rainbowvisions - rainbow rehabilitation centersshuttle that will provide tours of mcity, a test site...

CONCUSSION FRONT

RAINBOWVISIONSFor and about the brain injury and spinal cord injury community. Rainbow Rehabilitation Centers, Inc.

FALL 2017 Volume XIV No. 3

rainbowrehab.com

Good News, Fake News and New News on the

By Tom Constand, President & CEO The Brain Injury Association of Michigan

• PLUS The Power of Positivity

Autonomous Vehicles

Nationally and Locally Rainbow Makes a Difference

Give Yourself Some Credit!

News at Rainbow

• PRESIDENT'S CORNER

Celebrating Success in Big and Little Ways! By Bill Buccalo, President & CEORainbow Rehabilitation Centers

As we work through our busy days and weeks, it is often easy to lose track of our successes along

the way. This can be true for people dealing with the consequences of a traumatic brain injury or working on a rehabilitation plan and also for an organization working to help people achieve their goals. Change can be slow and sometimes difficult to recognize in the moment. However, when viewed over the course of time, the successes can be significant. While the successes are the goal, the celebration of those successes is also valuable and important.

Over the years, Rainbow and those we serve have made some nice advancements. Here are some of the successes we recognize:

Program SuccessWe work continuously to expand and improve our

Continuum of Care. This effort continues today as we recently opened our 14-bed Southfield Center. This beautiful residential facility expands our services to the city of Southfield and adds much needed capacity for high quality rehabilitation care.

Vocational opportunities are such a critical component of the rehabilitation process and getting back to productive and fulfilling activities outside of treatment. Rainbow's Vocational Team continues to make great strides by significantly expanding placements in jobs and returning to work for our clients. The team has expanded the variety of work opportunities in supported employment, community work groups, and through individualized placements. We now have dozens of community placement sites and work product options, providing individuals with the best chance of getting back to the type of work performed before their injury or in line with their

interests. Following traumatic brain injuries, several persons served have recently worked their way through the vocational continuum to get back to independent community work.

Client SuccessGraduates–year in and year out, the Pediatric and

Young Adult programs support clients in their individual achievements including navigating the rigors of high school, participating in important milestone and social events, and graduation. High school can be tough, and our young graduates deserve special recognition.

A new series of family support groups have taken off this year. Thanks to Dr. Scott, Dr. Young, and Dr. King, families are actively participating in weekly groups to discuss a variety of topics of importance following traumatic brain injury. “I think the group gave the families a sense of belonging and knowing that they were not alone on their journeys,” said Dr. Young. These new support groups have been a welcome addition for families.

Community leadership, education, and advocacy success—a couple little seeds that continue to grow

For the third year in a row, Rainbow has collaborated with the Brain Injury Association of Michigan (BIAMI) to sponsor special screenings of movies during National Brain Injury Awareness Month. The movies selected are done so with the purpose of promoting dialog, education, and awareness regarding brain injury and are followed by a panel discussion of industry experts. This last spring, the event grew to three different screens around the state of Michigan.

During the BIAMI Fall Conference this year, several of our employees will be presenting on various topics to educate and raise awareness of brain injury. Also at the

Continued on page 33

Concussion may not be avoidable, but society seems to finally be getting a handle on its management.

Page 10

Copyright September 2017—Rainbow Rehabilitation Centers, Inc. All rights reserved. Published in the United States of America. No part of this publication may be reproduced in any manner whatsoever without written permission from Rainbow Rehabilitation Centers, Inc. Contact the editor: [email protected].

Our mission is to inspire the people we serve

to realize their greatest potential

Features 2 Technology Corner Autonomous Vehicles Barry Marshall

6 Success Story The Power of Positivity Sarah Parks, MSOT, OTR/L, Abby Dull, PT, DPT, CBIS, CKTP & Kaitlin O’Hara, PT, DPT, CBIS

10 Industry News Good News, Fake News and New News on the Concussion Front Tom Constand, President & CEO, The Brain Injury Association of Michigan

14 Success Story Unbelievable! Laura Sarten, ETS

18 Industry News Nationally & Locally Rainbow Makes a Difference Lynn Brouwers, MS, CRC, CBIST

20 Therapy Corner Walking Again Payal Desai, LPT NDTC, CBIS, CKTP

24 TBI Topics Family Support Groups Carolyn Scott, Ph.D., CBIST

26 Industry News Give Yourself Some Credit! Kathleen Sobczak, BSN, RN, CBIS, WCC, CRRN

28 Conferences & Events

News at Rainbow 30 CARF Accreditation | Summer Fun! | Outcomes Report | Synapses & Sneakers

32 Employees of the Season

34 New Professionals at Rainbow

Editor Barry Marshall

Associate Editor/Designer Jill Hamilton-Krawczyk

Email questions or comments to: [email protected]

6

• ON THE COVER

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14 20

Autonomous Vehicles Changing the Future and Increasing Mobility

• TECHNOLOGY CORNER

By Barry Marshall Rainbow Rehabilitation Centers

It’s a cool, cloudy day high in the California desert, and an engineer hits “pickup” on a watch-like device. An empty car pulls out of a parking space and stops beside him. The engineer hops in for a spin around an autonomous vehicle test facility. The car stops for a

jaywalker, at all stop signs and, when on the highway, goes around a slower car—all without the engineer touching the wheel or pedals.1

Believe it or not, this sort of thing happens every day on test tracks, streets and highways around the world. To ride in this car is akin to hopping in a time machine and arriving in a scene straight out of Hollywood's Minority Report or I, Robot. It’s that impressive.

The self-driving car will likely change society more than any technology has over the past century. Roads will be safer, we will have more free time and greater independence, cities will be reshaped and traffic may become a thing of the past.1

Current DevelopmentsThe race to introduce the first fully autonomous vehicle (AV) is similar to the gold rush or

the race to space. Most automakers and other tech companies have put a heavy foot on the accelerator to accomplish this. The following are some current developments:

Two autonomous vehicles crossed from Detroit, MI to Windsor, Ontario, Canada in early August to test automated driving technology in a variety of settings. The trip took them through the Detroit Windsor Tunnel to test how the technology reacts while being driven under water while enclosed in the concrete of the tunnel. They then crossed back into the U.S. via the Bluewater Bridge to test the vehicle driving on a steel bridge.2

French autonomous carmaker Navya recently announced it will open its first assembly plant in the U.S. in Saline, MI and begin assembly this fall. Navya and the University of

Continued on page 4

2 | RAINBOWVISIONS • FALL 2017

RAINBOWREHAB.COM FALL 2017 • RAINBOWVISIONS | 3

• TECHNOLOGY CORNER AUTONOMOUS VEHICLES

Michigan in Ann Arbor, MI announced they will work together on a fully autonomous, 15-passenger electric shuttle that will provide tours of Mcity, a test site for connected and autonomous vehicles. The goal is to build 15-20 fully autonomous shuttles by the end of the year.3

This fall, General Motors is launching Super Cruise on the Cadillac CT6. It is the first hands-free highway driving system. This allows the driver to operate hands-free on limited access highways—highways with on and off ramps and no cross traffic. It isn't a fully autonomous system. The driver still must be engaged and paying attention.

Google formed Waymo in 2016, a company that is working toward producing fully driverless vehicles that have no steering wheel or pedals. The company has a fleet of test vehicles in four U.S. cities that drive 25,000 autonomous miles each week. Waymo is inviting residents of Phoenix to be part of their early riders program. Residents can use their self-driving cars to go to work, school, or other locations and then share their experiences with Waymo.4

Construction has begun at The American Center for Mobility. It will be a uniquely purpose-built facility focused on testing, verification and self-certification of connected and automated vehicles and other mobility technologies. It is located at the 335-acre historic Willow Run site in Ypsilanti Township in southeast Michigan.⁵

Domino’s has been delivering pizzas using self-driving robots in Australia and New Zealand since 2016 and earlier this year announced doing the same in Germany and the Netherlands.⁶

Increasing MobilityIt is the hope that autonomous technology in vehicles

could help improve the availability of transportation for the elderly, people with a traumatic brain injury (TBI), or other disabilities.

“There is a lot of potential for individuals with hearing, vision, cognitive disabilities, etc. who can't drive today. If they have the ability to get into an AV and program it where they want to go, that vehicle can take them there safely and securely and then bring them back. That provides an added layer of mobility that they don't experience now,” said Kevin Kelly of General Motors.

Having convenient and reliable transportation would give those who are unable to drive on their own the ability to independently explore their community, attend classes and obtain a degree, connect with family and friends, or rejoin the work force.

Greater access to health care and having the ability to schedule one’s own appointments and therapy sessions may lead to healthier lives for those who were previously unable to have control over their own itineraries. An increased social life and being able to attend gatherings and events makes for a happier, healthier and more interesting life.

What is an Autonomous Vehicle? Depending on who you talk to, AVs can be referred to as

autonomous, robotic or self-driving vehicles. Autonomous vehicles are versions of our current vehicles but have the capability of taking over for the driver under certain situations.⁷

Continued from page 2

Autonomous vehicle remote sensing technology


Autonomy in automobiles has been in the research phase for several decades. There are technologies in vehicles today that have been the building blocks to AV. Examples include: Lane Keep Assist which will steer the vehicle back into the lane if the driver begins crossing the center or edge lines; Lane Departure Warning, which is similar to Lane Keep Assist, will alert the driver using visual, vibration or sound warnings if they are leaving the lane; and Adaptive Cruise Control that, when activated, will automatically adjust the vehicle speed and maintain an appropriate or preset distance to anterior vehicles. Another example is the Forward Collision Warning which will automatically apply the brakes if the distance to a vehicle ahead is closing too quickly. All of these features play a critical role in building on the foundation to realizing full autonomy.

The next stage is driverless cars. These types of vehicles usually have no steering wheel or pedals and they sense their surroundings using the following technology:

• LIDAR (Light Detection and Ranging)–a remote sensing method that uses light in the form of a pulsed laser to examine the surface of the Earth.

• Radar–a system for detecting the presence, direction, distance and speed of objects by sending out pulses of high-frequency electromagnetic waves that are reflected off the object and back to the source.

• GPS (Global Positioning System)–an accurate worldwide navigational system based on the reception of signals from an array of orbiting satellites.

• Computer Vision–a machine that analyzes objects in a way similar to how the human eye processes images and understands what it sees.

Levels of Autonomy The Society of Automotive Engineers (SAE) has defined six levels of automation in vehicles. They are:

Level 0–No autonomy Level 1–This vehicle has technology such as adaptive cruise and parking assistLevel 2–Partial automation. The vehicle can drive itself under certain conditions.Level 3–Conditional automation. The car monitors its surroundings and can alert the driver if needed. Most functions are automated. The driver doesn’t need to be engaged in driving, but needs to be ready to take control of the vehicle at any time.Level 4–High automation. A vehicle at this level should be able to function without a driver.⁸

Safety With the introduction of AV technology, it is hoped that

the number of accidents and fatalities could be sharply reduced. Studies show that 90% of accidents are due to human error. Former National Highway Traffic Safety Administration Chief Mark Rosekind estimates that the number of fatalities in the U.S. could drop to zero from a current average of 35,000-40,000 each year.

But, how safe is safe? When will we know that AVs are safe? Waymo has logged millions of miles in their driverless vehicles and reports only one accident. Is that safe enough? Legislators and regulators have to define what is considered safe and then consumers will have to decide if they are comfortable with that assessment.

Driverless vehicles could help to greatly reduce or even eliminate alcohol-related accidents and fatalities, which are currently approaching 10,000 per year.

The completely driverless car is still in development. However, the various features already available in partial and conditional automated vehicles could greatly benefit individuals with a TBI, a spinal cord injury, or another form of disability. AV is an interesting and exciting technology which will hopefully make for safer roads and add a level of mobility for those who are unable to operate traditional vehicles. ❚

References1. Claypool H, Bin-Nun, Ph.D A, Gerlach, J. The Ruderman White Paper Self-

Driving Cars: The Impact on People with Disabilities

2. http://www.crainsdetroit.com/article/20170731/news/635196/autonomous-cars-to-take-self-driving-trips-across-us-canada-border. Autonomous cars to take self-driving trips across U.S.-Canada border. Accessed Aug. 1

3. http://www.crainsdetroit.com/article/20170718/news/634146/autonomous-carmaker-navya-to-open-first-north-american-plant-in-saline. Autonomous carmaker Navya to open first North American plant in Saline. Accessed July 18, 2017.

4. waymo.com. Access Aug. 10, 2017

5. acmwillowrun.org/. Accessed Aug. 15, 2017

6. http://www.businessinsider.com/dominos-pizza-self-driving-pizza-robot-delivery-car-2016-9/#according-to-dominos-pizza-dru-is-the-worlds-first-autonomous-pizza-delivery-vehicle-1. A totally unexpected company beat everyone to self-driving cars. Accessed Aug. 18, 2017

7. https://axleaddict.com/safety/Advantages-and-Disadvantages-of-Driverless-Cars. Advantages and Disadvantages of Driverless Cars. Accessed July 20, 2017

8. 360.here.com. The difference between autonomous and driverless cars. Accessed July 20, 2017


• SUCCESS STORY

THE Power OF POSITIVITY


On any given day in the summer of 2016, you could have found Greg Graham playing basketball with his friends, hanging out with his cousins, or playing

video games with his little brother.Greg had just graduated from high school and was well

on his way towards working a full-time job in construction at the Little Caesars Arena in Detroit. Growing up, Greg had worked hard to be a positive role model for his younger brother and close family, and he held high aspirations for himself.

As the summer was coming to an end, Greg spent the day just like many others—driving around with friends and having a good time. But on this day the driver became distracted and lost control of the vehicle. The car collided into the concrete barrier of the highway and, without a seatbelt on, Greg was ejected from the car.

The world Greg had come to know and love quickly came to a jarring new beginning. He sustained a traumatic brain injury (TBI), multiple oral fractures, fracture of his right shoulder, laceration of his liver and a serious renal injury. He underwent a series of complicated surgeries and began his rehabilitation journey. The next three months were a blur as Greg spent his time fully dedicated to his physical and mental recovery in the hospital.

During the course of his hospital stay, he recalls having talked with doctors about what he could expect for recovery. One doctor told him that it could take him at least two years before he might walk again. These were words that resonated with Greg.

In January 2017, Greg moved into Rainbow Rehabilitation Center’s NeuroRehab Campus (NRC) in Farmington Hills, MI to begin his next stage of rehabilitation. Right off the bat, he began daily treatments

in physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), and mental health (MH).

During this time, Greg often struggled with negative thoughts and feelings towards his situation. He could not help but wonder why he had been dealt such a bad hand and think about how this change affected the plans he had made for his life. It would have been easy to dwell on the negative feelings that he was experiencing. However, that simply was not the Greg way to navigate through life. Greg had grown up knowing that hard work, paired with a positive attitude, is what yields the best results. So he harnessed his frustrations and applied them toward making progress in his therapies.

When he first moved to the NRC, Greg was dependent on others to complete the once simple tasks of dressing, bathing, toileting, transferring himself, and walking. This dramatic change in lifestyle and independence was difficult for Greg to cope with, but he kept reminding himself of his mantra—“hard work pays off.” He found himself thinking about what his doctor had told him about walking, and he decided he was going to prove him wrong.

Through his perseverance and diligent hard work, Greg began to build up his endurance and strength. He began to squeeze his hand a little harder, reach a little further, sit with less assistance. Day by day, the little gains culminated into large, grossly noticeable changes. Within three months of intensive therapies, he could transfer himself to and from his wheelchair with use of a cane. He began walking using a four-wheeled walker with the assistance of two therapists at his side, and he could complete components of dressing and bathing himself again. It was these gains

THE Power OF POSITIVITYBy Sarah Parks, MSOT, OTR/L, Abby Dull, PT, DPT, CBIS, CKTP and Kaitlin O’Hara, PT, DPT, CBIS

Rainbow Rehabilitation Centers

Continued on page 8


• SUCCESS STORY THE POWER OF POSITIVITY

About the authors

Abby Dull, PT, DPT, CBIS, CKTP Physical TherapistAbby is a physical therapist at Rainbow’s Oakland Treatment Center, serving the pediatric and young adult population. She earned her Doctorate of Physical Therapy from Grand Valley State University and has worked at Rainbow for the past 3 years. Abby is a specialist in Brain Injury and Kinesio Taping and has received advanced training in Pediatrics, Sports Therapy, Interactive Metronome, and Neuro-Developmental Treatment.

Kaitlin O’Hara, PT, DPT, CBIS Physical TherapistKaitlin has been a physical therapist with Rainbow’s NeuroRehab Campus since June 2014. She holds a Doctorate of Physical Therapy from Washington University in St. Louis and a bachelor’s degree in Health Fitness in Preventive and Rehabilitative Programs from Central Michigan University. Kaitlin is certified to provide treatment for individuals with movement disorders related to Parkinson’s disease and other neurological disorders using the LSVT BIG® modalities. She is also a Certified Brain Injury Specialist and primarily works with the adult population.

in functional independence that kept Greg motivated to continue putting forth his best effort at all times. That is, unless it was 8 a.m. on a Saturday morning. But even in these instances, Greg found something positive to look forward to each day, whether it be a trip to the movies, the bottomless popcorn he so enjoys, or a visit from his family.

At the NRC, Greg was one of the youngest individuals at the center and it was difficult for him to be away from his family during his recovery. Despite that, he demonstrated a great ability to make the best of his situation, and he managed to find ways to keep himself and his therapy team laughing through the tough times.

In April 2017, he received great news—he was able to go home and continue his therapies as an outpatient at Rainbow’s Oakland Treatment Center in Farmington, MI. In addition, he would participate in the young adult vocational program to regain work skills. In this environment, amongst peers of his age who have gone through similar experiences, he continued to progress and grow. He would come to therapy sessions and casually state that he had done an activity at home that he worked on in therapy sessions. That’s right—he was giving himself

his own homework to complete to expedite his progress even more.

At this time, 10 months after his injury, Greg is now able to transfer himself to and from his wheelchair. He can dress himself with near independence. He no longer has to rely on others to access his environment, as he has built up his arm strength in order to wheel himself in the community in his wheelchair. Walking is not just something to think about in another year’s time. Through hard work in PT, he can walk up to 300 feet with the use of a cane.

Greg is truly an inspiration and a role-model to be followed by all. He proves that hard work and a positive attitude really do pay off. When asked what advice he has for others, he responded with, “Always wear a seatbelt, drive the speed limit and do not let anything distract you when driving. If you are positive, you will get positive things. It’s all up to you.”

What really is special about Greg is his uncanny ability to find laughter in any situation. Words of wisdom that we can all live by are, “Laughter is the best medicine you can have...without a prescription.” ❚


Sarah Parks, MSOT, OTR/L Occupational TherapistSarah has been at an Occupational Therapist at Rainbow’s Oakland Treatment Center since April 2016. She received her Master of Occupational Therapy at Washington University in St. Louis and holds a Bachelor of Science degree in Kinesiology with a Specialization in Health Promotions from Michigan State University. Sarah specializes in treatment of pediatric through young adult populations and has received training in Pediatrics, Brain Injury and Interactive Metronome.


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• INDUSTRY NEWS


GOOD NEWS, FAKE NEWS, and NEW NEWS on the

CONCUSSION FRONT

In the quarter century from 1975 to 2000, Google lists 335,000 citations on concussion. Yet in the single decade from 2000–2010, that number

virtually doubled to 653,000 citations. And in the seven years from 2010 to today, citations on concussion skyrocketed to 4.17 million and counting. If concussion were a Facebook page or energy drink, that would be great news. But is it really? And what accounts for such dramatic growth?

Fortunately, people don’t seem to be getting concussed in greater numbers or with more frequency. And even though underreporting remains a huge problem, there appears to be more reporting of concussion—especially by female athletes and by males especially when athletic trainers or knowledgeable adults are present. Awareness is the key. As the NFL has slowly become more open about brain injuries, and professional athletes have gone public with their concerns, concussion has taken center stage.

This dramatic citation growth reflects two trends, the first of which is certainly positive: a significant number of those citations, especially recently, link to scientific and medical journal articles. And that in turn demonstrates the growing importance of concussion and brain injury as a valid investigational field—and clearly, one benefiting from new funding sources.

The second trend, mostly positive for reasons detailed below, is the public’s increasing interest in concussion, largely fueled by the media.

In 2006, former Harvard football player and WWE wrestler Christopher Nowinski kicked off the firestorm with the publication of Head Games, a book about his football and wrestling concussions. Six years later came the documentary film version Head Games: The Global Concussion Crisis.

Meanwhile, in a 2005 journal article,1 forensic pathologist Dr. Bennet Omalu demonstrated that former Pittsburgh Steeler Mike Webster’s brain showed unmistakable signs of chronic traumatic encephalopathy (CTE). First ignored by the medical community and then roundly criticized by the NFL, Omalu’s work was later featured in a 2009 GQ article,2 a 2015 book, and companion feature film, Concussion. Just prior to that film, the NFL’s response was detailed in a series of NYTimes3 articles and later, a book and PBS documentary, League of Denial, in 2013.

With this kind of media exposure, it’s no surprise that concussion awareness and concern filtered down from the pros to college and university, high school, and even middle school athletes and their parents. And with that concern came unintended consequences.

For those of us who work in the brain injury field, greater awareness is invariably a good thing. But when awareness is driven by exaggerated, fear-mongering media reports, inaccurate depictions in movies and books, even a congressional grilling of NFL Commissioner Roger Goodell,4 the public can mistakenly jump to conclusions.

By Tom Constand, President & CEO The Brain Injury Association of Michigan



• INDUSTRY NEWS NEWS ON THE CONCUSSION FRONT

One such conclusion was that football was so high risk that parents should prohibit their children’s participation. As a result, the nation’s largest youth football program, Pop Warner, saw participation drop 9.5 percent between 2010-12, a sign that the concussion crisis that began in the NFL is having a dramatic impact at the lowest rungs of the sport.5 Worse, six to 14 year olds’ participation in football dropped from three million in 2010 to two million just five years later—a 27.7 percent decline. Even diehard Hall of Fame player and coach Mike Ditka proclaimed “the risk is worse than the reward” of playing football, telling a reporter he’d encourage a youngster to try golf.6

It’s no wonder many parents and athletes jumped to the conclusion that CTE was all but inevitable after a concussion, but the blame really belongs with the media for confusing correlation with causation. Even the medical group most proactive in CTE research, Boston University’s CTE Center, notes that while multiple concussive and sub-concussive hits can lead to CTE, that link has not been scientifically proven. There are both athletes and non-athletes who experienced multiple concussions and sub-concussive hits who did not show signs of CTE, so other factors, including genetics, may be involved.7 In other words, eliminating football and contact sports, or placing a Surgeon General’s warning on them, may be premature.

Thankfully, there are voices of evidence-based moderation. Findings from the most recent International Consensus Statement on Concussion in Sport8 suggest that early diagnosis, a period of rest, and a gradual return to activity and play may be sufficient to ensure recovery and reduce future risk for many. For those individuals presenting with symptoms which don’t resolve in a day or two—such as headache, dizziness, memory loss, fatigue,

cognitive deficits, sleep disturbances, and others, post-concussive syndrome may be a possibility and medical attention is required.

But nothing in concussion diagnosis is simple. Numerous studies have established that too much rest can also be detrimental, and some concussion symptoms experienced by committed, elite athletes may instead be due to anxiety and depression from not being able to play.⁹

While we wait for treatment science to catch up, there’s much activity on the prevention and diagnosis fronts. New procedures and innovations range from pre-season baseline testing of athletes10 to biomarker analysis,11 new helmet12 and mouth guard technologies,13 neck strengthening,14 vision training,15 and, among others, woodpecker-inspired neck collars16 that increase cerebral blood volume as a kind of bubble-wrap.

Today, insiders regard the current spate of proposed remedies and products as something like “the wild west.”17 With more rigorous research, testing, and formalized approval processes, we’ll hopefully soon see innovations reducing concussion’s incidence, moderating its severity, and making diagnosis and treatment more definitive. In the interim, new practice guidelines designed to limit contact, safer rules for hits and tackles,18 and continuing education for coaches, trainers, and athletes are already having—if you’ll forgive the term—an impact on concussion reduction. Concussion may not be avoidable, but society seems to finally be getting a handle on its management. ❚

About the author

Tom Constand, President & CEO The Brain Injury Association of Michigan

Tom Constand serves as President and CEO of the Brain Injury Association of Michigan, a nonprofit 501(c)(3) organization that functions as the primary conduit to resources between an estimated 200,000 brain injury survivors and their families in Michigan, and the broad network of rehabilitative care facilities, programs and professionals across the state that serve them.


NOTE: The views expressed here are those of the author and do not necessarily represent or reflect the views of Rainbow Rehabilitation Centers.


References1. https://www.ncbi.nlm.nih.gov/pubmed/15987548

2. http://www.gq.com/story/nfl-players-brain-dementia-study-memo-ry-concussions

3. http://www.nytimes.com/2011/07/21/sports/football/re-tired-players-sue-nfl-over-treatment-of-concussions.html?r-ref=collection%2Ftimestopic%2FHead%20Injuries%20in%20Football&action=click&contentCollection=sports&region=stream&mod-ule=stream_unit&version=latest&contentPlacement=443&pgtype=col-lection

4. http://www.nfl.com/news/story/09000d5d813c29ef/article/goodell-de-fends-nfl-policies-on-head-injuries-to-congress

5. http://www.espn.com/espn/otl/story/_/page/popwarner/pop-war-ner-youth-football-participation-drops-nfl-concussion-crisis-seen-caus-al-factor

6. https://www.si.com/nfl/2015/12/23/mike-ditka-golf-football-concus-sion-safety

7. http://www.bu.edu/cte/about/frequently-asked-questions/

8. http://bjsm.bmj.com/content/early/2017/04/26/bjsports-2017-097699

9. https://www.amazon.com/Back-Game-Concussion-Doesnt-Athletic/dp/0190226609

10. https://www.cdc.gov/headsup/basics/baseline_testing.html

11. https://www.futuremedicine.com/doi/full/10.2217/cnc-2015-0002

12. https://www.forbes.com/sites/abigailtracy/2016/02/04/nfl-cte-foot-ball-concussions-injuries-helmet-vicis-zero1-super-bowl/#503a76595f05

13. https://www.digitaltrends.com/cool-tech/fit-guard-mouthpiece-ces-2016/

14. https://www.usatoday.com/story/sports/college/2015/01/09/neck-strength-importance-concussion-prevention/21526633/

15. https://www.dynavisioninternational.com/news/need-for-visiontraining

16. http://gizmodo.com/this-woodpecker-inspired-collar-could-protect-ath-letes-1782249329

17. https://www.nytimes.com/2015/07/05/business/effective-concus-sion-treatment-remains-frustratingly-elusive-despite-a-booming-indus-try.html

18. https://www.nfhs.org/media/1014079/2014-nfhs-recommenda-tions-and-guidelines-for-minimizing-head-impact-final-october-2014.pdf

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• SUCCESS STORY


The first day I met Tom Sparschu, he asked me to thread a needle for him. Upon returning the threaded needle, he said, “Thanks Buddy. Just wait,

you’re going to be my new buddy.” Little did I realize at the time how true this statement would turn out to be and how much I would come to rely on Tom.

Prior to his accident in 2009, Tom was living at home with his parents in Mt. Clemens, MI. He spent his days working as a prep cook at an upscale Italian restaurant. He was responsible for keeping the kitchen clean, doing the dishes, emptying the trash, and stocking the wine cellar. He enjoyed his work and liked the owners of the restaurant.

In his spare time, he enjoyed drawing, gardening and taking care of the angel fish in the 10 gallon fish tank his father kept in their kitchen. Tom states that he was born with artistic talent that runs in his family. His Uncle Howard was also a budding artist. Prior to his accident, Tom had drawn two beautiful bird pictures that can now be seen hanging in the hallway at Rainbow’s corporate offices. He also states that he has always had a green thumb and a knack for taking care of fish. The green thumb he credits to his mother, and Tom’s affinity for fish comes from his father.

One night, after finishing his shift at the restaurant, Tom walked over to a store. He crossed three of the four lanes successfully before he was hit by a vehicle.

He doesn’t remember the accident itself, how he arrived at the hospital or his subsequent transfer to another. Tom suffered two broken legs, damage to his face, head and eye, and a traumatic brain injury (TBI). He was later told

that his head hit the roof of the car which caused him to lose one of his eyes. He spent three weeks in a coma and required a tracheostomy, feeding tube, and multiple surgeries.

Tom was eventually transferred to a rehabilitation facility to begin the recovery process. While there, Tom began physical therapy to help him regain his ability to walk. Due to his bilateral leg fractures, Tom required the placement of titanium rods. He was initially wheelchair bound but progressed quickly to crutches and then to walking on his own again. It was during this time that Tom received his prosthetic eye, which he states does not affect his vision at all.

Tom received many visits from his parents during this time, and they brought him special mementos, many of which he still has today, including a shaggy rug for his room and a Christmas tree. Tom credits the support he received from his family for helping him in his recovery.

After 10 months, Tom was ready to move on to the next step in his rehabilitation process. He says that he still remembers touring Rainbow and walking into the fitness room for the first time. He knew then that Rainbow was where he wanted to continue his recovery.

At Rainbow, Tom began with occupational therapy, fitness and mental health counseling. He remembers working with Richard Monarch, COTA, building dinosaurs and “putting things together.” Together they worked on Tom’s fine motor skills, problem-solving, direction-following, sequencing, and decision-making. Tom also ran on the treadmill and participated in strength training exercises to continue regaining the strength in his

UNBELIEVABLE!A TBI HASN'T TAMED TOM'S

Artistic TalentsBy Laura Sarten, ETS




legs. Eventually, Tom started getting more involved in our day treatment program, Rainbow U. One class in particular caught his attention: Introduction to Fibre Arts.

Introduction to Fibre Arts was taught by Char Sobieski-Greco, whom Tom states taught him everything he knows about fibre arts. When Char first created the fibre arts Rainbow U class, she wasn’t sure anyone would sign up. Tom was one of the many clients that expressed interest.

On the first day of the class, Char asked each client why they were there. Tom stated, “I just love art. I don’t know anything about fibre arts, and I want to learn about it.” It was through this class that Tom began to break out of his shell.

He initially worked at the end of the table, in his own space. Char remembers that everything Tom first created had to match and be symmetrical. She said he rarely used any colors except oranges, reds and yellows. Eventually she noticed that, as he got more comfortable, he started mixing things up by experimenting with more cool color tones.

At the end of the first semester, Char decided to hold the class a second time. She was shocked when the very same clients signed up again. She had planned on holding

another Introduction to Fibre Arts class but quickly realized that she would have to branch out. She remembers Tom telling her that as long as she offers classes, he’ll keep coming because he loves art, and he’s making friends. “He really grew through his art. It helped him to open up, make friends, and get out of his comfort zone,” Char recalls.

It was this class that lead Tom to where he is today in the vocational program at Rainbow. As Tom and I talk about his accident and where he is today, he is multi-tasking like the best of them. As his job coach, it’s my job to help him build the vocational skills that he will need to seek community employment. Today he is putting the finishing touches on a custom ordered birdhouse, painting a superhero logo on a child’s Adirondack chair, and hoping to get started on felting scarves with Char.

The most common thing that Tom says to me is, “Oh, that’s easy. I can do that!” He can, and he does. From his first days in the vocational program painting and assembling wooden kits, to now showing off the painted picnic tables, tie-dyed end tables, painted scarves, decorated birdhouses and much more in the showroom of Rainbow’s Vocational Rehab Campus (VRC) in Ypsilanti,

• SUCCESS STORY UNBELIEVABLE!



About the author

Laura (LJ) Sarten, ETS Job Coach

Laura (LJ) Sarten works as a job coach at Rainbow's Vocational Rehab Center in Ypsilanti, Michigan. She began her career as a job coach two years ago during a summer spent in North Carolina. During that time she worked directly alongside individuals living with autism, providing supportive structures for independent living. Beyond the two years of direct experience with job coaching, LJ has 16 years of experience working with those affected by traumatic brain injuries, 15 of those years being spent in various positions at Rainbow. She is currently pursuing her bachelor’s degree in therapeutic recreation from Eastern Michigan University.

MI. These activities have boosted Tom's confidence and have helped him form an identity for himself.

Aside from being my go-to for almost all things that need to be painted or decorated in the woodshop, Tom has also recently started working at a restaurant in Ann Arbor, MI. He started out, of course, decorating cookies but has now moved on to prepping food, making pies, and doing anything else that comes his way. He looks forward to it every week, reminding me on Tuesdays that he’ll be at the restaurant on Wednesday.

Tom still keeps busy gardening at his house where he is currently growing enormous tomato and cucumber plants, mint, basil, and parsley. He still has a knack for taking care of fish and maintains three tanks and five fish in his room, often bringing in pictures to show them off. On Mondays he volunteers at a cat shelter. Tom is one busy guy.

When I was approached about writing this article, I made a point to ask Tom how he felt about it. “They want you to talk about your successes,” I told him. “Oh, that’s easy. I can do that,” he replied. When I asked him specifically what he is most proud of and what he feels is his greatest success, he responded that it’s the silk scarves that he makes with Char. “The women eat them up!” he said.

Of all the things that Tom has been through over the years since his accident, he credits Rainbow’s Vocational Rehabilitation Program with allowing him to grow the most. “My art has really blossomed at the VRC, and I’m able to be creative and create my art.” Tom’s story is the definition of a success story. ❚

� Tom proudly shows off a couple of his hand-painted floral silk scarves that are displayed, and for sale, at Rainbow's Vocational Rehab Campus in Ypsilanti, Michigan.


Survival after severe brain injury was a medical accomplishment that occurred during our lifetime. However, health professionals soon discovered that

brain injury recovery was a unique and difficult process for the person who survived, their family members, and for health providers. Treatment was haphazard, and access to medical rehabilitation was limited because “people with traumatic brain injuries didn’t cooperate and couldn’t learn.”

Nearly 30 years ago, a survey was sent out to over 500 hospitals, nursing facilities, and post-acute residential programs regarding the training needs of persons providing brain injury rehabilitation services. The results drove the work of a committed group of professionals to rectify the lack of a consistent staff training approach.

The Brain Injury Association of America (BIAA) established the American Academy for Brain Injury Certification (ACBIS) in 1996. This voluntary national certification program established best practices for the training of individuals working with this population.

In 2004, Rainbow was one of 11 nationally recognized rehabilitation programs that supported the development of brain injury specialist certification by serving as a founding member on its Corporate Advisory Council. In 2005, Rainbow leadership joined the ACBIS Board of Governors and served for over 10 years.

Rainbow Rehabilitation Centers’ leadership lent its professional staff in areas of creative design, clinical educational development, and editorial skills to the development of the published training curriculum called the Essential Brain Injury Guide. With the most recent

edition, Rainbow leaders served as production editor, and technical editors.

At the state level, Rainbow’s leadership was integral to Michigan achieving the status of having the most Certified Brain Injury Specialists (CBIS) of any state. Rainbow was one of a handful of programs that worked with the Brain Injury Association of Michigan to bring this organized training and examination to the state. Rainbow employees volunteered their time to train and proctor exams. This led to a formal education award from the Brain Injury Association in 2006.

Locally, since 2009, Rainbow opened its bi-annual certification training program to other professionals who partner with Rainbow in serving people with brain injury. Case managers, therapists and nurses from referring hospitals, insurance adjusters, medical office personnel, and many others have joined Rainbow employees in working toward certification. Nearly 300 external participants have benefited.

Currently, Rainbow has seven Certified Brain Injury Specialist Trainers serving as mentors and trainers internally and externally. The preparation course continues to be offered for free and is approved for 14 nursing and case manager CEs. The next class scheduled for this October is full. Another course will be scheduled in the spring of 2018. If you are a professional who partners with Rainbow, you have an open invitation to join us! ❚

Helpful Links

1. The Brain Injury Association of Michigan: biausa.org/acbis2. CBIS Exam Prep Flashcards:

rainbowrehab.com/cbis-exam-prep-handouts

NATIONALLY and LOCALLYRAINBOW MAKES A DIFFERENCE

• INDUSTRY NEWS

By Lynn Browers, MS, CRC, CBISTRainbow Rehabilitation Centers

A Leader in Brain Injury Rehabilitation Education Supporting the Brain Injury Association of America’s effort to assure high quality post-acute care


Email [email protected] ASAP to reserve your spot!

Join more than 1,500 Certified

Michigan Professionals

Become a

CERTIFIED BRAIN INJURY

SPECIALIST

Earn 14 CCM and/or RN CEs

The Academy of Certified Brain Injury Specialists (ACBIS) offers a national certification program for experienced professionals working in the field of brain injury. ACBIS provides an opportunity to learn about brain injury, to demonstrate learning with a written examination, and to earn a nationally recognized credential.

As a service to our brain injury community, Rainbow is offering a free training course to prepare for the CBIS exam. Receive a discounted exam fee of $200 ($100 less than the individual application cost) when you take the exam with Rainbow's group.

Nurses, case managers and other professionals who partner with Rainbow and have at least one year of experience working in the field of traumatic brain injury rehabilitation are invited to attend.

FREE CBIS TRAINING

COMPREHENSIVE BRAIN INJURY REHABILITATION TRAINING May 10-11, 2018 • 8:30 a.m.–4:30 p.m.PROCTORED EXAMS Scheduled at your convenience

LOCATION Rainbow Rehabilitation Centers17187 N. Laurel Park Dr., Suite. 160, Livonia, MI 48152

2018 SERIES DATES

THIS CLASS IS NOW

2 DAYSAND USES THE

NEW EBIG 5.0

Textbooks will be available for loan with a deposit or purchase

at a discounted price of $80

This activity has been approved by the Ohio Nurses Association. The Ohio Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission. (OBN-001-91). This program has been approved by the Commission for Case Manager Certification to provide board certified case managers with 14.0 clock hour(s). To verify successful completion of this program and 14.0 contact hours, you must sign in and sign out on-site each day, attend the entire presentation and complete an evaluation form after the program concludes. The planners and faculty have declared no conflict of interest. Please call Marianne Knox at 734.482.1200 for more information about contact hours.


• THERAPY CORNER


Powered exoskeletons, wearable robotics, passive exosuits and “powered clothing” are bringing Iron Man’s armor down to earth—and maybe into your

closet. Even if you lack the resources of Tony Stark, you can obtain a high-tech suit to enhance your natural abilities or at least help you avoid a backache. Mechanical outfits, known as exoskeletons, are gaining a foothold in the real world.1

The Japanese company Panasonic recently announced that it will start selling an exoskeleton designed to help workers lift and carry objects more easily and with less risk of injury. Panasonic’s device is among a small but growing number of exoskeletons available commercially—less fantastic and more cumbersome versions of a technology that’s been a staple of science fiction for some time.

U.S. Bionics, a company cofounded by Homayoon Kazerooni, a professor at the University of California, Berkeley, is also working to commercialize two exoskeletons—one for rehabilitation, which is currently being tested in Italy, and another for industrial use. These are designed to be very lightweight and conform well to a person’s normal motion.

Exoskeletons have found commercial traction for rehabilitation, especially in the area of stroke or spinal cord injury patients and as walking aids. Such exoskeletons

are sometimes also called Step Rehabilitation Robots. A company called ReWalk, based in Marlborough, MA, has a device for people with spinal cord injuries.

ReWalk has already propelled former chiropractor Claire Lomas into the record books. Five years after a horse-riding accident left Lomas paralyzed from the chest down, she became the first person to complete a marathon in a bionic exoskeleton at the London Marathon in May 2012 while using the ReWalk. ReWalk is a safe, ambulatory-powered orthosis for patients with a complete spinal cord injury at the thoracic level or below.

Ekso Bionics is the original developer of HULC, now under military development by Lockheed Martin, and the current developers of Ekso (formerly eLEGS), which allows wheelchair users to stand and walk.2

Approximately 200,000 Americans currently live with a disability related to spinal cord injury (SCI). Stroke is the fifth leading cause of death in the United States and is a major cause of serious disability for adults. About 795,000 people in the United States have a stroke each year. Advances in medical care have resulted in increased rates of survival and longer life span.3

Nearly 70 percent of patients with a new SCI have been shown to have a reduced quality of life, pain and long-term reduction in satisfaction. Among those patients, the

By Payal Desai, LPT NDTC, CBIS, CKTPRainbow Rehabilitation Centers

WALKING AGAINRealizing Independence through Technology

Three and a half years ago Tommie Lee McMullen was involved in an automobile accident. The driver walked away with minor injuries, but Tommie was left partially paralyzed from the chest down. When therapists at Rainbow's Ypsilanti Treatment Center in Ypsilanti, MI asked Tommie if he would like to try the ReWalk exoskeleton, he seized the opportunity!


• THERAPY CORNER WALKING AGAIN

different factors affecting life satisfaction include mobility limitations, changes in occupational roles or physical health.4

The physical deconditioning resulting from largely sedentary lives of individuals with injuries that leave them wheelchair bound is well documented. Lack of standing, walking, muscle work or weight bearing all contribute to impaired bowel and bladder function, increased spasticity, joint contractures, decreased muscle mass, obesity and decreased bone density among other things.

Exercise has shown to be an effective contributor to overall health, but therapeutic exercise for wheelchair bound individuals has several limitations: difficulty in execution, insufficient cardiovascular stimulus, potential for injury and need for specialized equipment. Functional walking is an excellent means to accomplish exercise without the extra time commitments. But it is a difficult option for patients who don’t have sufficient strength, range of motion, appropriate tone or balance to stand or walk.

That is where the exoskeletons come into use. They provide support from lower trunk through bilateral lower extremities like traditional knee ankle foot orthoses (KAFO) but also add in the component of independently controlled bilateral hip and knee joint motors and a computerized control system. The joint motors and computerized systems on the ReWalk are controlled through a portable watch/remote and by the user through subtle trunk motion and changes in center of gravity.

The device is adjustable in height and width and uses straps to secure the patient into the exoskeleton. It allows for a sit to stand, stand to sit and walking modes for activity types.

The appeal of this technology is that it can provide substantially higher repetitions for walking without placing strain on therapists. They require active participation from the patient in swing initiation and foot placement. They are also used over ground walking and require the patient to be responsible for maintaining trunk and balance control as well as navigating their path over varying surfaces.

The ReWalk™ Personal 6.0 System is designed for all day use at home and in the community. It is the most customizable exoskeleton and is configured specifically for the client. This precise fit optimizes safety, function and joint alignment.


There have been several studies conducted on exoskeletons that have shown no adverse events during the course of the training intervention. One study reported minor and temporary adverse effects such as skin irritation, pinching or pain from cuffs.5

A 2016 report from the Veterans Administration has suggested that over 60 training sessions may be needed to achieve proficiency with both indoor and outdoor mobility, including door/threshold navigation, stopping, turning, and reaching. There are concerns about the safety of these devices under regular use, including the potential to trip and fall. The evidence is insufficient to determine the effects of the technology on health outcomes.

Even if current exoskeleton suits don’t bestow superhuman powers, they will increasingly impact people’s lives by helping them get around safely and independently.

Rainbow Rehabilitation Centers currently has two physical therapists who are certified ReWalk trainers who can assist clients like Tommie McMullen progress through ReWalk training with good success. ❚

About the author

Payal Desai, LPT NDTC, CBIS, CKTP Physical Therapist and Clinical Manager

Payal has a bachelor’s in physical therapy and a PG Diploma in clinical psychology. She is certified in neuro-dynamic therapy from the Neuro-Dynamic Therapy Organization. She is also a Certified Brain Injury Specialist, Certified Kinesiotaping practitioner, Vestibular rehabilitation and a Certified ReWalk Trainer.

Candidates for the ReWalk™ should have the following characteristics:

• Hands and shoulders can support crutches or a walker

• Healthy bone density • Skeleton does not suffer

from any fractures • Able to stand using a device

such as a standing frame • Good health in general • Height is between 5’3”-6’2” • Weight does not exceed 220 lb

The appropriateness of a patient for an exoskeleton is determined by a combined effort from their rehabilitation team. They look at the patient’s injury, co-morbidities, goals and funding.

References1. https://www.technologyreview.com/s/539251/the-exoskeletons-are-

coming

2. http://eksobionics.com

3. Center for Disease Control Website: cdc.gov

4. The ReWalk Powered Exoskeleton to Restore Ambulatory Function to Individuals with Thoracic-Level Motor-Complete Spinal Cord Injury Article by Alberto Esquenazi, MD, Mukul Talaty, PhD, Andrew Packel, PT, NCS, Michael Saulino, MD, PhD. Published in Americal Journal of Physical Medicine and Rehab.

5. Powered robotic exoskeletons in post-stroke rehabilitation of gait: a scoping review, Dennis R. Louie and Janice J. Eng. Journal of NeuroEngineering and Rehabilitation201613:53 https://doi.org/10.1186/s12984-016-0162-5, Received: 16 March 2016, Accepted: 3 June 2016, Published: 8 June 2016


The Importance of a

Support Network FAMILY SUPPORT GROUPS AT RAINBOW

• TBI TOPICS

By Carolyn Scott, Ph.D., CBISTRainbow Rehabilitation Centers

Brain injury affects more than just the individual with the injury; families also experience a wide range of reactions and disruptions to their daily lives. To help

address these stressors, Rainbow Rehabilitation Centers offers a support group open to the community.

The support group meets once a week for eight weeks to provide educational information and a venue for peer support. Each of the weekly meetings is designed to provide helpful information and spur conversation. Because each attendee brings a different level of knowledge to the meetings, the depth of coverage and resulting conversation can vary depending on the audience.

In the first week, functional neuroanatomy is reviewed, providing family members with an opportunity to develop a greater understanding of their family member’s injury. Families gain insight into how brain injury is expressed similarly and differently in individuals.

The next three weeks cover the physical, cognitive, and emotional/behavioral changes common after traumatic brain injury (TBI). Often it is the cognitive and behavioral complications of an injury that stresses the family the most. When your family member is unable to communicate or recognize you, it can be heart-breaking. Similarly, if the individual is impulsive and inappropriate,


About the author

Carolyn A. Scott, Ph.D., CBIST Psychologist

Dr. Scott earned her Ph.D. in Clinical Psychology at Wayne State University. After an internship at the John D. Dingell VA Medical Center, she completed specialized post-doctoral training in Neuropsychology and Rehabilitation Psychology at the Rehabilitation Institute of Michigan. While there, Dr. Scott worked with individuals who had experienced traumatic brain injuries, stroke, spinal cord injuries, and other neurological and orthopedic conditions on both an inpatient and outpatient basis. In addition to other responsibilities, Dr. Scott provides client and team consultation services and brief and expanded neuropsychological evaluations at Rainbow Rehabilitation Centers, Inc.

it can feel isolating or frustrating. Families benefit from an opportunity to see how others in their same position cope with and manage challenging behaviors or changes in cognition and physical ability. Evidence-based strategies for managing these changes is also presented.

The last four sessions focus on healthy coping strategies including effective communication. Family members often take on the role of advocate and caregiver after a catastrophic brain injury. Communication skills are essential in these new roles. Additionally, it is essential that family members communicate their own needs in order to reduce caregiver burn-out and process the many emotions and thoughts that occur after a life-changing event. Grief and loss are also discussed.

Ultimately, the goal of the educational portion of the support group is for families to feel more comfortable with their understanding of TBI and confident in how to manage the different challenges that may arise. We hope that family members feel empowered to manage their multiple stressors.

Additionally, the support group is designed to allow families to meet others in similar situations and, ideally, build support networks. While their circumstances may have been different prior to the injury, the common bond of TBI seems to draw families together. Families often keep in contact with one another even after they leave Rainbow. They are each other’s cheerleaders and shoulder on which to cry.

A recent participant stated the following about the support group:

We enjoyed the group so much. Thank you for making it available to us. It was nice to be with others who are in the same boat as we are and be allowed to share what we are feeling and going through. It was very uplifting knowing that all of you at Rainbow know our struggle and are there to support us. Thank you all so much for everything you did and still do. You all have become a part of our family. Love to all!

Research has demonstrated the importance of social support. For instance, caregivers who felt that they had adequate social support reported better life satisfaction and were better able to cope with some of the negative consequences of brain injury.1 This is only one of many examples available which reflect

the importance of a support network.For more information about Rainbow Rehabilitation

Centers’ family support group, email [email protected]. Childcare is available with a reservation. If you need a group closer to home, visit biami.org or call neighborhood hospitals to find potential options. ❚

References1. Ergh TC, Hanks RA, Rapport LJ, Coleman RD. Social support moderates

caregiver life satisfaction following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology . 2003; 1090-1101.

It was very uplifting knowing that all of you at Rainbow know our struggle and are there

to support us.


• INDUSTRY NEWS

Congratulations! You have worked hard to earn your license and certification. Your professional dedication is acknowledged and recognized by

Rainbow Rehabilitation Centers!In order to maintain your license and certification,

you are required to complete continuing education. Continued education is intended to keep you current with emerging trends and technologies. Each licensing agency or certification board has required a specific amount of continuing education (CEs) per certification/licensure period. Generally, each year 12-16 contact hours or continuing education credits are needed for health care professionals.

While licensing requirements vary by state, the certification requirements are dictated by each particular board. Certified Case Manager (CCM) certification mandates 80 continued education hours over five years. Certified Brain Injury Specialist (CBIS) certification renewal requires 10 CEs from at least two types of sources each year. The certification required for Certified Brain Injury Specialist Trainer (CBIST) certification requires 15 continued education hours each year. These are just a couple of examples. Be certain to check your particular certification requirements. You don’t want to have to retake that exam!

Rainbow Rehabilitation Centers offers free continuing education hours in a couple of ways. Currently, we have eight articles on our website which meet the requirements for CCM and CBIS certification. You can earn 1-1.5 CEs per article.

CLEARING THE CONFUSION REGARDING CONTINUING EDUCATIONCommonly, in the business of health care, we misuse the term CEU. Most know that it stands for Continuing Education Unit. Most people also commonly mistake it to mean one hour of continuing education credit.

TO CLARIFY:A contact hour consists of 50-60 minutes

1 contact hour = 1 continuing education credit

CE = 1 contact hour or 1 continuing education credit

CEU = 10 contact hours or 10 continuing education credits

Source: Michigan Department of

Licensing and Regulatory Affairs

GIVE YOURSELF SOME CREDIT!Rainbow offers free continuing education hours

By Kathleen Sobczak, BSN, RN, CBIS, WCC, CRRNRainbow Rehabilitation Centers


About the author

Kathleen Sobczak, BSN, RN, CBIS, WCC, CRRN Admissions Manager

In 1999, Kathleen started as the first nurse case manager to two of Rainbow's medical houses. When Rainbow opened their NeuroRehab Campus in 2007, Kathleen became the Nurse Case Manager. Her role there evolved and in 2011 she became the Nurse Manager. Throughout her Rainbow career, Kathleen has become Wound Care Certified, a Certified Brain Injury Specialist, a Certified Rehabilitation Registered Nurse, and an American Red Cross CPR instructor. Last year, Kathleen joined the Admissions team as an Admissions Manager at Rainbow's Corporate Center in Livonia, Michigan.

PEDIATRIC • ADOLESCENT • YOUNG ADULT • ADULTRainbow provides outpatient and day treatment services to clients living in their own homes who wish to participate in rehabilitation programs at one of our state-of-the-art treatment centers. Our in-house staff of highly trained and experienced professionals provide individual and group therapies at all of our centers. Programs feature individualized care plans and treatment, regularly scheduled progress meetings and peer grouping to promote socialization and skill building.

Outpatient and Day Treatment Programs

No better place to heal

800.968.6644

These articles can be found under the Education tab on our website or directly at rainbowrehab.com/continuing-education. To utilize the website articles, it’s as simple as clicking on a title, reading the article, and then completing the corresponding forms. The CBIS journal article review asks you to summarize the article by asking a couple of basic questions. The CCM journal evaluation form asks if you achieved the objectives of the article.

The completed journal evaluation form can be submitted as documentation of your required continuing education requirements. It is that simple!

The topics of the articles range from descriptions of research projects to aquatic therapy to pediatric TBI. All articles will help you reach your certification requirements and may provide you with new information that will help you in your job.

Rainbow also has four opportunities for presentations available to in-service your group. Each one of these presentations offers credits to attendees.

Two of our in-service presentations have credits for nurses as well as CCM and CBIS. The subjects of our presentations include triple diagnosis, conflict resolution, school reintegration, and post-traumatic confusion and behavior. To schedule an in-service for your group of five or more, please call the Admissions Department at 800-968-6644.

Again, congratulations on your licensure and certification! Let us help you maintain it with our continuing education opportunities. ❚


• 2017-18 CONFERENCES & EVENTS

SeptemberSeptember 14-15 BIAMI Annual Conference Lansing Center – Lansing, MI biami.org

September 20-22 Int’l. Conference on Paediatric Acquired Brain Injury Rome, Italy internationalbrain.org

September 26-26 MAJ No-Fault Institute The Dearborn Inn – Dearborn, MI michiganjustice.org

OctoberOctober 6 Michigan Adjusters Association Frankenmuth, MI michiganadjustersassoication.org

October 12 ACMA Conference - Great Lakes Chapter Crystal Gardens – Howell, MI acmaweb.org

October 20 CMSA Detroit Full Day Conference Burton Manor – Livonia, MI cmsadetroit.org

October 23-25 AMRPA 2017 Educational Conference & Expo Swissôtel – Chicago amrpa.org

October 23-28 ACRM Annual Conference Hilton – Atlanta, GA acrm.org

October 27 Michigan Guardianship Conference Double Tree Hotel – Bay City, MI michiganguardianship.org

October 28 CPAN Gala Detroit Science Center – Detroit, MI cpan.us

NovemberNovember 1 MSU Case Management Conference Kellogg Center at MSU – East Lansing, MI nursing.msu.edu

November 7 BIAMI Quality of Life Conference Crown Plaza Lansing West – Lansing, MI biami.org

November 8-11 ARN National Conference Washington Convention Center – Seattle, WA rehabnurse.org

November 9-11 2017 ASHA Convention Los Angeles Convention Center asha.org/events/convention

DecemberDecember 6-8 National Workers Comp & Disability Conference & Expo Mandalay Bay – Las Vegas, NV wcconferences.com

January 2018January 7-10 Brain Injury Summit Conference Craig Hospital Vail, CO craighospital.org

May 2018May 10-11 Comprehensive Brain Injury Rehabilitation Training Rainbow Rehabilitation Centers – Livonia, MI rainbowrehab.com


NOTICE: The conferences and events information listed on these pages is dated information. For the most up-to-date information on industry-related conferences and events, please visit: rainbowrehab.com.

Registration at 11:30 a.m. • Lunch at Noon Presentation 12:30–2 p.m.

Learn Over LunchMeeting times are noon – 1:30 p.m.

(Registration at 11:30 a.m.)Cost: MBIPC Member $25 / Non-member $60

For information call 810.229.5880

Speakers and topics to be determined

October 10, 2017Location: Calvin College, Prince Conference Center, Grand Rapids, MI

November 14, 2017Location: Schoolcraft College, Livonia, MI

December 12, 2017Location: Calvin College, Prince Conference Center, Grand Rapids, MI

January 9, 2018Location: Schoolcraft College, Livonia, MI

February 13, 2018Location: Calvin College, Prince Conference Center, Grand Rapids, MI

April 10, 2018Location: Schoolcraft College, Livonia, MI

May 8, 2018Location: Calvin College, Prince Conference Center, Grand Rapids, MI

June 12, 2018Location: Schoolcraft College, Livonia, MI

For updates on meetings, visit rainbowrehab.com or mbipc.org

RINC meetings are presented the third Friday of each month except July, August and December

For location of meeting or more information, please email [email protected]

UPCOMING MEETINGS

September 29, 2017Members Only Meeting

October 27, 2017CE Presentation

Rehabilitation Insurance Nurses Council


Created by pediatric rehabilitation specialists, Rainbow Rehabilitation Centers’ Summer Fun! programs are designed especially for young people with brain and spinal cord injuries who could benefit from structure and supervision when school is not in session.

There were two 2017 Summer Fun! locations both featuring the theme: Let your imagination run WILD! The programs were held at the Oakland Treatment Center in Farmington, MI and Genesee Treatment Center in Flint, MI.

Summer at Rainbow is a fun and educational experience for all age groups. Appropriate activities and outing are designed for four individualized participant groups: Elementary School, Middle School, High School and Postsecondary.

Some of the outings this summer included: • Fishing

• Detroit Zoo

• Picnic outings

• Overnight camping trip

• Detroit Tigers baseball game

• C.J. Barrymore’s entertainment park

• Talent show

• Water parks

• Crossroads Village

• Dave and Busters

• Surfin' Safari Party

• Wild Life Safari

• Field Day

• Adaptive Gymnastics

For more information about Rainbow's Summer Fun! program, visit rainbowrehab.com/pages/summer-fun

Rainbow Receives Three-Year CARF Accreditation

The kids let their imaginations run WILD this summer in Rainbow's Summer Fun! Pediatric Programs

Rainbow has once again received a three-year accreditation—the best result a rehabilitation company can receive! Rainbow is in substantial compliance with the Commission on Accreditation of Rehabilitation Facilities (CARF) standards, and the survey team had many compliments.

In addition, the survey team provided a variety of recommendations for program improvement. Those recommendations have been reviewed and changes and improvements are already being implemented. As always, we continue to grow and refine our programs to meet the needs of the people we serve.

According to the survey team, “Persons served and families not only stated satisfaction with services and choices, but it was also evident through observation of the persons served that they were happy, satisfied, and engaged with Rainbow Rehabilitation Centers’ programs and personnel. Each person served has a highly individualized program that includes a focus on person-driven treatment.” Rainbow received its first CARF Accreditation in 1989.

Rainbow's Three-Year Accreditation applies to the following Brain Injury Specialty programs/services:

Home & Community Services Adult & Children/Adolescents

Interdisciplinary Outpatient Medical Rehabilitation Programs Adults & Pediatric Specialty

Residential Rehabilitation Programs Adults & Pediatric Specialty

Vocational Services Adults


• NEWS AT

A group of Rainbow employees participated in the Dexter-Ann Arbor run for the second consecutive year. This year, the team grew from nine employees to 16! Participants came from all areas of Rainbow including directors, executives, therapists, mentor/teachers, nurses and rehabilitation assistants.

When asked about the race, SLP Angie McCalla said, "Everyone had fun, from the highly competitive racers to those who walked—everyone was cheered on and supported no matter their finish time or ability."

The corporate challenge results are: 5K Team: Rainbow placed 5th with a team score of 124 10K Team: Double Rainbow 2 placed 1st with a team score of 60 10K Team: Double Rainbow placed 3rd with a team score of 113

Great job to all of our Rainbow Runners!

Rainbow has grown from a small provider of residential rehabilitation services to a much larger and more sophisticated network of programs. Recent network diversification and program development includes:

• Many new and diverse community employment opportunities for persons served• Expanded residential services which includes opening a new center in Southfield• Expansion of day treatment services in Farmington Hills and Flint• Enhanced mental health, substance misuse and behavioral programming

Rainbow has a comprehensive continuum of care which allows us to serve individuals with the right treatment, at the right time, in the right setting. From behavioral to medical services, from pediatric to adult and everything in between, Rainbow has it covered.

Here are some of the results of the 2017 Outcomes Report:

Rainbow has a high customer satisfaction rate. Results showed that 97% of our customers would recommend Rainbow to others. Customers include referral sources such as hospitals, case managers, insurance companies, attorneys, doctors, and family members.

Rainbow serves nearly 600 individuals each year. Here's the breakdown:• 64% are male• 42 is the average age• 77% have an acquired brain injury• 32% have an orthopedic injury

Rainbow has over 800 employees. Of those, 125 are therapists with an average of seven years experience with Rainbow. Seventy percent of the clinical professionals are Certified Brain Injury Specialists (CBIS).

There are 45 locations in the Rainbow system: Our five treatment centers are located in Genesee, Oakland, and Washtenaw counties. Two vocational centers are located in Oakland and Washtenaw counties. In addition, Rainbow has 38 residences.

For more information on Rainbow’s outcomes, please contact the Admissions Department.

Rainbow's 2017 Outcomes Report Released

97%SATISFACTION

600PERSONS SERVED

800DEDICATED EMPLOYEES

LOCATIONS

45Synapses & Sneakers – Rainbow’s running team excels in Dexter-Ann Arbor race


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Employees of the Season Winter 2017

Therapy StaffAbby Dull Jacqueline McCullough Ashleigh Harkness Melissa Hoffman Julie LoweBlake Avery Kristy Mumm Alissa Pelto Payal Desai Jill Coval Jessica Farris Melissa Burns Andrea SweetAngela Spears Rebecca Jaciuk Kyle Minier Paige Jaeger Tina Kowalski Yarizel Rodriguez

Residential Program ManagersAdrienne Swick Gabrielle Christmas Julie Mooring Stacy Henson Heidi AldridgeDenise Genereaux Tresa Ellis Tammy Zentz Katrina Miller Nicole Vedder

Professional/ Administrative StaffJenny Renaud Crystal Bajos Tanya Lee Bill Carlton Kim Waddell Karen Smith

Maintenance TeamRyan Kovacs Charlie Allen

Please join us in congratulating these outstanding employees!

Rehabilitation Assistants Arbor: Riad Alhakim, Chelsea Parker, Autumn LandrumBemis: Janifer EddinsBirchwood: Dawn Eichenberg, Ashli Terrell, Jillian Zamenski, Keshia RutledgeBriarhill: Glen KurzBrookside: Dashonay SpeightCrane: Nissma AbdullaGarden City Apts: Marocca DavisGlenmuer: Courtney Ward, Tiana Bingham, Vanessa CraigGTC: Teneya Parrish Taylor, Peyton Sha, Tara Morrison, Jasmine DouglasHome Care: Cheryl ChambersMaple: Carrie FarmerNRC: Jacqueline Murrey-Bey, Michelle Rousselo, Lauren Favazza, Salina Brown, Andreea Tatu,Shadell Wilcox, Lori Oliver-Jordan

NRC Kitchen: La Tonya CrawfordRehab Techs: Rebecca LaboShady Lanes: Kristen Cleveland, Toya Moore, Tyrone MoodyTextile: Angel MatthewsWestmoreland: Ashley BrownWhittaker: Jennifer LynchWoodsides: Jennifer McClelland, Asha HuntYTC: Kelly Jarzynski

Garden City Apartment Program StaffMichelle Smith, Marocca Davis, Emonda Burroughs, Debra Parks, Marketta Crutcher, Kenyatta Young, Lashanda Williams, Hilda Bracey, Jacquelin Jordon

Employee Spotlight Janifer Eddins, a Team Lead, was recently recognized at the Winter 2017 Employee of the Season for her commitment to the care of her clients at Rainbow. Janifer has been working at one of Rainbow's residential houses for 14 years and is a proud role model for many new employees. In fact, other managers have sent their new employees to shadow Janifer so they could get a solid introduction to the proper procedures. Janifer’s manager, Katie Miller, had this to say about Janifer:

“She is confident and willing to attend treatment and client progress meetings. Case managers and guardians know Janifer by name and ask for her specifically. She obviously takes great pride in her job and does it so well. Thank you for taking the lead and making it happen every day.”

Rainbow is so thankful to have great employees like you, Janifer!


Rainbow Rehabilitation Centers’ Young Adult Program is specially designed to assist individuals

with traumatic brain or spinal cord injury in gaining meaningful employment, developing the skills

necessary to initiate and maintain long-term relationships and solidify their identity.

To register or for more information, call

800.968.6644

It’s about reaching your potential

Education and structure for children pre-school age through adolescence who have experienced

a traumatic brain injury. Discover the program developed by pediatric rehabilitation specialists

to be therapeutic, safe and fun.

Therapeutic

Now offered in Oakland and Genesee Counties

800.968.6644

Take steps to boost academic and social success

conference, Rainbow is co-sponsoring an Advocacy Station with BIAMI to assist those impacted by an injury to have a voice and be heard by the state legislation regarding their needs.

What started out in the summer of 2013 as an informal lunch hour discussion between therapists on the topic of attention has now blossomed into a full-fledged education series called the Brown Bag Clinical Training Series. It is led by therapists for fellow therapists.

According to Angie McCalla, SLP, initiator of the program, “They (therapists) wanted an informal venue to share ideas, ask questions, and discuss client cases with an eye toward getting additional treatment ideas. After the first few informal meetings it quickly became apparent that this sharing of ideas about cognition could translate to just about any topic or discipline in brain injury.” Over the last four years, nearly 40 topics have been developed for the program, and several topics have been used for community education, conference presentations, and CE credits.

We build our Continuum of Care, educate each other, and focus on raising the bar on a hundred little things, because this will ultimately benefit those we serve.

Many clients have a daunting road to recovery. They work courageously to overcome obstacles and achieve those little successes every day that can add up to major successes. Relearning to walk or talk, building new relationships, taking back independence and getting back to work—these are the successes we all work to see our clients realize.

Over the next several issues of RainbowVisions magazine, we will highlight some of the client successes we have witnessed. To all of the Rainbow clients, employees, families, and stakeholders, congratulations for your part in these achievements, both big and small. ❚



Belinda Croft, BSWResidential Program ManagerBelinda joins Rainbow as a Residential Program Manager at the NeuroRehab Campus in Farmington Hills, MI. She graduated from Wayne State University with a Bachelor of Social Work. She is the former Developmental Supervisor for a behavioral health unit at a program in Black Mountain, NC.

New Professionals

Kelli Blackwood, BACase ManagerKelli joins Rainbow as a Case Manager working at the Ypsilanti Treatment Center in Ypsilanti, MI. She earned two Bachelor of Arts degrees in Behavior Science and Criminal Justice from the University of Michigan. She previously participated in an internship at Rainbow prior to graduation.

Derek BennettGroundskeeperDerek joins Rainbow's Maintenance Team as a groundskeeper. Prior to Rainbow, Derek worked for four years as a truck driver for a convenience store supplier and wholesale food distributor.

Brandi Jed, BS, RDRegistered DietitianBrandi joins the team at the Ypsilanti Treatment Center in Ypsilanti, MI. She earned a Bachelor of Science degree at Eastern Michigan University. Though she's a new grad, she has worked at a nursing care center as a Clinical Dietitian Assistant.

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Del Bancroft, BSNetwork EngineerDel joins the Information Technology team at the Corporate Center in Livonia, MI. Del attended Central Michigan University where he earned a Bachelor of Science in Mathematics and Military Science. Prior to Rainbow, Del worked as the North American and Europe Team Lead for Ciber’s Infrastructure support team and has 18 years of IT experience.

LaTisha Early, BAResidential Program ManagerLaTisha joins the team at the Farmington Hills Treatment Center in Farmington Hills, MI. She earned a Bachelors of Arts at Oakland University. She has previously worked at a residential facility for cognitive impaired teenagers who have been abused and neglected.

Taylor Medrea, DPTPhysical TherapistTaylor joins Rainbow as a Physical Therapist at the Oakland Treatment Centers in Farmington, MI. She recently graduated from Central Michigan University where she earned a Doctor of Physical Therapy degree.

Stephen Pynn, RRTRespiratory TherapistStephen joins Rainbow as a Respiratory Therapist working at the NeuroRehab Campus in Farmington Hills, MI. He attended Oakland Community College where he earned his Licensed Respiratory Therapist certification. He has previous experience in home healthcare and at hospitals.

Nicole Robinson, BACase ManagerNicole joins Rainbow as a Case Manager working at the Farmington Hills Treatment Center in Farmington Hills, MI. She earned a Bachelor of Arts from the University of Michigan-Dearborn with a double major in Criminal Justice and Behavioral Science and a minor in Psychology. She previously worked at another program with intellectually and developmentally delayed clients ages 2-21.

Abid TurpenResidential Program ManagerAbid joins Rainbow as a Residential Program Manager at the NeuroRehab Campus in Farmington Hills, MI. He is working on a BS in Healthcare Administration at Eastern Michigan University and expects to graduate in December. Abid previously worked at Rainbow as a Rehabilitation Assistant, Team Leader and Residential Program Manager. He has experience with autism and developmental disabilities.


Mikyia Williams, LPNNurseMikyia joins us as a Nurse working at the NeuroRehab Campus in Farmington Hills, MI. She earned her degree at Brown Mackie College in Findlay, OH. Previously, she has worked with acute rehabilitation patients and long-term care residents.

Matt Spivey, MS Director of IT OperationsMatt joins the Information Technology team at the Corporate Center in Livonia, MI. Matt attended Eastern Michigan University where he earned a Bachelor of Science and Master of Science in Technology Management. He also currently sits on the advisory board for The College of Technology at EMU. Matt brings with him over 18 years of IT experience and management in the healthcare industry.

Interested in a career with Rainbow? We welcome applications from qualified

candidates for a variety of positions.

To learn more, visit: rainbowrehab.com/employment

Work With Us!

Brain & Spinal Cord Injury Rehabilitation Programs

for People of all AgesWhen a life-altering injury requires quality care

To schedule a tour or to speak with an admissions team member, call

800.968.6644rainbowrehab.com

Residential Programs • Outpatient Services • Day TreatmentHome & Community-Based Rehabilitation • Home Care

Vocational Programs • Comprehensive RehabilitationMedical Care • NeuroBehavioral Programs


One Thousand Words

Abby Dull, a physical therapist at the Oakland Treatment Center in Farmington, MI, practices choreography moves with Robert, a client participating in the Young Adult program, for the Summer Fun! talent show. Our therapeutic Summer Fun! program is designed especially for young people with brain and spinal cord injuries. Summer at Rainbow is a fun and educational experience for all age groups. It brings out the best in the kids who attend, and the adults who are a part of the program.

Locations [email protected]

GENESEE COUNTYGenesee Treatment Center5402 Gateway Centre Dr., Suite B, Flint, MI 48507T: 810.603.0040 F: 810.603.0044

OAKLAND COUNTY Farmington Hills Treatment Center 28511 Orchard Lake Rd., Suite A Farmington Hills, MI 48334T: 248.306.3170 F: 248.306.3197

NeuroRehab Campus®25911 Middlebelt Rd., Farmington Hills, MI 48336T: 248.471.9580 F: 248.471.9540

Oakland Treatment Center32715 Grand River Ave., Farmington, MI 48336T: 248.427.1310 F: 734.629.0453

Southfield Center25285 W. Eleven Mile Rd., Southfield, MI 48033

WASHTENAW COUNTY Ypsilanti Treatment Center5570 Whittaker Rd., Ypsilanti, MI 48197T: 734.482.1200 F: 734.482.5212

Vocational Rehab Campus5 West Forest Ave., Ypsilanti, MI 48197T: 734.390.2450 F: 734.217.8174

WAYNE COUNTY Rainbow Corporate Headquarters17187 N. Laurel Park Dr., Suite 160, Livonia, MI 48152T: 734.482.1200 F: 734.482.3202

THROUGHOUT MICHIGAN Home Care T: 800.968.6644

Home and Community -Based RehabilitationT: 810.603.0040 F: 810.603.0044

Rehab Transportation®A wholly owned subsidiary of Rainbow Rehabilitation Centersrehabtransportation.comT: 800.306.6406



SOUTHFIELD CENTER The new Southfield Center offers comprehensive rehabilitation services provided by

professionals who specialize in caring for individuals who have been injured.

The program focuses on treating medically stable individuals with:Traumatic brain injuries • Spinal cord injuries

Neurologic impairments • Orthopedic injuries • Co-morbidities

The Southfield Center is conveniently located in Southfield, MI, close to medical facilities, community activities and major freeways.

The fully-accessible facility boasts numerous amenities including: Beautifully appointed 14-bed living environment • Fully accessible private rooms and baths

Cable TV, phone and Internet availability in each bedroom • On-site dining servicesTherapy areas on-site • A large patio deck, perfect for outdoor activities

If you would like to tour Rainbow’s newest premier facility, give us a call at

800.968.6644

Presorted StandardU.S. Postage

PAIDPermit 991

Ypsilanti, MI17187 N. Laurel Park Drive, Suite 160Livonia, Michigan 48152

Tell us what you think about RainbowVisions! Do you have a story idea or comment? Email: [email protected]

INSIDE:

Celebrating Success in big and little ways every day!

A therapeutic approach to day treatment programming for residential and outpatient clientsRainbow U is adding more options than ever in more places than ever! Our day treatment program is offered in Washtenaw, Oakland and Genesee Counties.

Contact a member of the admissions team today to learn more about this innovative and popular program!

800.968.6644

Day treatment designed around "U"

rainbowvisions - rainbow rehabilitation centersshuttle that will provide tours of mcity, a test site...

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