Devon Palermo trains Ray Bourgeois, an attorney for the Navy Office of the General Counsel who was paralyzed in a 2013 snow-tubing accident, at the MedStar NRH gym. Kent Keyser, right, a former congressional chief of staff, cracked his spine during a fall in 2007. (Sally Rountree/Sally Rountree)

“Pick it up, pick it up. Faster, faster!” Robby Febo spits out the words like a drill instructor. The students in his boxing class mimic his fast-paced moves.

“One, two, one, two. . . . If anyone stops, I add 10 seconds!”

The crowd appreciatively groans.

“Remember,” he tells them, “all movement is good movement!”

That’s especially true for this group, two dozen neurological, brain and spinal injury patients using wheelchairs, walkers and crutches. All are struggling to recover the use of limbs they lost to strokes, accidents, gunshots or disease. And Febo, 19 and a certified fitness instructor, is part of the MedStar NRH Adaptive Sports and Fitness Program, which offers 40 hours a week of fitness classes, sports conditioning, open-gym circuit training and adaptive sports, designed for those with spinal or neurological injuries.

Held on the sprawling campus of the National Rehabilitation Hospital in Northwest Washington, with satellite locations in Virginia and Maryland, the extensive program features specialized equipment and certified trainers skilled in tailoring exercise for those disabled by strokes, brain tumors, multiple sclerosis or genetic disorders.

And it’s absolutely free.

Funded by a partial grant from the Bethesda-based Gordon S. and Marilyn C. Macklin Foundation and through private donations and extensive fundraising, the program seeks to provide safe, effective, adaptive fitness for those otherwise unable to stay active.

“Individuals with physical disabilities have as much, if not more, need for physical activity as those who are able-bodied,” says Joan Joyce, NRH’s director of therapeutic recreation and community outreach. “By increasing physical activity, the program seeks to build and improve strength, muscle endurance, flexibility and function, as well as improving mood and confidence.”

Designed by Devon Palermo, 36, formerly with NRH and founder of DPI Adaptive Fitness, the program features an open-gym circuit of upper- and lower-body machines, including chest press, lat pull, chest flies, shoulder press, leg extensions, leg curls, leg press and calf press — each adaptable to a participant’s needs.

Dubbed the “No Limits Adaptive Fitness Program,” it seeks to aggressively push patients beyond their own expectations.

“This was my dream,” Palermo says. “A program where everyone, no matter what their condition, can work out together. Where they can encourage each other and have fun in the process.”

Palermo recognized the benefit and need for adaptive therapy in 2006 while working with a spinal cord injury patient who became housebound when the insurance money ran out. By adapting exercises to the injury, he was able to see firsthand such significant improvement that regular physical therapy became possible.

The program is available to anyone with spinal or neurological injuries after a waiver is signed and emergency contact information is supplied. A doctor’s order is required only if the patient is not known to the NRH therapists.

Since its inception in 2014, it has attracted more than 300 participants, reflecting disparate ages and backgrounds. For most of these men and women, ages 20 to 80, this is their only opportunity to stay active.

“This isn’t like other gyms,” says Bill Staderman, 45, a former defense contractor who has a genetic neurological disorder and has been in a wheelchair for 25 years. “No one is flexing their muscles or showing off. No one is competing. The best is getting out of the house and being active with others.”

Adds Kevin Boyd, 52, paralyzed from a leg injury and currently in a job training program, “I got to keep moving,” he says. “If I stop, the muscles stop. I don’t want to be put in a nursing home.”

Coordinating the program is Harsh Thakkar, 31, who also serves as an NRH peer mentor. Thakkar has been in a wheelchair for 10 years, paralyzed when he was robbed and shot outside a restaurant, the bullet severing his spine.

Today, besides serving on the MedStar staff, he plays in the National Wheelchair Basketball Association. “Harsh is a role model to anyone coming into the gym,” Palermo says. “That you can still play sports, work out, have a full-time job and do all the things you enjoy. He keeps people accountable by practicing what he preaches.”

The program also offers support for caregivers. Cesar Soriano, 74, has Parkinson’s disease and paralysis from a brain injury suffered from a fall in 2015. His wife, Sonia, 74, regularly accompanies him to NRH.

“Even though we’re both doctors, we didn’t know what help was available,” Sonia says. A social worker recommended the program, which she says is “heaven-sent. It gives you the feeling that you’re not alone.”

The fact that the NRH gym provides a safe environment for individuals with disabilities to do the same thing as those without disabilities is what makes this program so important, Thakkar says. He has traveled the country and found gyms to be inaccessible for the disabled, as well as equipment he has to modify to use.

“The next step of our program is to involve even more people . . . take it to [other] communities and advocate for more programs, equipment and trainers.”