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Past Research Projects 2006-2011

We are engaged in a number of studies involving people with spinal cord injuries. We are conducting two site-specific research projects and six multi-center studies as part of the Model Systems program. In addition, we are engaged in several other studies of people with spinal cord injuries. The National Institute on Disability and Rehabilitation Research (NIDRR) funds most of our studies.

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Site-specific Studies

Assessment of the Efficacy of Venlafaxine HCI as a Preventative Therapy for Depression and Pain Following New Spinal Cord Injury

We are studying the important issue of preventing major depression and treatment of mild to moderate symptoms of depression among people with spinal cord injury (SCI) using the antidepressant medication, Venlafaxine HCl (Effexor XR®). A secondary focus is to assess the impact of this medication on participants’ experience of pain. Despite widespread use of antidepressants, their effectiveness in treating people with SCI has not been formally evaluated. Since venlafaxine HCl has demonstrated effectiveness in treating both depression and pain in the population at large, we are examining the effect of this antidepressant on the experience of depression and pain in people with SCI. Participants in this study are people with SCI who have mild to moderate symptoms of depression. They are randomly placed into either a group that receives venlafaxine HCl or another that receives a placebo. Participants complete an interview that concerns their symptoms of depression and pain along with other aspects of their well-being at the beginning of the study, after the 13 week intervention, and again, 13 weeks after that.

More Information
Please contact the study coordinator, recruitment coordinator, Linton Cuff at 734-936-9334 or e-mail PMR-SCI-All@med.umich.edu find out more information or volunteer.

Psychosocial Symptoms and Pain in Inpatients with Spinal Cord Injury

This study is focusing on depression, anxiety and pain among people undergoing their initial inpatient rehabilitation for spinal cord injury, including both those with traumatic and non-traumatic etiologies. It has collected data on symptoms and treatments, including medications prescribed. It is examining the relationships among symptoms, treatments, and patient attributes.

Multi-center Studies

Controlled Trial of Venlafaxine XR for Depression after SCI

People living with SCI appear to have higher rates of Major Depressive Disorder (MDD) than are found in the general population. This study is evaluating whether the antidepressant venlafaxine XR (Effexor XR®) is an effective and well-tolerated treatment for MDD among people with SCI. This is a randomized clinical trial, with one group receiving venlafaxine XR and the other a placebo. The study has a three month intervention period. In addition to evaluating the effect of Effexor XR on participants’ levels of depression, the study is evaluating if there is an impact on their levels of pain, community participation and quality of life.  

More Information
For additional information about this study, please view our flyer or contact the recruitment coordinator, Linton Cuff at 734-936-93344 or e-mail us at PMR-SCI-All@med.umich.edu

Measuring Quality of Life in Spinal Cord Injury: The Next Generation of Instruments

This study’s primary goal is to develop and field-test a new measure of Health-Related Quality of Life (HRQoL) for use among people with SCI. This measure will focus on the physical/functional components of HRQoL. Currently, most measures that exist were developed for use among other populations, such as the able-bodied or those with cancer. They fail to address some issues that are important to HRQoL among people with SCI and address others inappropriately.
In the first phase of this study, a large pool of potential items was developed. They were selected from existing measures and through a series of focus groups that were held at the several participating sites during the study’s first year. In the study’s second phase, over 750 interviews were conducted, using this large pool of items. The results of these are currently be analyzed. The result will be a short but comprehensive measure.

The study’s third and final phase will involve testing this new measure through another series of interviews which we plan to start conducting in early 2011. Seven centers are participating in this study. It is being co-led by Dr. David Tulsky, here at the University of Michigan, and by researchers at the New England Regional Spinal Cord Injury Center Network in Boston.

More Information
For additional information about this study, please contact Study Coordinator, Jane Walters at 734-763-9773 or e-mail us at PMR-SCI-All@med.umich.edu

Identifying the Best Measure of Participation for Use among People with Spinal Cord Injuries

Participation was defined as “involvement in life situations” by the World Health Organization in its International Classification of Function, Disability, and Health. It is the primary outcome of disability at the social level. Numerous measures have been used to assess participation, varying in scope and perspective. Most have only included questions which can be answered in numeric terms, such as hours per week spent doing various activities. Several others focus on respondents’ opinions about the quality of their participation. A few adopt both numeric and subjective perspectives. This collaborative study, which conducted interviews with 635 subjects from seven Spinal Cord Injury Model Systems, is evaluating six participation measures. Researchers will also evaluate whether a new measure that is superior to the existing ones can be developed by selecting items from these six. 

Enrollment for this study is now closed.

The UAB Index of Motor Recovery: Validation of an Outcome Measure in SCI

The purpose of this study is to evaluate a muscle testing measurement tool, the UAB Index of Motor Recovery, to look for voluntary action of a lower extremity muscle groups following spinal cord injury. This tool was designed to document the presence and/or return of movement of a lower extremity muscle group. It is based on the presence of voluntary muscle contraction and not on muscle strength. Currently there is no established measure motor recovery for use in SCI. This would be valuable, both clinically and as a measure to be used in research on the effectiveness of treatments for SCI Recovery. Four Model Systems are participating in this study, which is evaluating people with both new and long-term SCI.

More Information
For additional information about this study, please contact the Study Coordinator, April Saval, at 734-615-6718

Development and Validation of the Thoracic-Lumbar Control Scale to Measure Strength and Coordination of Trunk Muscles

This project seeks to create an accurate, reliable tool for assessing thoracic (trunk) muscle strength and function after SCI. While medical teams have effective ways of evaluating arm and leg strength and function, the field lacks a measure for judging the condition of the thoracic spine. The thoracic spinal cord affects nerves and muscles in the trunk of the body, and is crucial to achieving and maintaining balance and stability. The Texas Model Spinal Cord Injury System leads this study which involves five SCI Model Systems.

More Information
For additional information about this study, please contact the study coordinator, April Saval, at 734-615-6718

The Natural History of Depression During the First Year After SCI

This study, focusing on depression, is examining the process of adaptation during the first year after onset of SCI. By gaining a better understanding of this process, we will be better able to assist people during this period of change. The study is gathering information from people with new injuries during inpatient rehabilitation and after discharge and includes both participants experiencing major depression and those who are not. The information collected concerns what people experience after SCI, the treatments they receive and how they view their health, both physically and emotionally. Three SCI Model Systems are participating in this study.

Other SCI Studies

Developing a Measure of Quality of Life for Individuals with Spinal Cord Injury

Quality of life (QOL) refers to a person’s well-being and ability to enjoy life activities. Although QOL instruments have been created specifically for people with cancer, AIDS and other conditions, none have been developed that focus on life with SCI. This study is developing such a measure. It will address physical, emotional and social well-being. The study is funded by the National Institutes of Health (NIH) and is led by Dr. David Tulsky. Five other centers have been collaborating on this study.

Initially, a large pool of questions was developed addressing each of these areas of well-being. These were gathered from other studies of QOL among people with disabilities, including the Patient-Reported Outcomes Measurement System (PROMIS) and the Neuro-QOL study, as well as from focus groups that were conducted at U-M and the other collaborating sites among people with SCI, caregivers and clinicians. Three questionnaires were developed and almost two thousand interviews have been conducted across the six study sites using computer adaptive testing.

More Information
For additional information about this study, please contact the study coordinator, Jane Walters at 734-763-9773 or e-mail us at PMR-SCI-All@med.umich.edu

Self-Management of Spinal Cord Injury and Disease

People with SCI are at risk of developing many possible health conditions related to their disability. Education is not enough to enable a person with SCI to follow a regimen that will help prevent complications including pressure sores, obesity, diabetes, and depression. The goal of this study is to develop a health management program that will prevent secondary conditions and improve health and quality of life for people with SCI. Two training packages will be developed: one for individuals with SCI and one for health care providers. By educating both groups in the expectations and skills associated with self-management, this project aims to facilitate better collaboration.   

Psychological and Physiological Aspects of Menopause in Women with Spinal Cord Injury

Little is known about menopause for women with SCI and how having a disability alters this life experience. The Menopause and SCI project examines the emotional, psychological, and physical changes that midlife and menopause can bring. Participants are surveyed about their levels of stress, depression, physical symptoms, and life events over the course of three years. This research will help determine how gender, SCI, and other factors affect the midlife years.

More Information
For additional information about this study, please contact, Mary Burton at 734-764-1454.

Menopause in Women with Spinal Cord Injury: A Pilot Study of Elevated Health Risks

This related study, funded by the National Institutes of Health is investigating physical changes during menopause, specifically related to bone loss and risks for heart disease and diabetes among women with SCI. Able-bodied women and men with SCI serve as control groups for this study. To learn more about this research project, please e-mail menopausesci@med.umich.edu.

More Information
For additional information about this study, please contact, Mary Burton at 734-764-1454.

Pathways to Depression: An Examination of Vulnerability and Stress in Adults with Spinal Cord Injury

Depression after spinal cord injury (SCI) is common. Depression occurs at higher rates among people with SCI than those without. Depression can limit independence, increase the risk of suicide and lead to poorer health overall. This study will research key factors that may cause some people to be more vulnerable to depression, both psychologically and physiologically, after an SCI. Such vulnerability factors (exposure to childhood adversity, one’s psychological background, substance abuse, genetic predisposition and gender) may sensitize individuals to stressful events, increasing their risk of depression in later life.  

We will attempt to broaden our insight into why some individuals are able to thrive after injury and others not. Also, the project seeks to understand why injury factors do not necessarily predict who will become depressed. A better understanding of the influences that incline some individuals towards depression can enable health providers to intervene and reduce the occurrence of depression and related difficulties.


Past Model System Projects (2000-2005)

The U-M Spinal Cord Injury Model System has five site-specific research projects and one that is being conducted in collaboration with other U.S. Model Systems.

Site-specific Projects

Collaborative Projects