NeuroRecovery Network (NRN)

Shepherd Center is one of seven rehabilitation centers that have partnered with the Christopher and Dana Reeve Foundation and the Centers for Disease Control and Prevention (CDC) as part of the NeuroRecovery Network.

Please review the information below to learn more about the program, the criteria for participation, and who to contact at Shepherd Center to set up an evaluation with the physician team.

What is the NeuroRecovery Network?

The NeuroRecovery Network (NRN) is designed to provide and develop therapies to promote functional recovery and improve the health and quality of life of people living with paralysis. The NRN translates the latest scientific advances into effective, activity-based rehabilitation treatments.

The NRN program at Shepherd Center is staffed with a group of dedicated professionals who have received specialized training in order to deliver the NRN’s therapies. The staff includes center directors, physicians, administrative and clinical supervisors, data managers, physical therapists and rehab technicians.

The NRN is an intense treatment program in which individuals participate in therapy five days per week for approximately 1.5 hour sessions each day. The minimum number of sessions that Shepherd Center recommends is 20 sessions. However, Shepherd Center has found that many individuals benefit from participating in more than 20 sessions.

What Is Locomotor Training?

Locomotor training is the method of physical therapy currently employed by the NRN. In Locomotor Training sessions, the body of the paralyzed patient is suspended in a harness over a treadmill, while specially-trained therapists move their legs to simulate walking. As the patient regains functioning, they move from the treadmill to walking overground.

Locomotor training derives from recent advances in scientific understanding about neural plasticity (the ability of the neurons in the nervous system to develop new connections and “learn” new functions) and the role the spinal cord plays in controlling stepping and standing. Locomotor training works to “awaken” dormant neural pathways by repetitively stimulating the muscles and nerves in the lower body - allowing patients whose lower bodies are completely disconnected from any input from the brain to regain walking ability.

Data Collection Information

Participants in the NRN will become part of a network-wide database that will collect comprehensive medical information about the progress of each patient. By collecting and analyzing this information, the NRN will be able to accurately measure program outcomes.

Criteria for Admission to the NRN Program

Patients selected for the NRN must meet the following guidelines:

1. Not actively participating in an inpatient rehabilitation program.

2. Stable with no deteriorating medical condition. No pacemaker present.

3. Non-progressive spinal cord lesion at level T10 or above; T11 and T12 may be considered in the absence of lower motor neuron signs.

4. Has some lower extremity movement (if spinal cord injured,

ASIA C or D with upper motor neuron lesion in the absence of anti-spasticity medication).

5. The following diagnostic groups may be included in the NRN:    

- Traumatic     

- Transverse myelitis     

- Spinal cord infarct     

- Surgically decompressed primary tumor (excluding radiation and        chemotherapy)     

- Stable infectious treated infections (excluding HIV)

6. Not ventilator dependent

Patients’ Frequently Asked Questions

Who do I Contact at Shepherd Center for More Information?

To set up an evaluation at Shepherd Center, please contact Neile Greenway at 404-350-3102 or email Neile

 

Who qualifies to participate in the NRN?

At the present time, the program is open to individuals with an incomplete cervical or thoracic spinal cord injury who have some movement or muscle tone in their legs.

What steps does one have to take to receive treatment by the NRN?

Patients must have a referral from a physician to receive this therapy. All potential patients must be seen by the NRN physician and physical therapists at the NRN facility, to be screened for any complicating medical issues that would make this therapy inappropriate. Following this evaluation, if deemed appropriate for this therapy, a plan of treatment will be established.

How long will the course of therapy take?

The average person receives the therapy for one to three months. Each patient is re-evaluated every 20 sessions. At that time, the NRN physicians and therapists will make any adjustments to the number of days per week and talk about the goals for continuation in the program.

How much time will each Locomotor Training session take?

Each session generally lasts one and a half hours. When a patient enters the program, they start five days per week. As they progress through the phases of recovery, the number of days per week declines to four days per week and then to three days per week.

What is the cost of receiving therapy through the NRN? Who will pay for it?

NRN sites are committed to working with every patient to secure full reimbursement for participating in this program. It is expected that the costs will be covered by your insurance company.

What should I bring to each session? Do I have to buy special equipment?

All patients need to bring to a training session is loose-fitting clothes appropriate for physical activity. The equipment needed will be provided by the NRN.

What results can I expect? What long-term improvements to my health will this therapy provide?

A range of results and health improvements are reported in the scientific literature; others are beginning to emerge as we apply this therapy to human patients. What we know is that results will vary from patient to patient. No two NRN patients will respond in exactly the same way, nor is each patient likely to experience the entire range of possible changes and improvements.

This therapy may contribute to improved cardiovascular and pulmonary function and blood flow to the arms and legs. In some patients, it may boost the healing potential of the skin, help increase bone density and improve bladder function. Functional results among NRN patients have ranged from improved trunk stability to recovery of standing and stepping ability.

NeuroRecovery Network Centers

Shepherd Center, Atlanta, GA

Email Neile Greenway

Email Sarah Morrison

Frazier Rehab Institute, Louisville, KY

Email Linda Shelburne

Magee Rehabilitation Hospital, Philadelphia, PA

Email Mary Schmidt Read

The Institute for Rehabilitation and Research, Houston, TX

Email Daniel Graves

Boston Medical Center, Boston, MA

Email Jane Wierbicky

Kessler Medical Rehabilitation Research and Education Center/Kessler Institute for Rehabilitation, West Orange, NJ

Email Sue Ann Sisto, PT, Ph.D.

Email Gail Forrest, Ph.D

Ohio State University Medical Center - Dodd Hall, Columbus, OH

Email D. Michele Basso

The program is funded through a cooperative agreement between the Christopher and Dana Reeve Foundation and the Centers for Disease Control and Prevention.