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Research

man on MountainThe University of Michigan is a leader in research to improve life for individuals with SCI. Some of our studies are conducted through the SCI Model Systems, which is funded by the National Institute on Disability and Rehabilitation Research. Much of our research dissemination is done through publications in peer-reviewed journals and conference presentations.

If you are interested in participating in research on spinal cord injury, you can join our Research Registry, and your name will be placed on a confidential list of people whom we contact about studies for which they may be eligible.

Current Research Projects 2011-2016

For the 2011-2016 Spinal Cord Injury Model Systems grant, we will be conducting two site-specific research projects and two multi-center studies along with other SCI Model Systems. In addition, we will continue to participate in the National SCI Model Systems Database.

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The National SCI Model Systems Database

Newly injured individuals who receive their inpatient rehabilitation for SCI at the University of Michigan Hospital are invited to participate in this longitudinal study. During participants' initial hospitalizations, data is collected about their injuries and a brief survey is conducted. Participants are contacted one and five years after their injuries and every five years thereafter to complete follow-up interviews. The data collected is confidentially added to the database of the National Spinal Cord Injury Statistical Center, the world's largest database about SCI. This database currently includes information on over 27,000 people with SCI, nationwide, of whom over 1,000 have come from our Model System. In addition to collecting data, we continue to actively conduct research with it. During the past two years, we have published over 10 papers using this database.

Principle Investigators: Denise Tate, Ph.D. and Anthony Chiodo, M.D.

Site-specific Study 1: Bladder and Bowel Complications and their Impact on Quality of Life Outcomes after SCI

Site Specific Study 1 proposes and tests a conceptual model to explain the role of personal characteristics, injury characteristics, prescribed treatments, environmental support and health behavior factors on bladder and bowel complications and downstream effects on QOL in persons with chronic SCI. The scope of this study builds on and broadens research in this area by accounting for not only physiological factors such as injury level, but also contextual factors such as the environment, alliance with care providers and behavior. Given the high prevalence of bladder and bowel problems among people with SCI, the lack of more specific recommendations for prescribed treatments and guidelines that account for psychosocial and behavior factors is both surprising and disturbing.

Principal investigators: Denise G. Tate, PhD, ABBP and Anthony Chiodo, MD 

Site-specific Study 2: Bladder and Bowel Complications and their Impact on Quality of Life Outcomes after SCI

This study will examine the factors that explain bladder and bowel complications among persons with SCI, focusing on personal and injury characteristics, prescribed treatments, adherence, environmental barriers and supports, health behaviors. It will also examine the way in which these complications affect quality of life (QOL). 450 adults who have lived with SCI for at least 5 years will be recruited to participate in this study. Information will be obtained from an interview and review of medical records. A subsample of 40 individuals will be asked to participate in a more in-depth assessment of the impact of bladder and bowel issues on daily life.

Principle Investigators: Denise Tate, Ph.D. and Claire Kalpakjian, Ph.D.

Recruitment: We expect to begin recruiting for this study in the spring.

Site-specific Study 3: Applying Health Mechanics to Enhance Bowel and Bladder Health for Persons with Spinal Cord Injury

This study will evaluate the efficacy of a self-management program, Health Mechanics, to develop and improve bladder and bowel management skills among persons with new SCI. Program participation is expected to prevent bladder and bowel related medical complications, leading to enhanced social participation and QOL. People who join this study will be randomized to either the usual care control group or the Health Mechanics intervention and will be followed for one year. The intervention group will receive self-management training via telephone, so that distance from UM Hospitals will not interfere with participation. The program focuses on enhancing skills, encouraging positive health behaviors and empowering people within their environments, recognizing that people have different resources and abilities.

Principle Investigator: Michelle Meade, Ph.D.

Recruitment: We expect to begin recruiting for this study in the spring.

Multi-Center Studies at the U-M SCI Model Systems beginning in 2012

Multi-Center Study 1: Evaluating the sensitivity and responsiveness of the SCI-QOL CATs

The SCI-QOL was developed during the past 5 years to measure patient reported outcomes across a 4 broad domains: physical activity; physical medical issues; emotional functioning; and social participation. These measures were tested in large samples of individuals with traumatic SCI. The SCI-QOL was developed so that measures could be given through Computer Adapted Testing (CAT). This study, involving 7 SCI Model Systems and led at the U-M, will evaluate the CAT's sensitivity to clinically meaningful changes over time as well as how scores on the CATs relate to those on existing measures and participants' perceptions of change. Participants will first be interviewed within a month of their initial hospital discharge following injury and again, 1 and 2 years later.

Principle Investigator: David Tulsky, Ph.D.

Recruitment: For additional information, contact the Study Coordinator, Siera Goodnight at 734-763-4485 or send an e-mail to: PMR-UMROAR@med.umich.edu.

Multi-Center Study 2: Enhancing and Evaluating the SCI-CAT

The SCI-CAT is a patient-reported tool to evaluate functional well-being. It was developed as a Model Systems multi-center study during the 2006-2011 grant cycle. It has 5 scales: Ambulation; Basic Mobility; Fine Motor Function; Self-Care; and Wheelchair Mobility. This study will modify the scales to more fully address the range of assistive technologies that people use. It will evaluate the modified SCI-CAT in comparison to the Functional Independence Measure (FIM), the current standard for functional assessment.

U-M Principle Investigator: David Tulsky, Ph.D.

Recruitment: For additional information, contact the Study Coordinator, Siera Goodnight at 734-763-4485 or send an e-mail to: PMR-UMROAR@med.umich.edu.

Pregnancy, Labor, Delivery, and Postpartum Outcomes of Women with and without Spinal Cord Injury: An Observational Study

This is a prospective study to determine the occurrence of defined outcomes and unexpected complications for women with spinal cord injury who become pregnant. Women with spinal cord injury who become pregnant will be identified and asked to be part of this observational study. For comparison, each woman will be matched with an able-body pregnant woman similar in age (+ 6 years), parity and race. No interventions are planned for these sensitive patient populations.

Principal Investigator: Amie B. Jackson, M.D., University of Alabama at Birmingham

Recruitment: Women with SCI with subsequent identification of a matched, able-body woman, who are 1-12 weeks pregnant, will be recruited through obstetrical and Physical Medicine and Rehab clinics at the participating centers from 2012 to 2015.  

Other SCI Research at the University of Michigan

SCI Research Registry

People with SCI who are interested in participating in clinical or survey research are welcome to join the SCI Research Registry. U-M Investigators conducting studies use the Registry to locate potential subjects. Any individual with a SCI is welcome to join the Registry. Access to the Registry is controlled to ensure safety and confidentiality.

Project Director: Claire Kalpakjian, Ph.D.

Recruitment: Send an e-mail to: spinalcordinjury@umich.edu or follow this link.

Prevalence and Correlates of Secondary Conditions following Spinal Cord Injury

While it is understood that there are a number of health conditions that occur commonly among people with SCI and others that while not directly related to SCI may occur more frequently in this population, the extent to which these occur and their impacts are not well understood. This study is evaluating the prevalence of conditions secondary to SCI and comorbidities, as well as their relationships to QOL and participation. A second sub-study is interviewing people who have had a SCI for an extended period. Through these interviews we will evaluate the relationships of health to functional independence, activity, stress, community engagement and QOL.

Principle Investigator: Denise Tate, Ph.D.

Funding Source: University of Michigan Injury Center Grant

Recruitment: If you are interested in participating or just learning more, contact Connie Pines at canewman@umich.edu

Evaluating the Effectiveness of Health Mechanics: A Self-Management Program for Individuals with Spinal Cord Injury

For individuals with SCI, secondary conditions can limit independence, decrease functioning and community integration, and lead to expensive treatments and hospitalizations. However, they can be prevented or minimized with appropriate management, including using specific health maintenance behaviors and strategies. Health Mechanics is a self-management program that teaches people with SCI skills that can help them to keep healthy and manage their lives. The basic skills that are taught in this program are: attitude, self-monitoring, problem-solving, communication, organization and stress management. This study will evaluate whether the Health Mechanics program improves self-regulatory skills and QOL, and reduces the number of secondary conditions.

Principle Investigator: Michelle Meade, Ph.D.

Funding Source: PVA Educational Foundation

Recruitment: If you are interested in participating or just learning more, contact the SCIMS office at 734-763-0971, or send an e-mail to: spinalcordinjury@umich.edu.

Addressing Self-Management Skills through Electronic Gaming: Meeting the Needs of Underserved Individuals with Spinal Cord Injury

This study is developing an electronic gaming application that will be both entertaining and help individuals with SCI to develop skills to better manage their health and participate more readily in their homes, health care and communities. Similar games (designed for other than pure entertainment) have been created for people with asthma and diabetes, and have been found to help improve self-care, reduce illness and decrease health care costs. Using the self-management program Health Mechanics as a conceptual base, researchers and programmers at the University of Michigan are creating a game for the iPod Touch that will appeal to younger males with SCI, including those who are from racial and ethnic minority populations.

Principle Investigator: Michelle Meade, Ph.D.

Funding: NIDRR

Recruitment: At the present time, we are looking for males, age 18-30 with SCI who have a good sense of humor and familiarity with video games to serve as members of the project's Advisory Board. Contact the SCIMS office at 734-763-0971, or send an e-mail to: spinalcordinjury@umich.edu.

Sleep Apnea and Spinal Cord Injury

This study will examine the benefits of using a home-based monitoring system to improve the diagnosis of sleep-disordered breathing in patients with SCI. Evaluations in a sleep lab are difficult for people with SCI because of poor accessibility and lack of ability to do usual night time care in a laboratory setting. We will study the incidence of sleep disordered breathing, study clinical features associated with this and determine the impact of treatment on health and QOL. It is expected that this method of evaluation will allow better management and improve the health of patients with SCI.

Principle Investigator: R. Sitron and K. Bauman.

Funding: Department of Defense

Improving Measurement of Patient-Reported Rehabilitation Outcomes

This multi-site study is testing a set of new outcome measures for use in research and clinical practice. We are accepting participants with spinal cord injuries, traumatic brain injuries, or who have experienced a stroke. This study will take 4-5 hours on each of two days.

Recruitment: For additional information contact Julie Grech at 734-763-3805 or send an e-mail to: PMR-UMROAR@med.umich.edu

Follow this link for previous research projects