Wearable Robot Helps People Walk Again 05.17.2021 Exoskeleton that has enabled over 125 million steps around the world now available in Central Virginia RICHMOND, Va. (May 18, 2021) – Sheltering Arms Institute, a collaboration with VCU Health, is enhancing its rehabilitation programs by now offering the EksoNR™ robotic exoskeleton to help patients who have experienced neurological illness or injury learn to walk again. Sheltering Arms Institute is the first inpatient rehabilitation hospital in Virginia to have an EksoNR clinical program. The Sheltering Arms Institute outpatient location in Hanover has also acquired an EksoNR, providing hospital patients the opportunity to continue using the device on an outpatient basis as they progress in their recovery. Each year, nearly 60 million people suffer from acquired brain injury, 15 million suffer a stroke, and as many as 500,000 experience a spinal cord injury (SCI). EksoNR is the first exoskeleton approved by the FDA for use with stroke and spinal cord injuries and the only exoskeleton with FDA approval for use with acquired brain injury patients. “The EksoNR offers many unique benefits to our patients who are relearning to walk, as the device promotes early mobilization and can help improve gait speed and distance, which are critical factors for optimal recovery,” said Amber Walter, PT, DPT, NCS, director of clinical science at Sheltering Arms Institute. The wearable robotic device offers patients upper trunk support and the opportunity to practice over-ground walking early on in their recovery process, retraining the brain and muscles how to properly walk again. This cutting-edge exoskeleton technology helps patients re-learn correct step patterns, weight shifting, and posture. Additionally, this device has shown promising results in walking speed, endurance, lower extremity strength, and functional mobility for persons with spinal cord injury. Clinical evidence suggests that including EksoNR gait training in inpatient rehabilitation for stroke improves independence in functional mobility. Most patients take an average of 400 steps during first-time training in the device. The purchase of the two EksoNR devices and support for ongoing staff training is funded by generous donors to Sheltering Arms Foundation. ### Attachments: Photos of the EksoNR Contact: Dianne Jewell Public Information Officer djewell@shelteringarms.com About Sheltering Arms Institute Sheltering Arms and VCU Health System have formed a joint venture, Sheltering Arms Institute, a state-of-the-science physical rehabilitation hospital and network of outpatient centers, that brings together the brand and clinical reputation of Sheltering Arms and the nationally ranked programs and research of VCU Health. The Institute blends advanced technology, research, and evidence-based clinical treatment to create an innovative, transdisciplinary model of rehabilitative care that facilitates superior outcomes for patients. For more information, please visit www.shelteringarmsinstitute.com. About Sheltering Arms Sheltering Arms Corporation is part owner, along with VCU Health, of Sheltering Arms Institute. Sheltering Arms also offers a vast array of fitness, wellness, and recreation services, including its mission-driven day recreation program, Club Rec. To learn more, visit www.shelteringarms.com or call (804) 764-1000.
Sheltering Arms Institute Hosts First Community Research Symposium 01.19.2021 Sheltering Arms Institute hosted a virtual research symposium on January 13, 2021, in an effort to collaborate with the wider Richmond-area community on current research impacting clinical practices. The symposium was attended by at least 60 people and opened with remarks from Amber Walter, clinical science manager, highlighting the potential for the event to connect clinicians and scientists, a known method for closing the gap between research and practice. Platform presentations were delivered by 4 scientists representing various institutions: Sheltering Arms Institute, Sheltering Arms Physical Rehabilitation Centers, and Hunter Holmes McGuire Veterans Administration Medical Center. The work presented has been supported by the Sheltering Arms Foundation, Virginia Commonwealth University, and the Central Virginia VA Health Care System. The first presentation, delivered by Dr. Zach Crump, DPT, utilized a case series methodology to examine an algorithm for the prediction of walking recovery with patients at Sheltering Arms Hospital who utilized a myriad of advanced rehabilitation technologies. Crump, a board-certified neurologic physical therapist, showed the prediction was correct for some people undergoing inpatient rehabilitation after stroke, but some also fared better than the initial predictions. He reported one conclusion to draw may be the intensity of interventions for stroke survivors may matter more than just technology use alone. Next, Dr. Ashraf Gorgey, PhD and Director of Research for Spinal Cord Injury and Disorders at Central Virginia VA Health Care System, discussed the results of his recent research on neuromodulation. Gorgey emphasized his research taps into the capability of the spinal cord to be “smart” or learn from the implanted spinal stimulation techniques he utilized in his research. In his study for people who had sustained a cervical spinal cord injury, he used this stimulation with an exoskeleton, or overground walking robot, to deliver walking interventions. Results showed less power had to be used from the robot to produce steps by the participants over several weeks of training. Dr. Carrie Holman, DPT, followed with a presentation in her specialty area of vestibular rehabilitation. Her project aimed to see if individuals with some loss of inner-ear functioning responded to therapy better when dual-task training was incorporated. Dual-task training occurs when patients work on two separate activities at the same time and it has been effective in some patient populations but not the one Holman sought to study. Holman reported those receiving dual-task interventions did improve in a measure of dynamic balance, but not more than those who did not receive the dual-task training. She emphasized the need for therapists to capture outcome measures in order to better investigate questions relating to best practices. The presentations closed with work by Dr. Logan Shuping, DPT, also a board-certified neurologic physical therapist. Shuping’s work looked at a whole-body vibration intervention on stroke survivors’ walking ability during the inpatient rehabilitation stay. The treatment involving standing on a vibrating platform has recent research that is conflicting and not often addressing the population Shuping looked at. Results did not show statistically significant differences in walking function at the end of the project. Shuping noted her results were limited by a large number of patients that needed to be excluded from the study. The finding may help understand more about the population of stroke survivors in inpatient rehab hospitals to better direct interventions and studies. To conclude the symposium Alan Lombardo, CEO of Sheltering Arms Institute, gave remarks summarizing important points of each presentation. Attendees were invited to ask questions to the presenters to improve their understanding of the projects’ results and impact on practice. Many thanks are given to an excellent audience who engaged in the conversation. Walter will be working to organize a larger symposium in the Fall with expanded subject areas, which will hopefully be presented in person. Special thanks to the following individuals for support in organizing the symposium: Dr. Amol Karmarkar, PhD Dr. Cristin Beazley, DPT Lisa Cheney Tricia Ambler Devin Bowers
Therapeutic Recreation – Open, Integrated & Expanded 01.12.2021 Therapeutic Recreation has an abundance of options to educate, engage, and help patients recover while having fun. Sheltering Arms Institute boasts seven full-time recreation therapists who create new and innovative ways to challenge patients. Thanks to a range of activities each day, patients have more opportunities to sharpen mental skills, facilitate coordination, and share a laugh. There are numerous programs including Lawn Games, Textured Tin Foil Art, Giant Jenga, and the Price is Right, just to name a few. This fresh approach has created an environment of unparalleled positivity. Brianna “Brie” Kilmartin, Therapy Program Manager says, “When they were building this new facility, one of the goals for the therapeutic recreation program was to help the team have patients up and out of bed as much as possible.” As a result of this careful planning, the Institute has an energized team of recreation therapists to motivate patients; this new and exciting program presents a sharp contrast to the single recreation therapist who shared time between the former Hanover and South hospitals. A bigger staff advances this focused approach to achieve stronger results, as well as extend activities for patients to nights and weekends. One of the most rewarding parts of Brie’s job has been to work in such a cohesive environment. “We have a huge recreation therapy center and I love being able to see all the patients through the bright, beautiful windows. In the past, I always felt that we worked behind closed doors. Now, I enjoy being able to see people experiencing the adaptive equipment and integrating all services we provide. It is amazing!” observes Brie, who came to the Institute from the Brain Injury Unit at VCU Health. Brie highlights the accomplishments of her enthusiastic team who work hard to keep patients moving forward in their recovery. “This week, Chelsea Fields created a Putt-Putt course in the gym. I love watching people laugh and enjoy life again.” Chelsea, a rec therapist, is committed to inventing a variety of activities and making them purposeful and entertaining. Putt-Putt, for example, allows patients to have fun while also working on balance and extending the amount of time they stand on their own. “I try to make things myself even if it is out of a cardboard box to meet a patient’s needs and I often brainstorm ideas online to see how I can help.” She coordinates a patient’s rehab with a potential game offering, which allows for more productive activity in a fun way. By designing a mini-golf course, Chelsea created a situation that patients would likely enjoy as a leisure activity once they return home. One of the reasons games are so helpful, Chelsea notes, is that everyone can genuinely enjoy themselves without worrying about their performance. Challenges are an integral part of a patient’s physical, occupational, and speech therapy. Chelsea taught a group of patients how to do Origami, the Japanese art of folding paper into animals and shapes. Any questionable shapes created a ripe opportunity for the jokes to flow. For Chelsea, it was all about being present in that moment. “I like it when a patient is having a good time while progressing in their health.” The games allow everyone to relax and have a good time, but there is a purpose. Recreation therapy helps individuals suffering from injury and illness develop new strategies to learn to live with their disability, enhancing their quality of life. It works by reducing the isolation patients experience and helping them learn new ways to participate in leisure activities. The recreation therapy team’s passion for helping patients is contagious and the positive energy is flowing at the Institute. So, the next time you visit the new hospital, you may just stumble upon an anniversary celebration, balloon tennis, or a push-up contest. There are no limits to having fun on the road to recovery. What is Recreation Therapy? Recreation therapy enhances physical, cognitive, emotional, social, and leisure development allowing individuals to participate fully and independently in life. Therapy plans are highly individualized to the patient, taking into account past, present, and future interests and lifestyles. It differs from other therapeutic interventions by incorporating recreation activities into intervention strategies such as: playing Jenga to enhance concentration, UNO to help with cognitive retraining, or allowing the patient to become engaged in a social aspect of therapy to be used as a diversion to assist with pain management so the patient is not reliant on pain medication. Incorporating healthy living into treatment to improve functioning, but also enhancing independence and successful involvement in all aspects of life.
Generosity on the Menu – Junior Board Makes New Café Possible 01.12.2021 Thanks to the support of the 2016, 2017, 2018, 2019, and 2020 Bal du Bois sponsors, the Junior Board has generously committed $1 million to help make Sheltering Arms Institute a reality! We are extremely grateful for the community’s partnership in our capital campaign. The Junior Board is honoring this spirit of community by naming the hospital’s dining space, the Junior Board Café. Enhancing the recovery process, the Junior Board Café is where team members, patients, and their families gather and dine together, learn to regain independence, and return to what is important in their lives.
An Interfaith Ministry – Mind, Body & Spirit 01.12.2021 “You don’t come here to give up. You come here to live again,” says Dr. Gloria White Flowers, the Interfaith Chaplain at Sheltering Arms Institute. The chapel is a place for everyone of all denominations to worship, offering respite for patients, family, friends, and staff members. She adds, “You will see every known faith on the beautiful stained-glass windows.” “The Sheltering Arms Institute Chapel is an oasis – not just for prayer and reflection, but for solace and strength. I am grateful to Sheltering Arms Institute for recognizing that the rehabilitation journey not only involves the patient, but the family as well. And that journey can be lonely and overwhelming. The opportunity to reboot and find sanctuary in such a peaceful place is deeply appreciated,” says Madeline Mayhood, a family member of a patient. Honoring the mind, body, and spirit connection, Chaplain Flowers meets with every single patient that comes to the Institute. She wants them to know she is always available to help. “As an interfaith chaplain, I provide a ministry of care and support, which respects the personal integrity and religious traditions of all persons. I assist our patients and families in using their inner strength, faith, and relationships to work toward understanding their present experience from a faith or spiritual perspective. Ultimately, their faith will lead them to full healing and wholeness.” Her main objective is always to listen. Thanks to copious amounts of research, Chaplain Flowers honors all of the patients’ religious beliefs and brings a message of healing in a language they understand. For example, if the patient is of the Jewish faith, she uses messages from the Torah to help with recovery. Chaplain Flowers has been with Sheltering Arms for more than 25 years. She concludes, “I have been called to a field where I can work with every faith, which I find very rewarding.”
Donor-Funded EKSO Arrives 11.21.2020 Thanks to the support of donors, the Sheltering Arms Foundation can bring cutting-edge treatment technologies to the community. The latest purchase is the EKSO, a lower extremity robotic exoskeleton that is utilized for patients receiving neurorehabilitation. Sheltering Arms Institute will be the first inpatient rehabilitation hospital in the state of Virginia to have an EKSO clinical program. The Sheltering Arms outpatient location in Hanover also received an EKSO, which supports the continuum of care. “EKSO will offer our patients the opportunity to experience over-ground walking early in their recovery process, which may not have otherwise been possible due to the severity of their injuries,” said Zach Crump, DPT, Locomotor Specialist. The EKSO is one of the most widely researched exoskeletons for over-ground ambulation. Current research indicates that the EKSO is both safe and feasible for use in the inpatient rehabilitation setting. Additionally, this device has shown promising results in walking speed, endurance, lower extremity strength, and functional mobility for persons with spinal cord injury1-2. “This device will be a tremendous resource for our therapy teams to give our patients the best opportunity to regain walking function and to reinvent rehabilitation for life beyond limits!” Zach said. “We are so grateful to donors for making this gift, which will serve our patients for years to come.”
Inspired to Help Others Walk Again: Patient Becomes Team Member 11.11.2020 The road to Ben Barbee’s new job as a rehab tech started with a short drive to see a friend. That was back in March; he never made it to the friend’s house. A car accident nearly took his life. He was unresponsive at the scene and spent three weeks in a coma. The extent of his serious brain injury would not be known until he regained consciousness. “My brain wasn’t getting enough oxygen and I wasn’t supposed to walk or talk again,” Ben said. When he started rousing from coma, he was disoriented and pulled the IVs out of his arms. Then he remembers waking up, not able to move or feel his hands that had been restrained to the bed. “I asked the nurse watching me, ‘Do I have hands?’” He spent another week in a stepdown unit before transferring to VCU Health Department of PM&R to begin inpatient rehabilitation learning to use his body again. Like other patients in those early days of COVID-19, he was doing this without the physical presence of family and friends. Visitors weren’t allowed, so the recreation therapists helped him use FaceTime to connect with family. During his two and a half weeks in PM&R, he worked to overcome a stutter he didn’t have before the accident and learned to walk again. “Learning to walk again was the best feeling I ever had,” Ben said about the experience that inspired his next career move. “I wanted to give that feeling to somebody else!” During the next step in his recovery, outpatient treatment at Sheltering Arms Bon Air, he learned about Sheltering Arms Institute and the open positions that could help him achieve his goal. “Nowadays I find happiness in serving another person,” Ben said about his new job, which is a departure from his previous jobs selling residential solar panels and as a soldier in the U.S. Army. “When I am walking by a patient’s room and I see a dinner tray, I step in, introduce myself, and clear the tray. I really act like, ‘If I was in their shoes – like I was 3 months ago – I would want that dirty tray out of my room.’” Only a few weeks into his new job and he’s already had a taste of his dream as he helps people use equipment like the Hocoma Andago and Bioness Vector. “The feeling is indescribable to be honest,” Ben said. “Especially when we set up the mirror in front of them and they can see themselves walk again. I got pretty close with this one patient and his family. A few times while watching him walk again, we both kind of shed a tear – before a smile of course!”
Canine Companions for Independence® Facility Dog Joins Sheltering Arms Institute Team 09.24.2020 Motivation and support come in many forms, including a cold nose and a warm heart. Sheltering Arms Institute, a collaboration with VCU Health, is pleased to welcome its newest team member, Canine Companions for Independence Facility Dog, Clara. Clara will assist handler Dr. Cynthia Rolston, Director of Psychosocial Services and Inter-Professional Science, in her work with patients. Clara is a two-year-old Lab/Golden Retriever cross and has been training since she was eight weeks old. After being carefully matched with one another, Clara and Dr. Rolston spent the last two weeks working with professional Canine Companions instructors to prepare for their new roles. Training consisted of intensive lectures, hands-on practice and simulations, and multiple examinations in order to acquire public certification. In just her first few days on the job, Clara has already acclimated to the many changes in her life and settled into her new home and work environment, bringing smiles to our patients’ faces. “This is a new and exciting program for all of us, and I can’t wait to see how Clara helps our patients achieve independence,” Dr. Rolston said. “We will be working together as a team as we integrate Clara into patient therapy sessions at Sheltering Arms Institute.” Since 1975, Canine Companions has bred, raised, and expertly trained assistance dogs in more than 40 commands designed to assist people with disabilities or to motivate and inspire patients with special needs. Clara can pull toy wagons, push drawers closed, and retrieve all kinds of items. She has specific commands that allow her to interact with patients in a calm and appropriate way. “We have full confidence Clara will be an exceptional facility dog for Sheltering Arms Institute and bring a host of skills and smiles to the halls daily. She will assist the patients with their therapies, help patients practice their activities of daily living, and bring an added psychological assist,” said Debra Dougherty, Northeast Region Executive Director for Canine Companions for Independence. Canine Companions for Independence enhances the lives of people with disabilities by training and placing more than 6,000 assistance dogs with program graduates. Canine Companions depends on the support of tens of thousands of donors and volunteers to match our facility with an assistance dog like Clara entirely free of charge. The support for staff training and Clara’s ongoing needs is being provided by generous Sheltering Arms Foundation donors. ### About Sheltering Arms Institute Sheltering Arms and VCU Health System have formed a joint venture, Sheltering Arms Institute, a state-of-the-science physical rehabilitation hospital, that brings together the brand and clinical reputation of Sheltering Arms and the nationally ranked programs of VCU Health. The Institute blends advanced technology, research, and evidence-based clinical treatment to create an innovative, transdisciplinary model of rehabilitative care that will facilitate superior outcomes for patients. All outpatient services for both parent organizations will operate separately for now and into the foreseeable future. For more information, please visit www.shelteringarmsinstitute.com. About Canine Companions for Independence Canine Companions for Independence provides expertly trained assistance dogs to children, adults, and veterans with disabilities at no charge. Established in 1975, Canine Companions has six training centers across the country. The largest non-profit provider of assistance dogs, Canine Companions is recognized worldwide for the excellence of its dogs, and the quality and longevity of the matches it makes between dogs and people. For more information, visit cci.org or call 1-800-572-BARK. Attachments: Images of Clara (.jpg) Media Kit
