Overcoming Traumatic Brain Injury Through Intensive Rehab at Cleveland Clinic London

In March 2023, Keith Skinner’s life changed instantaneously when he was hit by a car while crossing the road. The accident left him with a traumatic brain injury that has forever altered his life.

After a three-month acute inpatient stay at King’s College Hospital, where he was mostly bedbound, he spent another six months in Orpington Hospital’s inpatient neuro-rehabilitation unit where he relearned how to walk, talk and do things like dress and bathe himself. “It’s like I was a baby again,” Keith says. “I was paralyzed in some areas—It took me four to five months just to start regaining function.”

Despite the challenges, Keith learned to approach his recovery with a positive mindset. “You can’t be miserable about what happened,” he says. “You must be as positive as you can and work really hard. Progress comes, but it’s a long-term process.”

After his discharge from Orpington in Nov. 2023, Keith continued therapy at home, but after a few months his case manager felt he could benefit from more intensive therapy. She recommended Cleveland Clinic London’s three-week intensive inpatient rehab program – one of the few U.K. rehabilitation centres with the staff and resources to provide individualised rehabilitation for three to four hours daily. 

Dr Rachel Farrell, Consultant Neurologist at Cleveland Clinic London, and Keith’s physician says, “Keith sustained a very severe brain injury, and while he had made significant progress, he still faced challenges with mobility, spasticity and fine motor function. At Cleveland Clinic London, we could offer more intensive therapy using advanced technology and robotics to help maximize his recovery.”

One of the key therapies Keith underwent was Functional Electrical Stimulation (FES), which uses electrical impulses to help stimulate muscles. As a result of his left-sided brain injury, Keith had a lot of weakness in his limbs on his right side. “We used FES to stimulate his arm muscles to improve his strength and stretch and help him regain functional use of his hand,” says Dr Farrell. “We also applied it to his leg and ankle to aid with walking and balance.”

Keith has also benefited from using a robotic-assisted treadmill system called the Lokomat. When using the Lokomat, a robotic exoskeleton is attached to Keith's legs while a harness suspends him over the treadmill. The robotic exoskeleton then moves his legs in a natural walking pattern. This repetitive motion helps improve Keith’s strength and endurance.

“Although he can walk independently, the Lokomat helps refine his balance and posture,” his therapy team explains. “It’s about maintaining progress and preventing complications.”

Keith’s therapy team also incorporated robotics into his upper limb therapy, allowing him to practice repetitive tasks essential for recovery with the long-term goal of self-management at home. By focusing on exercises, stretches, and integrating his arm into daily activities like dressing, his therapists taught him how to adapt and use assistive equipment as needed. Over time, these everyday tasks—brushing his teeth, showering—become part of his therapy, helping him maintain progress and regain function in a meaningful way.

Keith says the inpatient rehab was so good that he did it twice, once in July and again in October. “It was nice to have my own room, and the nurses were lovely and had a lot of time for me. The nurses, the therapy team, the food, everything was fantastic,” he says.

Keith has achieved several important milestones in his recovery since coming to Cleveland Clinic London. “I can walk faster than I could before,” he says. “I’ve also been able to get back to playing guitar, which is a big deal for me. I was a pretty good guitarist in my younger years. The occupational therapists made a special splint to help me play again.”

It’s been nearly two years since his accident and Keith continues to receive therapy at Cleveland Clinic London once a week, working on fine motor skills, mobility and overall strength. “I feel like more of me is coming back,” he says. “When I first got home from the hospital, I was more emotional about everything. Now, I’m talking more like I used to, and my brain is getting better.”

“Recovery from a traumatic brain injury is not just physical—it’s deeply emotional and psychological,” says Dr Farrell. “The brain controls everything, from movement to thoughts and emotions, and many individuals face depression and difficulty adjusting after such a life-altering event.”

Dr Farrell says a strong support system and engagement in rehabilitation can make a significant difference in recovery outcomes. “Keith was fortunate to have a dedicated family by his side, as well as access to intensive rehab at the right time,” she says. “With the right resources and a determined mindset, he has made remarkable progress.”

Recovery from a traumatic brain injury is an ongoing process and that’s why long-term rehabilitation is so important. Keith is optimistic about his future. “No one can guarantee what the final outcome will be,” he acknowledges, “but every bit of progress is a win.”

Cleveland Clinic London has been more than just a rehabilitation center for Keith—it’ been a place of encouragement, hope and transformation. “The care I’ve had all along has been amazing. Everyone here knows me now, and I know them. It’s not just therapy—it’s a community that’s helped me rebuild my life.”