It takes 10 minutes to get Natalie Barnhard into the harness of a Hocoma Lokomat, tighten six straps and clasp them around her abdomen, hips and upper legs, then steady her lower legs and ankles into orthotic braces. Afterward, she is hoisted upright as her toes dangle a few inches above a moving treadmill below.
Two exercise physiologists spend the next few minutes using computer software to lower her feet, fix and steady her gait, and slowly put some of her own weight and energy into her movements.
For a short time, Barnhard is out of her wheelchair, walking.
She can put one foot in front of the other, nourishing her muscles, joints and bones, reveling in a position that was easy to take for granted before a workplace accident in 2004 paralyzed her from the neck down.
“Look how tall you are,” exercise physiologist Kyle Johnson said as she paced on Tuesday afternoon.
Even in her wheelchair, the 5-foot-1 Barnhard feels tall this week. She celebrated the grand opening Wednesday night of the Natalie Barnhard Center for Spinal Cord Injury Rehabilitation and Recovery in Cheektowaga.
This milestone, more than a decade in the making, will give those in the region – and from hundreds of miles away – more tools to build mind, body and spirit after sustaining serious neurological damage from traumatic injuries and disease.
The Lokomat is the centerpiece in a setting that takes the Buffalo Niagara region to a higher level in such rehab care.
“People don’t realize really how profound and important this center is for our community,” Barnhard said. “Having this equipment and this type of rehabilitation, you don’t have to leave. There are only so many places like this throughout our country and most of them are in larger cities.”
Barnhard, then 24, was a new physical therapy assistant and licensed massage therapist in 2004 when a 608-pound Cybex leg extension machine toppled over on her while she helped a client stretch. The impact shattered a disc in her lower neck and heavily damaged another beneath it, leaving her without movement or feeling in all parts of her body below them.
Quick work by specialists at Erie County Medical Center helped save her life before she moved to Atlanta in 2005 to be treated at the Shepherd Center, a hospital that specializes in traumatic injury rehabilitation.
She spent most of the next decade living in Atlanta so she could get intensive, one-on-one physical therapy at least three times a week.
“It took a while to get through my emotional devastation and grieve for my own loss,” she said. “Then, little by little, I felt God just gave me strength.”
Rebuilding from tragedy
Barnhard made headlines in 2012 when her lawsuit against the exercise machine’s manufacturer, Cybex International, and former employer, Amherst Orthopedic Physical Therapy, led to a jury award of $66.5 million. A final $26 million settlement among the three parties brought legal appeals to a close.
She received a far lower sum based on estimated interest that would accrue to the lesser figure over a lifetime, minus legal fees, workers’ compensation reimbursement and other expenses.
Lifetime care for someone with her kind of injury runs $3 million to $5 million, Barnard said. Muscle and skin atrophy, digestive trouble and waste elimination become ongoing challenges, as does sensing body temperature and many forms of pain.
Since suffering a severe spinal cord injury at work in 2004, Natalie Barnhard has devoted herself to helping others through her Wheels With Wings Foundation. She dreams of helping build a local rehab center for people with such
The settlement allowed Barnhard to provide for her own needs and medical costs. The damage was not worth the financial result.
“From Day One,” she said, “I wanted just enough money to live my life, be OK medically, be able to afford caregivers and build a center for people like me.”
Turning a corner
Barnhard began to imagine a new life as she threw herself into rehabilitation and created the Wheels With Wings Foundation, devoted to helping individuals and families impacted by spinal cord injury. She also founded the Western New York chapter of United Spinal Association, visiting Washington, D.C., annually for the Roll on Capitol to advocate for association legislative priorities.
“I couldn't physically do what I did professionally anymore, and I just prayed for something else,” Barnhard said. “I thought, ‘I don't want to love what I used to do, I want to love something else. God didn't take my passion. He molded it into something new.”
She spent time in Atlanta determined to get healthier, longing to be back home with her parents, three siblings and extended family, and making new connections with others who suffered similar tragedies.
“I had really great acute care,” she said, “and I did my traditional physical therapy, my occupational therapy, my outpatient treatment. But once insurance says you’re done, what do you do? When they told me I was done with therapy, I couldn’t push my hair out of my face. I couldn’t eat by myself. A lot of people will go and find a place like the Shepherd Center at that point, but it’s expensive.”
Barnhard returned home in 2015, bent on opening her recovery center.
She struggled to find the specialized care she had in Atlanta and began to suffer health setbacks. Urinary tract infections became more common. She struggled through two bouts of pneumonia, one of which four years ago cascaded into acute respiratory distress syndrome and almost killed her.
“I was no longer socially around people living with an injury like mine,” she said. “I felt alone. All my friends and family were moving on, getting married, having kids. This was a big adjustment for me.”
Then the pandemic struck. Healthier by last year, and familiar with her limitations, she plowed her energy into the rehab center and renamed her foundation the Motion Project Foundation, to better reflect the mission that has come with its opening.
The new center can help address spinal cord injury, cerebral palsy, traumatic brain injuries, spina bifida, spinal muscle atrophy, myelitis, amputation, stroke, ALS, multiple sclerosis, mitochondrial deficiencies, neuropathy, and post-surgery strengthening.
Barnhard plowed more than $1 million of her settlement money into the 6,000-square-foot rehab building that bears her name. The center at 4820 Genesee St., between Transit Road and Buffalo Niagara International Airport, is centrally located in the region and easy to access for those from out of town.
It includes the rehab workout area, massage therapy and treatment room, kitchen, offices and an all-purpose room with an infrared sauna and enough space for adaptive yoga classes and support group gatherings.
There are no curbs in the parking lot, no stairs inside the center. Wide doorways open easily or automatically. Contractors punched windows into the walls that are closer to the ground.
Bathrooms contain plenty of space. One includes a mat table for those like Barnhard who need a catheter and find it a greater challenge to change clothes before or after a workout.
“I’m coming from a perspective of somebody who’s lived this versus somebody creating a space from just a clinical perspective,” she said. “I wanted to create a space where people feel like part of a family. You’re not just going to come and do your couple hours of exercise and leave. You’re going to make friends, going to have get-togethers and peer support activities.”
Toronto has a smaller similar rehab center, Barnhard said, and the next closest is part of the Mount Sinai Spinal Cord Injury Rehabilitation Program in New York City.
For the first time in the region, a dedicated space will be available for the estimated 70 members of the regional spinal association chapter.
Barnhard was honored by the national organization in June with its Finn Bullers Advocate of the Year Award for her association involvement, as well as persistence in building the rehab and recovery center that bears her name.
The late Bullers, a journalist, advocated better Medicare and Medicaid coverage for customized wheelchairs, ratification of the Convention on the Rights of People with Disabilities and working to adopt a more dynamic disability symbol through the Accessible Icon Project.
The rehab space includes kettle bells, treadmills and full-body strengthening equipment. Bands, straps and harnesses abound. A Kaiser machine can tailor weight changes that can be reset as slightly as a half-pound, bowing to progress for those with limited muscle strength. It is the only thing in the gym that needs to be bolted down because there is nothing to counterbalance its weight stack.
A ZeroG Gait & Balance System allows users harnessed to a track in the ceiling to walk, kneel or crawl along a 95-foot line on the floor shaped in a U.
Much of the equipment brings limbs that don’t move into a state of weightlessness, focuses on joints and muscles that can move, and takes other parts of the body along for the ride. Software measures benefits and progress over time.
“Recovery doesn’t mean you’re exactly the way you were before,” Barnhard said, “but no matter what your situation still is, whatever limitations you have, it shouldn’t limit you from living your best life.”
Peter Brady, of Orchard Park, met Barnhard four years ago through the Spinal Association and is a member of the Motion Project board. He has used several pieces of equipment during the last several weeks.
Supported walking “is an unbelievable feeling” that provides an emotional and physical boost, said Brady, 29, paralyzed a decade ago after a diving accident.
“You can’t just go to the Y,” he said. “That’s what really stinks.”
Brady awaits clearance from a doctor to assure his bone density is strong enough for him to use the two most sophisticated pieces in the center. Both use robot-assisted therapy to enable intensive training that boosts muscle strength, range of motion and cardiovascular fitness.
The Madonna ICARE is an elliptical that supports body weight, simulates gait pattern, and includes a vibe plate that bolsters bone integrity.
Hocoma, a Swiss company, makes the Lokomat, the most expensive piece in the rehab center arsenal. It cost $600,000 and is one of only 1,000 of its kind worldwide.
“It’s a world-leading robotics device that will get either adults or children into the walking position,” Barnhard said. “It’s interactive with games. It has recognition software, so it can detect in the movement where you’re strongest or weakest. It even has a module that instead of you walking very roboticlike, it will allow your hips to translate movement so it is a lot more like normal gait. We have their newest model.”
Both sophisticated devices can be operated by a single rehabilitation therapist with far less physical strain.
“I went to Shepherd Center in Atlanta,” Brady said. “This center doesn’t compare in size, but it does compare in the amount of awesome equipment.”
Barnhard, now 41, continues to maintain her PT assistant and massage therapy licenses. She has hired three exercise physiologists – she calls them recovery specialists – all University at Buffalo graduates who have received extra training through the Shepherd Center. Her mother, Mary Lynn, serves as office manager; her father, Lee, as the maintenance supervisor.
The center forged a memorandum of understanding with the UB Department of Rehabilitation Science to collaborate on education and research. University interns will start to serve and learn there in coming months. Barnhard forged ties with Greater Buffalo Adaptive Sports and hopes to do the same with UB-affiliated specialists and regional hospitals.
“Buffalo is small enough that we shouldn't really compete,” Barnhard said. “It should be more of a collaboration.”
The Barnhards also hope to convince health insurers to help cover the cost of center rehabilitation. Meanwhile, it will charge $100 an hour for its services and do what it can to help as many people as possible who are unable to pay.
Motion Project Foundation can help defray costs through its supplemental grant program, Mary Lynn Barnhard said, and other avenues also are available. Those interesting in using or supporting the center can visit motionprojectny.org or call 716-668-4724.
The Barnhards understand the benefits of intensive rehab. Through the years, painstaking work has helped Natalie Barnhard feed herself, apply her own makeup, brush her teeth and use a smartphone. She remains unable to use a pen, grab a pot or pan, or fasten a clasp.
“The makeup took over three years,” her mother said. “When she first did it, she poked yourself in the eye with mascara. Anybody with this kind of injury, they work. It is incredible. Some young men come in here that are in their 20s and they’re working out like they’re athletes, like they’re training for some major competition.”
Barnhard hopes one day to drive, own a house, get married – and walk.
“I want to be able to stand at my wedding,” she said, “whether it's at the altar, or a dance. I really, really want to do that. That's going to be something I work hard on.”
Until then, she plans to make her time count by creating a community that feels stronger together as they face related challenges that can be much more daunting when faced alone.
“In the beginning, it’s very bumpy because you’re emotional,” Barnhard said. “The mental aspect is really tough. Anybody will have their ups and downs, That’s natural. Progress tends to be slow. You don’t make huge gains overnight. But when you can look back and see how much you’ve gained, it’s incredible. And for somebody that goes from not being able to put their hand to their mouth or eat, and then can do it, that’s life-changing.”