steroids I was taking, so losing it all, plus a little more, has definitely been an added benefit of the study. Learning to exercise again made me healthier in general which is especially important for MS patients.

I hope that the study has good results so that researchers can better understand what works well for patients and what doesn’t. I would love to participate in more studies.

Do you have any advice for someone who has recently been diagnosed with MS?

Paul: You’re definitely in the right place and right time with the advancement of medicine. Know that if you have the right doctor, that’s your security blanket. Being under Dr. Thrower’s care, there’s very little I have to worry about. Also, I’d say you should focus on moving forward and maintaining a healthy lifestyle and eating habits.

Christina: I know it sounds cliché, but don’t give up. I felt like crawling in a hole and giving up so many times, but I kept going. The advice I would give is to talk about it more. I made the mistake of not wanting to go to support groups or psychologists when I was first diagnosed. I had family and friends, and that’s great, but just recently I started talking to a professional, and it’s made a world of difference. My mom gave me this little plaque when I first got sick that says, “You never know how strong you are, until being strong is the only option you have.” That keeps me going.

Also, make sure you are happy with your doctor. This is something that’s not going away – it can get better if you treat it, but you need to find someone you trust with your health and more importantly, is your advocate for what you need while navigating the MS world.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence-based information needed to make better-informed healthcare decisions. This work was supported through a Patient-Centered Outcomes Research Institute (PCORI) Project Program Award (MS-1610-36999). For more information about PCORI’s funding, visit www.pcori.org. Click here to view an overview of the study.

Written by Damjana Alverson

“I am pleased to announce the appointment of Dr. Johnstone,” said Mike Jones, Ph.D., FACRM, vice president of research and technology at Shepherd Center. “He is an innovative, creative leader and shares our commitment to improving the care Shepherd provides to survivors of acquired brain injury.”

Prior to this role, Johnstone served as senior scientific director of the Defense and Veterans Brain Injury Center in Fort Belvoir, Virginia. He previously held multiple positions at the University of Missouri from 1990 to 2017, including professor and chair of the Department of Health Psychology and associate professor and director of neuropsychology in the Department of Physical Medicine and Rehabilitation.

Johnstone earned an M.S. in clinical psychology and a doctorate in child clinical psychology from the University of Georgia, after which he completed a neuropsychology postdoctoral fellowship at the University of Washington School of Medicine. He completed his undergraduate degree at Duke University.

Brains and brawn: how brain stimulation and task-related training may help people with SCI

While people are inpatients at Shepherd Center, they receive comprehensive care from a team of rehabilitation professionals. If the person has sustained an incomplete SCI and still has some movement in his/her legs, this care may include locomotor training to help improve and recover walking function and balance. Once a person finishes the rehabilitation program and returns home, it can understandably be difficult to continue the kind of training needed to maintain the gains made in therapy.

The SCI research team is analyzing a novel training approach that can be done in the home, which is intended to help people retain the gains they made during locomotor training after leaving Shepherd Center. The approach involves a circuit of six training activities, designed so that no special equipment is needed and focused specifically on the muscles that are important for walking. In the circuit, each of the six training activities are performed for one minute at a quick speed in order to increase heart rate. Activities that increase heart rate have been shown to improve the ability to learn a skill. Once all six circuit activities are completed, the circuit is repeated three more times.

The training activities are not the only novel part of the study. Participants in the clinical trial are randomly assigned to one of two groups. In addition to doing the circuit activities, half of the participants also receive brain stimulation called transcranial direct current stimulation (tDCS) where a continuous, low-intensity current is applied to the scalp over the area of the brain that controls movement in the leg muscles. The other group performs the same circuit activities, but without brain stimulation.

The brain areas controlling the muscles needed for walking are activated when a participant is performing the training activities regardless of whether or not the participant is receiving brain stimulation. The question that the SCI research team wants to answer is whether applying brain stimulation simultaneously with the training activities helps the brain become even better at controlling the muscles. The idea is that brain stimulation may make the brain better at sending information down the spinal cord so more information gets to the muscles, and this may improve walking function and balance even more than the training alone. Ultimately, the goal is that regardless of which group participants are in, the training activities will help retain or improve the gains they made during therapy at Shepherd Center.

Dr. Field-Fote hopes this approach proves to be effective so it can become part of standard rehabilitation practice.

“One of the hallmarks of Shepherd Center’s innovative research program is to focus on initiatives that are accessible, practical and founded in the latest science to improve function and quality of life,” said Dr. Field-Fote. “This particular study is the first of its kind to test whether a circuit of training activities without special equipment can help improve walking function. It is also the first to use a clinically available form of brain stimulation to improve walking function after an SCI.”

This clinical trial is funded by a federal grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) as part of the Spinal Cord Injury (SCI) Model Systems Program. Enrollment in the study is open through early 2021, at which point researchers will begin analyzing the data to determine the next phase of the research based on the results. If you would like to apply to participate in this or any of our studies for participants with SCI, click here to browse through the available options and contact the study coordinator of the study you are interested in for additional information.

Written by Damjana Alverson

After leaving the hospital, people with brain injuries still face an array of physical, cognitive and psychological challenges, such as dizziness, pain, weakness, loss of memory and concentration, depression, irritability and anxiety, all of which can impede recovery. Previous research has shown – and experts agree – that having a reliable and engaged caregiver is one of the most important factors in optimizing ABI recovery.

But caring for someone with an ABI requires a tremendous amount of time and energy, and without proper support or relief, caregivers may fall into a pattern of self-neglect and succumb to anger, depression, feelings of isolation, resentment and even illness. Studies have shown that failing to adequately support caregivers can lead to poorer outcomes for people with ABIs and their family members.

“Caregivers are often ill-equipped to meet challenges that arise when a person with an ABI moves from inpatient rehabilitation to the home,” says Mike Jones, Ph.D., vice president of clinical research and assistive technology at Shepherd Center, and founding director of the Center’s Virginia C. Crawford Research Institute. “Many rehabilitation centers that treat people recovering from ABIs are still struggling to find the most effective methods to support caregivers and help extend positive outcomes.”

As part of a three-year grant, Dr. Jones and his team will provide the first head-to-head comparison of two programs designed to support caregivers of people with ABI following discharge. The first program, Building Better Caregivers, was developed by Kate Lorig, Dr.P.H., and colleagues at Stanford University and provides group support facilitated by peer mentors. These peer mentors are volunteers who have been through the recovery process before and who can counsel new caregivers on how to cope with the many difficulties of taking care of people with ABIs. They will receive in-depth training and orientation to help them be effective sources of support. The second program, Problem Solving Training, provides individualized support by a clinician, usually a rehabilitation or family counselor. Both programs consist of six sessions, which can be attended in person or by phone/Skype.

Previous research has shown both programs can benefit people with ABI and their caregivers, but to date, there is no data showing the relative strengths and limitations of these programs, or which is the more effective method for different subgroups of patients and families.

To address this knowledge gap, researchers at Shepherd Center will compare the impact of these programs on: 1) caregiver burden and depression, 2) caregivers’ level of “self-efficacy” (confidence in their ability to provide and sustain care to their loved ones), and 3) healthcare utilization (e.g., the number of return hospital or doctor’s office visits during the first six months post-discharge). Dr. Jones notes that this initiative builds on Shepherd Center’s previous work with people with spinal cord injuries, which clearly demonstrated the benefits of peer-to-peer support.

Dr. Jones stresses that caregiver burden should be pre-emptively addressed soon after the injury. He and his team plan to identify what types of interventions can support family needs during the acute and post-acute stages of recovery – well before the patient is discharged to go home.

“We hope to find ways to intervene early to avoid or reduce the significant caregiver stress and burden that can lead to adverse outcomes for these individuals and their families,” Dr. Jones says.

The study is funded by a $600,000 grant recently awarded to Shepherd Center by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), and aligns with its efforts to improve the economic, social and health-related well-being of family caregivers of people with disabilities.

For more information, contact Mike Jones, Virginia C. Crawford Research Institute, Shepherd Center. Email: mike.jones@shepherd.org. Phone: 404-350-7595.

Written by Amanda Crowe, MA, MPH

Shepherd Center is playing a pioneering role in advancing such innovative mobile solutions through its App Factory – a tech development initiative that brings together rehabilitative medicine experts and app developers with the intended user – people living with disabilities – at the center of all efforts.

“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,” says Mike Jones, Ph.D., vice president of clinical research and assistive technology at Shepherd Center. “But amid the explosive growth of mobile healthcare apps, technologies must evolve and/or be adapted so that people with disabilities can use them.”

To date, more than 35 apps have emerged from the program with more than 850,000 downloads. Early efforts by Dr. Jones and his team have focused on developing app-based technologies to make specific mobile or wearable devices more useable and accessible to a person with a disability or limited dexterity.

The success of Shepherd Center’s App Factory has garnered national attention and was recently awarded a five-year $2.375 million grant from the National Institute of Disability, Independent Living and Rehabilitation Research in the U.S. Department of Health and Human Services.

The grant will allow the App Factory to develop, test and deploy several mobile health apps per year that target high-priority needs based on patient feedback and surveys. The goal is to create apps that can meaningfully help users better manage their health, improve function and quality of life. The hope, too, is that through the App Factory model, which typically doesn’t award funds until the app is available to the public, will generate some healthy competition among leading mobile app developers to assure their technology stays current.

“With the App Factory, we’ve opened it up to the whole market of app developers in the United States and Canada – academic centers, but also private businesses and tech start-ups, too,” Dr. Jones says. “They first must validate their idea and how their particular solution might work, conduct extensive user testing to demonstrate that it works and then publish it in the App Store or Android marketplace to demonstrate efficacy – that people have downloaded the app, are using it and that it’s meeting their needs.”

There will also be a central website with information about curated apps that are suitable for people with disabilities, as well as publications documenting the effectiveness of select mobile healthcare apps in improving functional outcomes.

Tracey Wallace, MS, CCC-SLP, project director of the App Factory and a speech pathologist at Shepherd Center, led the development of the BreatheWell Wear app, an Android Wear smartwatch app that provides discrete visual, tactile and auditory guidance to pace breathing for stress management, including showing users their heart rate in real time.

Thanks to user input into the design, the app allows users to play their own calming music, set multiple reminders to practice breathing and view a progress tracking screen that allows them to set a goal and monitor progress. The team behind developing the app hopes that a future version will also anticipate periods of higher stress and prompt users to breathe deeply to stem a panic attack.

“Everyone we’ve had test the app says they want to keep using it,” Wallace says. “It’s like having a personal breathing coach, and our patients tell us it really helps them – whether it’s overcoming fears of going places, managing anger or calming their anxiety.”

For more information on assistive technology research, click here.

Here are a few of the apps developed with support from the App Factory:

BreatheWell Wear

Assists with: managing stress through diaphragmatic breathing for people with mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD).

Available on: Google Play for Android Wear smartwatches.

When people endure stress, they experience the fight-or-flight response. Their heart rate increases and breathing becomes shallow, exacerbating anxiety. Slowing their breathing, particularly when exhaling, can help calm them. BreatheWell Wear assists the user in performing deep, slow, diaphragmatic breathing by providing visual and auditory guidance to pace breathing, including a display of the user’s heart rate in real time. It also provides the user with the option of listening to calming sounds and music or selecting a song from their own music library. BreatheWell Wear allows users to set reminders to practice during periods of low stress so they can perform the breathing technique effectively when they need it most.

BEST Suite

Assists with: energy/time management, task completion, goal setting and strategy management.

Available on: iOS devices and can be found in the App Store.

Brain Education Strategies & Technology (BEST) has developed a suite of four apps designed to help people with brain injuries and other cognitive challenges learn to optimize their energy, self-regulate behavior, set goals, track strategies, and get more done at home, school and work. The apps are integrated, allowing users to easily use the entire suite or use each app independently.

More information on the BEST Suite can be found on their website here.

SwapMyMood

Assists with: problem-solving and emotion regulation.

Available on: iOS devices and can be found in the App Store.

SwapMyMood was designed to assist people with brain injury in engaging in problem-solving and emotion regulation. The app is an electronic mobile version of evidence-based tools that were previously only available in paper format. SwapMyMood guides the user through the multiple steps involved in a problem-solving and emotion regulation intervention. Links to supportive resources and tips are integrated throughout, and effective, personalized interventions can be saved for reference in future situations.

The contents of this app are based on the Short-Term Executive Plus Intervention for Executive Dysfunction developed at the Brain Injury Research Center of Mount Sinai and funded by the Centers for Disease Control and Prevention (grant no.1R49CE001171-01).

Pow!r Mount Plus

Assists with: mobility impairments due to amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), spinal muscular atrophy (SMA) or high-level spinal cord injuries.

Available on: Google Play for the Android platform and supports devices on a Wink network.

The Pow!r Mount gives users the freedom and independence to position and interact with equipment such as speech devices, laptops, phones, cameras, tablets, hydration and suction equipment.

The Pow!r Mount Plus app adds home control capabilities to the Pow!r Mount app, enabling users to control smart devices in their home using their phone or tablet. Both apps can be controlled by directly touching the screen or using accessible switches plugged into the Pow!r Mount’s End Cap.

SpeakUp: An SPL Meter

Assists with: speaking volume.

Available on: Google Play for Android operating systems.

SpeakUp is designed for people that need assistance modulating or increasing their speaking volume. The target use population are pediatric patients that have difficulty modulating the volume of their voice and children who have difficulty using a loud voice. The adjustable nature of the application allows it to be used with adults, most notably those with Parkinson’s disease.

Speech2RTT Communicator

Assists with: non-verbal communication.

Available on: Google Play for Android operating systems.

Speech2RTT® is an Android application that enables people who are deaf, hard of hearing, and non-verbal to communicate with anyone using their Android smart phone or tablet. It works over cellular networks and for Wi-Fi calling.

The app captions and then streams the text of what is being said between individuals. If a user cannot speak, or opts not to speak, they can type what they want to say in real time.

Tetra Alarm

Assists with: reminders for people with spinal cord injury or other conditions or illnesses.

Available on: Google Play for Android devices.

Many people with spinal cord injuries (SCI) often have a tough time with the built-in alarm functions of a smartphone. Unfortunately, the app versions haven’t been much better. Designed for people with full manual ability, many apps are difficult to use for someone with limited dexterity.

Tetra Alarm is designed so you just need to select a box corresponding to a particular time. Tetra Alarm is not only a useful tool for people with SCI, but also for people who have other injuries or chronic illnesses that have affected their memory and cognitive function.

Tummy Time Fun

Assists with: encouraging young children to spend time in the prone position.

Available on: iOS devices and can be found in the App Store.

Tummy Time Fun (TTF) is an iOS app that can be used to encourage children to spend more time in the prone position, improving postural control. During tummy time sessions, a baby/child wears a small, lightweight electronic sensor between the shoulder blades, which measures the angle of the upper body relative to a horizontal, prone position. This sensor communicates wirelessly with the TTF app that is installed on a smartphone or tablet. When the child pushes up from prone so that the angle of his or her upper body is above a preset threshold level, the app activates music or video to motivate the child to remain in that position. For video feedback, the smartphone or tablet can be placed directly in front of the baby to be in the line of sight when he or she pushes up from prone.

This website contains more information, including an instructional video.

AccessLyve 

Assists with: providing real-time audio streaming for people who are blind, have low vision or are hard of hearing.

Available on: iOS devices and can be found in the App Store.

AccessLyve provides real-time audio streaming for people who are blind, have low vision or are hard of hearing.

Written by Amanda Crowe, MA, MPH

One viable solution is mobile rehabilitation, or mRehab, the delivery of services and support for home-based rehabilitation using innovative mobile information and digital health technologies. mRehab includes app-based therapy, sensor-based activity tracking and gamified exercises, and advanced monitoring that allows therapists to adjust treatments between outpatient visits. Dr. Jones and several collaborators recently received a multi-million dollar grant to develop and study mRehab solutions that optimize recovery. Researchers say a shift to this type of a model has the potential to transform and extend the rehabilitation care patients receive in clinic.

Dr. Jones explains that while most people with health insurance have a defined outpatient rehabilitation benefit, many plans impose limits. For example, someone may only get 12 outpatient visits, regardless of how serious their condition or injury.

“If we do it right, mRehab could address key challenges of access and affordability of rehabilitation services for people with disabilities,” Dr. Jones says. “Ultimately, we want better outcomes and practical solutions to make outpatient visits more efficient and to support ongoing care after someone’s reimbursed visits run out.”

How? For starters, mRehab interventions:

• Use remote sensor technology to gather real-time data to gauge if and how well a patient is doing their exercises instead of relying on their own assessment and recall during clinic visits;
• Present data to the patient and clinician in an actionable manner;
• Allow the clinician to adapt and tailor prescribed home-based therapy in between visits to make sure patients are maximizing their recovery and progression of exercises; and
• Often marry rehabilitation and gaming to engage and motivate patients to stick with their therapy.

“It’s a new era for rehabilitative medicine,” Dr. Jones says. “We will now be able to send people home with instructions and instrumented exercise equipment that can actually measure and monitor what they are doing at home and, in some cases, adjust exercises as they go. The hope is that by using mRehab, defining new algorithms and predictive management tools, patients can get the most mileage out of their rehab visits.”

As part of the $4.5 million five-year grant, the Rehabilitation Engineering Research Center on ICT Access for Mobile Rehabilitation (mRehab RERC) at Shepherd Center will complete nine research projects to help advance the mRehab field and test how these technologies can be seamlessly embedded into practice. Central to their efforts will be to create a central repository – what researchers are calling a big data lake – that will fold in historic data from 500,000 

individuals, as well as new data from patients across three centers.

Applying “Big Data” analytic methods, researchers will be able to look for trends and gain insights into:

• The factors associated with or predictive of successful outcomes;
• How to best tailor strategies to improve exercise adherence, engagement and outcomes by patient type; and
• What algorithms can help optimize patients’ progress based on tracking their participation and performance at home.

The idea for the Center came after Dr. Jones invited David Reinkensmeyer, Ph.D., a professor of engineering and neuroscience at the University of California at Irvine, to visit Shepherd and speak about his research. Dr. Reinkensmeyer and his former graduate students are the brains behind two popular neurorehabilitation devices commercialized by their start-up company FlintRehab Devices:

• MusicGlove, a sensorized glove and Guitar Hero-style video game that allows wearers, often stroke survivors, to perform hand and finger exercises to music to regain movement; and
• FitMi, a program that uses two sensorized pucks that can be held or set on a table in front of a mobile device to direct various exercises that are tailored to a patient’s function and recovery. The app adjusts what the patient is doing in real time based on their performance.

Between these two devices, FlintRehab has logged more than 70 million practice movements. Shepherd Center will partner with Dr. Reinkensmeyer, FlintRehab Devices and another rehab tech company, Pt Pal, that has developed a home therapy management platform for outpatient therapists. Outcomes of this work will include the development of a new therapy platform for Sensor-Enhanced Activity Management (SEAM) that combines the benefits of FlintRehab Devices and Pt Pal. The goal is to create a platform with algorithms that makes mRehab interventions simple to incorporate into practice.

Shepherd Center is one of five U.S. facilities participating in the clinical trial sponsored by ReNetX Bio, Inc., a biotechnology company in New Haven, Connecticut. The goal of this trial is to evaluate the safety, tolerability and pharmacokinetics of single ascending doses of AXER-204. Ultimately, researchers hope the drug will improve motor function by promoting neural plasticity and the regrowth of neural networks in individuals with chronic spinal cord injury.

While a single dose of AXER-204 is not expected to promote neurological recovery in humans, this Phase I clinical trial will confirm its safety and tolerability. With successful completion of the first study, the next study will evaluate the potential effects of repeated doses of AXER-204 in comparison to a placebo. AXER-204 is delivered via lumbar puncture injection into the spinal cord.

Clinical sites are still recruiting for the RESET trial.

Click here to learn more about participating in the RESET trial at Shepherd Center.

To meet the clinical trial’s eligibility criteria, patients must meet the following criteria:

• 18 – 65 years old
• Traumatic SCI that occurred more than one year ago
• Cervical SCI with weakness in the arms and/or hands
• In excellent overall health
• If any of the following apply to you, you are not eligible to participate:
  • History of a stroke, brain injury or any other chronic medical condition
  • Implanted baclofen or pain pump
  • Require any assistance to breathe (i.e., mechanical ventilation)

More than 17,000 people sustain a spinal cord injury each year, yet there are no FDA-approved therapeutics that could potentially restore some function in the 300,000 individuals living with a chronic spinal cord injury. While  still in the very early phases of evaluating the safety and tolerability of AXER-204, the hope is that it will someday prove to be a viable option in restoring function in participants.

A specialized team of clinicians in the Shepherd Spine and Pain Institute, led by Erik Shaw, D.O., and the Shepherd Center intensive care unit and Shepherd Center Pharmacy, is working on the trial.

After spinal cord injury, the recovery of function requires the regeneration and rewiring of neurons. But in central nervous system tissue, extracellular inhibitors called Nogo-A, MAG and OMgp limit regrowth. This ongoing research involves a decoy receptor called the Nogo Trap, which binds the growth inhibitors, allowing the body to grow nerve fibers naturally and directly targeting restoration across all facets of growth. The Nogo Trap was initially developed by Stephen Strittmatter, M.D., Ph.D., at Yale University and is being commercialized by ReNetX Bio..

To learn more, please visit: shepherd.org/resources-healthcare-professionals/research/reset-trial