Kessler Foundation Inc

INTER-SYSTEM CLOSED-LOOP CONTROL OF LOCOMOTOR AND BLADDER FUNCTION IN INDIVIDUALS WITH ACUTE SPINAL CORD INJURY

INVESTIGATING THE UTILIZATION EFFECTS OF POWERED WEARABLE ORTHOTICS IN IMPROVING UPPER EXTREMITY FUNCTION AND ADL IN PERSONS WITH SCI.

THE CONTEXT OF LIVING WITH SPINAL CORD INJURY: A PROGRAM OF COLLABORATIVE RESEARCH ADVANCING THE SCIENCE OF ENVIRONMENTAL FACTORS AND DISABILITY - THE CONDITIONS IN THE PLACES WHERE PEOPLE LIVE, WORK, AND SOCIALIZE HAVE A POWERFUL EFFECT ON HEALTH. FOR PEOPLE WITH SPINAL CORD INJURY (SCI), COMMUNITY CONDITIONS CAN AFFECT EMPLOYMENT OPPORTUNITIES, HEALTHCARE ACCESS, AND INDEPENDENT LIVING. UNFORTUNATELY, MANY COMMUNITY PLACES REMAIN INACCESSIBLE, PLACING PEOPLE WITH SCI AT RISK FOR POOR OUTCOMES. THE GOAL OF THIS FIVE-YEAR MULTISITE COLLABORATIVE PROJECT IS TO BUILD THE RESEARCH INFRASTRUCTURE NEEDED TO GENERATE ACTIONABLE INFORMATION ABOUT HOW COMMUNITIES LIVE SHAPE DISABILITY. THIS INFORMATION WILL INFORM ONGOING POLICY EFFORTS TO MAINTAIN THE HARD-FOUGHT GAINS FOR SOCIAL INCLUSION FOR PEOPLE WITH DISABILITIES. THE OBJECTIVES ARE: 1) TO IMPROVE THE CAPACITY OF THE NATIONAL SCI MODEL SYSTEMS (SCIMS) DATABASE TO CONDUCT ONGOING RESEARCH IN GEOGRAPHIC DISPARITIES IN OUTCOMES (THE SCIMS-CDF); 2) TO GENERATE ROBUST ESTIMATES OF GEOGRAPHIC, RACIAL/ETHNIC, AND RURAL-URBAN HEALTH DISPARITIES; AND 3) TO IDENTIFY THE PROCESSES THAT SHAPE HEALTH DISPARITIES BY ENGAGING WITH PEOPLE WITH SCI AS THEY NAVIGATE COMMUNITY PLACES USING SMARTPHONES AND WEARABLE TECHNOLOGY. ANTICIPATED OUTCOMES INCLUDE: 1) A DATABASE RESOURCE THAT WILL IMPROVE THE SURVEILLANCE OF THE NEEDS OF THE SCI POPULATION CONDUCTED BY THE SCIMS PROGRAM; AND 2) NEW KNOWLEDGE ABOUT PATTERNS OF DISPARITIES AND THE ROLE OF ENVIRONMENTAL FACTORS. PRODUCTS OF THIS RESEARCH WILL INCLUDE THE SCIMS-CDF DATABASE. THE UTILIZATION OF THE SCIMS-CDF WILL PRODUCE NEW KNOWLEDGE ABOUT PATTERNS OF DISPARITIES AFTER SCI. COMBINED WITH THE INFORMATION GAINED DIRECTLY FROM CONSUMERS ABOUT ENVIRONMENTAL BARRIERS ENCOUNTERED IN DAILY LIFE, THIS INFORMATION WILL HELP REHABILITATION PROFESSIONALS AND POLICY MAKERS DETERMINE WHERE TO TARGET RESOURCES TO IMPROVE THE LIVES OF PEOPLE WITH SCI: TOWARDS DISADVANTAGED GROUPS, DISADVANTAGED COMMUNITIES, OR BOTH.

FUNCTIONAL AND NEUROPHYSIOLOGICAL EFFECTS OF A PROGRESSIVE ROBOT ASSISTED GAIT INTERVENTION EARLY POST STROKE

IMPROVING BALANCE IN TBI USING A LOW-COST CUSTOMIZED VIRTUAL REALITY REHABILITATION TOOL

TEACHING SELF-MANAGEMENT SKILLS TO IMPROVE SELF-EFFICACY AND QUALITY OF LIFE FOR CAREGIVER DYADS IN TBI AND DEMENTIA POPULATIONS

NATIONAL INSTITUTE ON DISABILITY AND REHABILITATION RESEARCH - SPINAL CORD INJURY MODEL DEMONSTRATIONS

PERSONALIZED COGNITIVE INTEGRATED MOTOR TRAINING USING VIRTUAL REALITY TO IMPROVE GAIT AND BALANCE

TRANSCUTANEOUS SPINAL STIMULATION AND GAIT TRAINING TO IMPROVE MOBILITY AND MOTOR CONTROL IN INDIVIDUALS WITH TRAUMATIC BRAIN INJURY

USE OF THE KF MODIFIED STORY MEMORY TECHNIQUE TO IMPROVE NEW LEARNING AND MEMORY IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT - PROJECT SUMMARY PREVALENCE RATES FOR MILD COGNITIVE IMPAIRMENT (MCI) RANGE FROM 7-25% FOR ADULTS OVER THE AGE OF 60, WITH RISK INCREASING WITH AGE. IMPAIRMENTS IN NEW LEARNING AND MEMORY (LM) ARE COMMON IN PERSONS WITH MCI AND NEGATIVELY IMPACT SEVERAL ASPECTS OF EVERYDAY LIFE, INCLUDING INDEPENDENCE IN DAILY ACTIVITIES AND SOCIAL FUNCTIONING. DESPITE THE DEMAND FOR LM TREATMENTS BY OLDER ADULTS AND CLINICIANS ALIKE, FEW COGNITIVE REHABILITATION (CR) PROTOCOLS TO DATE ARE SUPPORTED BY CLASS I RESEARCH EVIDENCE, THEREBY LIMITING THE DEGREE TO WHICH POTENTIALLY EFFICACIOUS TREATMENTS CAN BE APPLIED TO INDIVIDUALS WITH MCI. THE KESSLER FOUNDATION MODIFIED STORY MEMORY TECHNIQUE (KF-MSMTTM) IS A MANUALIZED, 10-SESSION CR PROTOCOL DESIGNED TO TREAT IMPAIRED LM. OVER A DECADE OF RESEARCH AND DEVELOPMENT CONDUCTED AT OUR CENTER HAS DEMONSTRATED THE KF-MSMT TO BE EFFECTIVE FOR IMPROVING LM IN INDIVIDUALS WITH NEUROLOGICAL CONDITIONS (E.G., MS, TBI), ACROSS THREE REALMS OF FUNCTIONING (OBJECTIVE BEHAVIOR, NEURAL FUNCTIONING, AND EVERYDAY LIFE) WITH IMPROVEMENTS MAINTAINED OVER TIME. THIS CONVINCING DATA PROVIDES CLASS I EVIDENCE SUPPORTING THE EFFICACY OF THE KF-MSMT FOR IMPROVING LM IN THESE POPULATIONS. IN ADDITION, WE HAVE ACCUMULATED STRONG PILOT DATA ON THE EFFICACY OF THE KF-MSMT IN INDIVIDUALS WITH MCI, HIGHLIGHTING THE LIKELY SUCCESSFUL APPLICATION OF THE KF-MSMT TO INDIVIDUALS WITH MCI. WE WILL CONDUCT A MULTI-SITE, DOUBLE-BLIND, PLACEBO-CONTROLLED RANDOMIZED CLINICAL TRIAL (RCT), ADMINISTERING THE KF-MSMT TO 120 PARTICIPANTS WHO MEET CRITERIA FOR MCI. OUTCOME WILL BE ASSESSED IMMEDIATELY FOLLOWING TREATMENT, 6 MONTHS FOLLOWING TREATMENT AS WELL AS 18 MONTHS FOLLOWING TREATMENT TO EXAMINE THE LONG-TERM IMPACT. OUTCOME WILL BE MEASURED VIA 3 MECHANISMS: (1) NEUROPSYCHOLOGICAL EVALUATION (NPE) TO EXAMINE POST-TREATMENT CHANGES ON OBJECTIVE COGNITIVE PERFORMANCE (2) ASSESSMENT OF GLOBAL FUNCTIONING (AGF) TO EXAMINE POST-TREATMENT CHANGES IN COGNITION IN DAILY LIFE AND (3) FUNCTIONAL MAGNETIC RESONANCE IMAGING (FMRI) TO EXAMINE PRE TO POST-TREATMENT CHANGES IN PATTERNS OF CEREBRAL ACTIVATION UNDERLYING LM PERFORMANCE. THE EXAMINATION OF DAILY LIFE ACTIVITIES AS AN A PRIORI ENDPOINT IN THIS RCT IS A HIGHLY INNOVATIVE ASPECT OF THE PROPOSED WORK, HIGHLIGHTED AS A SIGNIFICANT GAP IN THE REHABILITATION LITERATURE BY MANY EXPERTS IN CR. IMPORTANTLY, THE RIGOROUS RESEARCH DESIGN EMPLOYED IN THE CURRENT STUDY IS HIGHLY RESPONSIVE TO THE OBJECTIVES SET FORTH BY THE NIA IN THEIR STRATEGIC DIRECTIONS (P.14), TO “DETERMINE HOW INDIVIDUALS CAN MAINTAIN FUNCTION WITH AGE OR REGAIN THAT FUNCTION AFTER LOSS DUE TO IMMOBILITY, ILLNESS, OR TRAUMA”, WHILE ALSO DESIGNED TO IDENTIFY THE “MECHANISM THROUGH WHICH COMMON INTERVENTIONS, BOTH MEDICAL AND BEHAVIORAL, MAY SLOW THE PHYSICAL AND COGNITIVE DECLINE.”

NORTHERN NEW JERSEY SPINAL CORD INJURY SYSTEM: 2021-2026

DISABILITY AND REHABILITATION RESEARCH PROJECTS

NORTHERN NEW JERSEY TRAUMATIC BRAIN INJURY SYSTEM (NNJTBIS)

NORTHERN NEW JERSEY SPINAL CORD INJURY SYSTEM: 2016-2021

TESTOSTERONE COMBINED WITH ELECTRICAL STIMULATION AND STANDING: EFFECT ON MUSCLE AND BONE

NEUROPHYSIOLOGICAL EVALUATION OF TRAINING EFFECT ON CANCER-RELATED WEAKNESS

TREADMILL WALKING EXERCISE TRAINING EFFECTS ON COGNITION AND BRAIN FUNCTION IN MULTIPLE SCLEROSIS: A SYSTEMATICALLY-DEVELOPED RANDOMIZED CONTROLLED TRIAL

MRI MARKERS OF FEEDBACK TIMING DURING LEARNING IN INDIVIDUALS WITH TBI WITH AND WITHOUT CLINICAL DEPRESSION - PROJECT SUMMARY/ABSTRACT THE OVERALL OBJECTIVE OF THE PROPOSED PROJECT IS TO INVESTIGATE BRAIN MECHANISMS DURING LEARNING IN INDIVIDUALS WITH TRAUMATIC BRAIN INJURY (TBI) WITH AND WITHOUT CLINICAL DEPRESSION. SUCH KNOWLEDGE CAN HELP GUIDE REHABILITA- TION STRATEGIES AND REDUCE THE BURDEN OF TBI. FEEDBACK ABOUT THE ACCURACY OF ONE’S ACTIONS CAN IMPROVE LEARN- ING BY INFORMING INDIVIDUALS WHETHER THEIR ACTION IS CORRECT OR NOT. INDIVIDUALS WITH DEPRESSION HAVE BEEN SHOWN TO HAVE LEARNING DEFICITS AND ALTERED BRAIN ACTIVITY DURING LEARNING COMPARED TO HEALTHY INDIVIDUALS WHEN FEED- BACK IS PRESENTED IMMEDIATELY. IMPAIRED LEARNING THROUGH IMMEDIATE FEEDBACK HAS ALSO BEEN OBSERVED IN PAR- KINSON’S DISEASE (PD) PATIENTS. HOWEVER, PD PATIENTS ARE ABLE TO LEARN FROM FEEDBACK WHEN IT IS PRESENTED AF- TER A DELAY THROUGH ENGAGEMENT OF SEPARATE NEURAL MECHANISMS. WE SHOW THAT INDIVIDUALS WITH TBI EXHIBIT DEF- ICITS IN LEARNING THROUGH IMMEDIATE FEEDBACK THAT ARE LIKELY EXACERBATED BY DEPRESSIVE SYMPTOMS. DEFICITS IN LEARNING THROUGH IMMEDIATE FEEDBACK CAN LEAD TO PERSEVERATION OF INCORRECT ACTIONS AND DECREASED STRATEGY USE DURING REHABILITATION. HOWEVER, THERE IS NO EVIDENCE DIRECTLY EXAMINING THE NEURAL MECHANISMS OF LEARNING IN INDIVIDUALS WITH TBI WITH AND WITHOUT DEPRESSION. THE PROPOSED RESEARCH FILLS THIS GAP. THE IDENTIFICATION OF THE NEURAL MECHANISMS ASSOCIATED WITH LEARNING IN INDIVIDUALS WITH TBI WITH AND WITHOUT CLINICAL DEPRESSION WILL INFORM 1) SCIENTIFIC KNOWLEDGE ABOUT THE EFFECT OF DEPRESSION ON THE INJURED BRAIN, 2) TBI INTERVENTIONS ABOUT THE EFFECTIVENESS OF FEEDBACK AND ITS TIMING, AND 3) THE DEVELOPMENT OF GENERALIZED INTERVENTIONS FOR OTHER CLINICAL POPULATIONS THAT REQUIRE REHABILITATION AND HAVE HIGH OCCURRENCE OF DEPRESSION. THESE OBJECTIVES LIE AT THE HEART OF THE MISSION OF THE NINDS AS THEY WILL BROADEN “FUNDAMENTAL KNOWLEDGE ABOUT THE BRAIN AND NERVOUS SYSTEM” ASSOCIATED WITH LEARNING IN TBI. THE KNOWLEDGE GAINED FROM FULFILLING THE ABOVE OBJECTIVES WILL “REDUCE THE BURDEN” OF LEARNING DEFICITS AFTER TBI. TO TEST OUR HYPOTHESES, TBI PARTICIPANTS WILL BE RECRUITED BASED ON STRUCTURED CLINICAL INTERVIEW. QUALIFIED PARTICIPANTS WILL PERFORM AN EXPERIMENT WHERE THEY STUDY WORD PAIRS OUT- SIDE OF THE FUNCTIONAL MAGNETIC RESONANCE IMAGING (MRI) SCANNER. THEN, IN THE MRI, PARTICIPANTS WILL SEE WORD PAIRS IN MULTIPLE-CHOICE FORMAT, ALONG WITH NOVEL DISTRACTORS, AND SELECT THE CORRECT PAIRED-ASSOCIATE. AFTER EACH CHOICE, FEEDBACK WILL BE EXPERIMENTALLY MANIPULATED TO BE PRESENTED EITHER IMMEDIATELY OR AFTER A 25-MINUTE DELAY. DURING THE FINAL PHASE OUTSIDE OF THE MRI, PARTICIPANTS COMPLETE A SECOND DIAGNOSTIC PAIRED-ASSOCIATE MULTIPLE-CHOICE ASSESSMENT TO EVALUATE THE INFLUENCE OF IMMEDIATE VS. DELAYED FEEDBACK ON LEARNING. WE HY- POTHESIZE THAT DEPRESSED INDIVIDUALS WITH TBI WILL SHOW IMPROVEMENTS IN LEARNING FROM DELAYED COMPARED TO IMMEDIATE FEEDBACK. THIS LEARNING DISSOCIATION WILL OCCUR BECAUSE LEARNING THROUGH DELAYED FEEDBACK RELIES ON NEUROCIRCUITRY THAT IS NOT NEGATIVELY AFFECTED BY TBI AND DEPRESSION. NON-DEPRESSED INDIVIDUALS WITHOUT TBI AND CLINICALLY DEPRESSED INDIVIDUALS WITHOUT TBI WILL ALSO BE RECRUITED TO DIFFERENTIATE THE INFLUENCES OF DEPRES- SION FROM THE IMPACT OF TBI ON THE BRAIN.

RERC ON ADVANCING REHABILITATION TECHNOLOGIES FOR AMBULATION

EVALUATION OF A THEORY-DRIVEN MANUALIZED APPROACH TO IMPROVING NEW LEARNING AND MEMORY IN MS

NORTHERN NEW JERSEY TRAUMATIC BRAIN INJURY MODEL SYSTEM - NORTHERN NEW JERSEY TRAUMATIC BRAIN INJURY SYSTEM (NNJTBIS) THE NNJTBIS, A CURRENT NIDILRR TBI MODEL SYSTEM CENTER, PRESENTS AN INNOVATIVE PROPOSAL TO CONTINUE THAT DISTINCTION. THE NNJTBIS INCLUDES A PREMIER REHABILITATION RESEARCH FACILITY, KESSLER FOUNDATION (KF), TOP-RANKED INPATIENT REHABILITATION HOSPITAL (KESSLER INSTITUTE FOR REHABILITATION) AND 4 TRAUMA CENTERS, WITH THE GOAL OF IMPROVING THE QUALITY OF LIFE OF INDIVIDUALS WITH TBI. NNJTBIS OBJECTIVES AND ANTICIPATED OUTCOMES ARE MULTIFACETED. (1) WE WILL ENROLL AT LEAST 35 PARTICIPANTS PER YEAR INTO THE NATIONAL DATABASE, FOLLOWING PARTICIPANTS 1-, 2- AND 5-YEARS POST-INJURY AND BEYOND, MEETING OR EXCEEDING ESTABLISHED BENCHMARKS. (2) WE WILL CONDUCT AN INNOVATIVE SITE-SPECIFIC RANDOMIZED CLINICAL TRIAL EVALUATING THE EFFECTS OF A COMBINATION OF AN OPTIMIZED VERSION OF THE KF MODIFIED STORY MEMORY TECHNIQUE (KF-MSMTTM) AND AEROBIC CYCLING EXERCISE TRAINING TO MAXIMIZE IMPROVEMENTS IN NEW LEARNING AND MEMORY ABILITIES, ELUCIDATING ITS NEURAL UNDERPINNINGS, AND IMPROVING EVERYDAY LIFE IN PERSONS WITH MODERATE-TO-SEVERE TBI. (3) THE NNJTBIS WILL COLLABORATE ON AT LEAST 2 MODULAR STUDIES AND PROPOSES A COLLABORATIVE MODULAR PROJECT UTILIZING A MIXED METHODS APPROACH TO MOVE BEYOND IDENTIFYING THE EXISTENCE OF HEALTH DISPARITIES IN TBI REHABILITATION BY EXAMINING THE WAYS IN WHICH THE SOCIAL DETERMINANTS OF HEALTH ARE ASSOCIATED WITH THE PERSISTENCE OF THOSE DISPARITIES. EXPECTED PRODUCTS WILL INCLUDE BROAD DISSEMINATION OF RESULTS VIA OUR WEBSITE (WWW.KESSLERFOUNDATION.ORG), SOCIAL MEDIA, CONSUMER AND PROFESSIONAL PUBLICATIONS, PRESENTATIONS AND MORE. WE WILL COORDINATE WITH THE NIDILRR-FUNDED MODEL SYSTEMS KNOWLEDGE TRANSLATION CENTER FOR COLLABORATIVE, STREAMLINED, AND FAR-REACHING DISSEMINATION. OUR TBI CONSUMER PARTICIPATION WILL CONTINUE TO BE QUINTESSENTIAL TO THE SUCCESS OF THE NNJTBIS AND OUR DIVERSITY, EQUITY AND INCLUSION COMMITTEE WILL ENSURE MAXIMAL DIVERSITY WITHIN RESEARCH AND DISSEMINATION ACTIVITIES.

REHABILITATION RESEARCH AND TRAINING CENTERS

BUILDING A SCIENCE FOR TREATMENT OF SPATIAL NEGLECT

REHABILITATION RESEARCH AND TRAINING CENTERS

IMPROVING READING COMPETENCE IN APHASIA WITH COMBINED AEROBIC EXERCISE AND PHONO-MOTOR TREATMENT - CLOSE TO 2.5 MILLION AMERICANS ARE CURRENTLY LIVING WITH POST-STROKE APHASIA, A DEBILITATING COMMUNICATION DISORDER AFFECTING MULTIPLE LANGUAGE MODALITIES. MOST STROKE SURVIVORS WITH APHASIA HAVE ACQUIRED READING DEFICITS, WHICH PERSIST CHRONICALLY AND SEVERELY LIMIT LIFE PARTICIPATION AND AUTONOMY. THERE IS AN URGENT NEED FOR EFFECTIVE TREATMENTS GROUNDED IN STROKE NEUROBIOLOGY WHICH YIELD ROBUST FUNCTIONAL IMPROVEMENTS. TREATMENTS TARGETING IMPAIRED READING PROCESSES AND AIMED AT RESTORING CEREBRAL BLOOD FLOW (CBF) CAN MEET THIS NEED BY DIRECTLY REMEDIATING DYSFUNCTIONAL BRAIN MECHANISMS. IN THE PROPOSED R01 WE WILL COMBINE AEROBIC EXERCISE TRAINING (AET) WITH AN INTENSIVE PHONO-MOTOR READING TREATMENT (PMT). OUR CENTRAL HYPOTHESIS IS THAT A SINGLE BOUT OF AEROBIC EXERCISE WILL INCREASE CBF AND OXYGENATION, AND IF DELIVERED BEFORE A PMT SESSION, WILL FACILITATE TREATMENT-INDUCED NEUROPLASTICITY, STRENGTHENING DAMAGED PHONOLOGICAL NETWORKS AND LEADING TO ROBUST FUNCTIONAL IMPROVEMENTS OVER TIME. WE AND OTHERS FOUND THAT REDUCED CBF IN PARTS OF THE LEFT HEMISPHERE OUTSIDE THE STROKE LESION PERSISTS FOR WEEKS TO MONTHS AFTER A STROKE AND PREDICTS MORE SEVERE LANGUAGE DEFICITS AND WORSE RECOVERY. PHONOLOGICAL PROCESSING, OR THE ABILITY TO DERIVE SOUND STRUCTURE OF WORDS, CRITICAL TO SO MANY LANGUAGE MODALITIES, IS CONSISTENTLY IMPAIRED IN LEFT-HEMISPHERE STROKE SURVIVORS WITH APHASIA AND REDING DEFICITS. WE EXPECT THAT THE PROPOSED TREATMENT TARGETING BOTH THE IMPAIRED CBF, AND PHONOLOGICAL DEFICITS WILL MARKEDLY INCREASE TREATMENT EFFECTIVENESS AND ENHANCE GENERALIZATION TO UNTRAINED LANGUAGE MODALITIES. WE WILL TEST OUR CENTRAL HYPOTHESIS BY PURSUING THREE SPECIFIC AIMS. UNDER AIM 1, WE WILL DETERMINE IF COMBINED AET AND PMT IMPROVE LANGUAGE OUTCOMES BY CARRYING OUT A RANDOMIZED CONTROLLED TRIAL IN 70 INDIVIDUALS WITH CHRONIC LEFT- HEMISPHERE STROKE. PARTICIPANTS WILL COMPLETE EITHER 20 MINUTES OF MODERATE AEROBIC EXERCISE OR LIGHT STRETCHING PRIOR TO EACH SESSION OF INTENSIVE PMT. WE EXPECT THAT WHILE BOTH GROUPS SHOULD IMPROVE, THE AET GROUP WILL SHOW MORE ROBUST LANGUAGE IMPROVEMENTS AFTER 40 SESSIONS OF COMBINED AET+PMT. UNDER AIMS 2-3, WE WILL STUDY BOTH THE IMMEDIATE AND SUSTAINED IMPACT OF AET AND PMT ON BRAIN FUNCTION USING 3 MRI SCANS, ADMINISTERED BEFORE THE INTERVENTION, AFTER THE INITIAL AEROBIC EXERCISE SESSION, AND AFTER THE FULL COURSE OF AET + PMT TREATMENT. WE EXPECT THAT AEROBIC EXERCISE WILL HAVE AN IMMEDIATE POSITIVE IMPACT ON CBF AND RESTING STATE FUNCTIONAL CONNECTIVITY, AS WELL AS INDUCE A SUSTAINED IMPROVEMENT IN THESE MEASURES AND IN TASK-RELATED BRAIN ACTIVITY COMPARED TO THE PRE-INTERVENTION BASELINE. WHILE EACH OF THESE INTERVENTIONS IN ISOLATION HAS SHOWN POSITIVE IMPACT ON STROKE RECOVERY, THE PROPOSED PROJECT WILL TEST IF AET PROMOTES ACQUISITION AND RETENTION OF THERAPY SKILLS WHEN ADJUVANT TO PMT. THIS HAS THE POTENTIAL TO RADICALLY CHANGE HOW THESE TREATMENTS ARE APPLIED, INCREASING THEIR EFFECTIVENESS, AND ULTIMATELY IMPROVING THE LIVES OF 2.5 MILLION AMERICANS LIVING WITH STROKE- RELATED APHASIA. IN ADDITION, IT IS LIKELY THAT THE RESULTS WILL CONTRIBUTE TO THE UNDERSTANDING OF STROKE RECOVERY MECHANISMS THEREBY FUNDAMENTALLY ADVANCING THE FIELD OF NEUROREHABILITATION.

DISABILITY AND REHABILITATION RESEARCH PROGRAM (DRRP)

SPINAL CORD INJURY MODEL DEMONSTRATIONS

REHABILITATION RESEARCH AND TRAINING CENTERS

NORTHERN NEW JERSEY SPINAL CORD INJURY MODEL SYSTEM

IMPROVING LEARNING IN MS: A RANDOMIZED CLINICAL TRIAL

PURPOSE: THE PURPOSE OF THIS $963,000 PROJECT IS TO UPGRADE THE RESEARCH DEDICATED MAGNETIC RESONANCE IMAGING (MRI) SCANNER HOUSED AT THE ROCCO ORTENZIO NEUROIMAGING CENTER (RONIC) AT KESSLER FOUNDATION. ACTIVITIES TO BE PERFORMED: THE CURRENT MRI SCANNER, A 3 TESLA, SIEMENS SKYRA MAGNETOM, WILL BE UPGRADED TO THE LATEST SIEMENS ?VIDA FIT? PRODUCT LINE. SPECIFIC UPGRADES INCLUDE NEW HARDWARE, THE BIOMATRIX SENSOR INTEGRATED SURFACE COILS, AS WELL AS THE NEWEST MRI SEQUENCES AND CONTROL SOFTWARE. THE ONLY ELEMENT OF THE CURRENT MRI SCANNER THAT WILL NOT BE UPGRADED IS THE CORE ELECTROMAGNET, EVERYTHING ELSE WILL BE REMOVED AND REPLACED WITH THE NEWEST VERSION. THE INSTALLATION WILL REQUIRE NEW RIGGING (E.G. WIRE HARNESSES, PIPES FOR CRYOGENS) TO BE INSTALLED, NEW CRYOGENS TO COOL THE SUPER CONDUCTING ELEMENTS OF THE MAGNET?S CORE TO 4 DEGREES KELVIN, A DIMPLEX CHILLER TO COOL THE CRYOGENS TO THE NECESSARY TEMPERATURE, AND FINALLY UPGRADES TO THE HOST COMPUTERS TO PROVIDE THE NECESSARY COMPUTING POWER TO FULLY SUPPORT THE UPGRADES TO THE SCANNER. THE UPGRADES WILL BE DONE BY SIEMENS (UNDER CONTRACT) AND SUPERVISED BY DR. GLENN WYLIE, DIRECTOR OF THE RONIC. EXPECTED OUTCOMES: THE UPGRADE TO THE MRI IS ANTICIPATED TO LEAD TO BETTER DATA QUALITY AND HIGHER WORKING EFFICIENCY FOR THE RESEARCHERS AT KESSLER FOUNDATION. IMPROVEMENTS ARE EXPECTED FOR STRUCTURAL T1 IMAGES, STRUCTURAL T2 IMAGES, PROTON DENSITY IMAGES, DIFFUSION WEIGHTED IMAGES, AND ECHO-PLANAR IMAGES. INTENDED BENEFICIARIES: THE UPGRADES WILL BENEFIT THE RESEARCH COMMUNITY OF NORTHERN NEW JERSEY THAT RELIES ON THE NEUROIMAGING CENTER AT KESSLER FOUNDATION, WHICH INCLUDES RUTGERS UNIVERSITY, NEW JERSEY INSTITUTE OF TECHNOLOGY, THE EAST ORANGE VA HOSPITAL, AND MONTCLAIR STATE UNIVERSITY AMONG OTHER. THE UNIQUE NATURE OF THIS UPGRADED MACHINE WILL ADDRESS ISSUES AFFLICTING THE DISABILITY COMMUNITY SO THAT SUCH DATA CAN BE MORE EASILY AND COMPLETELY GENERATED. THIS WILL ALLOW RESEARCHERS AT KESSLER FOUNDATION AND THE BROADER NORTHERN NEW JERSEY RESEARCH COMMUNITY TO CONTINUE TO CREATE EFFECTIVE INTERVENTIONS FOR PERSONS WITH DISABILITIES. SUBRECIPIENT ACTIVITIES: THE RECIPIENT DOES NOT INTEND TO SUBAWARD FUNDS.

RANDOMIZED CONTROLLED TRIAL OF THE GROUP-BASED MODIFIED STORY MEMORY TECHNIQUE IN TBI

NEUROBALANCE: NEUROMODULATION ENHANCED USE OF ROBOTIC BALANCE TRAINING TO IMPROVE POSTURAL CONTROL IN TBI

MENTORING TRANSLATIONAL COGNITIVE SCIENCE FOR STROKE RECOVERY

COMMUNITY EFFECTS ON LONG-TERM REHABILITATION OUTCOMES IN SCI

REHABILITATION OF READING DEFICITS IN SUBACUTE STROKE USING FMRI NEUROFEEDBACK AND MOTOR IMAGERY - STROKE IS THE LEADING CAUSE OF LONG-TERM DISABILITY IN THE US AND WORLDWIDE. UNILATERAL STROKE OF THE LEFT- HEMISPHERE CAUSES READING AND LANGUAGE DEFICITS IN 21-58% OF STROKE SURVIVORS AND THESE DEFICITS PERSIST CHRONICALLY, DESPITE PARTICIPATION IN THERAPY. THE MAJORITY OF THE AVAILABLE READING TREATMENTS SHOW THE CLEAREST BENEFITS ON TRAINED MATERIALS. THEREFORE, THERE IS AN URGENT NEED FOR NEW TREATMENT STRATEGIES THAT CAN GENERALIZE OUTSIDE OF THE TREATMENT CONTEXT. BIOLOGICALLY-BASED INTERVENTIONS CAN MEET THIS CHALLENGE BY DIRECTLY INFLUENCING BENEFICIAL POST-STROKE PLASTICITY. FOR EXAMPLE, REAL-TIME FUNCTIONAL MAGNETIC RESONANCE IMAGING NEUROFEEDBACK (FMRI NFB) IS AN INNOVATIVE APPROACH ALLOWING PARTICIPANTS TO REGULATE THEIR OWN BRAIN ACTIVITY. IT USES A COMBINATION OF MENTAL STRATEGIES AND CONCURRENT BRAIN ACTIVITY FEEDBACK. STUDIES HAVE SHOWN THAT REPEATED EFFORTS TO SELF-REGULATE BRAIN ACTIVITY LEAD TO LEARNING-INDUCED NEURAL CHANGES. PRELIMINARY EVIDENCE ALSO SUGGESTS THAT REAL-TIME FMRI NFB CAN IMPROVE POST-STROKE MOTOR AND COGNITIVE FUNCTION. THE MAIN GOAL OF THE PRESENT PROPOSAL IS TO BUILD ON THIS SUCCESS AND TO ADVANCE BIOLOGICALLY-INSPIRED INTERVENTIONS FOR READING. STRONG PRELIMINARY DATA SHOW THAT REDUCED RECRUITMENT OF THE INTACT LEFT-HEMISPHERE READING AREAS IS ASSOCIATED WITH SUBOPTIMAL READING OUTCOMES AFTER STROKE. IN ADDITION, PILOT DATA SUGGEST THAT RIGHT HAND FINGER TAP IMAGERY CAN EFFECTIVELY ACTIVATE THE LEFT INFERIOR PARIETAL REGION THOUGHT TO SUPPORT BINDING OF VISUAL ORTHOGRAPHIC INFORMATION WITH SOUND REPRESENTATIONS DURING READING. GIVEN THAT DIFFICULTY WITH ORTHOGRAPHY- PHONOLOGY CONVERSION IS THE MOST COMMON DEFICIT AMONG LEFT-HEMISPHERE STROKE SURVIVORS, THE CURRENT PROJECT PROPOSES TO USE RIGHT HAND FINGER TAP IMAGERY IN COMBINATION WITH FMRI NFB TO HELP RE-INSTATE LEFT INFERIOR PARIETAL ACTIVITY DURING READING. IT IS HYPOTHESIZED THAT EFFORTS TO INCREASE READING-RELATED BRAIN ACTIVATION IN THE LEFT-HEMISPHERE WILL RE-ENGAGE THE IMPAIRED READING MECHANISMS AND MAY ALLEVIATE READING DEFICITS. UNDER THIS K01 AWARD, THE APPLICANT WILL DEVELOP SKILLS NECESSARY TO TEST THIS HYPOTHESIS, NAMELY IN CARRYING OUT CLINICAL TRIALS USING FMRI NFB AND MOTOR IMAGERY. THIS PROJECT HAS 3 SPECIFIC AIMS. UNDER AIM 1, THE APPLICANT WILL BECOME PROFICIENT IN SPECIFIC HARDWARE, SOFTWARE, PRE- AND POST-PROCESSING REQUIREMENTS OF FMRI NFB, GAIN NFB RESEARCH EXPERIENCE, AND ACQUIRE CRITICAL SKILLS IN MOTOR IMAGERY AND CLINICAL TRIAL DESIGN. IN AIM 2, THE APPLICANT WILL APPLY THIS TRAINING TO CONDUCT A CLINICAL TRIAL FEASIBILITY STUDY FOR A COMBINED FMRI NFB AND MOTOR IMAGERY REHABILITATION OF READING IMPAIRMENTS IN LEFT-HEMISPHERE STROKE. LASTLY, UNDER AIM 3, THE APPLICANT WILL CHARACTERIZE THE NEURAL MECHANISMS OF READING IN SUBACUTE STROKE. AT THE END OF THIS AWARD PERIOD, THE APPLICANT WILL DEVELOP A VALID AND RELIABLE PARADIGM FOR A NEUROSCIENCE-BASED READING INTERVENTION THAT HAS THE POTENTIAL TO CHANGE HOW READING DEFICITS ARE TREATED. THE METHODS DEVELOPED HERE COULD BE EXTENDED TO OTHER DOMAINS AND TO OTHER CLINICAL POPULATIONS TO IMPROVE COGNITIVE REHABILITATION OUTCOMES.

IMPACT OF COGNITIVE RESERVE ON MEMORY FUNCTIONING IN MULTIPLE SCLEROSIS

STRIVING TO WORK AND OVERCOMING EMPLOYMENT BARRIERS AMONG VETERANS WITH SPINAL CORD INJURY

SYSTEMATIC ASSESSMENT OF CAREGIVING SKILL PERFORMANCE BY INDIVIDUALS WITH TETRAPLEGIA AND THEIR CAREGIVERS

DEVELOPMENT OF A VIRTUAL REALITY SPATIAL RETRAINING THERAPY TO IMPROVE NEGLECT IN STROKE SURVIVORS

THE EFFECTIVENESS AND UNDERLYING MECHANISM OF A MINDFUL ATTENTION PROGRAM FOR TRAUMATIC BRAIN INJURY:A RANDOMIZED CLINICAL TRIAL

REINVENTING YOURSELF WITH MULTIPLE SCLEROSIS (MS): AN INTERVENTION AIMED AT IMPROVING SELF-EFFICACY, COPING, PSYCHOLOGICAL WELL-BEING, AND QUALITY OF LIFE IN MS

USING VIRTUAL REALITY TO IMPROVE JOB REENTRY IN ADULTS WITH TBI: AN RCT

FIELD INITIATED

A RESEARCH-COMMUNITY PARTNERSHIP TO ENHANCE THE POTENTIAL OF TRAVEL INSTRUCTION SERVICES FOR PEOPLE LIVING WITH DISABILITIES

RETURN TO SCHOOL (RTS): A MIXED METHODS INVESTIGATION OF COMMUNITY INTEGRATION AFTER PEDIATRIC REHABILITATION

IMPROVING QUALITY OF PERSONAL CARE ASSISTANCE SERVICES FOR PEOPLE WITH SCI THROUGH ONLINE EDUCATION

DISABILITY AND REHABILITATION RESEARCH PROJECTS

FIELD INITIATED

SPINAL CORD INJURY VETERANS: DISABILITY BENEFITS, OUTCOMES, AND HEALTHCARE UTILIZATION PATTERNS

PATIENT-SPECIFIC IN-SHOE ORTHOSES FOR KNEE OA PRESCRIBED USING WEIGHT BEARING MRI

DISABILITY REHABILITATION RESEARCH PROJECTS

A STRENGTH-BASED TOOL TO ENHANCE EMPLOYMENT FOR ADULTS ON THE AUTISM SPECTRUM - INDIVIDUALS ON THE AUTISM SPECTRUM HAVE SIGNIFICANTLY HIGH RATES OF UNEMPLOYMENT. JOB INTERVIEW SKILLS HAVE BEEN IDENTIFIED AS A CRITICAL AREA FOR VOCATIONAL TRAINING BY THE AUTISM AND RESEARCH COMMUNITY. HISTORICALLY, TREATMENT FOR INDIVIDUALS ON THE AUTISM SPECTRUM HAVE BEEN DEFICIT-BASED (TO FIX WHAT IS DEFICIENT), WHILE THE AUTISM COMMUNITY HAS ADVOCATED FOR TOOLS WHICH FOCUS ON ONE’S STRENGTHS. THE GOAL OF THE CURRENT STUDY IS TO DEVELOP AND EVALUATE A STRENGTH-BASED JOB INTERVIEW PROGRAM: KESSLER FOUNDATION STRENGTH IDENTIFICATION AND EXPRESSION (KF-STRIDE). KF-STRIDE WAS DESIGNED TO HELP INDIVIDUALS ON THE SPECTRUM IDENTIFY THEIR PERSONAL STRENGTHS AND IMPROVE THEIR ABILITY TO EXPRESS THESE STRENGTHS TO OTHERS. KF-STRIDE WAS ORIGINALLY DEVELOPED FOR ADOLESCENTS ON THE SPECTRUM; THUS IN THE CURRENT STUDY OUR OBJECTIVES ARE: 1) TO ADAPT KF-STRIDE FOR ADULTS. THIS ADAPTATION WILL FOCUS ON MODIFYING THE CONTENT AND DESIGN OF AN EXISTING PROTOTYPE, KF-STRIDE, WHICH WAS DEVELOPED FOR YOUTH. 2) TO EVALUATE THE ACCEPTABILITY, USABILITY, FEASIBILITY, AND INITIAL EFFECTIVENESS OF THE ADAPTED KF-STRIDE IN ADULTS. ANTICIPATED OUTCOMES ARE: IN STAGE 1, KEY STAKEHOLDERS WILL PROVIDE FEEDBACK ON THE ORIGINAL KF-STRIDE PROTOTYPE. IN STAGE 2, WE WILL DEVELOP AN ADAPTED KF-STRIDE USING THE FEEDBACK COLLECTED IN STAGE 1. IN STAGE 3, REFINEMENTS WILL BE MADE TO THE ADAPTED KF-STRIDE BASED ON STAKEHOLDER TESTING. IN STAGE 4, WE HYPOTHESIZE THAT INDIVIDUALS WHO RECEIVE KF-STRIDE WILL SHOW IMPROVEMENTS IN THEIR JOB INTERVIEW SKILLS COMPARED TO A CONTROL GROUP. THE FINAL PRODUCT WILL BE AN ADAPTED KF-STRIDE WHICH BEST SUITS THE NEEDS OF ADULTS ON THE SPECTRUM. THE CURRENT STUDY WILL FOCUS ON ONE OF NIDILRR’S MAJOR OUTCOME DOMAINS, EMPLOYMENT.

UNEMPLOYMENT IN MULTIPLE SCLEROSIS : THE ROLE OF PERSONALITY, COPING AND HEALTH

FIELD INITIATED

THE EFFICACY OF UPPER EXTREMITY WEARABLE ROBOTIC ORTHOSIS ON IMPROVING UPPER EXTREMITY MOTOR FUNCTION AND ACTIVITIES OF DAILY LIVING IN PERSONS WITH

TREATING COGNITIVE DEFICITS IN TRAUMATIC SPINAL CORD INJURY (SCI): ARANDOMIZED CLINICAL TRIAL

LONGITUDINAL ASSESSMENT OF SPINAL CORD STRUCTURAL PLASTICITY USING DTI IN SCI PATIENTS

BRAIN MARKERS PREDICTING READING RECOVERY AFTER STROKE

FUNCTIONAL ELECTRICAL STIMULATION AND VOLITIONAL EFFORT TRAINING

COGNITIVE INTEGRATED MOTOR TRAINING TO IMPROVE GAIT AND BALANCE AND REDUCE FALLS IN OLDER ADULTS WITH MILD COGNITIVE IMPAIRMENT

THE DEVELOPMENT OF A VIRTUAL REALITY PROGRAM TO IMPROVE EXECUTIVE FUNCTIONING IN INDIVIDUALS WITH TBI

A VIRTUAL REALITY OCULOMOTOR EXERCISE FOR RESTORING FUNCTIONAL VISION AFTER HEAD TRAUMA

CHEMOTHERAPY EFFECT ON BRAIN STRUCTURE, NEUROPHYSIOLOGY AND PSYCHOMOTOR BEHAVIOR

COMBINING WEARABLE ROBOTIC ORTHOSIS WITH VISUAL AND HAPTIC FEEDBACK TO ENHANCE THE RECOVERY OF UPPER EXTREMITY MOTOR FUNCTION AND ADL IN PERSONS WITH ACUTE SCI. NEW AWARD.

IMPACT OF TRANSCUTANEOUS SPINAL STIMULATION ON BLOOD PRESSURE AND ORTHOSTASIS IN SPINAL CORD INJURY: SHORT AND LONG-TERM EFFECTS - INDIVIDUALS WITH A SPINAL CORD INJURY (SCI) IN THE CERVICAL OR HIGH THORACIC (≥T6) REGIONS OFTEN EXPERIENCE UNSTABLE LOW BLOOD PRESSURE (BP) AND ORTHOSTATIC HYPOTENSION (OH), A SUDDEN BP DROP UPON MOVING TO AN UPRIGHT POSITION. OH CAN CAUSE DIZZINESS, BLURRED VISION, SYNCOPE, AND FALLS, NEGATIVELY IMPACTING QUALITY OF LIFE (QOL) AND INCREASING LONG-TERM CARDIOVASCULAR (CV) RISKS AND COGNITIVE IMPAIRMENT. CURRENT THERAPIES HAVE LIMITED EFFICACY, WITH SIGNIFICANT BARRIERS TO LONG-TERM USE DUE TO SIDE EFFECTS AND DOSAGE RESTRICTIONS. WHILE SPINAL CORD STIMULATION (EPIDURAL AND TRANSCUTANEOUS) SHOWS INITIAL PROMISE FOR IMPROVING BP IN CHRONIC SCI, QUESTIONS REMAIN ABOUT LONG-TERM BENEFITS. THIS GRANT AIMS TO GENERATE PRELIMINARY DATA TO BETTER UNDERSTAND THE IMMEDIATE EFFECTS OF SPINAL CORD TRANSCUTANEOUS STIMULATION (SCTS) ON BP (AIM 1) AND TO EVALUATE WHETHER SCTS PRODUCES LASTING IMPROVEMENTS IN BP REGULATION AND SUBSEQUENTLY, DAILY FUNCTION (AIMS 2 AND 3). THIS APPROACH MAY INDICATE AUTONOMIC NERVOUS SYSTEM ADAPTATION RATHER THAN MERELY PROVIDING TEMPORARY BP ELEVATION. THE NOVELTY OF OUR APPROACH LIES IN OFFERING A NON-INVASIVE, FEASIBLE, AND ACCESSIBLE INTERVENTION, MAKING IT BROADLY APPLICABLE TO A LARGER POPULATION. THE STUDY WILL RECRUIT 10 INDIVIDUALS AT LEAST 1-YEAR POST-SCI, WITH OH AND LOW BP, FOR 20 30-MINUTE SCTS- CV TRAINING SESSIONS. ASSESSMENTS WILL BE CONDUCTED BEFORE, IMMEDIATELY AFTER, AND BI-WEEKLY FOR TWO MONTHS POST-TRAINING, USING PERSONALIZED STIMULATION PARAMETER MAPPING (E.G., SITE, FREQUENCY), AND FOCUSING ON CV AND PERSON-CENTERED OUTCOMES. AIM 1 WILL ASSESS THE IMMEDIATE BP RESPONSE TO SCTS-CV DURING A 70° TILT TEST. WE HYPOTHESIZE THAT STIMULATION WILL MINIMIZE THE BP DROP, REDUCE OH SYMPTOMS, AND PROLONG TILT DURATION COMPARED TO A TILT WITHOUT STIMULATION. AIM 2 WILL ASSESS THE LONG-TERM EFFECTS OF 20 SCTS-CV SESSIONS (‘TRAINING’) ON BP. POST-TRAINING, WE EXPECT: (A) REDUCED BP DROP, FEWER SYMPTOMS, AND LONGER TILT DURATION DURING A 70° TILT TEST; (B) HIGHER, MORE STABLE BP DURING A 30-MINUTE SEATED ASSESSMENT; AND (C) DECREASED FREQUENCY AND SEVERITY OF OH EVENTS IN 24-HOUR AMBULATORY BP MONITORING (ABPM). EFFECTS ARE EXPECTED TO GRADUALLY DIMINISH OVER THE 2-MONTH FOLLOW-UP. AIM 3 WILL ASSESS THE LONG-TERM IMPACT OF TRAINING ON DAILY FUNCTION AND COMMUNITY PARTICIPATION. WE HYPOTHESIZE POST-TRAINING IMPROVEMENTS IN REPEATED ASSESSMENTS OVER THE TWO MONTHS, INCLUDING THE SELF-REPORTED AUTONOMIC DYSFUNCTION FOLLOWING SCI (ADFSCI) AND SCI-QOL, AND THE CLINICIAN-ADMINISTERED CANADIAN OCCUPATIONAL PERFORMANCE MEASURE (COPM), WITH THESE EFFECTS GRADUALLY LESSENING OVER TIME. THE INVESTIGATION AIMS TO DEMONSTRATE THE FEASIBILITY AND DURABILITY OF SCTS-CV TRAINING AS A NON-INVASIVE BP REGULATION INTERVENTION FOR SCI PATIENTS. PRELIMINARY FINDINGS WILL INFORM A FUTURE R01 APPLICATION, EXPLORING TRAINING REGIMENS AND UNDERLYING MECHANISMS FOR SUSTAINED BP CONTROL. THE LONG-TERM GOAL IS TO ADVANCE SCI CARE, IMPROVE DAILY FUNCTION AND COMMUNITY PARTICIPATION, AND ENHANCE CV HEALTH OUTCOMES.

A STRENGTH-BASED INTERVENTION TO IMPROVE JOB INTERVIEW SKILLS IN TRANSITION AGE YOUTH WITH ASD - HIGH RATES OF UNEMPLOYMENT ARE OBSERVED IN TRANSITION-AGE YOUTH WITH AUTISM SPECTRUM DISORDER (TAY-ASD). MOREOVER, TAY-ASD WITHIN 2 YEARS OF HIGH SCHOOL GRADUATION ARE AT THE GREATEST RISK OF UNEMPLOYMENT. GIVEN THAT 1 IN 59 YOUTHS HAVE AUTISM, THE EXCLUSION OF THIS GROWING SUBPOPULATION FROM THE WORKFORCE IS EXPECTED TO HAVE A PROFOUND NEGATIVE IMPACT UPON THE ECONOMY AS THESE INDIVIDUALS AGE. THUS, TO HELP ENHANCE ACCESS TO EMPLOYMENT FOR TAY-ASD, THE CURRENT STUDY WILL EVALUATE THE ACCEPTABILITY AND EFFECTIVENESS OF A STRENGTH- BASED INTERVENTION (KESSLER FOUNDATION STRENGTH IDENTIFICATION AND EXPRESSION; KF-STRIDE) THAT CAN ENHANCE JOB INTERVIEW SKILLS AND EMPLOYMENT. DESPITE POSSESSING EMPLOYABLE TALENTS, THE CORE SOCIAL DEFICITS OF TAY- ASD MAKE IT DIFFICULT FOR THIS GROUP TO ARTICULATE THEIR INDIVIDUAL STRENGTHS. THIS INABILITY TO IDENTIFY AND EXPRESS ONE’S STRENGTHS TO A POTENTIAL EMPLOYER CAN NEGATIVELY AFFECT INTERVIEW PERFORMANCE AND LEAD TO DIFFICULTY WITH JOB OBTAINMENT. THUS, THE CURRENT PROPOSAL WILL EXAMINE THE EFFECTIVENESS (AIM 1), ACCEPTABILITY, USABILITY, AND FEASIBILITY (AIM 2) OF A NOVEL STRENGTH-BASED INTERVENTION, KF-STRIDE, WHICH IS DESIGNED TO ENHANCE THE ABILITY OF TAY-ASD TO IDENTIFY PERSONAL STRENGTHS AND EFFECTIVELY DISCUSS THEM. THE GOALS OF THE CURRENT STUDY ARE TO EVALUATE THE PRELIMINARY EFFECTIVENESS AND FEASIBILITY OF KF-STRIDE IN AN 8-WEEK RANDOMIZED CONTROLLED TRIAL COMPARING THE INTERVENTION TO SERVICES AS USUAL (SAU). THE STUDY WILL BE PERFORMED AT TWO PRIVATE THERAPEUTIC SCHOOLS. COMPARED TO A SAU GROUP, WE HYPOTHESIZE THAT THE KF-STRIDE GROUP WILL: A) IMPROVE THE ABILITY TO IDENTIFY STRENGTHS (HYPOTHESIS 1), B) IMPROVE THE ABILITY TO EXPRESS STRENGTHS (HYPOTHESIS 2), C) IMPROVE OTHER JOB INTERVIEW SKILLS (HYPOTHESIS 3) AND FINALLY C) IMPROVE ABILITY TO OBTAIN EMPLOYMENT 6-MONTHS FOLLOWING THE INTERVENTION (HYPOTHESIS 4). IN THIS WAY, THE CURRENT STUDY IS IN LINE WITH THE NIMH’S EXPERIMENTAL THERAPEUTICS MODEL, AS WE WILL EXAMINE WHETHER THE INTERVENTION IMPROVES EMPLOYMENT, AS WELL AS IDENTIFY POTENTIAL MECHANISTIC TARGETS THAT COULD AFFECT OUTCOME. IN AIM 2, WE WILL ALSO MONITOR FIDELITY, ACCEPTABILITY, USABILITY, AND FEASIBILITY OF THE STRENGTH-BASED INTERVENTION. THE LONG-TERM GOAL OF THE CURRENT RESEARCH IS TO COLLECT PILOT DATA THAT WILL LEAD TO FULLY-POWERED EFFECTIVENESS AND IMPLEMENTATION EVALUATIONS OF KF-STRIDE IN OTHER COMMUNITY SETTINGS.

COMMUNITY EFFECTS ON LONG-TERM REHABILITATION OUTCOMES IN SCI

FIELD INITIATED

PHYSICAL ACTIVITY IN TRANSITION-AGE YOUTH ON THE AUTISM SPECTRUM - PROJECT SUMMARY/ ABSTRACT THE LONG-TERM GOAL OF THIS K23 CAREER DEVELOPMENT AWARD IS TO PREPARE THE PI (YU-LUN CHEN, PHD) FOR AN INDEPENDENT RESEARCH CAREER THAT AIMS TO PROMOTE PHYSICAL ACTIVITY (PA) AND HEALTH IN PEOPLE ON THE AUTISM SPECTRUM, WITH A FOCUS ON TRANSITION-AGE YOUTH ON THE SPECTRUM (TAYS). PA, DEFINED AS ANY BODILY MOVEMENT INCREASING ENERGY EXPENDITURE ABOVE A BASAL LEVEL, IS CRITICAL IN PROMOTING PHYSICAL AND MENTAL HEALTH AND PREVENTING ADVERSE HEALTH CONDITIONS. HOWEVER, TAYS ARE FOUR TIMES LESS LIKELY TO ACHIEVE THE RECOMMENDED PA LEVELS THAN TYPICALLY DEVELOPING PEERS. THIS IS A SIGNIFICANT HEALTH CONCERN FOR TAYS THAT NOT ONLY DIMINISHES THEIR QUALITY OF LIFE BUT ALSO CORRELATES WITH A NEARLY DOUBLED RISK OF OBESITY COMPARED TO THE GENERAL POPULATION. INACTIVE LIFESTYLES IN TAYS LIKELY PERSIST INTO LATER ADULTHOOD AND MAY INCREASE RISKS FOR CHRONIC DISEASES IN LATER ADULTHOOD. FOR INSTANCE, ADULTS ON THE SPECTRUM FACE MORE THAN DOUBLED RISKS OF TYPE 2 DIABETES AND CARDIOVASCULAR DISEASES COMPARED TO THE GENERAL POPULATION, SUGGESTING AN URGENT NEED TO PROMOTE PA IN TAYS AND AVERT NEGATIVE HEALTH OUTCOMES. HOWEVER, HIGH-QUALITY PA INTERVENTIONS FOR TAYS ARE SCARCE DUE TO KEY KNOWLEDGE GAPS INCLUDING A LACK OF VALIDATED, OBJECTIVE OUTCOME MEASURES OF PA BEHAVIORS IN TAYS, AS WELL AS LIMITED SCIENTIFIC KNOWLEDGE ON THE MODIFIABLE FACTORS UNIQUE TO TAYS THAT ARE ASSOCIATED WITH PA AND CAN SERVE AS POTENTIAL INTERVENTION TARGETS. THE K23 RESEARCH WILL ADDRESS THESE THROUGH THE FOLLOWING AIMS: 1) TO CALIBRATE AND VALIDATE WRIST ACCELEROMETER OUTPUT OF PA MEASURES TO ACCOUNT FOR REPETITIVE HAND MOVEMENTS IN TAYS; 2) QUANTIFY PATTERNS OF PA BEHAVIORS IN TAYS IN EVERYDAY LIFE; AND 3) IDENTIFY MODIFIABLE INTERVENTION TARGETS FOR PA BY SYSTEMATICALLY ASSESSING PREDICTORS OF DAILY PA BEHAVIORS INCLUDING FUNCTIONAL IMPAIRMENT, CONTEXTUAL BARRIERS, AND MOTIVATION. THE PROPOSED K23 RESEARCH PROJECT WILL GENERATE NOVEL DATA ON PA OUTCOME MEASURES, PATTERNS OF PA BEHAVIORS, AND MODIFIABLE TARGETS FOR INTERVENTION FOR TAYS, ENABLING THE DEVELOPMENT AND EVALUATION OF A HIGH-QUALITY PA INTERVENTION IN SUBSEQUENT R21 AND R01 PROPOSALS. THE PROPOSAL EXPANDS THE PI’S PRIOR TRAINING IN HEALTH OUTCOMES RESEARCH WITH TAYS TO DEVELOP AN INNOVATIVE RESEARCH PROGRAM IN PA PROMOTION, A CRITICAL YET UNDERSTUDIED TOPIC. THE K23 TRAINING PLAN INVOLVES PA MEASUREMENT VALIDATION, ACCELEROMETRY DATA ANALYSIS, AND COMMUNITY-ENGAGED PA INTERVENTION DEVELOPMENT. THE K23 MENTORING TEAM HAS EXTENSIVE MENTORING EXPERIENCE, MULTIDISCIPLINARY EXPERTISE DIRECTLY RELEVANT TO THE PROPOSAL, AND A HISTORY OF PRODUCTIVE COLLABORATION WITH THE PI. BY THE END OF THE TRAINING, THE PI WILL BE ABLE TO INCORPORATE WEARABLE ACCELEROMETER MEASURES IN MOBILE-HEALTH PA RESEARCH AND DEVELOP AN INDEPENDENT RESEARCH PROGRAM ON HEALTH PROMOTION IN TAYS, ULTIMATELY IMPROVING WELL-BEING AND PREVENTING CHRONIC HEALTH CONDITIONS IN THESE VULNERABLE POPULATIONS.

HEALTH-RELATED QUALITY OF LIFE IN HUNTINGTON?S DISEASE RESEARCH AND PRACTICE: DE

VISUOSPATIAL REHABILITATION AFTER RIGHT HEMISPHERE STROKE

IDENTIFICATION OF RESPONDERS TO THE FES INTERVENTIONS IN STROKE POPULATION

A NOVEL EMPLOYMENT SPECIFIC SOCIAL COMMUNICATION ASSESSMENT TOOL FOR INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS (ASD) - PROJECT SUMMARY: IT HAS BEEN DOCUMENTED IN SEVERAL STUDIES THAT UNEMPLOYMENT RATES IN TRANSITION AGE YOUTH ON THE AUTISM SPECTRUM (TAY-AS) ARE SIGNIFICANTLY HIGHER THAN INDIVIDUALS WITH OTHER DISABILITIES, WITH APPROXIMATELY TWO THIRDS OF AUTISTIC INDIVIDUALS UNEMPLOYED. THE AUTISM COMMUNITY HAS IDENTIFIED SOCIAL COMMUNICATION AS A SIGNIFICANT CHALLENGE IN MAINTAINING EMPLOYMENT, AS THEY NEGATIVELY IMPACT THE INTERACTIONS OF TAY-AS WITH OTHER EMPLOYEES. POLITENESS, WHICH IS ONE OF THE KEY ASPECTS OF SOCIAL COMMUNICATION, IS VIEWED AS THE DEMONSTRATION OF APPROPRIATENESS IN SOCIAL INTERACTIONS. POLITENESS MARKERS (PMS) ARE THE UTTERANCES USED TO EXPRESS POLITENESS. ALTHOUGH PMS USE HAS BEEN EVALUATED IN OTHER POPULATIONS THAT DISPLAY SOCIAL COMMUNICATION DEFICITS, SUCH AS PERSONS WITH BRAIN INJURY AND PARKINSON’S DISEASE, THEY HAVE NOT BEEN EVALUATED IN THE AUTISTIC POPULATION. THE CURRENT STUDY WILL ADDRESS THIS GAP IN LITERATURE BY EVALUATING THE USE OF PMS USING THE VOICEMAIL ELICITATION TASK (VET). VET PROVIDES VARIABLE WORKPLACE CONTEXTS IN A ROLE- PLAY FORMAT TO STIMULATE LANGUAGE SAMPLES IN WHICH PMS ARE ASSESSED. THE AIMS OF THIS PROPOSED PROJECT ARE A) EVALUATE THE USE OF VET AS A SCREENING TOOL TO DETECT DEFICITS IN PMS USE IN TAY-AS AND COMPARE THIS WITH NEUROTYPICAL CONTROLS (NTCS) PERFORMANCE, B) EVALUATE WHETHER CURRENT VET SCORING SCHEMAS ARE ADEQUATE OR WHETHER THEY NEED TO BE UPDATED AND EXPANDED FROM THEIR ORIGINAL FORM TO DETECT AUTISM- SPECIFIC OR AUTISM-CENTRIC PMS, C) INITIAL EVALUATION OF THE PSYCHOMETRIC PROPERTIES OF VET (RELIABILITY AND VALIDITY).THIS PROPOSED PROJECT WILL ENROLL 30 TAY-AS AND 30 NTCS WITH AGE RANGE BETWEEN 16-24 YEARS. WE WILL COMPARE THE PERFORMANCE OF THE TWO GROUPS IN PMS AND THIS WILL ENABLE US TO DEFINE THE SPECIFIC DEFICITS IN PMS USE IN INDIVIDUALS WITH AUTISM WHICH WILL AID IN DESIGNING INTERVENTIONS THAT TARGET THESE DEFICITS.

IMPACT OF COGNITIVE RESERVE ON MEMORY FUNCTIONING IN MULTIPLE SCLEROSIS

FIELD-INITIATED PROGRAM

: REHABILITATION RESEARCH AND TRAINING CENTERS (RRTCS) PROGRAM

FIELD INITIATED

FUNCTIONAL NEAR INFRARED SPECTROSCOPY OF MILD TBI

VOCATIONAL RESOURCE FACILITATION DEMONSTRATION VRFD