Rehabilitation Centers

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1 Reeve Foundation Susan P. Howley Joseph Canose Rehabilitation Centers NRN Advisory Board: V. Reggie Edgerton, PhD Moses V. Chao, PhD Michael G. Fehlings, MD, PhD Andrei Krassioukov, MD, PhD Shelley Sorani, MA Network Director: Susan J. Harkema, PhD Co-Directors: Andrea L. Behrman, PhD, PT Sue Ann Sisto, PT, PhD Mary Schmidt Read, PT, DPT, MS Liz Ardolino, PhD, PT Dan Graves, PhD Director: Mary Schmidt Read, PT, DPT, MS Administrator: Mary Schmidt Read, PT, DPT, MS Physician: Guy Fried, MD Clinical Supervisor: Liz Watson, PT Director: Kim Atkinson, PT, NCS Administrator: Kim Atkinson, PT, NCS Physician: Darryl Kaelin, MD Clinical Supervisor: James Ochsner, PT Director: Heather Taylor, PhD Administrators: Rhonda Abbott, PT, MS Francine Mechoulam, BA Physicians: Jeff Berliner, MD Lisa Wenzel, MD Clinical Supervisor: Marcie Kern, PT Director: Keith Tansey, MD, PhD Administrator: Sarah Morrison, PT Physician: Anna Elmers, MD Clinical Supervisor: Anneke Bender, MPT Director: Gail Forrest, PhD Administrator: Pat Judd, PT, MHA, MS Physicians: Steven Kirshblum, MD Monifa Brooks, MD Clinical Supervisor: Buffy Wojciehowski, PT Director: D. Michele Basso, EdD, PT Administrator: Robert Vanecko, PT, MS Physician: W. Jerry Mysiw, MD Clinical Supervisor: Carol Eskay, MPT For a list of all team members, please visit The extraordinary vision, compassion and dedication of Christopher and Dana Reeve made the NeuroRecovery Network possible. This program is funded by the Christopher and Dana Reeve Foundation through Grant/Cooperative Agreement Number U10.CCU between the Reeve Foundation and the Centers for Disease Control and Prevention (CDC)

2 Reeve Foundation NRN NRN Advisory Advisory Board: Board: Susan P. Howley V. Reggie V. Reggie Edgerton, Edgerton, PhD PhD Joseph Canose Moses Moses V. Chao, V. Chao, PhD PhD Michael Michael G. Fehlings, G. Fehlings, MD, MD, PhD PhD Andrei Andrei Krassioukov, Krassioukov, MD, MD, PhD PhD Shelley Shelley Sorani, Sorani, MA MA Community Fitness and Wellness Facilities Network Director: Susan J. Harkema, PhD Co-Directors: Andrea L. Behrman, PhD, PT Sue Ann Sisto, PT, PhD Mary Schmidt Read, PT, DPT, MS Liz Ardolino, PhD, PT Dan Graves, PhD Director: Karey McDowell, MS,CTRS, CPT Administrator: Karey McDowell, MS,CTRS, CPT Facility Supervisor: Doug McCoy, BS Director: Janne Kouri, BBA Administrator: Christel Mitrovich, BS, MS Facility Supervisor: Christel Mitrovich, BS, MS Director: Jon O Connor, BS Administrators: Jon O Connor, BS Mike Keenum, PT Facility Supervisor: Sakina Valika, PT, DPT Director: Jan Black, MS, PT Administrator: Dale Hull, MD Facility Supervisor: Jan Black, MS, PT Director: Jeanne Olson, PT, : MBA Administrator: Karen Peterson, PTA Facility Supervisor: Rachael Kath- Dvorak, MPT For a list of all team members, please visit The extraordinary vision, compassion and dedication of Christopher and Dana Reeve made the NeuroRecovery Network possible. This program is funded by the Christopher and Dana Reeve Foundation through Grant/Cooperative Agreement Number U10.CCU between the Reeve Foundation and the Centers for Disease Control and Prevention (CDC)

3 NRN Advisory Board V. Reggie Edgerton, PhD Moses V. Chao, PhD Michael G. Fehlings, MD, PhD Andrei Krassioukov, MD, PhD Shelley Sorani, MA Community Representative San Francisco, CA

4 Mission To provide support for the development of specialized centers that provide standardized rehabilitation using activity-based therapy based on current scientific and clinical evidence for people with spinal cord injury and other selected neurological disorders. Current Intervention : Locomotor Training Chronic Spinal Cord Injury AIS C and D A rehabilitative strategy designed to re-train walking. Provide sensory cues to re-train neural patterns that will result in effective walking. Integrate locomotor training principles throughout the three therapeutic components of locomotor training.

5 Step Training using BWST (1 hour) Step Retraining Step Adaptability Stand retraining Stand Adaptability Step > Stand Retraining > Adaptability Components of Locomotor Training Overground assessment Community integration (30 min)

6 Network Organization Centers for Disease Control and Prevention Advisory Board Christopher and Dana Reeve Foundation NeuroRecovery Network Directors Center Director Network Data Management Center Medical Director Center Administration Center Data Management Clinical Supervision Multidisciplinary Team Members Occupational Therapy, Pulmonary Rehab, Psychology, Recreation Therapy, Case Management, Social Services Physical Therapists PTA s Activity-Based Technicians

7 NRN Clinics Enrollment Demographics N = 458 Years since injury /- 5; 1 [0.1, 53] Age /- 17; 39 [3, 86] Race White 73% Black 18% Hispanic 5% other 3% AIS A 2% B 2% C 29% D 67% Gender Male 76% Female 24%

8 NRN CFW Enrollment Demographics N = 169 Years since injury /- 8.4; 2.7 [.01, 53.1] Age /- 15.5; 36 [10, 81] AIS A 24% B 18% C 11% D 7% Unknown 40% Gender Male 78% Female 22%

9 Clinical Rehabilitation Centers

10 Community Fitness and Wellness Facilities

11 Publications A Multivariate Examination of Temporal Changes in Berg Balance Scale Items for Patients With ASIA Impairment Scale C and D Spinal Cord Injuries. Somnath Datta, PhD, Douglas J. Lorenz, MA, Sarah Morrison, PT, Elizabeth Ardolino, MPT, Susan J. Harkema, PhD, Archives of Physical Medicine and Rehabilitation, 2009 (July, V 90) Marginal Association Measures for Clustered Data. Douglas J. Lorenz PhD, Somnath Datta PhD, Susan J. Harkema PhD. Statistics in Medicine, : Establishing the NeuroRecovery Network: Multi-site rehabilitation centers that provide activity-based therapies and assessments for neurologic disorders Susan J. Harkema, PhD, Mary Schmidt-Read, MS, DPT, Andrea L. Behrman, PhD, PT, Amy Bratta DPT, Sue Ann Sisto PhD, PT, and V. Reggie Edgerton, PhD Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using Locomotor Training- based rehabilitation. Susan J. Harkema, PhD, Mary Schmidt-Read, MS, DPT, Douglas Lorenz, MA, MSPH, V. Reggie Edgerton, PhD, and Andrea L. Behrman PhD, PT Standardized Locomotor Training Program Allows for Across-Center Continuity for a Patient with Incomplete Spinal Cord Injury: A Case Study Sarah A Morrison, PT, Gail F Forrest, PhD, Leslie R. VanHiel, MSPT, Michele Davé, DPT, Denise DeLorenzo, PT

12 Publications Assessment of functional improvement without compensation reduces variability of outcome measures after human spinal cord injury. Andrea L. Behrman, PhD, PT; Elizabeth Ardolino, PhD, PT; Leslie VanHiel, MSPT; Marcie Kern, PT; Darryn Atkinson, PT; Doug Lorenz, MA; Susan Harkema, PhD. Ambulation and balance outcomes measure different aspects of recovery in individuals with chronic incomplete spinal cord injury. Gail F. Forrest, PhD, Douglas J. Lorenz, MA, Karen Hutchinson, PhD, Leslie VanHiel, MSPT, D. Michele Basso, EdD, Somnath Datta, PhD, Sue Ann Sisto, PhD, PT, Susan Harkema, PhD A dynamic longitudinal evaluation of the utility of the Berg Balance Scale in patients with motor incomplete spinal cord injury. Somnath Datta, Ph.D., Douglas J. Lorenz, M.A., M.S.P.H., Susan J. Harkema Ph.D. Longitudinal patterns of functional recovery in patients with incomplete spinal cord injury receiving activity-based rehabilitation. Douglas J. Lorenz, M.A., Somnath Datta, Ph.D., Susan J. Harkema Ph.D. Life Care Planning Outcomes for Individuals with Motor Incomplete Spinal Cord Injury Pre and Post Locomotor Training Intervention: A Case Series. Sarah A. Morrison, PT, Jamie L. Pomeranz, PhD, CRC, CLCP, Nami Yu, MHS, CRC, Mary Schmidt Read, PT, DPT, MS, Colleen Wescott, PT, DPT, Sue Ann Sisto, PT, MA, PhD, Andrea L. Behrman, PT, PhD, FAPTA ACCEPTED FOR PUBLICATION Journal of Neurologic Physical Therapy

13 Publications Relationship between ASIA Exam and Functional Outcomes in the NeuroRecovery Network Locomotor Training Program. Jeffrey J. Buehner, MS, PT, Gail Forrest, Ph.D., Mary Schmidt-Read, MS, DPT, Susan White, Ph.D., Keith Tansey, MD, Ph.D., D. Michele Basso, PT, Ed.D. IN REVIEW Archives of Physical Medicine and Rehabilitation Cardiovascular status of individuals with Incomplete Spinal Cord Injury from seven NeuroRecovery Network rehabilitation centers. Sue Ann Sisto, PT, PhD, Douglas Lorenz, PhD, Karen Hutchinson, DPT, PhD, Lisa Wenzel, MD, Susan Harkema, PhD, Andrei Krassioukov, MD, PhD IN REVIEW Archives of Physical Medicine and Rehabilitation Basic concepts of activity-based interventions for improved recovery of motor function after spinal cord injury. Roland Roy, PhD, Susan Harkema, PhD, V. Reggie Edgerton, PhD IN REVIEW Locomotor Training: As a treatment of spinal cord injury and in the progression of neurological rehabilitation. Susan Harkema, PhD, Jessica Hillyer, PhD, Mary Schmidt Read, PT, PhD, Elizabeth Ardolino, PT, PhD, Sue Ann Sisto, PT, PhD, Andrea Behrman, PT, PhD IN REVIEW

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