Defining Moment Unlimited Adventure A program for people with neurologic conditions that's literally "out there." By Carol-Ann Nelson, PT, DPT | March 2017 Listen to 'Defining Moment' They were 3 individuals who were very different from one another, but who cumulatively have had a major impact on my life and those of others. One was a woman in her 30s who lived with her parents because a brain injury prevented her from living independently. The second was a teenage boy whose life had been forever altered by a gunshot to the neck that left him paralyzed from the shoulders down. The third was an older gentleman with an Irish accent whose Parkinson disease (PD) resulted in frequent falls and stooped posture. They had very different conditions, goals, and physical therapy treatment plans, but they shared a deeply entrenched desire for independence, dignity, and a better quality of life. On their most frustrating and difficult days, we went back to their personal determination to persevere despite the significant obstacles in their path. "I want to be able to walk on my own." "I'd like to go out with friends without needing help." "I'd love to take my wife out on a date." They reminded me of the importance of hours spent outside the clinic walls. I knew that what I was offering them as their physical therapist (PT) improved their lives. Working together, we made huge mobility gains. But their daily lives still were more limited and isolated than I felt they should be. At the time, I didn't know what to do about that—or if there was anything I could do about it. Later, changes in my life brought a move across the country. As I made that geographic transition, I thought long and hard about possible changes in my career direction, as well. Those 3 patients, whose unfilled needs had made such an impression on me, were very much on my mind. I saw what I needed to do. Last year, I established Destination Rehab in Bend, Oregon—a nonprofit organization designed to take rehabilitation out of the clinic and bring it into the community. We focus on individuals with neurologic conditions—poststroke, PD and Guillaine-Barré, multiple sclerosis, and brain or spinal cord injury. Our mission is to promote improved independence and enhanced quality of life through skills training and adventure challenges. We provide a supportive environment in which to bridge the gap between traditional clinic-based therapy and community integration. We started off with small-group outings and 1-on-1 sessions offering a variety of opportunities: targeted rehab to address specific areas of weakness, community outings to fun sites such as the farmer's market and local festivals, and recreational adventures such as snowshoeing, through partnerships with local adaptive sports programs. Caregivers are welcome to join participants as needed. Some activities are free. We offer scholarships, and work hard to identify sponsorships and other funding sources so that everyone who wants to participate in our programs can. The results have been exciting and rewarding. Participants have given us a lot of positive feedback. One of them put it this way: "Everyone knows that exercise and physical fitness can help reduce the effects of a neurological condition, but there aren't many opportunities to go into the community and work with other people who are going through similar problems. Destination Rehab puts you in real-world settings where, while participating in activities, you build the skills and confidence you need to later pursue those activities on your own or with other groups." This spring and summer, we'll expand our services and offer 1-week "Adventure Rehab" camps in the Bend area to interested participants nationwide. These "working vacations" will, as I describe them, combine the best elements of The Biggest Loser and REI Adventures. Participants will be challenged through intensive rehab and fitness sessions, while also experiencing the amazing culture, cuisine, and mountain terrain of central Oregon. Comprehensive evaluations will determine each person's eligibility and resource needs for specific activities, which will include physical therapy sessions; fitness activities ranging from rock climbing and cycling to hiking and kayaking; tourist outings to restaurants, theaters, and museums; and painting and cooking classes. Meals and lodging will be included. Thanks to partnerships with local PT and physical therapist assistant (PTA) education programs, we also are laying a plan for a robust service learning program at Destination Rehab to mentor and train the next generation of neurologic PTs and PTAs. They then will spread—in their future workplaces and wherever they take their careers—our message of empowerment and inclusion. I had another inspiration in founding Destination Rehab—this quote from Helen Keller: "One can never consent to creep when one feels an impulse to soar." She spoke those words more than 100 years ago, but they are timeless. They guide me in what I'm doing now: spending my days in dedication to a profession and cause that helps others learn that they, too, can soar!