BEYOND THERAPY
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BEYOND THERAPY

CANDY TEFERTILLER, MSPT, ATP

Shepherd Centerís Beyond Therapy Program in Atlanta, Georgia is an innovative program offered to persons with neurological disorders including spinal cord injury (SCI).  It is designed to integrate the goals of each client into an individualized program that combines the principles of athletic training along with concepts of traditional physical therapy to promote neural recovery of the injured spinal cord.  Recent research suggests that the central nervous system, once thought to be irreparable, is actually able to functionally reorganize itself with the appropriate training and may allow recovery of lost abilities even in the presence of minimally intact neural tissue. 

The vision of this program is to create an environment of hope and determination for those clients who have sustained a catastrophic neurological injury and provide them with the appropriate assistance to achieve their highest level of sensory and motor recovery.  It is designed to challenge clients to reach a level of physical fitness or function that they had once thought impossible.  The program works to change the focus of the clientís mindset away from the wheelchair and toward rehabilitation and recovery.  The goals of this program include stimulating intact neural tissue within the spinal cord that was spared during the initial injury to promote neuromuscular recovery, facilitating neural recovery in individuals who have undergone experimental function-restoring surgeries and therapies throughout the world, and creating an individualized lifelong activity program to help individuals maintain physical readiness for neural recovery.  

Beyond Therapy is a physically rigorous program that combines the expertise of an individualized training team comprised of exercise physiologists, athletic trainers and physical therapists to assist their clients in attaining the highest level of personal strength and restoring function.  Because this program integrates multiple disciplines, there are no boundaries in the variety of experiences and stimuli that clients may receive.  The program extends beyond the range of acute care and predetermined functional goals, and continues the rehabilitation process by administering aggressive treatment of clinically researched protocols to achieve a higher-level of individual achievement.  

Each client entering into the program is first evaluated by a physical therapist who then designs an intense 9-hour/week program that combines state-of-the-art technological advancements in rehabilitative medicine with hard-core physical training.  Each client is evaluated to determine the most appropriate individualized training program which may include the following: Lokomat (Robotic assisted treadmill training), body-weight-support manual treadmill training, Giger training, FES (functional electrical stimulation) bike training, Bioness upper extremity orthotic electrical stimulation, aquatic therapy, standing and gait training with a variety of orthosis/equipment, lower extremity strengthening, upper body and core strengthening in a variety of developmental sequencing techniques. 

The philosophy behind the Beyond Therapy training program originates from three primary concepts.  The first of these is recovery through the use of neural patterned activity.  The client is able to use the most technologically advanced equipment to take their bodies safely through the normal movement patterns and weight bearing that they completed on a daily basis before their injury to remind and re-teach their damaged nervous system how to function appropriately. This may include timed walking on the Lokomat, cycling on an FES Bike and/or passive/active cycling with a Giger MD.  The second concept is that of task specificity.  The injured nervous system responds to training and has the ability to modify activity based on the specific training program or inputs that it receives.  This includes teaching the injured nervous system specifically how to crawl and stand again as individual components of their recovery process.  The third concept is that of functional strengthening.  All four limbs and core must be strong enough to support the bodyís weight to complete the activity demands being placed upon it by a healing nervous system. 

The experimental protocol aspect of the Beyond Therapy Program was designed to assist clients with navigating through the neurological experimental procedures offered at Shepherd and throughout the world.  This component of the program serves to assist those clients who wish to pursue innovative procedures around the world and need information on how to participate in them.   

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