With its new disruptive business model and services, Paraquad, a non-profit center in the greater St. Louis area, seeks to create lasting changes within the community by filling a well-known gap in the traditional medical model. Dedicated to empowering those with disabilities, Paraquad offers a wide range of services including health and wellness, advocacy, employment, and independent living. Annie Morrow, director of Paraquad’s Stephen A. Orthwein Center, explains Paraquad’s mission and goals, the company’s business model, and the value of advanced technologies in this unique setting. Paraquad’s portfolio of advanced technologies include the Lokomat®, C-Mill, Erigo®Pro, and Armeo®Power.
You are a physical therapist by trade as well as the director of Paraquad’s Stephen A. Orthwein Center. What do you do in your current position and how does that fit into your career journey?
My career journey started as a physical therapist in the inpatient rehab setting working on the spinal cord injury team at SSM Health. I started up the Parkinson’s program for the SSM health network here in Saint Louis and from there transitioned within SSM Health to the adult day neuro program in St. Louis for the next six years. This led me into the health promotion and wellness side of physical therapy here at the Stephen A. Orthwein Center. I’ve been a board-certified clinical specialist in neurology since 2021. As director I dabble in a little bit of everything. One of the things that first drew me to this job is that I still get to work with clients. About 25% to 30% of my week is spent working one-on-one as an adaptive exercise specialist with our clients.
The Center has a unique business model. Can you describe it?
We serve as an adaptive community exercise center, so we are a fee for service model. We transitioned to this model in 2020 after the former director and some of our current staff visited the PEAK Center, a program at Craig Hospital in Colorado. We took inspiration from their model. That’s where the model of the gym membership and additional costs for one-on-one personal training came from. The unique part about our gym is that all of the staff are physical and occupational therapists. Although we are therapists by trade, we operate as adaptive exercise specialists in this realm. We are supporting individuals through their lifelong exercise and fitness journey. We recommend that our members follow-up within the traditional medical model if therapy is warranted. If a member is only getting therapy once a week, they can choose to come into our center to continue exercising. Some people will also choose to wait until they’re done with therapy to join. We are removed from the traditional medical model, offering continued health promotion and wellness services.
You offer multiple advanced technologies from Hocoma and Motek, including the C-Mill by Motek, ErigoPro, ArmeoPower and Lokomat, which makes your organization the leader in advanced technology in the Greater Saint Louis area. How do advanced technologies such as these fit into your model and goals as an organization, and where do you find value?
We are the only place in Saint Louis that has all of these pieces of equipment in the same place.
As an organization we’re all about providing access to people. Traditionally, in order to use this equipment, you would have to be in an inpatient or outpatient facility. This means that you would typically need to have insurance to use a device like Lokomat and be a patient at a hospital. We provide access and a choice to those who want to continue to use advanced technology. Maybe it’s someone who used [Lokomat] in inpatient rehab, or maybe it’s someone who’s lived a long time with a disability in the community. This technology fits into our model well, as we have expert and qualified staff to be able to operate these pieces of equipment.
We are utilizing this equipment uniquely within the exercise model. For example, we use ErigoPro to assist people to get up into an upright position and continue exercising in that position. We’re using our technology in a slightly different way than most traditional settings. When using the C-Mill by Motek for instance, our goal might be to just increase the mass repetitions of walking in a safe, harness-based system. We might also throw in dual-tasking components and try to equalize some of the member’s steps from side to side or work on balance. Balance is a hard thing to offer from an exercise standpoint because you almost always need someone actively there to support you. In order to see improvements, you need to challenge balance. The C-Mill provides the opportunity to train balance safely.
What I like most about the Hocoma and Motek products, is that they are very user friendly. The time required to get someone on and off equipment can cause people to shy away from adopting advanced technologies. The Hocoma and Motek products are really easy to use, and I think that’s why they are so popular. Therapists see the benefits of them because they’re able to get clients in and out of the devices easily and start their routine.
Paraquad’s mission is to champion equity and independence for people with disabilities through services, partnerships, education, and advocacy. How would you describe your values as an organization? What’s your overall goal for the community?
Our vision is to provide an environment and world free of barriers for people with disabilities so that they can live, work, play and do what they want in life. We try to break down discrimination and look at disability as just another part of human diversity. Our values include dignity for all people, inclusion, and opportunity. Equity, or the right to be treated with fairness and justice is another value. We support the right to equitable programs. If someone is low income or doesn’t have enough therapy visits from insurance, we provide them with the same opportunities to pursue their individual goals. We aim for an inclusive community and we support inclusivity in all of our programs and in our community through advocacy. Our final value is self-determination. We empower people to be able to make their own decisions and to control their own lives.
In your model, anyone can be a member. So if you no longer qualify for outpatient therapy visits, you don’t need a doctor’s referral to continue to go to your facility, correct?
As long as a perspective member can get transportation to our facility and has the motivation to exercise, they can come to our center. Since we are a community-based exercise program, a referral is not necessary. If someone were to have an identified precaution or contraindication to exercise, then a physician’s release may be warranted. You don’t ever have to discharge from here. As long as our doors are open at the gym, you can continue to come and exercise.
Think of our model as supporting the traditional medical model, where people can go back to visit with their physical or occupational therapist to check in, then they come to us for the continued exercise component. Our goal is to help prevent some of the secondary and tertiary complications that come from disability and other health-related issues.
Are there any other benefits of using these advanced technologies from a business perspective?
Having advanced technology in our center helps people to recognize that there is support outside of the medical model and that can help supplement from a business perspective. Advanced technologies have helped to grow our one-on-one offerings. Members have the ability to choose to use specialty equipment versus more traditional exercise approaches and equipment. It’s all about choice. Because we offer these technologies, we have also seen more awareness of Paraquad in the community, which has been great for us.
Learn more about the Stephen Orthwein Center at Paraquad and its programs on their website Paraquad | Making Independence Accessible, or call to arrange a tour and receive more information at 314-289-4202.
DIH is dedicated to providing its customers with a Total Solution for rehabilitation. To learn more about Motek’s C-Mill visit us at www.motek.com. To learn about Hocoma’s Lokomat, ErigoPro, and ArmeoPower visit us at www.hocoma.com.
