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Disability and Rehabilitation Research Projects.
University of Alabama at Birmingham (UAB) Traumatic Brain Injury Model System (UAB TBIMS).
University of Alabama/Birmingham.
619 - 19th Street South, SRC529.
Birmingham, AL 35249-7330.
E-mail: novack@uab.edu.
URL(s): http://www.uab.edu/tbi.
Principal Investigator: Thomas A. Novack, PhD.
Public Contact Phone: 205/934-3283.
Project Number: H133A070039.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $434,398; FY 08 $434,399; FY 09 $434,397; FY 10 $434,398; FY 11 $434,397.
Abstract: This project provides rehabilitation services specifically designed to meet the special needs of individuals with traumatic brain injury (TBI) through a multidisciplinary, comprehensive model system which spans the clinical continuum from emergency services through rehabilitation and community re-entry. The project includes one collaborative research module and one in-house research project, aimed at improving the health and function, as well as the community participation of the individuals with TBI. The collaborative research module involves examination of the risks and consequences of weight gain after TBI, which has never been explored in depth. The in-house research project focuses on an in-home training program to improve visual perceptual speed that could impact return to driving.
Descriptors: Brain injuries, Driving, Health promotion, Model Systems, Traumatic Brain Injury Model Systems, Vision.
Northern California Traumatic Brain Injury Model System of Care.
Santa Clara Valley Medical Center (SCVMC).
751 South Bascom Avenue.
San Jose, CA 95128.
E-mail: stephanie.hayner@hhs.sccgov.org jerry.wright@hhs.sccgov.org.
URL(s): http://www.tbi-sci.org.
Principal Investigator: Stephanie Hayner, PhD; Jeffrey Englander, MD.
Public Contact Phone: 408/793-6446, 408/793-6433.
Fax: 408/793-6434.
Project Number: H133A070038.
Start Date: October 7, 2007.
Length: 60 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 07 $426,720; FY 08 $426,720; FY 09 $426,720; FY 10 $426,720; FY 11 $426,720.
Abstract: This project conducts research with a focus on fatigue in individuals with traumatic brain injury (TBI). Current studies have identified a strong association of fatigue with sleep disorders, depression, pain, and cognitive challenges; the prevalence of pituitary dysfunction is high in this group as well but the level of dysfunction is not proportional to levels of fatigue. This site specific research effort is a prospective, randomized, single-blind crossover study that evaluates the impact of a graduated physical activity program on fatigue and related factors of depression, sleep quality/daytime drowsiness, cognitive function, and general health measures.
Descriptors: Brain injuries, Fatigue, Model Systems, Physical activity, Traumatic Brain Injury Model Systems.
Collaborative Spinal Cord Injury Model Systems Centers Program: Improving Spinal Cord Injury Rehabilitation Outcomes.
Craig Hospital.
3425 South Clarkson Street.
Englewood, CO 80113.
E-mail: gale@craig-hospital.org.
URL(s): http://www.craighospital.org.
Principal Investigator: Gale G. Whiteneck, PhD.
Public Contact Phone: 303/789-8204.
Fax: 303/789-8441.
Project Number: H133A060103.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Phillip Beatty, PhD.
NIDRR Funding: FY 06 $2,200,000; FY 07 $900,000; FY 08 $900,000; FY 09 $900,000; FY 10 $900,000.
Abstract: Inpatient rehabilitation for spinal cord injury (SCI), like all of rehabilitation, has been studied largely as an undifferentiated black box. Research has examined the whole “rehabilitation package” but has not addressed which specific therapy interventions, medical procedures, patient education, counseling, or activities are effective when offered in various combinations or sequences, for specific types of patients and impairments. To address this limitation, this project uses Clinical Practice Improvement (CPI) research methodology to isolate specific components of rehabilitation interventions, and to determine how, and to what degree, each component is associated with outcomes.
Specific aims are to: (1) identify individual patient characteristics, including demographic data, severity of SCI, and severity of illness (complications and comorbidities), that explain significant variation in the outcomes of acute rehabilitation for SCI; (2) identify specific medical/nursing procedures and therapy interventions, or combinations of procedures and interventions that are associated with better outcomes, controlling for patient characteristics; and (3) determine whether specific impairment-by-treatment interactions are associated with better outcomes. This project is a collaborative research partnership with five other prominent SCI rehabilitation facilities: Rehabilitation Institute of Chicago, Shepherd Center, Mt. Sinai Medical Center, National Rehabilitation Hospital, and Carolinas Rehabilitation. Also collaborating is the Institute for Clinical Outcomes Research at International Severity Information Systems in Salt Lake City, Utah, which has extensive experience applying CPI methodology, and MobileDataForce in Boise, Idaho, with expertise in handheld data capture technology.
Descriptors: Model Systems, Outcomes, Rehabilitation, Rehabilitation success, Spinal cord injuries.
The National Data and Statistical Center for the Traumatic Brain Injury Model Systems.
Craig Hospital.
3425 South Clarkson Street.
Englewood, CO 80113.
E-mail: charrison-felix@craighospital.org.
URL(s): http://www.tbindsc.org.
Principal Investigator: Cynthia Harrison-Felix, PhD.
Public Contact Phone: 303/789-8565.
Fax: 303/789-8441.
Project Number: H133A060038.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Phillip Beatty, PhD.
NIDRR Funding: FY 06 $625,000; FY 07 $625,000; FY 08 $625,000; FY 09 $625,000; FY 10 $625,000.
Abstract: By implementing a comprehensive and innovative program of new data management technologies and operating procedures that emulate the best practices of clinical research organizations and data coordinating centers, the National Data and Statistical Center (NDSC) increases the rigor and efficiency of scientific efforts to longitudinally assess the experience of individuals with traumatic brain injury (TBI) and advances TBI rehabilitation. The TBIMS database and the NDSC introduce the following innovations: a state-of-the-art, web-based data management system; a computer-assisted interview system; a Standard Operating Procedures Manual; training through quarterly web-based conferences, as well as more frequent in-person conferences; comprehensive Data Collector certification; annual data monitoring visits to each center; analysis of ethnic/racial bias in participant recruitment and retention and collaboration with the NIDRR-funded Center for Capacity Building on Minorities with Disabilities Research; providing more comprehensive methodological as well as statistical consultation; continuation of the TBIMS survival study; a system for following participants from defunded centers; and the use of common procedures, technologies, and training among all Model System Data Centers.
Descriptors: Brain injuries, Databases, Model Systems, Outcomes, Traumatic Brain Injury Model Systems.
The Rocky Mountain Regional Brain Injury System (RMRBIS).
Craig Hospital.
3425 South Clarkson Street.
Englewood, CO 80113.
E-mail: charrison-felix@craighospital.org.
URL(s): http://www.craighospital.org/Research/TBIModelsystems.asp.
Principal Investigator: Gale G. Whiteneck, PhD.
Public Contact Phone: 303/789-8565.
Fax: 303/789-8441.
Project Number: H133A070022.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 07 $426,720; FY 08 $426,720; FY 09 $426,720; FY 10 $426,720; FY 11 $426,720.
Abstract: The Rocky Mountain Regional Brain Injury System (RMRBIS) conducts two site specific research projects, participates in three collaborative research modules, contributes to the longitudinal Traumatic Brain Injury (TBI) National Database, and maintains a TBI Model System of care and research. Research Project R1: Atomoxetine (Strattera) for the treatment of attention disorders in individuals with TBI determines if the only drug approved for attention deficit hyperactivity disorder improves attention, behavioral functioning, and depression in individuals with TBI, using a randomized double-blind placebo-controlled crossover study design. Research Project R2: A health and wellness intervention for individuals with TBI, evaluates a specific, replicable small-group educational approach to improve health-related self-efficacy, health promoting behaviors, and health-related quality of life in individuals with TBI using a randomized wait list control group study design. If effective, this intervention could improve the health and wellness of the many people with secondary conditions and less than healthy lifestyles after TBI. Collaborative Module 1: Sexuality after TBI examines the frequency, type, and severity of changes in sexual function associated with TBI. Collaborative Module 2: Natural history of headache after TBI investigates incidence, prevalence, and types of headache after TBI. Collaborative Module 3: Enhancing Core dataset to expand research on environmental influences affecting outcomes from TBI evaluates the feasibility, reliability, and utility of recording geographic identifiers for place of residence after TBI.
Descriptors: Attention deficit disorders, Brain injuries, Headache, Health promotion, Model Systems, Sexuality, Traumatic Brain Injury Model Systems.
UCHSC Burn Model System Data Coordination Center (BMS/DCC).
University of Colorado Denver - Anschutz Medical Campus.
13001 East 17th Avenue, Box B119.
Aurora, CO 80045.
E-mail: erin.delong@ucdenver.edu.
URL(s): http://bms-dcc.uchsc.edu.
Principal Investigator: Dennis C. Lezotte, PhD.
Public Contact Phone: 303/724-4388.
Fax: 303/724-4491.
Project Number: H133A070006.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 07 $300,000; FY 08 $300,000; FY 09 $300,000; FY 10 $300,000; FY 11 $300,000.
Abstract: The Burn Model System Data Collection Center (BMS/DCC) provides scientific and technical support to the Burn Model Systems' mission, which is “to conduct research that contributes to evidence-based rehabilitation and clinical interventions as well as develop practice guidelines that improve the lives of individuals with burn injuries.” The BMS/DCC addresses four important areas in rehabilitation research: project design and management, data management and quality, scientifically appropriate analytical support, and broad dissemination for long-term impact. The data center strives to provide quality support by developing integrated information systems, providing professional consultation, and designing and delivering dedicated training programs. The primary goal is to improve the scientific rigor of clinical and rehabilitation research in the area of burn injury. Areas of specific concern include: collecting multi-site longitudinal outcomes data; coordinating multi-center research data; providing analysis and oversight to achieve scientifically sound multi-center collaborative and site-specific clinical and rehabilitative research; collaborating with other National Data and Statistical Centers to exchange ideas and ensure the most efficient operations; publishing scientifically rigorous articles; and coordinating other effective dissemination strategies. The BMS/DCC consists of two functionally independent but related units, a data administration core and an analytical core. The data administration core continues to support and manage the BMS Level 1 (National) Database while implementing the necessary improvements to ensure quality and scientifically sound data for burn research. In addition, the data administration core implements web-based data collection and research support tools for collaborative modules and, as needed, assists in the conduct of the site-specific research studies. The analytical core provides statistical support (analysis, consultation, study-design, and study implementation) for projects that use either Level 1 data or data generated from collaborative and site-specific research.
Descriptors: Burn Injury Model Systems, Burns, Model Systems, Outcome, Rehabilitation medicine, Statistics.
Midwest Regional Traumatic Brain Injury Model System: Innovative Approaches to Improve Cognition, Function, and Community Living.
Rehabilitation Institute Research Corporation.
345 East Superior Street.
Chicago, IL 60611.
URL(s): http://www.ric.org/research/centers/MRTBIMS/index.aspx.
Principal Investigator: Elliot J. Roth, MD; Felise Zollman, MD.
Public Contact Phone: 312/238-4637.
Fax: 312/238-1417.
Project Number: H133A080045.
Start Date: October 1, 2008.
Length: 48 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 08 $418,139; FY 09 $418,528; FY 09 Rehabilitation Institute of Chicago; FY 10 $418,143; FY 11 $418,395.
Abstract: The Midwest Regional Traumatic Brain Injury Model System (MRTBIMS) accomplishes several important objectives in support of an interdisciplinary, multidimensional center focused on providing and improving care for people with traumatic brain injury (TBI). MRTBIMS establishes a coordinated, multilevel, interdisciplinary system of care for people with TBI, including pre-hospital, emergency, acute, long-term acute, intensive rehabilitation, and community care. This continuum of care is provided at Northwestern Memorial Hospital, RML Specialty Hospital, and the Rehabilitation Institute of Chicago and its System of Care. Data is submitted on at least 35 TBI patients per year to the National TBI Database. Research plans include implementation of two site-specific research projects, which consist of clinical trials on the effectiveness of acupuncture to improve sleep in TBI patients and on the effectiveness of a virtual reality robotics program to improve attention and concentration in TBI patients. The Center is engaged in dissemination of educational and other materials on TBI to a variety of target audiences, including persons with TBI and their families, professionals who care for patients with TBI, and the public—collaborating with the Brain Injury Association of Illinois and other NIDRR-funded centers as appropriate.
Descriptors: Alternative medicine, Cognitive rehabilitation, Community living, Robotics, Traumatic Brain Injury Model Systems, Virtual reality.
Reducing Obesity and Obesity-Related Secondary Conditions in Adolescents with Disabilities.
University of Illinois at Chicago.
1640 West Roosevelt Road, Suite 712 M/C 626.
Chicago, IL 60608-6904.
E-mail: jrimmer@uic.edu.
URL(s): http://www.rectech.org.
Principal Investigator: James H. Rimmer, PhD.
Public Contact Phone: 312/413-9651.
Fax: 312/355-4058.
Project Number: H133A060066.
Start Date: November 1, 2006.
Length: 36 months.
NIDRR Officer: Margaret Campbell, PhD.
NIDRR Funding: FY 06 $250,000; FY 07 $250,000; FY 08 $250,000; FY 09 $ 0.
Abstract: This project examines the antecedents and consequences of obesity using the ICF framework that addresses both person and environment contextual factors that relate to obesity in adolescents with disabilities; evaluates the validity and utility of an alternative approach for establishing more accurate cutoff points for overweight and obesity in adolescents with disabilities; develops a pilot intervention using an innovative personalized exercise and nutrition program (PEP-for-Youth) for managing obesity among youth with physical and developmental disabilities; and develops mutually beneficial working partnerships with community-based organizations to promote reduction of obesity in youth with disabilities. The research projects operate in partnership with Shriners Hospitals for Children and five national disability organizations (Easter Seals, United Cerebral Palsy, Spina Bifida Association, the Arc, and Blaze Sports America).
Descriptors: Obesity, Secondary conditions, Youth.
Johns Hopkins University Burn Injury Rehabilitation Model System (JHU-BIRMS).
Johns Hopkins School of Medicine.
4940 Eastern Avenue.
Baltimore, MD 21224.
E-mail: smason23@jhmi.edu.
URL(s): http://www.hopkinsmedicine.org/burn/research/index.html
http://www.hopkinsmedicine.org/burn/research/psqscq.pdf.
Principal Investigator: James A. Fauerbach, PhD.
Public Contact Phone: 410/550-9846.
Fax: 410/550-8161.
Project Number: H133A070045.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $362,500; FY 08 $362,500; FY 09 $362,500; FY 10 $362,500; FY 11 $362,500.
Abstract: The Johns Hopkins University-Burn Injury Model System (JHU-BIMS) includes three projects: two site-specific randomized, controlled trials (RCT), and one multi-site collaborative study. The first site-specific project is an RCT to test the efficacy of an innovative “Augmented Exercise Program” in enhancing recovery of strength and endurance in those with generalized deconditioning. Preliminary results demonstrate that this 12-week, 36-session conditioning regimen, relative to baseline and to usual care, significantly improves aerobic conditioning. The second site-specific project is an RCT to test the effectiveness of an intervention entitled “Safety, Meaning, Activation, and Resilience Training” (SMART). SMART is a four-session intervention that aims to reduce acute psychological distress and sleep disturbance and to thereby prevent chronic psychiatric disorders and disability. Pilot data show that SMART effectively reduces post-trauma distress, sleep disturbance, and depression. The third project is a multi-site collaborative module entitled “Long-Term Follow-up of the National Database Sample” that extends follow-up to five years post-burn. The NIDRR funded Burn Model System national database provides an unprecedented opportunity to conduct a prospective, multi-site study to assess the long term needs of burn survivors. The Johns Hopkins Burn Center continues to contribute to the Burn Model System national database, as well.
Descriptors: Burn Injury Model Systems, Burns, Exercise, Mental health, Model Systems, Posttraumatic stress disorders.
Michigan Traumatic Brain Injury Model System (SEMTBIS).
Wayne State University.
5057 Woodward Avenue, Suite 6402.
Detroit, MI 48202.
E-mail: ckoviak@dmc.org.
URL(s): http://www.semtbis.org.
Principal Investigator: Robin A. Hanks, PhD.
Public Contact Phone: 313/745-9737.
Fax: 313/745-9854.
Project Number: H133A080044.
Start Date: October 1, 2008.
Length: 48 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 08 $438,074; FY 09 $437,676; FY 10 $437,855; FY 11 $438,138.
Abstract: SEMTBIS focuses on the following major areas: research, education, clinical and systems analysis studies, collection and dissemination of data, and promotion of professional development for individuals with disabilities as well as their family members or caregivers. Two studies address enhancement of health and function of persons with traumatic brain injury (TBI). Projects evaluate the predictive validity of three newly developed brain magnetic resonance imaging (MRI) techniques with respect to functional independence, level of disability, and neurobehavioral outcomes at one and two years post-injury; and examine the safety and efficacy of an antibiotic medication that is thought to positively influence neuroplasticity in the acute stages of recovery from TBI. SEMTBIS recruits, educates, and promotes professional development of individuals with disabilities as well as their family members or caregivers; with consumer involvement in the advisory board and as project staff. SEMTBIS continues to participate in clinical and systems analysis studies of the TBIMS by collecting and contributing data to a uniform, standardized national database on patient characteristics, diagnoses, causes of injury, interventions, outcomes, and costs. Evaluation of these research projects and the overall operations of the SEMTBIS employs a multifaceted approach of quantifiable and objective procedures.
Descriptors: Disabilities, Professional education, Professional training, Rehabilitation, Research, Traumatic Brain Injury Model Systems.
Health Care Coordination for Individuals with Physical Disabilities: Critical Elements and Consumer Outcomes.
University of Minnesota.
111 Pattee Hall
150 Pillsbury Drive Southeast.
Minneapolis, MN 55455-0223.
E-mail: abery001@umn.edu.
Principal Investigator: Brian Abery, PhD.
Public Contact Phone: 612/625-5592.
Fax: 612/624-9344.
Project Number: H133A080049.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 08 $277,233; FY 09 $282,465; FY 10 $299,941; FY 11 $296,405; FY 12 $299,900.
Abstract: This project creates new knowledge about health care coordination within Minnesota’s Special Needs Basic Care (SNBC) program. Project activities include establishing and testing an operational definition of health care coordination for adults with physical disabilities and examining the extent to which the various components of health care coordination enhance access to health care, improve health outcomes, and create cost savings. The project uses a Participatory Planning and Decision Making process and key informant interviews to identify, classify, and richly describe care management models used in SNBC as well as the critical components of effective care coordination. Cognitive testing and reliability and validity assessment are used to modify several instruments to measure the elements of managed care and managed care outcomes for persons with physical disabilities. Finally, a combination of survey research (in-person interviews) and analysis of secondary data sets (Centers for Medicaid and Medicare utilization information, and Minnesota Department of Human Services assessment and utilization data) is used to examine managed care outcomes for a total of 350 individuals participating in the SNBC program, taking into account variables such as type and severity of disability (including the presence of dual diagnoses), urban or rural location, age, and other demographic characteristics known or hypothesized to be associated with health care access, outcomes and costs. The impact of care coordination models is tested on several outcomes including health care access (Health Care Quality Scale, annual DHS mandated health care accessibility survey results), outcomes (including but not limited to health care self-direction, stress, disability impact), and costs. Products from this line of research include an operational definition of the elements of care coordination, validated reliable instrumentation to measure elements of care coordination, and academic and research-to-practice publications describing the impact of care coordination on access to health care, health care outcomes, and cost.
Descriptors: Health promotion, Physical disabilities, Service delivery.
Mayo Clinic Traumatic Brain Injury Model System.
Mayo Clinic.
200 First Street.
Rochester, MN 55905.
E-mail: brown.allen@mayo.edu.
URL(s): http://www.mayo.edu/model-system.
Principal Investigator: Allen W. Brown, MD.
Public Contact Phone: 507/255-3116.
Fax: 507/255-7696.
Project Number: H133A070013.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 07 $423,590; FY 08 $423,590; FY 09 $423,590; FY 10 $423,590; FY 11 $423,590.
Abstract: The purpose of the Mayo Clinic Traumatic Brain Injury Model System (TBIMS) is to provide comprehensive, integrated, team-based rehabilitation care and education to individuals with traumatic brain injury (TBI), their families, and significant others along the continuum of recovery and to fill gaps in research knowledge and service delivery through clinical research that promotes full personal and social participation. The Mayo Clinic TBIMS conducts one site-specific project. This project, an Advocacy Training Clinical Trial (ATCT), targets the gap in knowledge concerning the most efficacious method of teaching effective self and system advocacy skills. The goal of the ATCT is to identify efficacious advocacy training methods using a randomized practical behavioral trial methodology in three Midwest states. Objectives of the ATCT are threefold: (1) develop TBI specific measures of advocacy activity, perceived control, and self efficacy; (2) implement, evaluate, and continuously improve upon the ATCT; and (3) assess the statewide impact of the ATCT on greater communities, public policy, systems change, and in the media. The ATCT is designed to establish a sustainable program of efficacious and effective advocacy training in the trial communities, and provide a model for implementation in other communities.
Descriptors: Advocacy, Brain injuries, Model Systems, Outcomes, Telerehabilitation, Traumatic Brain Injury Model Systems.
A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe Traumatic Brain Injury.
JFK Johnson Rehabilitation Institute.
2048 Oak Tree Road.
Edison, NJ 08820.
E-mail: jgiacino@solarishs.org.
URL(s): http://www.njrehab.org/tbims/index.asp.
Principal Investigator: Joseph T. Giacino, PhD.
Public Contact Phone: 732/205-1461.
Fax: 732/632-1584.
Project Number: H133A031713.
Start Date: January 1, 2004.
Length: 48 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 03 $599,862; FY 04 $599,994; FY 05 $599,994; FY 06 $599,994; FY 07 $599,994; FY 08 $ 0; FY 09 $ 0.
Abstract: This project conducts a prospective double blind randomized controlled trial of amantadine hydrochloride on disorders of consciousness. Severe traumatic brain injury may result in severe disorders of consciousness (DOC), including coma, the vegetative state (VS) and the minimally conscious state (MCS). The longer the duration of impaired consciousness, the worse the ultimate functional prognosis, with only about half of those individuals who remain unconscious for a month post-TBI regaining consciousness within a year. The severe functional disability associated with prolonged DOC places enormous emotional, financial, ethical, and logistical strains on caregivers and major resource demands on society. In this study, seven facilities (including two with TBI Model Systems designations) that participated in a multi-center research network called the Consciousness Consortium, join with four additional brain injury rehabilitation centers (two in the U.S. and two in Europe) and a Data Coordinating Center at Columbia University. 184 patients who remain in VS or MCS 4 to 16 weeks post-TBI are randomized in a stratified fashion to 4 weeks of amantadine (200 to 400 mg/day) vs. placebo, followed by a two-week washout period. The Disability Rating Scale (DRS) is the primary dependent variable with the Coma Recovery Scale-Revised (CRS-R) serving as a supplementary measure. The project also explores whether treatment response differs by time post-injury and by diagnosis (i.e., VS or MCS) at treatment onset, and whether specific outcomes of importance to caregivers are achieved more often in the amantadine group. The project includes intensive education of caregivers and clinicians about this study to address perceived barriers to enrollment and also uses the information gathered during these interactions to develop consumer-oriented dissemination activities. Project outputs and findings are disseminated to appropriate consumer and professional audiences using a variety of formats and include: (1) improved family member understanding of DOC which will facilitate improved adjustment and caregiving and (2) clear guidance to clinicians regarding the effectiveness of amantadine for persons with DOC.
Descriptors: Brain injuries, Drugs, Rehabilitation medicine.
JFK-Johnson Rehabilitation Institute TBI Model System.
JFK Johnson Rehabilitation Institute.
2048 Oak Tree Road.
Edison, NJ 08820.
E-mail: tbims@solarishs.org.
URL(s): http://www.njrehab.org/tbims.
Principal Investigator: Keith D. Cicerone, PhD.
Public Contact Phone: 732/906-2640.
Fax: 732/906-9241.
Project Number: H133A070030.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $419,921; FY 08 $419,921; FY 09 $419,921; FY 10 $419,921; FY 11 $419,921.
Abstract: Site-specific research represents a sustained investigation of cerebral activation in patients with disorders of consciousness (DOC): vegetative state (VS) and minimally conscious state (MCS). At present, clinical judgment and experience guide diagnostic, prognostic, and treatment decisions for individuals with DOC. Prior research on functional MRI (fMRI) activation patterns suggests that patients in MCS retain the neural circuits for receptive language and visual processing. This project tests a novel fMRI protocol that is designed to reliably detect conscious awareness in patients who may be unable to execute behavioral signs of active cognitive processing, using a hierarchical stimulation paradigm that systematically assesses levels of cognitive processing in the auditory and visual systems. In light of provocative findings suggesting that cognitive processing may be maintained in patients who appear to be unconscious on bedside examination, the investigation is extended to individuals with VS as well as those in MCS. A collaborative module extends prior investigations of the effectiveness of specialized, post-acute brain injury rehabilitation. This project is driven by the question of how to characterize the course of post-acute brain injury rehabilitation, and its impact on the long term outcomes of people with brain injuries. Although there is increasing evidence that postacute brain injury rehabilitation can improve functional outcomes after TBI, population-based outcome studies have generally not considered the influence of different pathways of postacute rehabilitation on outcomes after TBI. A longitudinal, observational study characterizes postacute rehabilitation in the TBI Model Systems, and examines the pathways of postacute rehabilitation in relation to casemix variables, patterns of service utilization, barriers to service delivery, and participants' perceived needs and satisfaction with treatment. This collaborative project examines the contribution of postacute rehabilitation to functional and psychosocial outcomes at one and two years after injury using multivariate analyses and causal modeling.
Descriptors: Brain injuries, Functional evaluation, Model Systems, Postacute rehabilitation, Traumatic Brain Injury Model Systems.
Northern New Jersey Traumatic Brain Injury System (NNJTBIS).
Kessler Foundation Research Center.
1199 Pleasant Valley Way.
West Orange, NJ 07052.
E-mail: tbi@kesslerfoundation.org.
URL(s): http://www.kesslerfoundation.org/research/lab/modelsys.php.
Principal Investigator: Nancy D. Chiaravalloti, PhD; Bruce M. Gans, MD.
Public Contact Phone: 973/530-3640.
Fax: 973/324-3536.
Project Number: H133A070037.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $423,590; FY 08 $423,590; FY 09 $423,590; FY 10 $423,590; FY 11 $423,590.
Abstract: The Northern New Jersey Traumatic Brain Injury System (NNJTBIS) conducts both a site-specific research study and a collaborative research module. These projects, both related to ongoing NIH-funded studies, contribute to evidence-based rehabilitation interventions and quality of life measurement to improve the lives of individuals with traumatic brain injury (TBI), as follows: (1) An innovative, double-blind, randomized controlled trial of a cognitive rehabilitation intervention utilizing a proven methodology shown to be effective with the multiple sclerosis population; and (2) a collaborative module that adapts, develops, and validates an innovative quality-of-life outcome measurement system for use in TBI intervention research. Each of these projects has been subjected to initial pilot testing to assure the applicability and feasibility of the methodology. The evaluation of this project is guided by a multifaceted approach, which uses a highly quantifiable, objective means of evaluating progress. This is supplemented by a Community Advisory Board, NNJTBIS Steering Committee, and an external Scientific Advisory Board, which provides feedback on a quarterly, annual, and bi-annual basis, respectively. In addition, project management staff meets internally on a regular basis to review data management and data quality issues and assure effective communication with Kessler Institute for Rehabilitation (KIR) and staff from the trauma centers. Finally, the NNJTBIS coordinates with the NIDRR-funded Model Systems Knowledge Translation Center at the University of Washington to provide scientific results and information for dissemination to clinical and consumer audiences. The NNJTBIS is a cooperative effort of the Kessler Foundation Research Center, KIR, and trauma centers from the University of Medicine and Dentistry of New Jersey - The New Jersey Medical School (UMDNJ-NJMS), Hackensack University Hospital, Morristown Memorial Hospital, and St. Joseph's Hospital.
Descriptors: Brain injuries, Cognitive rehabilitation, Model Systems, Rehabilitation medicine, Traumatic Brain Injury Model Systems.
Classification and Measurement of Medical Rehabilitation Interventions.
Mount Sinai School of Medicine.
One Gustave L. Levy Place, Box 1240.
New York, NY 10029-6574.
E-mail: marcel.dijkers@mssm.edu.
Principal Investigator: Marcel Dijkers, PhD.
Public Contact Phone: 212/659-8587.
Fax: 212/348-5901.
Project Number: H133A080053.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Scott Brown, PhD.
NIDRR Funding: FY 08 $350,000; FY 09 $350,000; FY 10 $350,000; FY 11 $350,000; FY 12 $350,000.
Abstract: The development of a Rehabilitation Treatment Taxonomy (RTT) covering all treatments (experience-based, medications, education, assistive devices, etc.) delivered in medical rehabilitation is a multi-year, multidisciplinary process requiring the interweaving of many different conceptual and empirical steps, which needs to be guided by an overall blueprint to direct and link individual efforts. This project develops such a blueprint, and performs research to explore strategies and methods that are needed to create and test the full RTT. Specifically, in phase 1, the project scrutinizes existing treatment literature for theories that underlie treatment; develops a theoretical framework; specifies performance requirements and practical constraints for an RTT; and reviews existing ad-hoc classifications for spinal cord injury (SCI), traumatic brain injury (TBI), stroke, and joint replacement rehabilitation for practicality. Researchers present the resulting blueprint for feedback at an interdisciplinary conference with representatives of all rehabilitation disciplines, revised as necessary in response to feedback, and, in phase 2, uses this feedback to develop two partial taxonomies: (a) of interventions to improve ambulation in persons with neurological disorders, and (b) of treatments of executive dysfunction after acquired brain injury. Evaluation of the process of development and operationalization of the taxonomy is used to modify, expand, and enhance the blueprint. A second interdisciplinary conference is used to present the modified blueprint to the rehabilitation field and obtain input on directions the field needs to take to develop the entire RTT.
Descriptors: Measurement, Medical rehabilitation, Outcomes, Taxonomy.
New York Traumatic Brain Injury Model System (NYTBIMS).
Mount Sinai School of Medicine.
One Gustave L. Levy Place, Box 1240.
New York, NY 10029.
E-mail: wayne.gordon@mssm.edu.
URL(s): http://www.mssm.edu/tbicentral/nytbims/.
Principal Investigator: Wayne A. Gordon, PhD.
Public Contact Phone: 212/659-9372.
Fax: 212/348-5901.
Project Number: H133A070033.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 07 $419,921; FY 08 $419,920; FY 09 $419,920; FY 10 $419,921; FY 11 $419,921.
Abstract: The research program of The New York Traumatic Brain Injury Model System (NYTBIMS) aims to advance the understanding of traumatic brain injury (TBI) and develop better methods of treating secondary conditions of TBI, especially fatigue, mood, cognition, and sleep disorders. Research goals of this project are to: (1) demonstrate and evaluate a multidisciplinary system of care for persons with TBI in the New York City metropolitan area, including a number of innovative clinical programs; (2) contribute longitudinal data to the National Database of the TBI Model Systems program; and (3) conduct one module and two local studies to: (a) systematically study sleep architecture, insomnia, and other types of sleep disorders after TBI, to better understand post-TBI fatigue; and (b) evaluate the effectiveness of exercise as a treatment of post-TBI fatigue, mood, and cognition. Dissemination, education, and training activities constitute the third component of the NYTBIMS, including a policy newsletter, expanded web-based information, journal publications, presentations at national and local meetings, a newsletter for consumers, and several formal educational and training programs, including training of physiatric residents as well as interns and postdoctoral researchers in psychology.
Descriptors: Brain injuries, Exercise, Fatigue, Model Systems, Secondary conditions, Traumatic Brain Injury Model Systems.
Carolinas Traumatic Brain Injury Rehabilitation and Research System (CTBIRRS).
Carolinas HealthCare System.
1100 Blythe Boulevard.
Charlotte, NC 28203.
E-mail: fhammond@carolinas.org.
URL(s): http://www.carolinasrehabilitation.org/body.cfm?id=191.
Principal Investigator: Flora M. Hammond, MD.
Public Contact Phone: 704/355-4330.
Fax: 704/355-0709.
Project Number: H133A070042.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $438,571; FY 08 $438,571; FY 09 $438,571; FY 10 $438,571; FY 11 $438,571.
Abstract: The Carolinas Traumatic Brain Injury Rehabilitation and Research System (CTBIRRS) is a comprehensive service delivery and research system serving individuals with traumatic brain injury (TBI). The System begins with prevention and emergency medical services and extends through intensive care, acute care, and comprehensive medical rehabilitation to long-term follow-up, community reintegration, and vocational rehabilitation. The research of this Model System focuses on the challenging problem of post-traumatic irritability and aggression using a comprehensive, rigorous approach to generate and disseminate new knowledge on this high impact, pervasive, and under-studied problem. This approach to understanding irritability entails two randomized, controlled studies that build on a solid base of prior research by the investigators in this area: (1) a multi-center module study: "A Multi-Center, Parallel-Group, Randomized, Double-Blind, Placebo-Controlled Trial of Amantadine Hydrochloride for the Treatment of Chronic TBI Irritability and Aggression: A Replication Study"; and (2) a local research study: "Carbamazepine for the Treatment of Chronic Post-TBI Irritability and Aggression: A 42-day Single-Site, Forced-Titration, Parallel-Group, Randomized, Double-Blind, Placebo-Controlled Trial." The research studies were developed with in-depth input from the TBI community, with a solid plan for continued input along the course of the project through all aspects including research implementation, interpretation of findings, knowledge translation, project planning, and evaluation. The evaluation plan is directly linked to the target impacts, and provides a list of clear criteria to facilitate project administration, judge success, ensure dissemination of findings, and provide iterative feedback. CTBIRRS utilizes innovative means of knowledge translation to target audiences (consumers, providers, researchers, third party payers, policy makers), including a consumer conference, provider skill packs and workshops, fact sheets, tip cards, surveys of current practices, peer-reviewed publications, scholarly presentations, and evidence-based reviews. The project evaluates target familiarity with the subject matter and product usefulness. The CTBIRRS project collaborates with the Model System Knowledge Translation Center to disseminate materials that integrate project findings within the larger body of research on post-TBI behavioral management.
Descriptors: Brain injuries, Mental health, Model Systems, Pharmacology, Traumatic Brain Injury Model Systems.
TBI Model System Collaborative Study of Amantadine for Post TBI Irritability and Aggression.
Carolinas Rehabilitation.
1100 Blythe Boulevard.
Charlotte, NC 28232.
E-mail: flora.hammond@carolinashealthcare.org.
URL(s): http://www.carolinasrehabilitation.org/body.cfm?id=200.
Principal Investigator: Flora M. Hammond, MD.
Public Contact Phone: 704/355-4330.
Fax: 704/355-0709.
Project Number: H133A080035.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 08 $855,000; FY 09 $855,000; FY 10 $855,000; FY 11 $855,000; FY 12 $855,000.
Abstract: This study focuses on the challenging problem of irritability (primary aim) and aggression (secondary aim) in post-traumatic brain injury by using a rigorous approach to generate and disseminate new knowledge on this high impact, pervasive, and under-studied problem that affects approximately 29-71 percent of individuals with traumatic brain injury (TBI). Building upon prior research, project goals include: (1) assess the effect of amantadine for 28 days at reducing TBI irritability; (2) assess the effect of amantadine for 28 days at reducing TBI aggression; (3) assess the effect of amantadine for 60 days on TBI irritability and aggression; and (4) assess the effect of amantadine on cognitive function following TBI. Continuous input from the TBI community is incorporated into the development and implementation of the project, and throughout the course of this project in the areas of research implementation, interpretation of findings, knowledge translation, project planning, and evaluation. Additionally, this project is a collaborative research partnership between five other prominent TBI research centers: University of Washington, The Institute for Rehabilitation and Research, The Ohio State University, Kessler Institute for Rehabilitation, and Spaulding Rehabilitation Hospital. The knowledge generated by this project benefits those living with TBI by increasing awareness through targeted products and training with healthcare providers, consumers, researchers, vocational counselors, independent living providers, third party payers, and policy makers.
Descriptors: Aggression, Amantadine, Brain injuries, Drugs, Irritability, Model Systems.
Individualized Planning for the First Year Following Acute Rehabilitation Project.
Ohio State University.
1166 Dodd Rehab Hospital
480 Medical Center Drive.
Columbus, OH 43210.
E-mail: brello.1@osu.edu.
URL(s): http://www.ohiovalley.org.
Principal Investigator: John D. Corrigan, PhD.
Public Contact Phone: 614/293-8879.
Fax: 614/293-4870.
Project Number: H133A080023.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 08 $854,780; FY 09 $854,881; FY 10 $854,469; FY 11 $853,685; FY 12 $854,475.
Abstract: The Individualized Planning for the First Year Following Acute Rehabilitation Project is a multi-center research partnership among the Ohio Regional TBI Model System, the Institute for Clinical Outcomes Research in Salt Lake City, Utah, and the TBI Model Systems National Data and Statistical Center and the Rocky Mountain Regional Brain Injury System at Craig Hospital in Colorado. This project conducts a Practice Based Evidence (PBE) study of individual differences in demographic characteristics, pre-morbid status, injury-related conditions, and medical course that differentially predict the effectiveness of rehabilitation interventions on functional independence, participation, and subjective well-being up to one year following traumatic brain injury (TBI). Incorporating data collected for the NIH-funded PBE study, this project focuses on acute rehabilitation, and on the recovery processes occurring after discharge from rehabilitation. PBE methodology studies naturally occurring differences in treatment practices in order to identify individual differences in treatment effectiveness. It allows a large number of intervention-by-impairment interactions to be examined, while individual patient differences, including severity of TBI and medical complications, are controlled. Data is collected at 10 TBI rehabilitation programs in the United States and Canada: Ohio Regional TBI Model System, Carolinas TBI Model System, New York TBI Model System at Mt. Sinai, National Rehabilitation Hospital, Shepherd Center, Intermountain Medical Center, Rush University Medical Center, Brooks Rehabilitation Hospital, Loma Linda University Rehabilitation Institute, and the Toronto Rehabilitation Institute. Research subjects are 2,315 consecutive, consenting patients admitted for rehabilitation of a moderate or severe TBI. Interviews occur at 3 and 6 months post-discharge and 1 year post-injury allowing for detailed characterization of change during the first year of recovery.
Descriptors: Acute rehabilitation, Brain injuries, Individualized planning, Model Systems, Statistics.
Ohio Regional TBI Model System.
Ohio Valley Center for Brain Injury Prevention and Rehabilitation.
Dodd Rehabilitation Hospital
480 Medical Center Drive.
Columbus, OH 43210.
E-mail: brello.1@osu.edu.
URL(s): http://www.ohiovalley.org.
Principal Investigator: John D. Corrigan, PhD; Jennifer Bogner, PhD.
Public Contact Phone: 614/293-8879.
Fax: 614/293-6521.
Project Number: H133A070029.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Delores Watkins.
NIDRR Funding: FY 07 $434,393; FY 08 $457,354; FY 09 $434,353; FY 10 $434,381; FY 11 $434,376.
Abstract: This project includes one local research project and a collaborative research module. The local project is an extension of two previous randomized clinical trials in which a targeted financial incentive was found efficacious for engaging and retaining persons with traumatic brain injury (TBI) in substance abuse treatment. The current study investigates the efficacy of a financial incentive for engendering attendance at work as persons with TBI and substance use disorders initiate employment. The collaborative research module replicates and extends a preliminary study recently completed at OSU. That project used geographic identifiers to compile data about the social and economic characteristics of a person's neighborhood. Researchers then examined the contribution of these environmental factors to outcomes from TBI. The current module contributes to an evaluation of the utility of adding a geographic identifier, based on a person's residence at follow-up, to the TBI Model Systems National Dataset. With this identifier, future Model Systems researchers could access an ever-growing array of information about the environment and link it to Model Systems data about an individual's outcome. Dissemination efforts include “SynapShots”, an educational website produced with the Brain Injury Association of America, and a systematic review of Screening and Brief Interventions for the Model Systems Knowledge Translation Center.
Descriptors: Brain injuries, Employment success, Model Systems, Statistics, Substance abuse, Traumatic Brain Injury Model Systems.
Health and Health Care Disparities Among Individuals with Disabilities.
Oregon Health and Science University.
P.O. Box 574.
Portland, OR 97239.
Principal Investigator: Charles Drum, PhD.
Public Contact Phone: 503/494-3533.
Fax: 503/494-6868.
Project Number: H133A080031.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Shelley Reeves.
NIDRR Funding: FY 08 $450,000; FY 09 $450,000; FY 10 $450,000; FY 11 $450,000; FY 12 $450,000.
Abstract: The Health Disparities Project generates new knowledge about health access and health outcomes, and translates and disseminates the findings for researchers, policy makers, and others. Assisted by an assembled national expert panel and other key project staff, the project determines working definitions, key questions, and analytic models for the studies. Disability perspectives are integrated throughout the project process from development of the research hypotheses and selection of design to analysis of data. This project has four major components: (1) review and synthesize existing health and health care access among individuals with disabilities and subgroups of individuals with disabilities; (2) use the Medical Expenditure Survey data to perform two series of logistic regression and path analysis modeling studies; the first series of studies determines models of systems level, environmental level, and individual level factors that relate to health care access among persons with a range of disabilities; the second series extends these analyses to determine models of health outcomes for persons with a range of disabilities; (3) utilize research findings in future research, program, and policy development through proactive and passive dissemination methods; and (4) integrate project activities to ensure the field of health disparities research advances beyond documentation to explanation, and opportunity for resolution.
Descriptors: Access, Disabilities, Disparities, Health care, Outcomes.
The Moss Traumatic Brain Injury Model System.
Albert Einstein Healthcare Network.
60 East Township Line Road.
Elkins Park, PA 19027.
E-mail: thart@einstein.edu.
URL(s): http://www.einstein.edu/facilities/mossrehab/index.html.
Principal Investigator: Tessa Hart, PhD.
Public Contact Phone: 215/663-6153.
Fax: 215/663-6113.
Project Number: H133A070040.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $434,399; FY 08 $434,399; FY 09 $434,399; FY 10 $434,399; FY 11 $434,399.
Abstract: The Moss TBIMS includes two site-specific research projects embedded within a state-of-the-art traumatic brain injury (TBI) treatment and clinical research facility. Project 1 is a placebo-controlled pilot study of the effects of dextroamphetamine (DEX) on attention, engagement in therapy, cognitive and motor speed, and other outcomes in subacute TBI. This project also examines the possibility that DEX accelerates the pace of functional recovery in the subacute phase. Project 2 is a cross-national collaboration with a specialty TBI service in a Copenhagen hospital, which has many similarities to the Moss TBIMS in terms of patient mix, treatment philosophy, and cultural milieu. The Copenhagen facility provides significantly longer and, in some respects, more intensive inpatient care and rehabilitation compared to Moss (and other US rehabilitation facilities), even for patients with comparable injury severity. This affords a natural experiment in which persons with TBI treated at the two facilities are compared on a range of 6- and 12-month outcomes, including functional status, emotional well-being and quality of life, and caregiver burden. The Moss TBIMS also collaborates in multi-center longitudinal database research and collaborative module projects. In addition, extensive knowledge translation projects provide evidence-based skills and knowledge enhancement for clinicians specializing in TBI care and for consumers via collaboration with the Brain Injury Association of Pennsylvania.
Descriptors: Brain injuries, International rehabilitation, Model Systems, Pharmacology, Traumatic Brain Injury Model Systems, Vocational rehabilitation.
North Texas Burn Rehabilitation Model System (NTBRMS).
The University of Texas Southwestern Medical Center.
5323 Harry Hines Boulevard.
Dallas, TX 75390-9136.
E-mail: radha.holavanahalli@utsouthwestern.edu.
URL(s): http://www.utsouthwestern.edu/utsw/home/research.ntbrms.
Principal Investigator: Karen Kowalske, MD.
Public Contact Phone: 214/648-9540, 214/648-3654.
Fax: 214/648-2005.
Project Number: H133A070024.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $362,500; FY 08 $362,500; FY 09 $362,500; FY 10 $362,500; FY 11 $362,500.
Abstract: The North Texas Burn Rehabilitation Model System (NTBRMS) includes one collaborative research module project entitled “Long-Term Follow-up of the Burn Model System National Database Sample (LTF=NDS)” and two site specific research studies entitled “Biomechanical Properties of Burn Scar” and “Efficacy of Social Interaction Skills Training Post Burn Injury.” Collaboration occurs on many levels at the NTBRMS. Clinical collaboration is the hallmark of the burn team, which includes individuals from several institutions who work together seamlessly as well as collaboration with our rural care providers through outreach clinics. Research collaboration occurs locally with the surgeons and academic computing and nationally with the other model systems. The evaluation plan specifically focuses on the overall objectives for demonstration, research, and dissemination with specific quantifiable targets, which are reassessed quarterly. Dissemination of NTBRMS materials occurs at many levels and in a variety of formats: lectures by key personnel, publication in peer reviewed journals, a quarterly newsletter, and an accessible website available in English and Spanish. The NTBRMS collaborates with NIDRR-funded Model Systems Knowledge Translation Center (MSKTC) by participating in its systematic reviews of evidence and facilitating knowledge management by identifying the information needs and barriers among the various stakeholders both at national and local levels.
Descriptors: Burn Injury Model Systems, Burns, Community integration, Model Systems, Outcomes, Social skills.
North Texas Traumatic Brain Injury Model System (NT-TBIMS).
The University of Texas Southwestern Medical Center.
5323 Harry Hines Boulevard.
Dallas, TX 75390-9036.
E-mail: caryn.harper@utsouthwestern.edu.
URL(s): http://www.utsouthwestern.edu/utsw/home/research/neurology/tbi/index.html.
Principal Investigator: Ramon R. Diaz-Arrastia, MD, PhD.
Public Contact Phone: 214/648-7613.
Fax: 214/648-3143.
Project Number: H133A070027.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $430,350; FY 08 $430,350; FY 09 $430,350; FY 10 $430,350; FY 11 $430,350.
Abstract: This project provides comprehensive continuum of care for traumatic brain injury (TBI) from the time of arrival at the emergency department through the intensive care unit, inpatient and outpatient rehabilitation, and long-term follow-up after community integration. The project conducts two local research projects aimed at furthering the goal of developing novel therapies and tailoring these therapies to individual patients: (1) Phase II randomized, placebo-controlled clinical trial to determine whether therapy with recombinant human growth hormone (rhGH) during the acute rehabilitation period after TBI results in improved functional outcome; and (2) an observational study using magnetic resonance imaging (MRI) during the acute rehabilitation period to validate the use of Diffusion Tensor Imaging as a biomarker of diffuse axonal injury. Additionally, the NT-TBIMS works collaboratively with other TBI-MS Health Module members in a modular project to develop a Brain Injury Assessment Scale, which allows reliable and validated assessment of sensorimotor impairments after TBI. The goal is that this scale be as useful in the TBI field as the NIH Stroke Scale has been in clinical trials in stroke. Finally, the NT-TBIMS provides patient and family education, and dissemination of research findings to the professional community by conducting seminars, presenting the results at professional meetings, and publishing in professional and lay journals devoted to TBI.
Descriptors: Brain injuries, Model Systems, Outcomes, Traumatic Brain Injury Model Systems.
Pediatric Burn Injury Rehabilitation Model System.
University of Texas Medical Branch.
815 Market Street, Route 1220.
Galveston, TX 77550.
E-mail: dherndon@utmb.edu patblakeney@earthlink.net Jlbailey@utmb.edu.
Principal Investigator: David Herndon, MD.
Public Contact Phone: 409/770-6718 or 713/661-1745, 409/770-6731.
Fax: 713/661-2871, 409/770-6919.
Project Number: H133A070026.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $362,500; FY 08 $362,500; FY 09 $362,500; FY 10 $362,500; FY 11 $362,500.
Abstract: This program conducts independent and multi-center projects focusing on evaluating and improving the rehabilitation provided to children with burn injuries, striving to decrease disability and improve reintegration into society. The model system includes one collaborative project assessing the efficacy of long term use of propranolol in the treatment of burn injury (in adults and children) with endpoints of improved survivability, improved cardiovascular condition, greater energy, improved muscle endurance, improved growth in children, and decreased anxiety. The project also includes a site-specific study to improve rehabilitative outcomes for children with greater than 40 percent total body surface area burned by combining an anabolic agent (oxandrolone, Ketoconazole, or propranolol) with a 3-month intensive outpatient rehabilitation program. The supervised exercise program has shown to be effective in ameliorating effects of the hypermetabolic response. This project assesses the effectiveness of combining the anabolic agents and the exercise program with the expectation that the effects will be additive and will improve linear growth, bone mass, muscle strength, lean body mass, physical function, and general well-being. The last study, also site specific, is a continuation from the previous funding cycle. It focuses on Acute Stress Disorder (ASD) and Post Traumatic Stress Disorder (PTSD), a problem that impairs the well-being of burn patients. The study follows children with ASD to access the relationship of the two disorders and to elucidate a history of the development of PTSD.
Descriptors: Burn Injury Model Systems, Burns, Children, Model Systems, Outcomes, Pharmacology, Posttraumatic stress disorders.
The Texas Traumatic Brain Injury Model System of TIRR.
The Institute for Rehabilitation and Research (TIRR).
1333 Moursund Avenue.
Houston, TX 77030.
E-mail: mark.sherer@memorialhermann.org.
URL(s): http://www.memorialhermann.org/locations/tirr/forhealthprofessionals/content.aspx?id=1162.
Principal Investigator: Mark Sherer, PhD.
Public Contact Phone: 713/799-7007.
Project Number: H133A070043.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Pimjai Sudsawad, ScD.
NIDRR Funding: FY 07 $430,350; FY 08 $430,350; FY 09 $430,350; FY 10 $430,350; FY 11 $430,350.
Abstract: The Texas TBI Model System of TIRR conducts a program of research, dissemination activities, and clinical care designed to address social relationships and to improve outcomes for persons with traumatic brain injury (TBI). Research activities include: (1) contributions to the TBI Model Systems National Database, (2) a collaborative, multi-center, research module project on sexuality after TBI, and (3) a local project on social communication difficulties after TBI. A collaborative project on sexuality determines the frequency, type, and severity of changes in sexual functioning after TBI. As part of this project, researchers conduct the first randomized, clinical trial of an intervention to increase satisfaction with sexual functioning and comfort level in discussing sexual issues for persons with TBI and their partners. A local project on social communication conducts a randomized clinical trial of an intervention to improve social communication skills and social integration for persons with TBI, with the largest sample size of any similar study and one of only two randomized controlled trials conducted in this area for over 20 years.
Descriptors: Brain injuries, Community integration, Rehabilitation medicine, Rehabilitation research, Sexuality, Traumatic Brain Injury Model Systems, Violence.
Virginia Commonwealth Traumatic Brain Injury Model System.
Virginia Commonwealth University.
Box 980542.
Richmond, VA 23298-0452.
E-mail: jhmarwit@vcu.edu.
URL(s): http://www.tbi.pmr.vcu.edu.
Principal Investigator: Jeffrey S. Kreutzer, PhD.
Public Contact Phone: 804/828-3704.
Fax: 804/828-2378.
Project Number: H133A070036.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $426,720; FY 08 $426,720; FY 09 $426,720; FY 10 $426,720; FY 11 $426,720.
Abstract: This project utilizes rigorous scientific methods to examine the benefits of intervention for survivors of traumatic brain injury (TBI) and their families before and after inpatient rehabilitation discharge. Traumatic Brain Injury Model Systems (TBIMS) and other researchers have expended considerable energy delineating outcomes. For example, researchers have thoroughly documented problems after injury, including memory disturbance, impaired self-awareness, executive skills dysfunction, slowness, visual dysfunction, poor motor coordination, and behavioral disorders. Recent studies have identified a high prevalence of depression, with many survivors reporting feelings of hopelessness, diminished self-esteem, and social isolation. Brain injury also affects the family system; family members commonly describe emotional distress, lack of respite, financial stress, and lack of community support. Projects at the Model System focus on both survivors and families. One study is a randomized controlled trial to examine the efficacy of a structured approach to the treatment of acute cognitive and neurobehavioral problems. A second study is a randomized controlled trial to examine the benefits of an intervention program for family crisis and support.
Descriptors: Brain injuries, Cognitive rehabilitation, Families, Model Systems, Traumatic Brain Injury Model Systems.
Controlled Trial of Venlafaxine XR for Depression After SCI: A Multisite Study.
University of Washington.
325 9th Avenue.
Seattle, WA 98104.
E-mail: chb@u.washington.edu.
URL(s): http://sci.washington.edu.
Principal Investigator: Charles H. Bombardier, PhD.
Public Contact Phone: 206/897-4731.
Fax: 206/897-4790.
Project Number: H133A060107.
Start Date: January 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $2,198,213; FY 07 $899,981; FY 08 $899,982; FY 09 $899,974; FY 10 $895,874.
Abstract: This project is a multisite, randomized, double-blind, placebo controlled trial of venlafaxine XR (Effexor XR) in 168 adults with spinal cord injury (SCI) and major depressive disorder (MDD) who are 18-65 years old and one or more years post injury. The purpose of the study is to examine the efficacy and tolerability of venlafaxine XR as a treatment for MDD. The primary outcome is the percent of responders (those who report at least a 50% reduction in depression severity from baseline to the end of treatment) in the venlafaxine XR versus placebo control group using intent-to-treat analysis. Secondary outcomes include changes in pain, health related quality of life, and participation. A successful clinical trial could lead to more aggressive identification and treatment of MDD as well as improved health and quality of life in this important population. This is a collaborative project with the Northwest Regional Model Spinal Cord Injury System.
Descriptors: Depression, Drugs, Model Systems, Rehabilitation, Rehabilitation medicine, Spinal cord injuries.
The Effect of Scheduled Telephone Intervention on Outcomes After Traumatic Brain Injury (TBI).
University of Washington.
Box 356490, BB-953 Health Sciences.
Seattle, WA 98195.
E-mail: krbell@u.washington.edu.
URL(s): http://depts.washington.edu/rehab/tbi.
Principal Investigator: Kathleen R. Bell, MD.
Public Contact Phone: 206/685-0935.
Fax: 206/685-3244.
Project Number: H133A040004.
Start Date: December 1, 2004.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 04 $600,000; FY 05 $600,000; FY 06 $600,000; FY 07 $600,000; FY 08 $600,000; FY 09 $ 0.
Abstract: This project evaluates the effect of scheduled telephone intervention (STI) on functional and health outcomes, at weeks 1-2, 4, 8, and 12, and months 5, 7, and 9 on functional level, health and emotional status, community integration, and perceived quality of well-being over 1 year after traumatic brain injury (TBI). This a low-cost, easily-implemented intervention is trialed in three states. Timely intervention to identify problems after TBI, to teach patients and their families coping techniques within their own communities and support their independent decision-making, may effectively decrease the need for expensive and often inaccessible services and may improve the quality of life for survivors of TBI. Researchers are evaluating the effect of additional STI at months 15, 18, and 21 on the same variables and employment at 2 years after TBI. Research examines whether the effects of such intervention are similar in multiple sites over a wide geographic area. It also examines the differential impact of the intervention in demographic subgroups, with particular attention to minority versus non-minority racial and ethnic populations.
Descriptors: Brain injuries, Outcomes.
University of Washington Burn Model System.
University of Washington.
Harborview Medical Center
325 Ninth Avenue
Box 359796.
Seattle, WA 98104.
E-mail: engrav@u.washington.edu.
URL(s): http://depts.washington.edu/uwnidrr/.
Principal Investigator: Loren H. Engrav, MD.
Public Contact Phone: 206/731-3209.
Fax: 206/731-3656.
Project Number: H133A020103 (See also H133A070047).
Start Date: October 1, 2002.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 02 $300,000; FY 03 $300,000; FY 04 $300,000; FY 05 $300,000; FY 06 $300,000; FY 07 $ 0; FY 08 $ 0.
Abstract: This model system conducts five research projects: (1) A New Approach to the Etiology of Hypertrophic Scarring develops an increased understanding of hypertrophic scarring. (2) Effect of Virtual Reality on Active Range-of-Motion During Physical Therapy uses distraction via immersive virtual reality as an adjunctive non-pharmacologic analgesic. This study tests the hypothesis that virtual reality allows patients to tolerate greater stretching during physical therapy compared to no distraction, and that in spite of achieving greater range-of-motion, patients still experience lower pain levels while in virtual reality. (3) Determination of Reasons for Distress in Burn-Injured Adults identifies reasons behind a burn survivor's distress at various time-points after hospital discharge. (4) Barriers for Return to Work identifies specific barriers to return to work for burn survivors. (5) Acute Stress Disorder Among Burn Survivors evaluates the effectiveness of cognitive-behavioral therapy, relative to a non-directive, supportive therapy control group, and a national comparison sample in reducing the prevalence of posttraumatic stress disorder diagnosis and symptom severity. Projects 4 and 5 are collaborative. In addition, this project participates in the national database.
Descriptors: Burn Injury Model Systems, Burns, Mental health, Model Systems.
University of Washington Burn Model System.
University of Washington.
Harborview Medical Center
325 Ninth Avenue
Box 359796.
Seattle, WA 98104.
E-mail: engrav@u.washington.edu.
URL(s): http://depts.washington.edu/uwnidrr.
Principal Investigator: Loren H. Engrav, MD; Peter C. Esselman, MD.
Public Contact Phone: 206/731-3209.
Fax: 206/731-3656.
Project Number: H133A070047.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $362,458; FY 08 $362,459; FY 09 $362,453; FY 10 $362,458; FY 11 $362,449.
Abstract: The University of Washington Burn Model System includes one multi-site, collaborative project, and two site-specific projects. Project 1: Psychological and Social Needs of Long Term Survivors of Major Burn Injury is a collaborative study (lead center Baltimore) to identify the needs of persons 5 and 10 years after injury. Project 2 (Site-Specific): Expanded Delivery Model for Burn Rehabilitation incorporates a novel intervention, an “expanded care provider”, who enables clinicians to “reach out” to individuals with burn injury and for them to “reach in” to care providers whenever care is needed, rather than on a rigid schedule to determine if this improves burn rehabilitation outcomes. In a randomized trial, Group 1 receives standard outpatient clinic-based rehabilitation. Group 2 has an additional care provider who uses multiple modalities to manage the multifaceted sequelae of thermal injury. Outcomes are assessed using an individualized Goal Attainment Scale and the validated Burn Specific Health Scale. Project 3 (Site Specific): Identification of the Pathways to Scarring utilizes bioinformatics tools to identify gene expression pathways associated with hypertrophic scarring. In addition, we contribute long-term follow-up data to the national database maintained at the University of Colorado in Denver.
Descriptors: Burn Injury Model Systems, Burns, Mental health, Model Systems, Outcomes, Service delivery.
University of Washington Traumatic Brain Injury Model System.
University of Washington.
Box 356490, BB-953 Health Sciences.
Seattle, WA 98195.
E-mail: krbell@u.washington.edu.
URL(s): http://depts.washington.edu/rehab/tbi.
Principal Investigator: Kathleen R. Bell, MD.
Public Contact Phone: 206/685-0935.
Fax: 206/685-3244.
Project Number: H133A070032.
Start Date: October 1, 2007.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $430,349; FY 08 $430,348; FY 09 $430,346; FY 10 $430,347; FY 11 $430,350.
Abstract: University of Washington's Traumatic Brain Injury Model System (UWTBIMS) provides a comprehensive, integrated continuum of medical, surgical and rehabilitation services to persons with acute and chronic traumatic brain injury (TBI). This project conducts two site-specific projects. The first is a randomized controlled intervention study evaluating the effect of a structured, telephone-based mentoring program for caregivers focusing on self-management skills. This study builds upon previous experiences with telephone counseling for both people with traumatic brain injury and multiple sclerosis. This research is particularly important because caregivers are so crucial to the successful rehabilitation and community re-integration of persons with TBI and the literature on successful interventions for this population is so sparse. The use of a telephone-based program allows researchers to reach those (especially in rural regions) who lack ready access to knowledgeable advice, behavior change support, and specialty care sufficient to maintain the health of their significant other and themselves. The second project utilizes a large and rich database to predict a number of important long-term outcomes. The modular project studies the natural history of headache under conditions of usual care during the first year after TBI. This project characterizes the course and nature of headache, a common but poorly studied consequence of TBI. It examines the impact of headache on outcome and its potential modifiers, describes patient treatment preferences, and lays the foundation for a multi-site clinical trial.
Descriptors: Brain injuries, Caregivers, Headache, Model Systems, Traumatic Brain Injury Model Systems.
Field Initiated Projects (FIPs).
A New Measure of Subjective Fatigue in Persons with Traumatic Brain Injury.
Santa Clara Valley Medical Center (SCVMC).
751 South Bascom Avenue.
San Jose, CA 95128.
Principal Investigator: Jeffrey Englander, MD.
Public Contact Phone: 408/793-6433.
Fax: 408/793-6434.
Project Number: H133G080168.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 08 $182,918; FY 09 $170,842; FY 10 $191,997.
Abstract: This research project addresses the lack of evidence supporting a specific fatigue scale, of the over 30 that have been used for clinical and/or research purposes, which is psychometrically sound, efficient, and useful in individuals with traumatic brain injury (TBI) to assess treatment interventions and the natural history of fatigue following TBI. The primary objective of the project is to evaluate the internal consistency, concurrent validity, and item/scale structure of a fatigue item pool and to identify the most psychometrically sound measure of fatigue in individuals post-TBI. To accomplish this goal, SCVMC has partnered with the Rehabilitation Institute of Michigan (RIM), a TBI Model System from 1987-2007 and a contracted center to continue TBI National Database follow-up. SCVMC and RIM have the largest number of cases eligible for follow-up in the TBI National Database.
The short-term outcome is to advance knowledge about the measurement of fatigue in individuals with TBI through creation of a psychometrically valid and useful fatigue assessment measure for individuals with TBI. The intermediate outcome is that availability of the new scale will lead to improved studies and treatment plans for individuals with TBI who have fatigue.
Descriptors: Brain injuries, Fatigue, Measurement.
Evaluating Dysphagia in Individuals with Spinal Cord Injury: Assessing Incidence, Associated Factors, and Preventable Complications.
Santa Clara Valley Medical Center (SCVMC).
751 South Bascom Avenue.
San Jose, CA 95128.
Principal Investigator: Kazuko Shem, MD.
Public Contact Phone: 408/885-7007.
Fax: 408/885-2028.
Project Number: H133G080165.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 08 $189,382; FY 09 $196,670; FY 10 $179,385.
Abstract: Dysphagia is known to occur in a significant number of individuals with spinal cord injury (SCI) presenting to acute care immediately after the injury and to inpatient rehabilitation. However, the exact incidence of dysphagia in this population has not been studied prospectively. The primary objective of this study is to determine the incidence of dysphagia using bedside swallow evaluation (BSE) and videofluoroscopy swallow study (VFSS) and to determine associated risk factors in individuals with SCI. The secondary objective is to determine if the BSE is an effective screening tool as compared with the VFSS for individuals with SCI and to determine the sensitivity and specificity of BSE in individuals with SCI. The third objective is to document the time course for the resolution of dysphagia post-SCI. To address this research question, individuals with SCI who are positive for dysphagia following either a BSE or VFSS are administered serial BSE and VFSS until resolution of dysphagia or discharge from the rehabilitation center.
Descriptors: Dysphagia, Evaluation techniques, Spinal cord injuries, Swallowing disorders.
Developing a Relevant Instrument to Assess Caregiver Distress and Benefit in Spinal Cord Injury.
Craig Hospital.
3425 South Clarkson Street.
Englewood, CO 80113-2899.
E-mail: susie@craighospital.org.
Principal Investigator: Susan Charlifue, PhD.
Public Contact Phone: 303/789-8306.
Fax: 303/789-8441.
Project Number: H133G090013.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 09 $199,999; FY 10 $199,999; FY 11 $199,999.
Abstract: This project employs a combined qualitative and quantitative methodology to develop a relevant instrument to assess caregiver distress and benefit in spinal cord injury (SCI). The project uses a focus group methodology to identify areas of concern for family members providing assistance to a loved one with SCI. Detailed qualitative analysis of the focus group transcripts is used to identify themes and concepts that may be operationalized into questions for a new instrument to assess caregiver distress and benefit in SCI. The instrument is pilot tested with 250 family SCI caregivers. Items for a final instrument are selected following factor analysis and Rasch analysis. The lived experience of SCI caregiving, as expressed by the caregivers themselves, helps identify what factors are associated with positive or negative experiences for SCI family caregivers. From this rich contextual information, a new measure to assess distress and benefit in SCI caregiving may be developed. Led by Craig Hospital in Englewood, Colorado, the project is a collaborative research effort with three other prominent SCI rehabilitation facilities: University of Alabama at Birmingham, Santa Clara Valley Medical Center in San Jose, California, and the Kessler Medical Rehabilitation Research & Education Center/Kessler Foundation in West Orange, New Jersey.
Descriptors: Assessment Tools, Caregivers, Qualitative analysis, Quantitative analysis, Spinal cord injuries, Stress.
Exercise Treatment of Obesity-Related Secondary Conditions in Adults with Paraplegia.
University of Miami.
1095 Northwest 14th (R48).
Miami, FL 33136.
Principal Investigator: Mark S. Nash, PhD.
Fax: 305/243-3913.
Project Number: H133G080150.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Thomas Corfman.
NIDRR Funding: FY 08 $199,738; FY 09 $199,922; FY 10 $198,594.
Abstract: This project investigates the effects of physical activity with or without a nutrient supplement known to increase body lean mass on adults with chronic paraplegia who are at risk for clusters of obesity and obesity-related secondary complications. Qualified subjects perform six months of circuit resistance training with half of the participants randomized to receive a whey protein supplement immediately before and immediately after each training session. The immediate post-exercise administration of whey protein is reported to increase body lean (muscle) mass, whose loss after spinal cord injury (SCI) is thought to decrease fat utilization and hasten body fat accretion. Outcomes measured include: (1) the effects of training and supplement on cardiopulmonary endurance and strength, a global disease risk score, health related quality of life as assessed by the SF-36 instrument validated for use in persons with SCI; and (2) participant perceptions of exercise benefits studied before and after training by a scientist-stakeholder with SCI. Data examining the personal and societal barriers to exercise participation after SCI is collected through a web-based form. This project improves the understanding of risks for obesity and obesity-related secondary complications. The results are analyzed and will improve the understanding of risks for obesity and obesity-related secondary complications.
Descriptors: Nutrition, Obesity, Paraplegia, Physical activity, Secondary conditions, Spinal cord injuries.
Investigating the Effects of Snoezelen in Children Recovering from Severe Brain Injury.
University of Miami.
1611 NW Twelfth Avenue, RTC-215.
Miami, FL 33136-1094.
E-mail: ghotz@med.miami.edu.
Principal Investigator: Gillian A. Hotz, PhD.
Public Contact Phone: 305/243-4004.
Fax: 305/243-4006.
Project Number: H133G070119.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 07 $197,907; FY 08 $196,697; FY 09 $198,370.
Abstract: This research study examines a novel therapeutic approach referred to as Snoezelen or controlled multisensory therapy for children with severe traumatic brain injury (TBI). The Snoezelen approach is based on a theoretical framework of using a controlled multisensory environment which promotes stimulation of the primary senses which include auditory, visual, olfactory, tactile, and gustatory systems which are impaired in the early stages of recovery. There is evidence that Snoezelen has been shown to find a balance between relaxation and activity or changing arousal within the framework of a safe, controlled, adapted environment. The purpose of this study is to investigate the effects of Snoezelen therapy on physiological, cognitive, and behavioral changes in children recovering from severe TBI. Seventy-two subjects from 5-18 years of age recovering from severe TBI are studied in a prospective randomized controlled trial. The treatment group that receives up to 20 Snoezelen treatment sessions is compared to a control group that receives up to 20 playroom sessions, with both groups receiving a standard comprehensive neurorehabilitation program in an inpatient pediatric rehabilitation unit. Specific physiological, cognitive, and behavioral outcome measures are collected and evaluated at baseline, and pre- and post-Snoezelen and playroom treatment sessions.
Descriptors: Brain injuries, Children, Coma.
Biopsychosocial Factors that Predict TBI Post-Acute Rehabilitation Outcomes.
Shepherd Center, Inc..
2020 Peachtree Road, NW.
Atlanta, GA 30309-1465.
E-mail: ron_seel@shepherd.org.
Principal Investigator: Ronald T. Seel, PhD.
Public Contact Phone: 404/367-1240.
Project Number: H133G070171.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 07 $192,500; FY 08 $194,973; FY 09 $195,411.
Abstract: This project develops models using biopsychosocial factors assessed during the initial days of traumatic brain injury (TBI) post-acute rehabilitation to predict good, fair, and poor post-acute rehabilitation discharge outcomes. Empirically derived biopsychosocial models improve understanding of TBI recovery, identify patients at risk for poor outcomes, inform individualized treatment planning, and increase the overall efficiency and efficacy of post-acute rehabilitation services. Clinical measures of motor and cognitive functioning are analyzed, and five experimental measures are administered to assess potential psychosocial and environmental risk factors for clients with TBI. The primary goals are to produce probabilistic and tree-based models of biopsychosocial factors that predict good, fair, or poor TBI post-acute rehabilitation outcomes with regard to: (1) physical and cognitive improvement; (2) independent living (no supervision required); and (3) community participation. Primary dissemination efforts include at least two peer-reviewed manuscripts that describe predictive models for clinical use, and development of an automated post-acute rehabilitation admission assessment protocol, made available for downloading from the Shepherd Center website. The long-term goal is to design and test interventions for treatable predictors of post-acute rehabilitation outcomes and establish evidence-based guidelines.
Descriptors: Brain injuries, Measurement, Outcomes, Rehabilitation.
Evaluating the Effects of Activity-Based Therapy for Individuals with Chronic Spinal Cord Injury.
Shepherd Center, Inc..
2020 Peachtree Road Northwest.
Atlanta, GA 30309.
Principal Investigator: Michael L. Jones, PhD.
Public Contact Phone: 404/350-7595.
Fax: 404/350-7596.
Project Number: H133G080031.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 08 $200,000; FY 09 $200,000; FY 10 $200,000.
Abstract: This project evaluates the effects of an activity-based therapeutic exercise program for individuals with chronic spinal cord injury (SCI) using Beyond Therapy—a program of state-of-the-art therapeutic exercise technology. Project goals include: (1) completing a randomized, experimental-control group comparison examining the effects of participation in activity-based therapy on neurological functioning, independence in activities of daily living, and community participation; (2) conducting further between-group and within-subject analyses to determine variations in outcomes as a function of level of injury and ASIA classification; (3) identifying factors associated with continued compliance with a self-directed maintenance program designed to sustain any gains in neurological functioning achieved from participation in activity-based therapy; and (4) examining the relationship between level of compliance with the maintenance program and preservation of gains achieved over a 12-month period. Research results are used to develop activity-based exercises for individuals with SCI that can be implemented in community-based fitness centers. Additionally, the project develops a training and technical assistance program to assist community fitness centers in implementing activity-based therapy programs.
Descriptors: activity-based therapy, Assistive technology, Evaluation, Exercise, Spinal cord injuries.
Augmenting Language Therapy for Aphasia: A Randomized Double-Blind Placebo-Controlled Trial of Levodopa in Combination with Speech-Language Therapy.
Rehabilitation Institute Research Corporation.
345 East Superior Street, Room 1353A.
Chicago, IL 60611.
E-mail: lcherney@ric.org.
Principal Investigator: Leora R. Cherney, PhD.
Public Contact Phone: 312/238-1117.
Fax: 312/238-2208.
Project Number: H133G070074.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 07 $199,843; FY 08 $199,772; FY 09 $199,465.
Abstract: This randomized, double-blind, placebo controlled clinical trial evaluates the effect of the pharmacologic agent, levodopa, in combination with speech-language treatment, on the language outcome of patients with chronic, nonfluent aphasia. There is preliminary evidence that increased levels of dopamine, in combination with language treatment, may improve the language deficits of aphasia following stroke. Most studies have investigated the adjunctive effects of bromocriptine, a dopamine agonist that acts on post-synaptic dopamine receptors, changing the tonic state of dopamine neurons. However, new evidence is suggesting that levodopa, a precursor to dopamine, may be preferred since it has the potential to increase the presynaptic availability of dopamine, thereby enhancing phasic dopamine signals which are important for learning enhancement. Accordingly, the specific aims of this clinical trial are to assess whether: (1) levodopa in combination with speech-language therapy improves language performance; (2) levodopa in combination with speech-language therapy improves language performance more than speech-language therapy alone; and (3) improvements in language performance resulting from combined levodopa and speech language therapy are maintained over time to a greater extent than improvements resulting from speech-language therapy alone. The intervention, which serves as the behavioral treatment platform on which to assess the adjunctive effects of levodopa, is administered via computer and involves repeated choral reading of sentences. Subjects receive five hours of the speech-language therapy intervention weekly plus the levodopa or placebo for six weeks. The primary outcome measure is the change in the Aphasia Quotient (AQ) score on the Western Aphasia Battery from pre-treatment to post-treatment. Other language, cognitive, and communication measures are collected pre- and post-treatment and at six weeks after completion of treatment.
Descriptors: Aphasia, Communication, Computers, Internet, Pharmacology, Treatment.
Effectiveness of a Teleconference Fatigue Management Program for People with Multiple Sclerosis.
University of Illinois at Chicago.
1919 West Taylor Street, MC 811.
Chicago, IL 60304.
E-mail: marciaf@uic.edu.
Principal Investigator: Marcia Finlayson, PhD.
Public Contact Phone: 312/996-4603.
Fax: 312/413-0256.
Project Number: H133G070006.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: David W. Keer.
NIDRR Funding: FY 07 $143,836; FY 08 $142,688; FY 09 $112,550.
Abstract: This project tests the effectiveness and efficacy of a teleconference energy conservation education program for people with multiple sclerosis (MS). The project is guided by self-efficacy theory and builds on existing pilot work. The program is delivered by teleconference by a licensed occupational therapist. Participants are provided with a telephone and headset, and a program manual. On the designated days, participants call a toll-free phone number and participate in an educational group session facilitated by the therapist. A total of six one-hour weekly sessions use the program materials developed through the pilot study. Measures of the primary and secondary outcomes are administered over the telephone by a research assistant before and after the program, at three months, and at six months. By collecting data at these points and having a wait-list control group, the project is able to test whether: (1) individuals in the immediate intervention group achieve better outcomes than individuals in the wait-list control group; (2) the program leads to significant reductions in fatigue impact and fatigue severity, and improved quality of life; and (3) improvements in the outcomes can be maintained over six months. Analyses involve t-tests and mixed effects regression models. The primary goals of the project are to reduce the impact of fatigue on participants' everyday lives, reduce fatigue severity, and improve quality of life. Secondary goals are to increase self-efficacy for managing fatigue and increase the number of energy conservation strategies used.
Descriptors: Fatigue, Multiple sclerosis, Occupational therapy, Telerehabilitation.
Enhanced Motor Recovery Using Serotonergic Agents.
Rehabilitation Institute of Chicago.
345 East Superior Street, Suite 1406.
Chicago, IL 60611-4496.
E-mail: g-hornby@northwestern.edu.
Principal Investigator: T. George Hornby, PhD, PT.
Public Contact Phone: 312/238-1397.
Project Number: H133G060124.
Start Date: November 1, 2006.
Length: 36 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 06 $142,710; FY 07 $146,280; FY 08 $145,648; FY 09 $ 0.
Abstract: The purpose of this project is to identify changes in voluntary and reflex behaviors, with an emphasis on walking ability, in individuals with stroke following specific pharmacological and physical interventions, with the potential to optimize walking recovery during intensive rehabilitation. This project focuses on improving independent walking ability in individuals with chronic hemiparesis post-stroke. A substantial body of literature demonstrates the effectiveness of body-weight supported treadmill training post-stroke, although the improvements in walking ability may be limited. The project’s goal is to enhance the benefits of training by increasing neural excitability and potential plasticity by application of serotonergic agents. The approach has two objectives: (1) demonstrate that serotonergic agents can modulate reflex and voluntary motor activity with acute and chronic selective serotonin reuptake inhibitors administration, and (2) accelerate motor performance and walking recovery using combined pharmacological and physical interventions as opposed to either intervention alone.
Descriptors: Drugs, Motor skills, Stroke.
Noninvasive Examination of ALS Using Surface EMG.
Rehabilitation Institute of Chicago.
345 East Superior Street, Room 1406.
Chicago, IL 60611-2654.
E-mail: p-zhou@northwestern.edu.
URL(s): http://www.smpp.northwestern.edu/.
Principal Investigator: Ping Zhou, PhD.
Public Contact Phone: 312/238-1365.
Fax: 312/238-2208.
Project Number: H133G090093.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 09 $188,537; FY 10 $199,858; FY 11 $199,059.
Abstract: This project develops a robust technique for noninvasive motor unit discrimination using the surface electromyogram (EMG), and then, to utilize the technique to supplement, and potentially replace in certain cases, the routine needle EMG examination of amyotrophic lateral sclerosis (ALS). There are two planned goals for the proposed study. The first goal is to develop and test noninvasive surface EMG unitary decomposition methods. This includes quality controls by validating and refining the developed methods using both computational and experimental approaches. The second goal is to perform a surface EMG examination of the pathological changes in ALS patients, mainly at the motor unit level, using these newly developed noninvasive methods. The strategies utilized in this project lie in both surface EMG recording and signal processing methods. Development is based on two-dimensional, high density electrode arrays for surface EMG recording, which represent the most recent advance in surface EMG electrode design. Taking advantage of the spatial information and multi-channel recording of the electrode arrays, the project uses the most appropriate EMG signal processing methods to extract single motor unit activities from the surface EMG. These methods include linear and nonlinear spatial filtering, two-dimensional motor unit action potential template matching, pattern recognition, and state-of-the-art blind source separation techniques. This includes laboratory-based studies and repeated testing in ALS clinics. The directly targeted population is patients with ALS, however these research activities may potentially benefit individuals with other neuromuscular diseases who may need EMG examination.
Descriptors: ALS, Electromyography, Muscles, Nerves, Research.
Weight Loss by Individuals with Physical Disabilities.
University of Kansas.
10212 South North Lake Avenue.
Olathe, KS 66061.
E-mail: msaundrs@ku.edu.
Principal Investigator: Muriel D. Saunders, PhD; Amanda Reichard, PhD.
Public Contact Phone: 785/864-1618.
Fax: 785/864-5323.
Project Number: H133G090230.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Margaret Campbell, PhD.
NIDRR Funding: FY 09 $199,801; FY 10 $199,992; FY 11 $199,674.
Abstract: This project conducts a randomized trial to evaluate weight loss and weight maintenance using both sides of the energy balance equation (i.e. energy intake and energy expenditure) in overweight and obese individuals with physical disabilities (PD) who have impaired mobility. Researchers compare participants who use the modified Stop Light Diet (SLDm) with participants who follow the National Heart, Lung and Blood Institute (NHLBI) Step 1 Diet (i.e., standard nutrition and intake recommendations or usual care (UC)). Following a 6-month period of reduced energy intake (weight loss), both groups are placed on a diet with sufficient energy to maintain weight (i.e., weight maintenance) for an additional 12 months. Both groups are encouraged to participate in a physical activity program appropriate for their physical abilities throughout the 18 months. Program intervention and participant acceptance are evaluated through extensive process analysis of quantitative and qualitative data. The project also tracks and analyzes the health care utilization patterns and secondary health outcomes of participants in both the SLDm and UC diets using secondary data analysis of Kansas Medicaid claims data.
Descriptors: Health promotion, Mobility impairments, Physical disabilities, Weight Loss.
Adapted Assessment of Speed of Information Processing in Children with Cerebral Palsy.
University of Michigan.
325 East Eisenhower, Suite 100.
Ann Arbor, MI 48108.
E-mail: sethaw@umich.edu.
URL(s): http://www.med.umich.edu/pmr/acal/speed.htm.
Principal Investigator: Seth A. Warschausky, PhD.
Public Contact Phone: 734/936-7052.
Fax: 734/936-7048.
Project Number: H133G070044.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 07 $199,995; FY 08 $199,996; FY 09 $199,983.
Abstract: This project develops an accessible assessment of processing speed that allows sensitive measurements of cognitive capabilities in children with severe motor and communicative impairments. The objective is to examine processing speed in children with cerebral palsy by utilizing inspection time as a measure of speed of visualization. Specific aims are: (1) to examine psychometric properties, including reliability, concurrent validity, and criterion-related validity of a modified inspection time task; and (2) to compare the inspection time profiles within and between groups using the traditional and modified inspection time task procedures. Processing speed is associated with development of critical cognitive functions including working memory and fluid intelligence, and is sensitive to brain dysfunction, medication effects, and aging.
Descriptors: Cerebral palsy, Children, Cognition.
Neuroanatomical Correlates of Positive Psychology Among People with Traumatic Brain Injury: A Biopsychosocial Model.
Wayne State University.
261 Mack Avenue, Suite 546.
Detroit, MI 48201.
Principal Investigator: Robin A. Hanks, PhD.
Public Contact Phone: 313/745-9763.
Fax: 313/966-7682.
Project Number: H133G080064.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 08 $199,078; FY 09 $194,402; FY 10 $199,543.
Abstract: This project investigates the complex relationships among strengths of character, structurally-imaged estimates of white matter damage in frontal brain regions, psychological resiliency, and outcomes including satisfaction with life and community integration among people with traumatic brain injury (TBI). Additionally, this project investigates the extent to which Peterson and Seligman’s Character Strengths model of recovery from physical illness and trauma holds true for people recovering from TBI during the acute transition phase of adjustment to disability. The psychosocial, cognitive, and physical characteristics which may influence these relationships are also explored. This project measures the satisfaction with life (as measured by the Satisfaction with Life Scale) and community integration (as measured by the Community Integration Measure). Character strengths are evaluated via two self-report scales. Estimates of structural brain damage are gathered via diffusion tensor imaging in three main areas of the prefrontal cortex: the dorsolateral, orbitofrontal, and ventromedial cortices. Ancillary measures are included in the design in order to elucidate the relationships between positive psychology constructs and important mediators/moderators of recovery from TBI: neuropsychological status, perceived social support, problem-solving coping style, positive and negative affectivity, and comorbid physical illness.
Descriptors: Anatomy, Biopsychosocial Model, Neurology, Psychology, Traumatic Brain Injury.
Pathways to Depression: An Examination of Vulnerability and Stress in Adults with Spinal Cord Injury.
University of Michigan.
300 North Ingalls, Room NI2A09.
Ann Arbor, MI 48109-0491.
Principal Investigator: Claire Kalpakjian, PhD.
Public Contact Phone: 734/763-0971.
Fax: 734/936-5492.
Project Number: H133G070020.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 07 $199,999; FY 08 $199,913; FY 09 $199,964.
Abstract: This project presents and tests a model (Pathways to Depression after Spinal Cord Injury [SCI]) of vulnerability factors interacting with current stressors (stressful life events and poor social support) to increase risk of depression and its adverse effects on community participation in adults with SCI. Depression after SCI is one of the most pervasive psychological conditions, occurring at rates exceeding the general population, and has the potential to substantially limit independence, compromise health and well-being, and increase risk for suicide. While many studies in the extant literature have examined injury and situational factors as correlates of depression, very few have examined other vulnerability factors that precede injury placing certain individuals at higher risk for depression post-injury. A deeper understanding of factors that predispose some individuals to depression after injury can inform treatment approaches and improve community participation impeded by depression. Using a cross sectional design and survey methodology (written and telephone interview), the project surveys 400 individuals with SCI about early life experience, psychological and substance abuse history (prior to injury), current stressful life events and social support, depression, and community participation. DNA samples are also collected to test for a polymorphism of the serotonin transporter known to interact with stress to increase risk of depression. Structural equation modeling is used to test the Pathways model of vulnerability factors.
Descriptors: Depression, Spinal cord injuries, Women with disabilities.
Development of an Intelligently Controlled Assistive Rehabilitation Elliptical (ICARE) Training System to Promote Walking and Fitness in Persons with Physical Limitations.
Madonna Rehabilitation Hospital.
5401 South Street.
Lincoln, NE 68506.
E-mail: jburnfield@madonna.org.
URL(s): http://www.madonna.org/research_institute/movement_neurosciences/about_us/index.html.
Principal Investigator: Judith Burnfield, PhD, PT.
Public Contact Phone: 402/483-9669.
Project Number: H133G070209.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Thomas Corfman.
NIDRR Funding: FY 07 $199,524; FY 08 $199,555; FY 09 $198,719.
Abstract: The goal of this project is to develop ICARE, an Intelligently Controlled Assistive Rehabilitation Elliptical trainer and therapeutic program to help individuals with physical or mobility disabilities regain and/or retain their walking ability and physical fitness. Specifically, the project develops, refines, and field-tests a prototype ICARE trainer. It includes an affordable, intelligent control system that adapts the movement pattern of the elliptical trainer to the unique physical assistance needs of individuals as they relearn to walk and exercise. The specific objectives of this project which address this goal are to: (1) identify the best commercially available elliptical trainer to redesign into an ICARE trainer; (2) develop, pilot test, and refine a prototype ICARE device in a controlled (laboratory) environment to improve function, features, beneficial therapeutic effects for walking, and equipment durability; and (3) implement usage of the ICARE system in three free-living environments (an inpatient rehabilitation center, outpatient neurologic and orthopaedic clinic, and a community-based fitness facility) to evaluate the capacity of the device to improve walking ability and cardiovascular function of persons with varied gait dysfunctions and develop a therapeutic intervention program using the device.
Descriptors: Exercise, Gait restoration, Physical fitness.
Investigation of Interventions for Sitting Postural Control in Young Children with Moderate to Severe Cerebral Palsy.
University of Nebraska at Omaha.
6001 Dodge Street.
Omaha, NE 68162.
E-mail: nstergiou@mail.unomaha.edu.
URL(s): http://biomech.unomaha.edu/.
Principal Investigator: Nicholas Stergiou, PhD.
Public Contact Phone: 402/554-3247.
Fax: 402/554-3693.
Project Number: H133G080023.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 08 $200,000; FY 09 $200,000; FY 10 $200,000.
Abstract: This project identifies interventions that improve the quality of life for children with cerebral palsy (CP). The first intervention focuses on principles of enhancing complexity in movement variability, which has been shown to be effective in improving infant sitting postural control in previous research. The second intervention uses the paradigm of adding stochastic noise to the support surface to improve postural responses, a method used successfully in adults with decreased postural control. This project conducts three experiments: Experiment 1 utilizes nonlinear dynamics techniques to quantify changes in postural control as measured by the center of pressure time series in sitting; Experiment 2 utilizes the same children as in Experiment 1, but examines functional changes in arm use, focused attention, and play over time as sitting postural control improves; Experiment 3 examines changes in self-care, participation, and gross motor function to determine the relationship between changes in postural control and participation within the child’s environment. These experiments enhance the ability to provide better methods to treat children with moderate to severe CP; and provide a better understanding of the development of cognition, function, play, and participation for children with CP in relation to improved postural control sitting.
Descriptors: Cerebral palsy, Children, Interventions, Posture.
Improving New Learning and Memory in TBI: Applying fMRI to Measure Outcome.
Kessler Foundation.
300 Executive Drive, Suite 10.
West Orange, NJ 07052.
E-mail: nchiaravalloti@kesslerfoundation.net.
URL(s): http://www.kesslerfoundation.org.
Principal Investigator: Nancy D. Chiaravalloti, PhD.
Public Contact Phone: 973/530-3640.
Fax: 973/736-7880.
Project Number: H133G090078.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 09 $198,744; FY 10 $198,737; FY 11 $193,549.
Abstract: Impairments in new learning and memory are among the most common deficits in persons with traumatic brain injury (TBI). This project examines the impact of a targeted behavioral intervention on functional cerebral activity using functional Magnetic Resonance Imaging (fMRI). Research determines if improvement in learning and memory is associated with particular patterns of functional, cerebral activity on fMRI. Participants receive pre and post-treatment fMRI evaluations, which are correlated with behavioral performance assessed concurrently. Additionally, participants complete a six-month post-treatment fMRI to examine the maintenance of treatment effects over time, as well as the impact of “booster sessions” to facilitate the maintenance of treatment effects from a neuro-functional perspective.
Descriptors: Brain injuries, Cognitive rehabilitation, Memory, Outcomes, Traumatic Brain Injury.
Quality of Life in Traumatic Brain Injury Research and Practice: Development of the TBI-QOL.
Kessler Medical Rehabilitation Research and Education Corporation (KMRREC).
1199 Pleasant Valley Way.
West Orange, NJ 07052-1499.
E-mail: dtulsky@kesslerfoundation.net.
Principal Investigator: David S. Tulsky, PhD.
Public Contact Phone: 973/243-6849, 973/243-6916.
Fax: 973/243-3527.
Project Number: H133G070138.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Phillip Beatty, PhD.
NIDRR Funding: FY 07 $199,830; FY 08 $199,414; FY 09 $199,910.
Abstract: The scarcity of quality of life (QOL) measurement tools specific to traumatic brain injury (TBI) hinders the efforts of TBI intervention researchers, whose goal is to obtain valid and useful data to evaluate new treatment approaches. The goals of this study are to: (1) develop an instrument for comprehensively assessing the health-related quality of life (HRQOL) of persons with TBI, regardless of the severity of their condition; (2) enable comparisons of HRQOL in TBI with HRQOL in other neurologic conditions by integrating this instrument with the Neuro-QOL project; and (3) investigate and develop strategies for determining the HRQOL of individuals with even the most severe TBI, thus ensuring that these individuals will be represented in initiatives that use this instrument, rather than excluded as is often the case due to the difficulty of assessing such persons.
Descriptors: Measurement, Quality of life, Rehabilitation medicine, Traumatic Brain Injury.
Improving Cervical and Breast Cancer Screening for Women with Intellectual Disabilities.
University of North Carolina.
325 Pittsboro Street, Room 563-I
CB 3550.
Chapel Hill, NC 27599-3550.
E-mail: parish@unc.edu.
Principal Investigator: Susan Parish, PhD.
Public Contact Phone: 919/962-6434.
Fax: 919/962-7557.
Project Number: H133G090124.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Margaret Campbell, PhD.
NIDRR Funding: FY 09 $200,000; FY 10 $200,000; FY 11 $200,000.
Abstract: This project addresses the need for training and support for women with intellectual disabilities to understand the importance of cervical and breast cancer screening, to assert their needs and concerns to their health care providers, and to manage their anxiety related to their health care needs. The Women Be Healthy intervention is designed to empower women with intellectual disabilities to improve their self-determination and knowledge related to preventive health care practices including cervical and breast cancer screening, and to enable these women to become active and equal partners in their health care. This project longitudinally tests the intervention by examining its impact on four outcomes: (a) women’s self-determination related to preventive health care; (b) women’s knowledge of their bodies and cervical and breast cancer screening; (c) women’s anxiety related to preventive screenings; and (d) actual receipt of cervical and breast cancer screening. The mixed-methods study includes quantitative and qualitative components that complement each other to provide rich data. Quantitative methods consist of a longitudinal experimental design with multiple baseline measures; qualitative methods include focus groups. The experimental component uses a rigorous randomized control trial to obtain information about the efficacy and effectiveness of Women Be Healthy. Equally important, focus groups are conducted with women with intellectual disabilities who are enrolled in Women Be Healthy; the qualitative data obtained will enable a better understanding of the viewpoints and experiences of these women regarding preventive health care.
Descriptors: Cancer Screening, Developmental disabilities, Health promotion, Intellectual Disabilities, Women with disabilities.
RISE - Reflection, Insight, and Self-Empowerment: Development of a Cognitive Behavioral Group Therapy Intervention for Women with Physical Activity Disabilities who Experience Depression.
Oregon Health and Science University.
3455 SW US Veterans Road, SN-637.
Portland, OR 97239-2941.
E-mail: phillide@ohsu.edu.
Principal Investigator: Dena Hassouneh, PhD.
Public Contact Phone: 503/494-2714.
Fax: 503/494-3878.
Project Number: H133G070214.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 07 $198,701; FY 08 $199,926; FY 09 $187,385.
Abstract: Rates of depression and suicide in women with physical disabilities (WPD) are up to five times higher than in the general population. Despite this disparity, few intervention studies that address the specific needs of this population are available. This project uses an existing cognitive behavioral therapy (CBT) intervention that has demonstrated effectiveness in reducing depressive symptoms in women without disabilities as a starting point to co-create an intervention that addresses the specific needs of WPD. The co-creation process occurs in the context of a partnership between the investigators, WPD in the community, and community-based organizations including Oregon Centers for Independent Living (CILs). The specific aims of this project are to: (1) Develop a cognitive behavioral group therapy intervention to address the specific needs of WPD who experience depressive symptoms; and (2) pilot-test the intervention to preliminarily evaluate its efficacy using a using a wait list control design. Phase I of the project involves development of the curriculum based on the following information sources: four focus groups conducted with WPD, review of empiric sources, community meetings, and feedback from our community advisors and consultants. Phase II pilot-tests the intervention using both quantitative and qualitative methods to assess its efficacy. A long-term goal of the proposed project is to increase the capacity of CILs and other community-based organizations across the country to offer a relevant, effective, accessible, and affordable intervention to help WPD with depression overcome this debilitating secondary condition.
Descriptors: Cognitive behavioral therapy, Depression, Intervention, Women with disabilities.
Treatment Components and Active Ingredients in a Scheduled Telephone Intervention for Traumatic Brain Injury.
Albert Einstein Healthcare Network.
60 East Township Line Road.
Elkins Park, PA 19027.
E-mail: thart@einstein.edu.
URL(s): http://www.einstein.edu/facilities/mossrehab/index.html.
Principal Investigator: Tessa Hart, PhD.
Public Contact Phone: 215/663-6153.
Fax: 215/663-6113.
Project Number: H133G070143.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $199,880; FY 08 $199,844; FY 09 $197,373.
Abstract: This project studies the treatment components and active ingredients of an intervention for post-acute, moderate and severe traumatic brain injury (TBI) known as Scheduled Telephone Intervention (STI). The STI was designed to help meet the multiple, evolving needs of people with TBI and their families following rehabilitation hospital discharge, and consists of telephone calls placed by a specially trained counselor at scheduled, gradually increasing intervals (seven calls in the first year post TBI). Using a theoretically motivated model of candidate active ingredients in three classes: treatment elements common to many interpersonal interventions (e.g., therapeutic alliance), treatment elements related to goal self-management/ executive function theories, and modifier variables such as total dose of treatment, the project analyzes the treatment components of the STI by coding archived, audiotaped treatment sessions (calls) from 175 participants in the treatment arm of the multicenter randomized controlled trial on the STI. This project: (1) develops an objective, reliable scoring system for measuring these treatment components; (2) characterizes relationships among pre-treatment participant characteristics (e.g., level of disability) and the treatment components delivered during a one-year course of STI; (3) examines the longitudinal trends in treatment components during one year of treatment; and (4) estimates the "activity" of various ingredients by examining the relationships among treatment components and one-year outcomes, accounting for the direct effects of baseline status on both treatment process and outcomes.
Descriptors: Brain injuries, Telerehabilitation.
Understanding the Determinants of Motor Ability, Self-Care, and Play of Young Children with Cerebral Palsy.
Drexel University.
245 North 15th Street, Mail Stop 502.
Philadelphia, PA 19102.
E-mail: lisa.chiarello@drexel.edu.
Principal Investigator: Lisa A. Chiarello, PT, PhD.
Public Contact Phone: 215/762-8805.
Fax: 215/762-3886.
Project Number: H133G060254.
Start Date: November 1, 2006.
Length: 36 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $149,981; FY 07 $149,927; FY 08 $149,359; FY 09 $ 0.
Abstract: The specific purpose of this project is to validate a multivariate model of determinants of change in basic motor ability and engagement in self-care and play of young children with cerebral palsy. The objective is to identify the child characteristics, family ecology, and rehabilitation and community services that optimize outcomes. The project targets a subset of children with cerebral palsy who as adults will not walk independently in the community and will require physical assistance for self-care at times throughout the day. Information on the factors that enhance outcomes for these children is particularly needed because families expend considerable time and resources to meet their children's health, education, and development needs. Knowledge of determinants of children's change in basic motor abilities and engagement in self-care and play will enable health care professionals and educators to provide evidence-based interventions, support families, and optimize community resources.
Descriptors: Cerebral palsy, Children, Motor skills, Play.
Virtual Reality Assessment and Treatment of Hemispatial Neglect.
Albert Einstein Healthcare Network.
1200 West Tabor Road, Korman 213.
Philadelphia, PA 19141.
E-mail: lbuxbaum@einstein.edu.
Principal Investigator: Laurel Buxbaum, PsyD.
Public Contact Phone: 215/456-5953.
Fax: 215/456-5926.
Project Number: H133G060086.
Start Date: December 1, 2006.
Length: 36 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 06 $149,593; FY 07 $149,819; FY 08 $149,910; FY 09 $ 0.
Abstract: The goal of this project is to address previous limitations in the assessment and treatment of neglect through the use of virtual reality (VR) technology. Hemispatial neglect, a failure to attend to and/or act on objects on the side of space opposite a brain lesion, is a common and persistent consequence of stroke, occurring in approximately 45 percent of the nearly 2 million Americans who have suffered a right hemisphere cerebral vascular accident. The neglect syndrome is associated with impairments in a wide range of activities of daily living, with significant consequences for functional independence. This project capitalizes on a number of VR's useful assets, including simulation of the spatial and cognitive demands of real world environments, quantification of aspects of performance, ready control of the experimental task, and ease of administration. The major aims are: (1) to develop and validate a VR navigation task measuring lateralized attention (the VRLAT), an extension of a sensitive VR task developed previously; (2) to perform clinical trials assessing the short-term efficacy of two VR-based treatments for neglect that induce different types of mismatch between proprioceptive and visual information, using the VRLAT as one of the measures of treatment response; and (3) to perform clinical trails of the two treatments focused on generalization and maintenance of gains with a longer course of treatment.
Descriptors: Activities of daily living, Stroke, Virtual reality.
Zolpidem and Restoration of Consciousness: An Exploration of the Mechanism of Action.
Albert Einstein Healthcare Network.
60 East Township Line Road.
Elkins Park, PA 19027.
Principal Investigator: John Whyte, MD, PhD.
Public Contact Phone: 215/663-6872.
Fax: 215/663-6113.
Project Number: H133G080066.
Start Date: October 1, 2008.
Length: 36 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 08 $199,553; FY 09 $197,540; FY 10 $191,313.
Abstract: Severe brain damage due to traumatic or non-traumatic causes frequently results in unconsciousness (coma) and, in a minority of cases, may lead to prolonged or permanent disorders of consciousness (DOCs) including the vegetative and minimally conscious states. This project assesses the responses of patients with DOCs to single doses of zolpidem and placebo in a double blind crossover design, initially with structured caregiver reporting. Repeat studies with quantitative assessment by a trained clinician follow for those who are believed to respond to the drug. Those classified as definite drug responders, along with a matched sample of non-responders, are studied intensively with a combination of structural and functional neuroimaging and electrophysiologic studies in an exploratory fashion to develop preliminary hypotheses about the neural substrate required for responding to zolpidem. Project activities include recruiting of a national sample of individuals with DOCs to participate in a consent-based, HIPAA compliant research registry, which will facilitate this and future studies. This study helps to define the potential size of the population who may benefit from zolpidem administration, encourages those who do benefit to seek ongoing clinical management, and allows formulation of hypotheses about the mechanism of drug response that can be tested definitively in subsequent research, making use of interested registry participants.
Descriptors: Brain injuries, Coma, Disorders of consciousness, Pharmacology.
A Longitudinal Study of Risk for Hospitalization, Pressure Ulcers, and Subsequent Injuries After Spinal Cord Injury.
Medical University of South Carolina.
77 President Street, Suite 117
PO Box 250700.
Charleston, SC 29425.
E-mail: cokerj@musc.edu.
URL(s): http://www.musc.edu/chp/sciorg/.
Principal Investigator: James S. Krause, PhD.
Public Contact Phone: 843/792-2605.
Fax: 843/792-5649.
Project Number: H133G050165.
Start Date: December 1, 2005.
Length: 36 months.
NIDRR Officer: Phillip Beatty, PhD.
NIDRR Funding: FY 05 $149,992; FY 06 $149,995; FY 07 $149,997; FY 08 $ 0; FY 09 $ 0.
Abstract: The onset of spinal cord injury (SCI) increases the risk for the development of a number of secondary conditions that may adversely impact an individual's life and even result in early mortality. Research has yet to sufficiently identify the factors that lead to secondary conditions, as most studies are limited by not using theoretical or empirical models in selecting variables, generally focusing on a single condition, or by investigating only a limited number of risk factors. The purpose of this project is to perform a longitudinal study to identify protective and risk factors associated with the onset of multiple types of adverse health events among a large sample of individuals with SCI. In 1997-8, researchers collected prospective data on 1,391 participants who included a substantial number of women (n = 362) and racial/ethnic minorities (n = 359). Risk and protective predictors were selected based on a general empirical risk model. Predictor variables were first measured over a 10-month period in 1997-1998, including: (a) biographical status, (b) injury status, (c) psychological status, (d) environmental factors, and (e) health behaviors. Several health outcomes measures were also used. During the follow-up, the current project administers multiple outcome measures, with a focus on adverse events -- pressure ulcers, subsequent injuries, hospitalizations, and treatments. To date, we have collected and entered data from 1549 participants, 835 of whom participated in the original study and an additional 714 that were added in conjunction with funding from another agency (29 new responses are being processed). These measures focus on adverse health events including hospitalizations, onset of pressure ulcers, and subsequent injuries. Structural equation modeling is performed to develop risk models for each outcome. A consumer advisory committee has met to review instrumentation and will continue to meet to make recommendations regarding all components of the project. The ultimate study goal is to enhance the lives of people with SCI by identifying the risk and protective factors associated with adverse health events to serve as a foundation for prevention efforts by rehabilitation and public health professionals.
Descriptors: Longitudinal studies, Pressure sores, Secondary conditions, Spinal cord injuries.
Ambulation and Secondary Complications: Participants with Chronic Spinal Cord Injury.
Medical University of South Carolina.
77 President Street, CHP-C
PO Box 250700.
Charleston, SC 29425.
E-mail: cokerj@musc.edu.
URL(s): http://www.sciandtbiresearch.blogspot.com/.
Principal Investigator: James S. Krause, PhD.
Public Contact Phone: 843/792-7051.
Fax: 843/792-5649.
Project Number: H133G090059.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 09 $199,986; FY 10 $199,978; FY 11 $199,973.
Abstract: A wave of recent research has identified short-term benefits of gait training for people with spinal cord injury (SCI); yet, other research suggests there may be unforeseen long-term adverse consequences of ambulation. Analysis of existing data shows that pain interference and depressive symptoms were substantially higher among ambulatory participants who were dependent on others for assistance, even when compared with wheelchair users. This project builds upon this preliminary research by testing a comprehensive mediational model of the relationships of three classes of ambulation parameters (reliance on assistive devices and orthoses, reliance on people, functionality) with two sets of secondary conditions (pain and fatigue). Structural equation modeling is used to test the mediational model that three ambulation parameters are associated with risk of two chronic secondary conditions, which are in turn are associated with variations in participation, depressive symptoms, and quality of life. By virtue of identifying the ambulation parameters that are associated with secondary conditions and when ambulation is a counterproductive after SCI, this study guides rehabilitation professionals and consumers in choosing the most appropriate mobility option (wheelchair or ambulation) that minimizes secondary conditions, promotes community participation, and enhances quality of life.
Descriptors: Ambulation, Gait restoration, Mobility aids, Spinal cord injuries, Training.
Participation, Subjective Well-Being, Health, and Spinal Cord Injury: A 35-Year Longitudinal Study.
Medical University of South Carolina.
77 President Street, Suite 117
PO Box 250700.
Charleston, SC 29425.
E-mail: cokerj@musc.edu.
URL(s): http://www.musc.edu/chp/sciorg/.
Principal Investigator: James S. Krause, PhD.
Public Contact Phone: 843/792-2605.
Fax: 843/792-5649.
Project Number: H133G060126.
Start Date: December 1, 2006.
Length: 36 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $149,954; FY 07 $149,987; FY 08 $149,946; FY 09 $ 0.
Abstract: The purpose of this 35-year longitudinal study is to identify the natural course of changes in participation, health, and subjective well-being among 5 cohorts of participants with spinal cord injury (SCI). Data were first collected in 1973 from 256 participants, 78 of whom have participated throughout the study. Using a revolving panel longitudinal design, participants are followed over time with new participant samples added to counter attrition. To date, there have been a total of 2,208 different participants over the six times of measurement, including nearly 100 who have lived 40 or more years with SCI. The proposed study is the seventh stage of data collection and addresses not only the natural course through analysis of both cross-sectional and multiple longitudinal elements, but also special issues including quality of life and termination of employment, change in living circumstance to a more restrictive environment, and the role of environmental factors on stability of health and quality of life. The project is currently conducting the primary data collection, having previously completed finalization of instrumentation, based on consumer panel recommendations and pilot testing. After conclusion of the primary data collection, the project utilizes consumer input into the development of recommendations for healthy living with aging for consumers and policy recommendations for rehabilitation professions and legislators. The consumer panel meets throughout the study, making recommendations at each stage of activities. At the beginning of the study, they met to review previous findings and the instrument package in order to eliminate redundant or unimportant measures or recommend additional constructs, and review the data collection protocol to insure the procedures are consistent with participant needs (e.g., format, instrument length). For the primary data collection, researchers are surveying the 1,568 respondents from the last follow-up using the Life Situation Questionnaire which has been used throughout the study and measures biographic and injury factors, activities of daily living, living circumstances, employment, participation, health, and subjective well-being (life satisfaction and self-reported problems). Additional instruments are being used to measure depressive symptoms, participation, health outcomes, environment, pain, and alcohol history. Additional measures of coping and social support are included in the current stage of data collection. These represent a combination of core measures dating back to the first time of measurement in 1973 and newer measures that have been added regularly since that time to address more diverse issues. Several sets of data analyses are conducted, including sequential designs that combine cross-sectional and longitudinal elements, as there are essentially several embedded longitudinal designs (i.e., 5, 10, 15, 20, 24, 35 years). The project identifies policy recommendations at the individual (recommended practices), rehabilitative (programmatic needs), and legislative-federal level (allocation of funds in areas that will promote better outcomes). A consumer guide for healthy aging will be developed and distributed through consumer recommended sources to insure the findings reach the consumer level.
Descriptors: Health promotion, Longitudinal studies, Quality of life, Spinal cord injuries.
Effectiveness of a Group Cognitive-Behavioral Intervention for Depression after TBI and Factors that Affect Response to Treatment.
Memorial Herman|The Institute for Rehabilitation and Research (TIRR)|.
2323 South Shepherd, Suite 907.
Houston, TX 77019.
E-mail: anclark@bcm.edu struchen@bcm.tmc.edu.
Principal Investigator: Allison Clark, PhD; Margaret Struchen, PhD.
Public Contact Phone: 713/630-0519.
Fax: 713/630-0529.
Project Number: H133G070222.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 07 $197,754; FY 08 $197,899; FY 09 $199,940.
Abstract: This project is designed to evaluate the effectiveness of a group cognitive behavioral intervention (CBT group) for treating depressive symptoms in persons with traumatic brain injury (TBI), to assess the impact of cognitive impairments on an individual's response to the CBT group, and to assess the impact of the CBT group on community participation and subjective well-being in persons with TBI. The initial phase of this study involves utilizing input from consumer and expert advisors to develop an approach and to adapt materials for use with persons with cognitive impairments. Once adapted, the intervention is piloted with a group of five individuals with at least mild symptoms of depression. After the pilot phase, a randomized, attention controlled clinical trial follows. Cognitive-behavioral approaches to treatment of depression have been demonstrated to have effectiveness in many populations, including a growing body of evidence for effectiveness in persons with other types of acquired brain injury. Given the inherent structure that such approaches utilize, which may help minimize cognitive demands, cognitive behavioral therapy would appear well-suited to use with persons with TBI.
Descriptors: Brain injuries, Cognitive behavioral therapy, Depression, Intervention.
Natural History of Headache Following Mild Traumatic Brain Injury.
University of Washington.
1959 NE Pacific Street, Box 356490.
Seattle, WA 98195-6490.
URL(s): http://tbi.washington.edu.
Principal Investigator: Jeanne M. Hoffman, PhD; Kathleen R. Bell, MD; Suriyya Dikman, PhD.
Public Contact Phone: 206/221-6511.
Fax: 206/685-3244.
Project Number: H133G090022.
Start Date: October 1, 2009.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 09 $199,923; FY 10 $199,324; FY 11 $199,682.
Abstract: This purpose of this project is to evaluate headache in those with mild traumatic brain injury (TBI) with the ultimate goal of developing a clinical trial to treat post-traumatic headache (PTH). Headache is a common diagnosis after TBI with an estimate of 30-90 percent of those with TBI developing migrainous or other type of headache, compared to the general population with 4 percent prevalence. Based on available literature and clinical observations, individuals with mild TBI are thought to suffer from headaches more frequently compared to those with more severe injuries. This study leverages existing resources by building upon a study being currently conducted through the TBI Model System at the University of Washington examining the natural history of headache in moderate to severe TBI and addresses the problem of headaches in the full spectrum of TBI severity. This project uses similar assessment tools as in the ongoing TBI Model Systems study to describe the characteristics of PTH using standardized headache measures and classifications. Additionally, it identifies predictors of headache and compares acute and chronic headache, as well as examines the impact of headache on return to work and other outcomes. Assessments occur at injury, and 3, 6 and 12 months after injury. This study, in conjunction with the current TBIMS study, provides a comprehensive description and natural history of PTH available at present.
Descriptors: Brain injuries, Evaluation, Headache.
Telephone and In-Person Cognitive Behavioral Therapy for Depression After Traumatic Brain Injury.
University of Washington.
Box 356560
1959 NE Pacific Street.
Seattle, WA 98195.
E-mail: fann@u.washington.edu.
Principal Investigator: Jesse R. Fann, MD, MPH.
Public Contact Phone: 206/685-4280.
Fax: 206/221-5414.
Project Number: H133G070016.
Start Date: October 1, 2007.
Length: 36 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 07 $199,873; FY 08 $199,981; FY 09 $199,915.
Abstract: This project continues previous efforts to establish evidence-based treatments for major depressive disorder (MDD) in people with traumatic brain injury (TBI). MDD is the most common psychiatric disorder among TBI survivors and has widespread negative effects on health and functional outcomes in people with TBI. This three-armed randomized controlled trial compares (1) in-person cognitive behavioral therapy for depression that is adapted for people with TBI (CBT-TBI) and (2) telephone-based CBT-TBI to a (3) usual depression care condition (UC). Previous research found that people with TBI and depression are highly interested in using psychotherapy to treat depression. Although psychotherapy is widely used in the treatment of general psychological aspects of TBI, solid evidence for the efficacy of psychotherapy for MDD in this population is absent. While CBT is the most evidence-based psychotherapy available for MDD, thus far there is only expert opinion to guide how CBT should be adapted for people with TBI (i.e., to accommodate patients with neurocognitive and neurobehavioral impairments). Therefore, this study adapts CBT specifically for people with TBI in a three-arm trial and measures the feasibility, acceptability, and potential effectiveness of this adapted intervention in both telephone-administered and in-person formats, compared with UC. The long-term goal of this research is to develop a feasible and effective manualized psychotherapy intervention to treat major depressive disorder in persons with TBI that is applicable across a wide array of settings.
Descriptors: Brain injuries, Cognitive behavioral therapy, Depression, Telerehabilitation.
Adverse Outcomes Following Inpatient Rehabilitation: Trends and Reasons.
University of Wisconsin/Milwaukee.
Enderis Hall 963
PO Box 413.
Milwaukee, WI 53201.
E-mail: johnsto@uwm.edu.
Principal Investigator: Mark Johnston, PhD.
Public Contact Phone: 414/229-3616.
Project Number: H133G060218.
Start Date: November 1, 2006.
Length: 36 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 06 $149,129; FY 07 $149,772; FY 08 $149,888; FY 09 $ 0.
Abstract: Research is needed to develop the knowledgebase and tools necessary to address the problem of increased rates of mortality and hospitalization following inpatient rehabilitation and to examine explanations for adverse outcomes. Descriptive analyses are conducted first to describe important trends in mortality and rehospitalization and to provide a basis for further analyses. Multivariate risk adjustment models – based on impairments, functional level, age, and other patient characteristics in extant databases – are then developed to predict adverse outcomes. These risk adjustment models provide the necessary basis to distinguish the effects of patient severity and caseload from other factors that affect adverse outcomes. Researchers then examine and test the effects of important facility characteristics that may affect rates of adverse outcomes. The primary outcomes to be studied are mortality and rehospitalization; functional decline is also studied, as it, too, may indicate medical instability, and all three outcomes may or may not be predicted and affected by the same set of factors.
Descriptors: Outcomes, Rehabilitation medicine, Rehabilitation services.
Conservative and Surgical Clubfoot Treatment: Multi-Center Study.
Marquette University.
P.O. Box 1881.
Milwaukee, WI 53201-1881.
E-mail: depps@mcw.edu.
URL(s): http://www.orec.org
http://www.marquette.edu.
Principal Investigator: Peter A. Smith, MD; Gerald F. Harris, PhD, PE.
Public Contact Phone: 414/288-0696.
Fax: 414/288-0713.
Project Number: H133G060252.
Start Date: January 1, 2007.
Length: 24 months.
NIDRR Officer: Leslie J. Caplan, PhD.
NIDRR Funding: FY 06 $150,000; FY 07 $150,000; FY 08 $150,000; FY 09 $ 0.
Abstract: This study is designed to compare the longer-term effects of two methods of clubfoot treatment: (1) the conservative Ponseti technique of manipulation and casting, and (2) progressive surgical release. Clubfoot is a congenital foot deformity occurring in 1 in 1,000 births. It is commonly treated at pediatric orthopaedic hospitals and its incidence has been constant and not expected to decrease. Treatment is ideally accomplished early in life, within the first year, and is often successful in accomplishing a satisfactory, plantigrade foot, which will fit in shoes. Little is known, however about the function of treated clubfeet. This project investigates the longer-term outcome of children with treated clubfoot deformity using patient-based outcomes, functional instruments, motion analysis, radiological assessment, and postural stability. The objective is to determine whether functional outcomes, postural stability, and gait analysis characterize overall patient satisfaction and motor performance and to quantify the effects of orthopaedic interventions.
Descriptors: Children, Longitudinal studies, Orthopedics.
Model Spinal Cord Injury Systems.
UAB Model Spinal Cord Injury Care System.
University of Alabama/Birmingham.
619 - 19th Street South SRC 529.
Birmingham, AL 35249-7330.
E-mail: mott@uab.edu.
URL(s): http://main.uab.edu/show.asp?durki=10712.
Principal Investigator: Amie B. Jackson, MD.
Public Contact Phone: 205/934-3283 (V), 205/934-4691 (TTY).
Fax: 205/975-4642.
Project Number: H133N060021.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 06 $474,471; FY 07 $474,471; FY 08 $474,471; FY 09 $474,417; FY 10 $474,417; FY 11 $474,417.
Abstract: The University of Alabama at Birmingham provides rehabilitation services specifically designed to meet the special needs of individuals with spinal cord injury (SCI) through its multidisciplinary, comprehensive Spinal Cord Injury Care System (UAB-SCICS). The UAB-SCICS spans the clinical continuum from emergency services through rehabilitation and community re-entry. The System’s research includes one collaborative research module and two in-house research projects, all of which ultimately aim at improving the health and function of its constituents. The collaborative research module involves the validation of an outcome measure for functional recovery. One in-house research project involves the assessment of the predictive value of key parts of the neurological exam for return of bladder function; the second is an investigation of the effect of nicotine on different types of SCI pain. The project continues to benefit from the active involvement of persons with SCI in the design and execution of the proposed activities. Project results are disseminated via a variety of accessible formats and venues for both professionals and persons with SCI and their families. A detailed plan of operation ensures timely completion of project goals and tasks. Finally, an evaluation plan has been designed to assess the quality and timeliness of project outcomes and dissemination, as well as short and long term impacts of project activities. Activities of the UAB-SCICS reflect an active partnership both within the components of UAB's health system and between UAB, the Lakeshore Foundation, and the Birmingham VA Medical Center. The project continues as a participant in data collection activities for the National Spinal Cord Injury Statistical Center.
Descriptors: Bladder function, Model Systems, Rehabilitation medicine, Research, Service delivery, Spinal cord injuries.
The Rocky Mountain Regional Spinal Injury System.
Craig Hospital.
3425 South Clarkson Street.
Englewood, CO 80113.
E-mail: susie@craighospital.org.
URL(s): http://www.craighospital.org/Research/SCIMain.asp.
Principal Investigator: Daniel P. Lammertse, MD; Susan Charlifue, PhD.
Public Contact Phone: 303/789-8306 (V), 303/789-8575 (TTY).
Fax: 303/789-8441.
Project Number: H133N060005.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 06 $489,000; FY 07 $489,000; FY 08 $489,000; FY 09 $489,000; FY 10 $489,000.
Abstract: The Rocky Mountain Regional Spinal Injury System (RMRSIS) goals are to: (1) implement a program of research focusing on the immediate and long-term health, function, and community integration and participation of people with spinal cord injury (SCI); (2) improve its existing lifetime system of care for people with SCI; and (3) continue exemplary participation in the National SCI Database. A site-specific study determines if high vs. low tidal volumes are more effective in achieving ventilator weaning for individuals with high level tetraplegia, using a randomized clinical trial design. A collaborative research module study involves the development of a reliable, valid measurement tool to assess community participation. RMRSIS includes two Level I trauma centers with specialized acute neurotrauma care facilities (St. Anthony Hospital and Swedish Medical Center) and the rehabilitation and lifetime follow-up services of Craig Hospital.
Descriptors: Community integration, Model Systems, Outcome, Rehabilitation medicine, Spinal cord injuries, Ventilator dependence.
National Capital Spinal Cord Injury Model System.
National Rehabilitation Hospital |MedStar Research Institute|.
102 Irving Street, NW.
Washington, DC 20010.
URL(s): http://www.sci-health.org
http://www.ncscims.org.
Principal Investigator: Suzanne L. Groah, MD.
Public Contact Phone: 202/877-1425.
Fax: 202/726-7521.
Project Number: H133N060028.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 06 $449,417; FY 07 $449,417; FY 08 $449,417; FY 09 $449,417; FY 10 $449,417.
Abstract: The National Capital Spinal Cord Injury Model System (NCSCIMS) serves Washington, DC and the nation. By focusing on the frequent and costly complication of pressure ulcers (PU), the NCSCIMS leverages two unique strengths: an existing Rehabilitation Research and Training Center on spinal cord injury (SCI) that focuses on reduction of secondary conditions, and the population of Washington, DC, which is predominantly composed of underserved individuals. The Center includes two site-specific and one modular project and describes a system of care that meets SCIMS priorities: Site Specific Project 1 is a Practice-Based Evidence (PBE) project specifically focused on PU prevention for all individuals with SCI and/or disease (SCI/D) during the acute and rehabilitative phases of care (to evolve to the community in later phases). The PBE approach allows a detailed examination of the effects of methods, modalities, and therapies utilized in rehabilitation to prevent PUs, which are often based on evidence-based medicine, but in reality may not be extrapolated to the broader population with SCI/D. In this project, researchers aim to utilize a PBE approach to augment evidence-based practice while addressing a critical secondary complication for individuals with SCI. Site Specific Project 2 is an SCI Navigator pilot project that combines elements of Peer Mentoring and Patient Navigation to decrease the occurrence of PUs once the individual has returned to the community. In this project, an SCI Navigator assists people with newly-acquired SCI in the transition from inpatient rehabilitation to the community, within the framework of an, at times, dysfunctional healthcare system. The NCSCIMS works with the Model System at the University of Pittsburg to explore Assistive Technology for Mobility (ATM). In this project, researchers investigate the degree to which inadequate wheelchair technology is the factor preventing people with SCI from doing more, work to understand the impact of changes in wheelchair reimbursement, and fully explore the issue of disparity in ATM prescription.
Descriptors: Assistive technology, Community integration, Model Systems, Peer counseling, Pressure sores, Rehabilitation medicine, Spinal cord injuries, Wheelchairs.
Georgia Regional Spinal Cord Injury Care System.
Shepherd Center, Inc..
2020 Peachtree Road Northwest.
Atlanta, GA 30309-1465.
E-mail: lesley_hudson@shepherd.org.
URL(s): http://www.shepherd.org.
Principal Investigator: David F. Apple, Jr., MD; Lesley M. Hudson.
Public Contact Phone: 404/350-7591.
Fax: 404/355-1826.
Project Number: H133N060009.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $474,417; FY 07 $474,417; FY 08 $474,417; FY 09 $474,417; FY 10 $474,417.
Abstract: The Georgia Regional Spinal Cord Injury Care System admits approximately 200 individuals annually with acute onset paralysis secondary to spinal cord injury (SCI), and collects post-discharge data on 600 individuals each year. Its patient population comes primarily from Georgia, the rest of the Southeast, and the Eastern Seaboard. The continuum of care begins at injury and continues through transport, assessment, acute care, rehabilitation, emotional adjustment, community reintegration, and lifetime follow-up. The project continues a long record of comprehensive and timely collection of data on subjects who meet the inclusion criteria in three categories: inpatient hospitalization; longitudinal collection at 1, 5, 10, 15, 20, and 25 years post-injury; and registry. In addition to continued model system research, the project conducts two site specific research projects: (1) Psychological Status During Inpatient Rehabilitation and One Year After Onset: Stress, Coping, and Expectation Hope for Recovery; (2) Development and Validation of a Clinical Measure of Wheelchair Seat Cushion Degradation. The project also manages a collaborative data collection research module entitled Impact of SCI on Labor Market Participation.
Descriptors: Employment, Model Systems, Rehabilitation medicine, Seating, Spinal cord injuries.
Midwest Regional Spinal Cord Injury Care System (MRSCIS).
Rehabilitation Institute of Chicago.
345 East Superior Street, Room 1146.
Chicago, IL 60611.
URL(s): http://www.ric.org/research/centers/MidwestRegionalSpinalCordInjuryCareSystem/MRSCICS.aspx.
Principal Investigator: David Chen, MD.
Public Contact Phone: 312/238-0764.
Project Number: H133N060014.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 06 $484,000; FY 07 $484,000; FY 08 $484,000; FY 09 $482,162; FY 10 $467,189.
Abstract: The Spinal Cord Injury Rehabilitation Program at the Rehabilitation Institute of Chicago and the Acute Spinal Cord Injury Program at Northwestern Memorial Hospital demonstrate the ongoing, comprehensive, multidisciplinary services that are provided to individuals with spinal cord injury (SCI) which allow them to optimize their rehabilitation outcomes and enhance their ability to return to productive, independent living in the community. In order to contribute to the improvement of outcomes for persons with SCI, the System conducts two site-specific research projects: (1) Development of Low-Cost Devices to Increase Delivery of Intensive Treadmill Training, and (2) Disparities in Access to and Outcomes of Rehabilitation Care for Medicare and Medicaid Beneficiaries with Spinal Cord Injury. In addition, the project includes collaboration on one research project, Assistive Technology for Mobility (ATM) Module. MRSCICS has the capacity to enroll 140 individuals from culturally diverse backgrounds with new spinal cord injuries annually into the Spinal Cord Injury Model Systems database, and collect follow-up data on individuals enrolled between 1973 and 2000.
Descriptors: Exercise, Model Systems, Outcomes, Rehabilitation medicine.
The New England Regional Spinal Cord Injury Center.
Boston University Medical Center.
Preston F-511
732 Harrison Avenues.
Boston, MA 02118-2393.
E-mail: jane.wierbicky@bmc.org.
URL(s): http://www.bmc.org/spinalcordinjurycenter/research.htm.
Principal Investigator: Steve Williams, MD.
Public Contact Phone: 617/638-7316 (Wierbicky), 617/638-7380 (Houlihan).
Fax: 617/638-7303.
Project Number: H133N060024.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Kenneth D. Wood, PhD.
NIDRR Funding: FY 06 $464,417; FY 07 $464,417; FY 08 $464,417; FY 09 $464,417; FY 10 $464,417.
Abstract: The New England Regional Spinal Cord Injury Center (NERSCIC), based at Boston Medical Center (BMC), uses a network of rehabilitation hospitals (including Gaylord Hospital, Wallingford, CT), partners, and affiliates to develop a regional capacity to disseminate materials in such a way that they will be utilized both by consumers with spinal cord injury (SCI) and their families, and health care professionals, with particular attention to minorities and underserved groups. NERSCIC’s site-specific research project involves designing an improved outcome instrument in SCI research. This project applies contemporary measurement methods (CATS) to initiate a major transformation in the outcome assessment technology used to assess activity limitation frequently monitored in SCI research. Once the SCI-CAT has been developed using data collected front major field study, a demonstration of the SCI-CAT evaluates its respondent burden, acceptability to patients and clinicians, as well as its breadth, precision, sensitivity to change, and validity with inpatients and outpatients with SCI who are receiving care from NERSCIC. Comparisons are made between the FIM and SCI-CAT over a 6-month follow-up period. Additionally, this site-specific project will be integrated with the NeuroQoL collaborative module, in order to expand and improve both projects and to avoid developing competing computer adaptive testing instruments. This project is now referred to as the QOL/SCI-CAT Combined Project. Lastly, NERSCIC is a participating site in the SCI Collaborative Participation Module, led by Gale Whiteneck at Craig Hospital, to address the importance of participation given the current absence of a standard acceptable measure of participation. This collaborative SCI module identifies the best existing measure of participation or combines the best items from existing measures of participation to form a new and improved tool with better psychometric properties validated in the SCI Model Systems to ensure broad acceptability in future SCI outcomes research, and to allow for meaningful testing of clinical interventions.
Descriptors: Measurement, Model Systems, Outcomes, Rehabilitation medicine, Service delivery, Spinal cord injuries.
University of Michigan Model Spinal Cord Injury Care System.
University of Michigan.
300 North Ingalls, Room NI2A09.
Ann Arbor, MI 48109-5491.
E-mail: model.sci@umich.edu.
URL(s): http://www.med.umich.edu/pmr/modelsci/.
Principal Investigator: Denise G. Tate, PhD, ABPP, FACRM.
Public Contact Phone: 734/763-0971.
Fax: 734/936-5492.
Project Number: H133N060032.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $457,417; FY 07 $457,417; FY 08 $457,417; FY 09 $457,417; FY 10 $457,417.
Abstract: The overall purpose of this project is to provide comprehensive rehabilitation and community participation services and to generate new knowledge through research, development, and demonstration designed to improve outcomes for persons with spinal cord injury (SCI). A site-specific research study is conducted in partnership with faculty from the University of Michigan Depression Center, Department of Psychiatry, and the Molecular and Behavioral Neurosciences Institute. This study is a randomized clinical trial study designed to evaluate the efficacy of a pharmacological agent, Venlafaxine HCI also known as Effexor XR, as a preventive agent for reducing depression among persons with SCI. This clinical trial addresses a major need in the field as there are no randomized clinical trials currently available on the effectiveness of antidepressants in persons with SCI. In this study, the drug's effects on pain are also assessed. An outcome of this study is the formulation of recommendations for antidepressant medication use in SCI and implications for clinical practice guidelines. The project continues to operate an efficient data collection system, facilitating research and contributions to the National SCI Database.
Descriptors: Clinical trials, Depression, Model Systems, Pain, Rehabilitation medicine, Spinal cord injuries.
Northern New Jersey Spinal Cord Injury System.
Kessler Medical Rehabilitation Research and Education Corporation (KMRREC).
1199 Pleasant Valley Way.
West Orange, NJ 07052-1499.
E-mail: dtulsky@kesslerfoundation.net.
URL(s): http://www.kmrrec.org/nnjscis.
Principal Investigator: David S. Tulsky, PhD.
Public Contact Phone: 973/243-6849, 973/243-6916.
Fax: 973/243-3527.
Project Number: H133N060022.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $457,417; FY 07 $457,417; FY 08 $457,417; FY 09 $457,417; FY 10 $457,417.
Abstract: The Northern New Jersey Spinal Cord Injury System (NNJSCIS) provides a comprehensive continuum of state-of-the-art care for persons with spinal cord injury (SCI) and their significant others from time of injury through long-term follow-up in the community and conducts spinal cord research, including clinical research and the analysis of standardized data. NNJSCIS conducts both a site-specific research study and a collaborative module. These studies contribute to evidence-based rehabilitation interventions and clinical and practice guidelines that improve the lives of individuals with SCI and consist of the following: An innovative rehabilitation intervention utilizing technology to prevent respiratory disease in persons with SCI, now the leading cause of death and the third leading cause of hospitalizations in this population; a collaborative module that adapts, develops, and validates an innovative and promising outcome system for use in SCI intervention research; and the NNJSCIS coordinates with the NIDRR-funded Model Systems Knowledge Translation Center to provide scientific results and information for dissemination to clinical and consumer audiences. This project is a cooperative effort of the Kessler Medical Rehabilitation Research and Education Corporation (KMRREC), the Kessler Institute for Rehabilitation (KIR), the University of Medicine and Dentistry of New Jersey - The New Jersey Medical School (UMDNJ-NJMS), and UMDNJ-University Hospital.
Descriptors: Model Systems, Outcome, Rehabilitation, Rehabilitation medicine, Respiratory disease, Spinal cord injuries.
Mount Sinai Spinal Cord Injury Model System.
Mount Sinai School of Medicine.
One Gustave L. Levy Place, Box 1240.
New York, NY 10029-6574.
E-mail: marcel.dijkers@mssm.edu.
URL(s): http://www.mssm.edu/rehab/spinal.
Principal Investigator: Kristian T. Ragnarsson, MD.
Public Contact Phone: 212/659-8587.
Fax: 212/348-5901.
Project Number: H133N060027.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $452,541; FY 07 $452,541; FY 08 $452,541; FY 09 $452,541; FY 10 $452,541.
Abstract: The purpose of the Mount Sinai Spinal Cord Injury Model System (MS-SCI-MS) is to (1) demonstrate and evaluate a multidisciplinary system of rehabilitation care for persons with spinal cord injury (SCI) in the New York City metropolitan area, including innovative programs for community integration; (2) contribute longitudinal data to the SCI National Database; (3) create and evaluate SCI quality of life assessment and participation assessment measures, and collect information on the labor force and economic impacts of SCI; and (4) evaluate the treatment of neuropathic pain using modified-release morphine. There are three major components of the MS-SCI-MS: (1) comprehensive clinical care, (2) research (site-specific, module projects and contributions to the national database); and (3) dissemination, education, and training. The comprehensive clinical program consists of the following components: (1) The NYC Emergency Medical Service (NYC-EMS), which ensures the early and safe extrication of individuals with SCI from the site of injury; (2) acute medical/surgical care at Elmhurst Hospital Center or at Mount Sinai Hospital (MSH), both of which provide state-of-the-art emergency and medical/surgical services; and (3) comprehensive inpatient medical rehabilitation services on the 25-bed, CARF-accredited SCI inpatient rehabilitation unit of MSH. The program stresses interdisciplinary care, and employs a primary team model to enhance coordination among caregivers. The research program of MS-SCI-MS is designed to advance the understanding of SCI and its consequences, and to develop better methods of treatment of secondary conditions of SCI, especially pain. The site-specific project studies modified-release formulation of morphine sulfate for neuropathic pain after SCI through a randomized, double-blind crossover trial of modified-release morphine and placebo for patients with uncontrolled neuropathic pain of three types. In addition, three module projects are executed in collaboration with SCI model systems elsewhere. Dissemination, education, and training for individuals with SCI, their families, students, and health professionals, constitute the third component of the MS-SCI-MS, and include publications in scientific journals, presentations at national and local meetings, publication of a newsletter for consumers, expanded web-based information, a variety of educational and training programs, including an SCI medicine fellowship, and training of physical medicine and rehabilitation residents from various residency programs.
Descriptors: Evaluation, Model Systems, Outcome, Pain management, Rehabilitation medicine, Spinal cord injuries.
Northeast Ohio Regional Spinal Cord Injury System.
MetroHealth System.
2500 MetroHealth Drive.
Cleveland, OH 44109.
E-mail: mroach@metrohealth.org.
URL(s): http://rehab.metrohealth.org/norscis.
Principal Investigator: Gregory A. Nemunaitis, MD.
Public Contact Phone: 216/778-8781.
Fax: 216/778-8782.
Project Number: H133N060017.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Dawn Carlson, PhD, MPH.
NIDRR Funding: FY 06 $449,417; FY 07 $449,417; FY 08 $449,417; FY 09 $449,417; FY 10 $449,417.
Abstract: The Northeast Ohio Regional Spinal Cord Injury System (NORSCIS) at MetroHealth Rehabilitation Institute of Ohio in collaboration with Case Western Reserve University and the Cleveland FES Center conducts research to further develop the effectiveness of an innovative Model Spinal Cord Injury Care System and to demonstrate how the application of advanced assistive technology can benefit persons with disabilities. Efficiency and effectiveness of care (and research potential) are enhanced as all components of the continuum of care (from trauma/emergency care to acute medical/surgical treatment, inpatient and outpatient rehabilitation, and community support services) are all available on the NORSCIS campus. A site-specific project studies advances in functional electrical stimulation (FES) technology to document improvements in function, health, and wellness. An innovative focus on trunk muscle stimulation targets specific clinical problems, including seated stability and mobility, reachable workspace, and pulmonary function. A collaborative research project with UPMC-SCI, is directed at testing and collecting the data needed to understand the impact of coverage changes and to fully explore the issue of disparity in assistive technology for mobility prescription. A collaborative project with Craig Hospital involves the development of a reliable, valid measurement tool to assess community participation. The goal of these hypothesis-driven research and demonstration projects is to develop and measure the effectiveness of new intervention strategies at both the individual patient level and overall systems of care for persons with spinal cord injury.
Descriptors: Assistive technology, Evidence-based practice, Functional electrical stimulation (FES), Rehabilitation medicine, Spinal cord injuries.
Regional Spinal Cord Injury Center of the Delaware Valley.
Thomas Jefferson University.
132 South 10th Street
375 Main Building.
Philadelphia, PA 19107-5244.
E-mail: Mary.Patrick@jefferson.edu.
URL(s): http://www.spinalcordcenter.org.
Principal Investigator: Ralph J. Marino, MD.
Public Contact Phone: 215/955-6579.
Fax: 215/955-5152.
Project Number: H133N060011.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $464,417; FY 07 $464,417; FY 08 $464,417; FY 09 $464,417; FY 10 $464,417.
Abstract: The Regional Spinal Cord Injury Center of the Delaware Valley (RSCICDV) provides and evaluates a comprehensive program of coordinated patient care, education, and research activities for individuals who have sustained a traumatic spinal cord injury (SCI). Clinical activities are directed at promoting evidence-based practice to improve outcomes and reduce medical complications in persons with SCI. Research activities are designed to develop and validate upper and lower extremity outcome measures for use in clinical trials. Specifically, RSCICDV: (1) contributes to the National Database by enrolling an estimated 50 new subjects per year into the database and by collecting follow-up data on previously enrolled subjects; (2) conducts an on-site research project whose focus is to develop and validate the Capabilities of the Upper Extremity Test (CUE-T), an objective test of arm and hand functional capabilities needed to conduct clinical trials for neurological recovery in SCI; (3) participate in a collaborative module on investigating the impact of policy changes on customizability and features of wheelchairs and investigate distance traveled, time spent active and speed traveled in a wheelchair and its relationship to wheelchair customizability and features, wheelchair breakdown, and quality of life; (4) participates in a collaborative module on validation of an outcome measure for motor recovery in incomplete SCI; and (5) develops educational resources for patients, healthcare providers, and researchers.
Descriptors: Evidence-based practice, Measurement, Model Systems, Rehabilitation medicine, Research, Spinal cord injuries.
University of Pittsburgh Model Center on Spinal Cord Injury.
University of Pittsburgh.
1400 Locust Street Bldg B, Suite 11516.
Pittsburgh, PA 15219.
E-mail: greekk@upmc.edu.
URL(s): http://www.upmc-sci.org
http://www.rehabmedicine.pitt.edu.
Principal Investigator: Michael L. Boninger, MD.
Public Contact Phone: 412/232-7949.
Fax: 412/232-7535.
Project Number: H133N060019.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $449,417; FY 07 $449,417; FY 08 $449,417; FY 09 $449,417; FY 10 $449,417.
Abstract: The UPMC-SCI continues its research focus on assistive technology (AT) for mobility. Pilot data collected during the previous funding cycle highlighted disparity in wheelchair prescription. Individuals from minority groups and people with low socioeconomic status received less and lower quality equipment. So that interventions can be developed, the project continues and expands this research to delve into the reasons for disparity. In addition, it investigates the impact of recent Centers for Medicare and Medicaid Services (CMS) changes for AT reimbursement. These changes will likely have a critical impact on the AT provided to individuals with spinal cord injury (SCI). Finally, the project develops a tool to determine how far, how fast, and when people travel in their wheelchairs. This data is related to the type of wheelchairs used, to the number of wheelchair failures, and to measures of participation. From these findings, researchers determine how the wheelchair prescribed impacts participation, and if greater use leads to greater failures. This data can be used to push for improvements in manufacturing and changes in coverage. UPMC-SCI also conducts a randomized, controlled trial to determine if following the Consortium of Spinal Cord Injury Medicine Guidelines on Upper Limb Preservation leads to decreased pain. These guidelines are applied to acutely injured patients who are followed for the first six months after injury. Validation of the guidelines' effectiveness helps assure that they become the standard of care across the country. SCI care at the University of Pittsburgh is provided in a multidisciplinary manner with a high level of communication among the constituent services. The project has fully implemented a system of continuity of treatment that begins with the emergency response at the scene of injury and continues with comprehensive treatment and rehabilitation from medical/surgical to acute stage rehabilitation through utilization of assistive technology services and vocational rehabilitation. UPMC-SCI continues to enroll and collect long-term follow-up data on SCI subjects for the National Spinal Cord Injury Statistical Center.
Descriptors: Assistive technology, Model Systems, Rehabilitation medicine, Spinal cord injuries, Wheelchairs.
Texas Model Spinal Cord Injury System.
The Institute for Rehabilitation and Research (TIRR).
1333 Moursund Street.
Houston, TX 77030-3408.
E-mail: dgraves@bcm.tmc.edu.
URL(s): http://www.texasmscis.org.
Principal Investigator: Daniel Graves, PhD; William Donovan, MD.
Public Contact Phone: 713/797-5946 (V), 713/797-5790 (TTY).
Fax: 713/797-5982.
Project Number: H133N060003.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $464,417; FY 07 $464,417; FY 08 $464,417; FY 09 $464,417; FY 10 $464,417.
Abstract: The Texas Model Spinal Cord Injury System (TMSCIS) provides services along the entire continuum of care for spinal cord injury (SCI) from emergency medical service to long-term follow-up and management of secondary conditions. The TMSCIS includes a site-specific research project that is designed to provide high level evidence of the efficacy of a novel treatment to prevent bladder complications. The project is a randomized, double-blind, placebo controlled, parallel groups investigation of the effects of Botulinum toxin A treatment of detrusor external sphincter dyssynergia (DESD) during early spinal cord injury. Many patients with SCI develop neurogenic bladder dysfunction associated with detrusor hyperreflexia and DESD that can lead to long-term complications in up to 50 percent of patients. These complications include hydronephrosis, vesicoureteral reflux, nephrolithiasis, sepsis, renal insufficiency or failure, and even death. This investigation is intended to determine if the prevention of DESD in the early phase of recovery can prevent some of these complications. In addition, the TMSCIS includes a module designed to develop an outcome measure of trunk and postural control to be utilized in activity-based therapy programs like locomotor training. The outcomes of large scale clinical trials of locomotor training highlight the need for outcome measures that are designed to capture changes brought about by translational research that may not have been necessary for more traditional therapy programs. This scale development project incorporates item response theory methods as well as reliability and validity investigations in a minimum of four model systems.
Descriptors: Bladder function, Evaluation, Measurement, Model Systems, Rehabilitation medicine, Spinal cord injuries.
Northwest Regional Spinal Cord Injury System.
University of Washington.
Box 356490.
Seattle, WA 98195-6490.
E-mail: scirehab@u.washington.edu.
URL(s): http://sci.washington.edu.
Principal Investigator: Charles H. Bombardier, PhD.
Public Contact Phone: 206/685-3999.
Fax: 206/685-3244.
Project Number: H133N060033.
Start Date: October 1, 2006.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 06 $464,417; FY 07 $464,417; FY 08 $464,417; FY 09 $464,417; FY 10 $464,417.
Abstract: The University of Washington's Northwest Regional Spinal Cord Injury System (NWRSCIS) serves a critical mass of patients with spinal cord injury (SCI) and has all the necessary disciplines to provide state-of-the-art medical, surgical, and rehabilitation care. One site-specific project is a randomized controlled intervention study evaluating the effect of proactive, structured, telephone-based counseling and care management on rehospitalization rate and quality of life during the first year after discharge from acute rehabilitation. This study builds upon successful experiences with telephone counseling for both people with traumatic brain injury and multiple sclerosis. This research is particularly important because the lifestyle changes and health care behaviors required for successful living after SCI are tremendously challenging, rates of rehospitalization are high, and many people (especially in rural regions) lack ready access to knowledgeable advice, behavior change support, and specialty care sufficient to maintain their health. A modular project studies the natural history of major depression under conditions of usual care during the first year after SCI. This project establishes reliable and valid means of screening and diagnosing major depression soon after SCI. It examines the impact of depression on rehabilitation efficiency and compares the effect of standard treatment to clinical practice guideline level care of depression. This study describes depression treatment preferences among people with SCI and lays the foundation for a multi-site clinical trial. The NWRSCIS also includes a collaborative, multisite, randomized, double-blind, placebo controlled trial of venlafaxine XR (Effexor XR) in adults with SCI and major depressive disorder (MDD). The purpose of the study is to examine the efficacy and tolerability of venlafaxine XR as a treatment for MDD. NWRSCIS contributes to the national statistics database at the University of Alabama at Birmingham.
Descriptors: Depression, Model Systems, Outcome, Rehabilitation, Rehabilitation medicine, Spinal cord injuries.
Rehabilitation Engineering Research Centers (RERCs).
Rehabilitation Engineering Research Center for Successful Aging with Disability: Optimizing Participation Through Technology (OPTT-RERC).
University of Southern California.
1540 Alcazar Street, CHP-155.
Los Angeles, CA 90033.
E-mail: winstein@usc.edu.
URL(s): http://www.isi.edu/research/rerc.
Principal Investigator: Carolee J. Winstein, PhD, PT (USC); Philip Requejo, PhD (Rancho Los Amigos).
Public Contact Phone: 323/442-2903.
Fax: 323/442-1515.
Project Number: H133E080024.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Margaret Campbell, PhD.
NIDRR Funding: FY 08 $950,000; FY 09 $950,000; FY 10 $950,000; FY 11 $950,000; FY 12 $950,000.
Abstract: The goal of this project is to enhance the lives of individuals aging with and into disability through: (1) development and delivery of cutting-edge technologies for identification, evaluation, and rehabilitation of motor processes that facilitate or impede functional performance, employment, and community participation for the intended beneficiaries; (2) employment of state-of-the-art data management, dissemination, and performance evaluation techniques to ensure that the knowledge and products emergent from the RERC are accessible for all intended beneficiaries; (3) assembly of a multidisciplinary team of experts in clinical rehabilitation, engineering, and gerontology, along with a select group of technology partners, and disability advocates to ensure that OPTT-RERC's short- and long-term outcome goals are successfully implemented; and (4) alignment of the clinical and technological strengths of several area programs into an integrated infrastructure to provide training opportunities for future rehabilitation researchers. The Dexterous Manipulation with the Fingertips Project evaluates a clinically useful metric and rehabilitation strategy for dynamic multifinger dexterity (R1) and, in collaboration with the second project area, develops a home-use gaming system to promote retention and improvement of dexterous manipulation via immersion technologies (D1). The Virtual Reality (VR) and Gaming for Home-Based Motor Assessment and Training Project develops low cost, home-based VR toolkits (VRT) for motor assessment and rehabilitation (D2) and investigates the efficacy of the VRT games for use in both the clinic setting and the home for individuals aging with and into disability (R2). The Optimizing Mobility in the Home and Community for Manual Wheelchair Users Project identifies optimal transfer and lifting mechanics to preserve the shoulder complex (R3) and uses VRT games for targeted and progressive shoulder exercise while sitting in a wheelchair (D3). The Neuromuscular Electrical Stimulation (NMES) for Mobility uses implantable wireless micro-stimulators to prevent recurrences of debilitating pressure ulcers in the middle age and older individuals with disability (D4).
Descriptors: Aging, Dexterity, Mobility, Pressure sores, Virtual reality, Wheelchairs.
Rehabilitation Research and Training Centers (RRTCs).
Rehabilitation Research and Training Center in Neuromuscular Diseases (RRTC-NMD).
University of California, Davis.
One Shields Avenue.
Davis, CA 95616.
E-mail: cmmcdonald@usdavis.edu.
Principal Investigator: Craig McDonald, MD.
Public Contact Phone: 530/752-3447.
Fax: 916/734-7838.
Project Number: H133B090001.
Start Date: October 1, 2009.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 09 $800,000; FY 10 $800,000; FY 11 $800,000; FY 12 $800,000; FY 13 $800,000.
Abstract: This RRTC has five goals: (1) develop and test improved outcome measures for use in intervention and natural history studies in persons with neuromuscular diseases (NMDs); (2) identify or develop and test the effectiveness of new medical rehabilitation interventions, and document the effectiveness of existing interventions in persons with NMDs; (3) provide training, including graduate, pre-service, and in-service training, to help rehabilitation personnel effectively provide rehabilitation services to individuals with NMDs; (4) disseminate informational materials and provide technical assistance to individuals with NMDs, their representatives, providers, and other interested parties; and (5) serve as a national center of excellence in rehabilitation research for individuals with disabilities, their representatives, providers, and other interested parties. This RRTC conducts four research projects related to developing improved outcome measures. In Project 1, both currently used and novel clinical endpoints related to mobility and secondary conditions are studied. The clinical meaningfulness of those outcome measures are assessed in comparison to a new person-reported outcome measure (the NeuroQOL) which addresses impaired mobility, decreased self-care due to weakness, pain, and fatigue. In Project 2, the NeuroQOL instrument is further refined and validated for children 5 to 12 years of age who are commonly targeted for new interventions. Projects 3 and 4 evaluate novel and existing medical rehabilitation interventions in Duchenne muscular dystrophy (DMD). Project 3 uses a multicenter prospective natural history study of 347 individuals with DMD to evaluate existing medical rehabilitation interventions designed to enhance mobility and reduce the severity of secondary conditions. Project 4 examines the uses of a first-in-class medication to maintain or improve function in patients with DMD who have a premature stop codon mutation. Project 4 also focuses on individuals severely affected with DMD who are non-ambulatory and evaluates ataluren and its effects on mobility/upper extremity function, secondary conditions, and health-related quality of life.
Descriptors: Health promotion, Intervention, Medical rehabilitation, Neuromuscular diseases, Rehabilitation research.
Rehabilitation Research and Training Center on Secondary Conditions in Spinal Cord Injury.
MedStar Research Institute.
102 Irving Street, NW.
Washington, DC 20010.
E-mail: matthew.e.kehn@medstar.net.
Principal Investigator: Suzanne L. Groah, MD.
Public Contact Phone: 202/877-1603.
Fax: 202/726-7521.
Project Number: H133B090002.
Start Date: October 1, 2009.
Length: 60 months.
NIDRR Officer: Pimjai Sudsawad, ScD.
NIDRR Funding: FY 09 $799,995; FY 10 $799,998; FY 11 $799,998; FY 12 $799,999; FY 13 $800,000.
Abstract: This RRTC focuses on the frequent and costly complications of obesity such as cardiometabolic syndrome (inclusive of obesity, insulin resistance, hypertension, dyslipidemia, and inflammation), and pressure ulcers among people with spinal cord injury (SCI), with a specific focus on the underserved. Utilizing novel diagnostic and therapeutic practices this RRTC addresses three major secondary conditions that lead to significant health decay in people with SCI. This RRTC includes three research (R1-R3) and training (T1-T3) projects. Project R1 determines the degree to which obesity is related to cardiometabolic health, cardiometabolic risk (CMR) factors, and atherosclerotic burden. Those requiring intervention based on CMR profile and atherosclerotic burden in R1 are selected to participate in Project R2, a randomized control trial examining impact of an omega-3 dietary supplement intervention. Project R3 determines the physiologic response of sacral and ischial skin to sitting and pressure relief. A behavioral self-management program is assessed to ensure future recommendations can be evidence-based. These research findings feed into three training activities that include culturally sensitive consumer education: T1 emphasizes underserved populations; T2 emphasizes professional training and education of rehabilitation and non-rehabilitation professionals utilizing online media; and T3 emphasizes dissemination through a state-of-science research and training conference.
Descriptors: Health promotion, Interventions, Secondary conditions, Spinal cord injuries.
Rehabilitation Research and Training Center on Enhancing the Functional and Employment Outcomes of Individuals Who Experience a Stroke.
Rehabilitation Institute Research Corporation.
345 East Superior Street.
Chicago, IL 60611.
E-mail: ejr@northwestern.edu.
URL(s): http://www.rrtc-stroke.org/.
Principal Investigator: Elliot J. Roth, MD.
Public Contact Phone: 312/238-6197.
Fax: 312/238-6998.
Project Number: H133B080031.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Theresa San Agustin, MD.
NIDRR Funding: FY 08 $849,813; FY 09 $849,514; FY 10 $849,582; FY 11 $849,263; FY 12 $849,981.
Abstract: As new and better stroke treatments have become available, the number of stroke survivors living in the community has increased. Therefore, not only is there a need for further research on promising new interventions that promote health and function, but also a growing need for interventions that can be delivered in home and community settings. This project studies rehabilitation interventions and assessments focused on improved mobility and secondary conditions that have been designed with the intent of promoting efficient function in the workplace or at home. It also looks at the barriers and facilitators for return-to-work from the perspective of stroke survivors who are seeking employment. The RRTC research projects include: (1) a study of the effectiveness of stretching as hand therapy for sub-acute hemiparesis; (2) development of a low-cost, non-mechanized gait retraining device; (3) testing a self-management approach to community living, participation, and employment; (4) examining the barriers and enablers for return-to-work from the perspective of the of the individual who experienced the stroke; and (5) development of a return-to-work vocational assessment using virtual reality technology. For this project, the Rehabilitation Institute of Chicago has partnered with Northwestern University, the University of Illinois at Chicago, Washington University at St. Louis, Marquette University, and Archeworks, Inc, as well as the National Stroke Association and the National Aphasia Association.
Descriptors: Community integration, Community-based services, Mobility, Secondary conditions, Stroke.
Rehabilitation Research and Training Center on Traumatic Brain Injury Interventions.
Mount Sinai School of Medicine.
One Gustave L. Levy Place, Box 1240.
New York, NY 10029.
E-mail: wayne.gordon@mssm.edu.
URL(s): http://www.tbicentral.org.
Principal Investigator: Wayne A. Gordon, PhD.
Public Contact Phone: 212/659-9372 (V), 212/241-8978 (TTY).
Fax: 212/348-5901.
Project Number: H133B040033.
Start Date: October 1, 2004.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 04 $700,000; FY 05 $700,000; FY 06 $700,000; FY 07 $700,000; FY 08 $700,000; FY 09 $ 0.
Abstract: The research program includes two randomized clinical trials (RCTs) and two projects supportive of better everyday interventions and better research: Research Study 1 (R1) is an RCT of a treatment for depression: cognitive behavioral therapy, adapted to address the unique cognitive and behavioral challenges of people with traumatic brain injury (TBI) that often pose barriers to treating depression, a major factor in reducing post-TBI quality of life, is compared to supportive therapy. In R2, a second RCT, a standard day treatment program is compared to a similar program (Executive Plus), augmented with modules to improve executive functioning and attention training. R3, Support for Evidence-Based Practice, evaluates all published research on post-TBI interventions and assessment of outcomes; it serves as a national resource for disseminating the results. It also implements three participatory action research-based analyses of high priority areas, including meta-analyses if appropriate. In addressing improved outcome measurement, R4 focuses on the PART instrument, a measure of participation currently being tested within eight TBI Model Systems. R4 focuses on creating a subjective approach to serve as a complement to the PART's current focus on objective assessment. A major focus of the RRTC is placed on capacity building of clinical and research professionals to address the need for better day-to-day interventions in the lives of people with TBI. Often their medical needs are misread, their brain injury goes unidentified, and they find services and accommodations inappropriate. Capacity building focuses on students early in their educational career - to help shape career choice and points of view; graduate and post-graduate students; and practicing "gate keepers" in the community, primarily psychologists and physicians.
Descriptors: Brain injuries, Community integration, Depression, Outcomes, Participatory action research.
Rehabilitation Research and Training Center on Interventions for Children and Youth with TBI.
Children’s Hospital Medical Center.
3333 Burnet Avenue.
Cincinnati, OH 45229.
E-mail: shari.wade@cchmc.org.
Principal Investigator: Shari L. Wade, PhD.
Public Contact Phone: 513/636-3370.
Fax: 513/636-7360.
Project Number: H133B090010.
Start Date: October 1, 2009.
Length: 60 months.
NIDRR Officer: A. Cate Miller, PhD.
NIDRR Funding: FY 09 $799,337; FY 10 $799,915; FY 11 $799,884; FY 12 $799,542; FY 13 $799,682.
Abstract: This project addresses the need for interventions for children and youth with traumatic brain injury (TBI). Interventions designed for this population must: (a) target the continuum of service delivery; (b) address the changing needs of the population; and most importantly, (c) include tools, training activities, and dissemination mechanisms for all of the “everyday” people who support children and youth. Project research identifies a reliable and valid measurement battery for assessing functional improvements arising from TBI interventions; and initiates a national, shared database of TBI outcomes data. This RRTC: (1) evaluates specific interventions to improve cognitive, behavioral, and psychosocial outcomes with a range of children and youth with TBI through randomized clinical trials; (2) evaluates the effectiveness of the validated interventions in natural settings; and (3) uses multi-method evaluations of the efficacy of training, technical assistance, and dissemination activities to verify the utility of the final products.
Descriptors: Brain injuries, Children, Interventions, Service delivery, Youth.
Rehabilitation Research and Training Center on Health and Wellness in Long Term Disability.
Oregon Health and Science University.
707 Southwest Gaines
P.O. Box 574.
Portland, OR 97207-0574.
E-mail: rrtc@ohsu.edu.
URL(s): http://www.healthwellness.org.
Principal Investigator: Charles Drum, PhD.
Public Contact Phone: 503/494-3533.
Fax: 503/494-6868.
Project Number: H133B040034.
Start Date: October 1, 2004.
Length: 60 months.
NIDRR Officer: Phillip Beatty, PhD.
NIDRR Funding: FY 04 $700,000; FY 05 $700,000; FY 06 $700,000; FY 07 $700,000; FY 08 $700,000; FY 09 $ 0.
Abstract: The vision of the RRTC is to contribute to the reduction of health disparities for person with disabilities through an integrated program of research, training, technical assistance, and dissemination. The Center has three inter-related strands of work to address its three intended outcomes/goals: (1) identify strategies to overcome barriers that impede access to routine healthcare for individuals with disabilities; (2) identify interventions in areas such as exercise, nutrition, pain management, or complementary and alternative therapies that promote health and wellness and minimize the occurrence of secondary conditions for persons with disabilities; and (3) develop improved status measurement tool(s) to assess health and well-being of individuals with disabilities regardless of functional ability. In order to achieve these outcomes, the RRTC conducts a coordinated program of research and training activities using a logic model framework. RRTC projects summarize and validate existing research findings on barriers to health care access as well as rigorously test and compare new strategies to overcoming identified barriers. The RRTC also examines and evaluates the practices of exemplary generic and specialized health promotion programs for people with disabilities in order to create an evidence-based set of evaluation and planning criteria. In addition, the RRTC organizes and uses panels to assess current health status measurement tools and develops or refines measures to more accurately reflect the health and well-being of people living with disabilities. Throughout these activities the RRTC disseminates informational materials and provide technical assistance to individuals with disabilities, their representatives, providers, and other interested parties.
Descriptors: Health promotion, Cerebral palsy, Spinal cord injuries, Multiple sclerosis, Long term disabilities, Internet.
Rehabilitation Research and Training Center on Secondary Conditions in Individuals with SCI.
Medical University of South Carolina.
77 President Street
P.O. Box 250700.
Charleston, SC 29425.
E-mail: cokerj@musc.edu.
Principal Investigator: James S. Krause, PhD.
Public Contact Phone: 843/792-1337.
Fax: 843/792-5649.
Project Number: H133B090005.
Start Date: October 1, 2009.
Length: 60 months.
NIDRR Officer: Pimjai Sudsawad, ScD.
NIDRR Funding: FY 09 $794,504; FY 10 $797,646; FY 11 $791,037; FY 12 $794,494; FY 13 $786,639.
Abstract: The RRTC combines an integrated program of research to identify risk and protective factors for secondary conditions in spinal cord injury (SCI) with a systematic program of education, training, dissemination, and technical assistance. This program allows new knowledge to be directly translated into prevention strategies at the policy, rehabilitative, clinical, community, and individual consumer levels. The key to prevention of secondary conditions is to first identify to whom they occur and why, then to widely educate and disseminate new knowledge to professionals and consumers in a format they can directly use in the prevention of secondary conditions. Through three research studies, integrating two theoretical models of risk of secondary conditions, the project identifies the risk and protective factors that put the greatest number of individuals at risk for the greatest number of conditions. Study 1 is a longitudinal follow-up of 1,755 participants who completed an extensive assessment of risk and protective factors for secondary conditions that include adverse events (e.g., pressure ulcers, hospitalizations), chronic conditions (e.g., pain, fatigue), and psychosocial conditions (e.g., depressive disorder). The study examines the stability of secondary conditions and identifies psychological, environmental, and behavioral predictors of future episodes of secondary condition. Study 2 identifies the association of access to health services, including initial rehabilitation services (i.e., inpatient, outpatient only, no rehabilitation), with presence of secondary conditions. By using a population-based cohort, this study identifies the role of access to services among those with the fewest resources as they are at greatest risk for secondary conditions. Study 3 utilizes a 17-year follow-up among 845 participants from Rancho Los Amigos National Rehabilitation Center to investigate the stability of metabolic syndrome over time and its relationship with secondary conditions including pain, fatigue, and a depressive disorder.
Descriptors: Prevention, Research and training centers, Risk Assessment, Secondary conditions, Spinal cord injuries.
Multiple Sclerosis Rehabilitation Research and Training Center.
University of Washington.
Box 356490.
Seattle, WA 98185.
E-mail: msrrtc@u.washington.edu.
URL(s): http://www.msrrtc.washington.edu.
Principal Investigator: George H. Kraft, MD.
Public Contact Phone: 888/634-6778, 206/221-5302.
Fax: 206/685-3244.
Project Number: H133B080025.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: David W. Keer.
NIDRR Funding: FY 08 $850,000; FY 09 $850,000; FY 10 $850,000; FY 11 $850,000; FY 12 $850,000.
Abstract: This project conducts a comprehensive program of research on issues critical to individuals living with multiple sclerosis (MS) in the areas of outcomes measurement, improved medical and community interventions, and improved employment outcomes. The project includes three coordinated core areas of research designed to enhance function and employment in individuals with MS. Program I: The Outcomes Measurement core includes a longitudinal study of 400 people with MS of secondary conditions such as pain, fatigue, depression, and cognitive impairment, and outcomes such as participation including employment. This program uses modern psychometric techniques to evaluate measures of these and other secondary conditions, develop cross-walking tables to allow comparison of scores across measures, and compare levels of pain, fatigue, and depression in MS to norms of the general population and other disability groups. Program II develops improved medical or community rehabilitation interventions by conducting a randomized controlled trial of individualized self-management training delivered by telephone to reduce secondary conditions such as fatigue and pain with a generic psychoeducational intervention for control. This program evaluates the impact on participation, including employment, in addition to evaluating reduction in interference from secondary conditions. Program III improves employment outcomes of persons with MS by examining the national RSA 911 database to identify process and outcome variables associated with successful vocational rehabilitation (VR) closures. Qualitative interviews are conducted with federal state VR counselors to understand their perspectives on VR services and MS. Longitudinal data on employment is analyzed to evaluate changes in employment status over time. Researchers conduct follow-up surveys about impact of accommodation services on employment with 200 recipients of services from MS Employment Assistance Service. The result is best practices and recommendations for improved employment services.
Descriptors: Employment, Mental health, Multiple sclerosis, Outcomes, Vocational rehabilitation.
Rehabilitation Research and Training Center on Aging with a Physical Disability: Reducing Secondary Conditions and Enhancing Health and Participation, Including Employment.
University of Washington.
1959 NE Pacific Street
BB-919 Box 356490.
Seattle, WA 98195.
URL(s): http://agerrtc.washington.edu/.
Principal Investigator: Mark P. Jensen, PhD; Ivan Molton, PhD.
Public Contact Phone: 888/634-6778.
Fax: 206/685-3244.
Project Number: H133B080024.
Start Date: October 1, 2008.
Length: 60 months.
NIDRR Officer: Margaret Campbell, PhD.
NIDRR Funding: FY 08 $850,000; FY 09 $850,000; FY 10 $850,000; FY 11 $850,000; FY 12 $850,000.
Abstract: The goal of this center is to foster a better understanding the challenges faced by those aging with a physical disability. The project focuses on four populations of persons with disabilities: persons with spinal cord injury (SCI), multiple sclerosis (MS), post-polio syndrome (PPS), and muscular dystrophy (MD). The project: (1) enhances understanding of the natural course of aging with these disabilities through a series of longitudinal surveys to examine the effects of aging in the development of secondary conditions; (2) develops and evaluates measures of key outcome domains for use with individuals aging with SCI, MS, PPS, and MD utilizing cross-population and cross-measure analyses to evaluate the psychometric properties of instruments used in disability research, as well as to develop better measures of depression, fatigue, participation, and pain; (3) tests the efficacy of two innovative interventions that enhance the health and participation in these populations, using remote monitoring of activity levels and a pilot intervention featuring remote prompting to enhance self-management of activity patterns; (4) enhances understanding of the experiences of individuals aging with SCI, MS, PPS, and MD in the workplace and with vocational rehabilitation and employment services through secondary data analysis and qualitative interviews; and (5) disseminates the findings from the research projects in an effective and efficient manner to individuals with disabilities, their family members, and their health care providers.
Descriptors: Aging, Employment, Multiple sclerosis, Muscular dystrophy, Poliomyelitis, Secondary conditions, Spinal cord injuries.
Small Business Innovation Research (SBIR), Phase II.
Utility Arm – An Upper Limb Prosthesis.
Motion Control, Inc..
115 North Wright Brothers Drive.
Salt Lake City, UT 84116.
E-mail: harold@utaharm.com.
Principal Investigator: Harold H. Sears, PhD.
Public Contact Phone: 801/326-3434.
Fax: 801/978-0848.
Project Number: H133S090131.
Start Date: October 1, 2009.
Length: 24 months.
NIDRR Officer: Joyce Y. Caldwell.
NIDRR Funding: FY 09 $255,950; FY 10 $244,050.
Abstract: This project continues to develop the innovative body-powered (BP) upper extremity (UE) prosthetic system, Utility Arm, which provides substantial improvements in functionality, comfort, and aesthetics for persons with UE deficiencies at all levels. The Utility Arm system increases independence and work capabilities for users of arm prostheses, with less complexity than a full myoelectric arm system, and at lower cost. Project goals include: (1) the design and fabrication of high-strength molded shells for the Utility Arm elbow, retaining the design features of the Utah Arm (enclosed forearm, forward hinge pin, exoskeletal structure, convenient battery compartment, etc.); (2) maintaining a body-powered elbow lock design of the Utility Arm which has the ability to function as a completely body-powered system; (3) development of the first plastic/composite adult BP terminal device (TD), the Gripper, featuring tough urethane surfaces for high friction, with no sacrifice in ruggedness, and at a competitive price; (4) development of rugged Quick Disconnect that is integrated into electric as well as BP TDs, is highly water/dirt resistant, and allows adjustable friction; (5) development of a water-resistant battery pack which extends the environments in which a hybrid arm prosthesis may be used with an electric TD and lock; and (6) improvement of the electronic control improving a wearer’s control of hand, wrist, and lock when using non-EMG alternative inputs.
Descriptors: Limbs, Prosthetics, Rehabilitation engineering.
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