The Path from Inspiration to Innovation

Created by Shepherd Center staff in 2005, Beyond Therapy® exemplifies how a culture that supports innovation allows ideas to grow into impactful advances in patient care. The intense, activity-based therapy program is rooted in the concept of neuroplasticity.

“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