NeuroRecovery Network (NRN) at Craig Hospital
The NeuroRecovery Network (NRN) at Craig Hospital is an outpatient intensive therapy program designed to improve functional mobility, independence and quality of life in individuals who have sustained catastrophic spinal cord injury through physical and occupational therapy. Craig Hospital joined the cooperative network of six cutting-edge rehabilitation centers across the nation in 2012. NRN is designed to provide and develop therapies to promote functional recovery and improve health and quality of life of people living with paralysis.
NRN physical therapy program
The NRN physical therapy program utilizes locomotor training as its primary intervention to stimulate the nervous system and drive motor recovery.
Locomotor training (LT) is an activity based therapy designed to activate spinal pathways below the level of injury through manually facilitated step retraining over a body weight supported treadmill. By manipulating variables such as speed and body weight support, the therapists can challenge the patient’s nervous system in efforts to improve trunk control, posture, strength, independence, and in some cases return of ability to walk.
NRN occupational therapy program
The NRN Occupational Therapy Program utilizes high frequency neuromuscular electrical stimulation applied to multiple muscles of the shoulder, forearm, and hands while providing the participant assistance performing common movements of the arm. This intervention aims to increase excitability of the nervous system and optimize function and upper extremity recovery. Patients may be referred to the OT NRN neuromuscular electrical stimulation program itself or in conjunction with the locomotor training program. A comprehensive set of outcome measures are assessed at baseline, and re-assessed every 20 sessions to measure improvements in functional mobility, balance, sensation, and overall health.
The NRN is part of the Christopher and Dana Reeve Foundation (in partnership with the Centers for Disease Control and Prevention) and was founded in 2004 to translate the latest scientific advances into effective, activity-based treatments. The NRN aims to inform clinical practice by providing standardized treatment, data analysis, and program evaluation across all sites within the network. Each center is staffed with a group of dedicated professionals who have received specialized training in order to deliver standardized treatment.
If you are interested in learning more about the NRN program at Craig Hospital, please complete our patient inquiry form below and our team will contact you. You may also email the NRN team with any questions or request additional information at firstname.lastname@example.org.
NeuroRecovery Network Frequently Asked Questions
- Is there criteria to participate?
Yes, there is specific criteria for a patient to participate in the NeuroRecovery Network at Craig. Learn more about the inclusion/exclusion criteria.
- What is the time commitment to participate?
Please review our NeuroRecovery Network Program Overview page for an overview of the program.
- What Is locomotor training?
Locomotor training is the method of physical therapy currently employed by the NeuroRecovery Network. In locomotor training sessions, the participant is suspended in a harness over a treadmill, while specially trained therapists move their legs to simulate walking. 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.
- What results and what long-term improvements to my health can I expect?
Although no two patients respond to the therapy in exactly the same way, all NRN patients experience change as a result of locomotor training. These changes can include improved recovery of independent walking and/or improvements in overall health and well-being. For some, health improvements can include better cardiovascular and pulmonary function, increased bone density, decreased spasticity, a decrease in the likelihood of skin lesions and improved glucose intolerance.
- How is my data used?
Data collected from evaluations and sessions with participants in the NRN will become part of a network-wide database that contains comprehensive medical and functional information about the progress of each individual. By collecting and analyzing this information, the NRN hopes to be able to accurately measure program outcomes.
- Who qualifies to participate in the NeuroRecovery Network?
The program is open to individuals not actively participating in an inpatient rehabilitation program and who have a non-progressive cervical or thoracic spinal cord injury at level T 10 or above; T 11 and T 12 may be considered in the absence of lower motor neuron signs.
- What steps does one have to take to receive treatment by the NeuroRecovery Network?
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 three to four months, and will undergo around 60 sessions. Each patient is re-evaluated every 20 sessions. At that time, the NRN physicians and therapists will assess if the patient is making adequate progress to warrant continued therapy, and discuss goals for the next 20 visits.
- What is the cost of receiving therapy through the NeuroRecovery Network? Who will pay for it?
NeuroRecovery Network sites are committed to working with every patient to secure reimbursement for participating in this program. It is expected that costs will be covered by your insurance company or one can self-pay.
- Is housing provided at Craig Hospital?
At this time, housing is not provided during participation in the NeuroRecovery Network at Craig Hospital. Craig Hospital does however have a partnership with the Marriott Town Suites located on Hampton and I-25 and the Marriott Tech Center on I-25 and Belleview, both of which provide reduced rates for Craig Hospital patients.
- Are there any medications that I cannot take while participating in the NeuroRecovery Network?
No use of botulinum toxin (botox) within the previous 3 months. No oral or intrathecal pump delivery (baclofen, morphine, or clonidine, benzos, antispasticity agents, etc) – or compliance to reduce and eliminate these medications. Neuropathic pain medication such as gabapentin (Neurontin) and lyrica are also prohibited. The NeuroRecovery Network physician will work closely with participants to develop a patient specific and safe weaning program.
- What if my needs/goals are primarily focused on my upper extremities?
The NeuroRecovery Network occupational therapy program utilizes neuromuscular electrical stimulation applied to the shoulder, forearm and hands paired with patterned repetitious movements of the upper extremity as its primary intervention to optimize function and recovery. Patients may be referred to the NeuroRecovery Network neuromuscular electrical stimulation program itself, or in conjunction with locomotor training. A comprehensive set of outcome measures are used to assess the impact of such locomotor training/UE neuromuscular electrical stimulation on functional mobility, balance, and overall health. These outcome measures are designed to measure functional recovery following intensive therapy and are administered at baseline, after every twenty sessions, and during discharge evaluation when the patient has concluded their participation in the program.
Our NeuroRecovery Network Team
Meghan Joyce, PT, DPT, Clinical Supervisor; Physical Therapist
Selena Efting, PT, DPT, NRN Physical Therapist
Patricia Bartelt, BS, NRN Exercise Tech
Maureen Stobbelaar , Occupational Therapist
John Gargaro, BS, NRN Exercise Tech