Shirley Ryan AbilityLab

The Shirley Ryan AbilityLab, formerly the Rehabilitation Institute of Chicago (RIC), is a not-for-profit nationally ranked physical medicine and rehabilitation research hospital based in Chicago, Illinois. Founded in 1954, the AbilityLab is designed for patient care, education, and research in physical medicine and rehabilitation. The AbilityLab specializes in rehabilitation for adults and children with the most severe, complex conditions ranging from traumatic brain and spinal cord injury to stroke, amputation and cancer-related impairment.[1] Affiliated with Northwestern University, the hospital is located on the Northwestern Memorial Hospital campus and partners on research and medical efforts.[2]

Shirley Ryan AbilityLab
Geography
LocationChicago, Illinois, United States
Organization
TypeAcademic health science center
Affiliated universityNorthwestern University
Feinberg School of Medicine
Northwestern Memorial Hospital
NetworkNorthwestern Medicine
Services
History
Opened1954
Links
WebsiteShirley Ryan AbilityLab
ListsHospitals in Illinois

Since 1991, the Shirley Ryan AbilityLab has remained the top ranked rehabilitation hospital in America by U.S. News & World Report.[3][4] Applied research focuses particularly in the areas of neuroscience, bionic medicine, musculoskeletal medicine and technology transfer.

Upon opening in March 2017, AbilityLab's new $550 million, 1.2-million-square-foot facility became the first-ever “translational” research hospital in which clinicians, scientists, innovators and technologists work together in the same space, surrounding patients, discovering new approaches, and applying research in real-time.[5]

History

The Birth of Physical Medicine & Rehabilitation (PM&R)

Rehabilitation is a relatively new medical specialty, becoming certified as such in 1947.[6] Immediately following World War II, which had a significant impact on the specialty of rehabilitation, President Truman appointed five-star General Omar Bradley to head the Veterans Administration (VA). General Bradley recruited Dr. Paul Magnuson,[7] a U.S. Army orthopaedic surgeon, who created the infrastructure for the VA to provide rehabilitation for Veterans. Dr. Magnuson served the Truman administration until 1951 and, shortly thereafter, declared his vision to establish a medical rehabilitation hospital for American citizens.

The Founding and Evolution of the Rehabilitation Institute of Chicago (RIC)

Dr. Magnuson endeavored to start a first-ever hospital for citizens who suffered injuries to their bodies and brains. With very modest philanthropic means, Dr. Magnuson purchased a vacant printing building at 401 E. Ohio Street in Chicago, Ill., and a new organization was formally incorporated as the not-for-profit Rehabilitation Institute of Chicago (RIC). By the spring of 1953, the building was converted into a small rehabilitation hospital and began serving a limited number of outpatients.

In 1958, the building was renovated, enabling the hospital to serve inpatients. In 1967, RIC formed an academic affiliation with Northwestern University, establishing a residency program in physical medicine and rehabilitation (PM&R), and soon thereafter appointed its first Chief Scientist. In 1974, RIC moved into a new location at 345 E. Superior Street in Chicago, Ill., and became the first free-standing rehabilitation hospital in the nation.

From RIC to the Shirley Ryan AbilityLab

In December 2009, RIC announced that it had purchased the site of the former Chicago CBS building site (355 E. Erie Street) on which to build a new hospital, expanding its capabilities and capacity. Groundbreaking took place on July 1, 2013.[8]

In 2016, Pat and Shirley Ryan gave a transformative gift to the new research hospital, which would be called Shirley Ryan AbilityLab, a change that would align with a new name and re-branding of the organization. Pathways.org, the organization founded by the Ryans 30 years prior, became part of Shirley Ryan AbilityLab in 2017.[9]

On March 25, 2017, RIC officially became known as the "Shirley Ryan AbilityLab", as it opened its new research hospital.

Patient populations

Shirley Ryan AbilityLab serves adults and children with the most severe, complex conditions – from traumatic brain injury and spinal cord injury to stroke, amputation-related and cancer-related functional impairment (i.e., physical/cognitive impairment or loss of function). They have introduced a model of care through five Innovation Centers focused on areas of biomedical science:

  • Brain Innovation Center
  • Spinal Cord Innovation Center
  • Nerve, Muscle & Bone Innovation Center
  • Pediatric Innovation Center
  • Cancer Rehabilitation Innovation Center

Central to applying research during care are working labs in which interdisciplinary teams develop new research and insights to help patients gain more function and achieve better outcomes. Each lab has a unique configuration based on a targeted function and the type of experimentation taking place therein:

  • Think + Speak Lab: Treatment for fundamental brain functions – arousal, lucidity, awareness, thinking, communication, perception, memory and learning.
  • Legs + Walking Lab: Improvement of locomotion, gait and walking via trunk and pelvis stability; positioning and control of the hips, knees and ankles; as well as stepping and propulsion.
  • Arms + Hands Lab: Improvement of hand function and movement, body and upper-limb coordination, strength, reaching and hand/finger control.
  • Strength + Endurance Lab: Improvement of stamina and resilience, complex motor and endurance activities, coordination, and higher-level activities of daily living (ADL) (e.g., cooking, housekeeping, exercise, sports).
  • Pediatric Lab: Treatment for all of the above, with a customized approach for the developing brains, bodies and conditions unique to children (infants to teens).

Research scope and diversity

Shirley Ryan AbilityLab strives to be the global source of science-driven breakthroughs in human ability. To take advantage of the convergence of new diverse technologies and science, it has designed its research program to integrate across disciplines (e.g. biomedical engineering, neuroscience, mechanical and electrical engineering, molecular and cellular biology, robotics, sensors and pharmacotherapeutics).

The organization's research budget is $19.4M and its research enterprise is among the largest of its kind in the United States. It also has five federally designated and funded centers for research and training. It receives approximately five times more research funding than any other PM&R department in the country from a diverse range of sources, among them:

The organization's research enterprise is renowned for breakthroughs in biomedical, neural, mechanical and electrical engineering; bionics; molecular/cellular biology; robotics and pharmacotherapeutics. At present, it has more than 350 clinical trials and research studies under way, from voluntary human-subject and applied research to proof-of-concept testing.

The translational model

One of the most significant challenges in healthcare is that scientific breakthroughs do not make their way to patients fast enough, if at all. The majority of science is conducted in laboratories that are physically separated from the clinical setting, often in different buildings. As a result, research in those healthcare or educational settings is not aligned with patients' needs. It takes an estimated average of 17 years for only 14% of new scientific discoveries to enter day-to-day clinical practice.[10]

Proprietary prototype of Translational Lab

In 2012, the organization began a living experiment by outfitting its existing facility with an ability lab, an applied-research and therapeutic space, on one floor. The prototype space allowed researchers to work shoulder-to-shoulder with patients, doctors and therapists. Central to applying research during care are working translational ability labs in which interdisciplinary teams develop new research and insights to help patients gain more function (ability) and achieve better outcomes:

  • Think + Speak Lab
  • Legs + Walking Lab
  • Arms + Hands Lab
  • Strength + Endurance Lab
  • Pediatric Lab

Research labs and centers

The hospital is also home to a number of other research groups.

Center for Bionic Medicine

The Center for Bionic Medicine at the Shirley Ryan AbilityLab is the largest bionic research group in the world. Discoveries and innovations include:

  • The first thought-controlled bionic arm[11] and leg[12]
  • The first manual wheelchair[13] to offer users mobility in either a seated or standing position
  • Pattern recognition-based myoelectric control of partial-hand prostheses
  • Lightweight powered lower-limb prostheses
  • Targeted muscle reinnervation (TMR), a surgical technique that “rewires” amputated nerves and allows intuitive control and sensation of bionic arms and legs

Biologics laboratory

A biomedical laboratory and equipment on the twenty-sixth floor of the hospital, comprising 10,280 square feet, enable the study of living human cells. These high-tech facilities are essential for solving patient conditions affecting the brain, spinal cord, nerves, muscles and connective tissues.

Max Nader Lab for Rehabilitation Technologies and Outcomes Research

This lab is one of the few clinical labs to develop and execute both industry-sponsored and investigator-initiated research in prosthetics, orthotics, rehabilitation robotics, as well as other assistive and adaptive technologies. Scientists have worked with more than two dozen industrial wearable robotics collaborators, including Ottobock, Honda, Össur, Ekso Bionics, ReWalk Robotics, Parker Hannifin, Hocoma, B-Temia Inc and Samsung to create pathways and practice guidelines for the use of technologies for individuals with various conditions, including stroke, spinal cord injury, multiple sclerosis and cerebral palsy. The lab also has dozens of research collaborations with top academic and research institutions, including Walter Reed Medical Research Center, Brooke Army Medical Center Research (BAMC–Research), Northwestern University, Stanford University, Harvard University, Vanderbilt University, University of California–Irvine, University of California–Davis, LA–EPFL and ETCH in Switzerland, Delft University of Technology (TU Delft) and University of Twente in the Netherlands, Nanyang Technological University (NTU) in Singapore and Imperial College London.

This lab also conducts outcomes-based research using advanced wearable sensors[14] in addition to traditional performance-based and patient-reported measures. This lab is one of the first to deploy sensors in an inpatient, outpatient and home rehabilitation setting for various patient populations (e.g., stroke, spinal cord injuries, Parkinson's disease, amputations). It is one of the first to create customized personal models of algorithms for multimodal sensors that monitor patients in the hospital and at home.

Academics and PM&R Residency Program

Academic home of Northwestern University Feinberg School of Medicine Physical Medicine & Rehabilitation (PM&R) Department,[15] the Shirley Ryan AbilityLab also serves as the primary clinical partner of the University's McCormick School of Engineering.

Medical Residency in Physical Medicine & Rehabilitation (PM&R)

The organization was among the first rehabilitation hospitals to offer a medical residency program in this specialty, and remains one of the largest. It is a four-year program. AbilityLab also has five fellowship programs: Pediatrics, Sports Medicine, Pain, Traumatic Brain Injury and Spinal Cord Injury.

References
  1. "AbilityLab New RIC Page". Shirley Ryan AbilityLab - Formerly RIC. Retrieved 26 May 2019.
  2. Schencker, Lisa. "$550M AbilityLab, rebranded Rehab Institute, will pair research, patient care". chicagotribune.com. Retrieved 27 May 2019.
  3. "US News 2018 Rehabilitation Rankings". US News and World Report.
  4. "Northwestern again best hospital in Illinois, says U.S. News list". Crain's Chicago Business. Retrieved 2018-08-14.
  5. Graham, Meg. "Pat and Shirley Ryan donate millions to Rehabilitation Institute research hospital". chicagotribune.com. Retrieved 27 May 2019.
  6. "History of the Specialty". www.aapmr.org. Retrieved 2018-08-14.
  7. Development, Office of Rehabilitation Research and. "Paul B. Magnuson Award for Outstanding Achievement in Rehabilitation Research and Development". www.rehab.research.va.gov. Retrieved 2018-08-14.
  8. "Groundbreaking ceremony held for new RIC research hospital". WGN-TV. 2013-07-01. Retrieved 2018-08-14.
  9. "Shirley Ryan AbilityLab Combines Pathways and RIC". Make It Better - Family, Food, Finances & Philanthropy. 2016-06-24. Retrieved 2018-08-14.
  10. Brownson, Ross C; Kreuter, Matthew W; Arrington, Barbara A; True, William R (2006). "Translating Scientific Discoveries Into Public Health Action: How Can Schools Of Public Health Move Us Forward?". Public Health Reports. 121 (1): 97–103. doi:10.1177/003335490612100118. ISSN 0033-3549. PMC 1497798. PMID 16416704.
  11. "Man With $6 Million 'Bionic' Arm". ABC News. 2006-01-06. Retrieved 2018-08-14.
  12. "First mind-controlled bionic leg a 'groundbreaking' advance". NBC News. Retrieved 2018-08-14.
  13. "This new wheelchair lets users move while standing up or sitting down". Digital Trends. 2017-05-23. Retrieved 2018-08-14.
  14. Matchar, Emily. "These Flexible Sensors Could Help Monitor a Stroke Patient In Recovery". Smithsonian. Retrieved 2018-08-14.
  15. "Home: Department of Physical Medicine & Rehabilitation: Feinberg School of Medicine: Northwestern University". www.feinberg.northwestern.edu. Retrieved 2018-08-14.

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