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Corey Beattie was in car crash. A horrific one. After a fall evening in 2010 out line dancing with her friends, their vehicle was involved in an accident on Route 896 near New London, Pennsylvania.
Some of the 17-year-old’s injuries – a broken clavicle, right femur fracture, a broken neck – would pale in comparison to the devastating traumatic brain injury (TBI) she received from the violent collision. In Hollywood, this impairment is often portrayed as a short-term hurdle.
“It’s way different in real life,” said Beattie, now age 23.
She would need years of intensive and acute care before she could even leave the hospital. She would never achieve her dream of graduating culinary school and becoming a chef … or so conventional wisdom would dictate.
But those who have met University of Delaware Department of Physical Therapy faculty member Cole Galloway and doctoral student Devina Kumar know they don’t believe in the words never or conventional.
Beattie’s mother Marie, a steadfast advocate for TBI survivors, regularly blogs about her experiences. Debbie Dunlap, whose daughter Anne participated in UD’s GoBabyGo research program, read a post and gave the name of the Beattie family to UD.
Soon after, Corey Beattie was standing in a harness system, working in the GoBabyGo Café in the University’s STAR Health Sciences Complex.
Kumar works with Beattie in an intensive balance and mobility research project that has her standing, socializing and working with food.
The little café is equipped with a system of cables attached to steel and aluminum tracks that allow a person with balance issues to stand, move and work without the risk of falling. They can rehabilitate and strengthen deficiencies while prepping meals and communicating with customers. The work keeps Beattie active and mentally engaged.
“We have seen and measured changes in cognition, hand function, mobility and balance,” said Kumar. “She went from requiring assistance while walking in a harness to making breakfast all by herself in just the first six weeks. That's a huge leap.”
But the café isn't the only place where Beattie is harnessing independent mobility. Local company ENLITEN, which patented the harness system, installed it at the Beattie’s home in nearby Lincoln University, Pennsylvania. The in-home research exemplifies the importance of an “enriched environment,” where the brain is stimulated by physical and social surroundings.
“When you put someone is an ‘enriched environment,’ their brains love it because it demands adaptation and creativity. Building an enriched environment in a lab is hard, but we have this whole world outside of the lab that we as researchers can use,” Galloway said. “Because Corey loves cooking so much, her home kitchen is an ideal social and physical environment. For future harness system users, whatever environment or location they want to be in, we want to find it and install a harness.”
The kitchen harness ensures Beattie is never simply an observer; she watches Food Network programs and other favorites, like Fox's MasterChef, walks to the kitchen, straps into the harness and cooks the meals with her mom. Beattie recently prepared a honey orange bake chicken dinner with roasted potatoes and asparagus for her sister’s birthday.
“When I get Corey in the harness, I can walk away to grab something rather than having to grasp onto her gait belt the entire time,” said Marie Beattie. “She’s much more independent.”
The other harness is in Beattie’s bedroom, which gives her physical and mental independence. With physical therapists, occupational therapists and her mother constantly by her side, the harness gives her a safe oasis for some hard-to-come-by quiet time.
“It’s a lot of mental therapy,” said Beattie.
Making harness systems attainable
In a world where medical technology is usually synonymous with unaffordability, ENLITEN is striving to make these harness systems attainable to families already overburdened with medical bills. Right now, the cost can range from $5,800 to $8,000 — a cost the company is working to reduce as the project matures.
Before getting sticker shock, consider that physical therapy sessions can cost $200 an hour; that can eclipse the cost of an in-home harness system in only six weeks — and that’s not including speech therapy and occupational therapy.
While the harness system is not meant as a replacement for all therapy, it does fill a huge gap between acute care – that provided in the hospital immediately following the injury – and limited outpatient care that comes well after the patient goes home.
“This harness for that treatment gap will help the individual accelerate their progress. If nothing else, even if we were in outpatient care, a harness in the home would help supplement what the therapist is doing,” said Marie Beattie. “Right now, if you do therapy for six hours per week, what do you do with the rest of the time?”
And as far as covering the cost of seemingly constant therapy sessions, Marie Beattie has learned more than she could ever want to know about insurance approvals.
“There comes a point when all insurance stops and the family says, ‘What now?’ The majority of insurance approval is from ‘moderate to mild’ injuries because they have the greatest physical improvements. Below that level [like Corey], recovery can be years and years. The investment can cost an insurer millions,” she said. “Insurance might not approve a case that requires a long length of recovery. It’s shortsighted in a lot of ways because it costs the insurer or the government more money. Limited rehab can cause higher number of infections, bedsores and a whole host of other issues.”
While the focus is understandably on the TBI survivor, the caregiver is often forgotten. The perpetual task of watching over and advocating for a loved one is often isolating. Many caregivers are forced to give up their job.
Always the big picture thinker, Galloway’s research is not only measuring Corey Beattie, but also her mother, who takes physical and cognitive evaluations just like her daughter. Kumar measures things like steps, sleeping patterns and quality of life.
Kumar recently presented alongside the Beatties at the Brain Injury Association of Pennsylvania. In the coming months, Kumar will present in Washington, D.C., for the Rehabilitation Engineering and Assistive Technology Society of North America Conference. Among other topics, the way immersion in a real-world environment accelerates progress will be discussed.
“Corey started with UD in November. Within six weeks, she was standing for an hour. Now she’s pushing a cart around the super market,” said Marie Beattie.
What makes this research stand out is the relationship between the investigators and the participants.
“Devina is the first person that’s really gotten it,” Marie Beattie said. “She is the first person to ask Corey about Corey. Simple things like ‘was she happy?’ For our family, that was huge.”
Corey Beattie likes that Kumar doesn’t go easy on her; she keeps the pressure on Beattie to push harder.
“I’m going to be a chef, so I better get used to the pressure,” Beattie said.
Working with Galloway and GoBabyGo has made Kumar realize the critical importance of mobility and independence.
“We often take it for granted because we have an intact body and mind,” she said. “When I see Corey and how young she is, I want her to have a near normal life. I want to give her the chance to walk and go shopping whenever she wants, make a sandwich whenever she is hungry and storm out of the house when she is angry. Everyone deserves to do what they want and when they want.”
Spreading the word
Just like Debbie Dunlap did for Marie Beattie, Marie Beattie is telling others about UD. She recently met a young man who was in a car crash two and a half years ago. She went to talk with the family as he’s going through a lot of the same ordeals that her daughter faced, and she facilitated installation of an in-home harness system.
The unit went in his home less than a month ago and the family reports that he is already standing stronger.
“Without the harness, they need three people to help him stand. In the harness, the mom can help him on his own,” said Marie Beattie.
This community advocacy is exactly the type of participatory research that GoBabyGo promotes.
“This is community-based, applied neuroscience. This is participatory action research,” explained Galloway. “It’s not the typical researcher-participant relationship; the Beatties have already helped us improve the study so much. If we want to make the biggest impact possible on the TBI community and on anyone else with mobility issues, we need people like Marie and Corey intimately engaged in the research.”
This study is active and looking for more participants. If you are a caregiver for a potential participant, contact Devina Kumar.
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