Completed Research

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Completed Research

Completed SCI Research Projects

Projects noted below with an * were done at Gaylord in its role as a partner of the Spaulding New England Regional Spinal Cord Injury Center (SNERSIC), one of only 14 Model Spinal Cord Centers in the United States.

* My Care My Call (MCMC)

The MCMC project uses telehealth techniques to improve the health and function of people with traumatic SCI. MCMC will help individuals with SCI find and maintain quality primary care, including preventive screenings and prevention of secondary conditions through conversations with a human Peer-Health Coach for identified problems; and an accompanying user-friendly resource book. 

* SCI-FI Enhancement and Validation (Spinal Cord Injury - Functional Independence Computer Adaptive Testing)

The SCI Model Systems National Database uses the Functional Independence Measure (FIM) as a tool to assess and track function. But there are concerns about the appropriateness of using the FIM in the SCI population because it may miss differences in function among people with SCI who have different levels of injury severity. Seven Model Systems Centers conducted a study over the past five years and developed a new measure that includes functional activities relevant and important to persons across all levels and severity of SCI injury. We are now continuing this study with nine Spinal Cord Injury Model Systems programs to enhance and evaluate the this new tool, called the Spinal Cord Injury Functional Index (SCI-FI).

* SCI-QOL (Spinal Cord Injury Quality of Life Computer Adaptive Testing)

This project will evaluate the validity, sensitivity, and responsiveness to change of the SCI-QOL measurement system. The sensitivity of the scales to detect change and the direction of change of key areas of functioning including activity limitations will be examined as well as secondary medical complications, emotional functioning, and social participation. These variables will be assessed at multiple points during the recovery process and injury “trajectories” of change will be developed from shortly after injury through the initial years of living with a disability.

* EQuATe- Equity and Quality in Assistive Technology

The purpose of this project is to improve the quality and equity of assistive technology provision and outcomes for individuals with SCI. By understanding utilization and impact of assistive technology, raising awareness of variation in wheelchair quality and identify factors associated with variation in quality and equity of care and outcomes, this project will identify areas of need in the procurement of SCI specific technology needs.

Other Completed Projects

Investigating Whether Discharge Destination from a Long Term Care Hospital Can be Predicted Using Admission FIM Scores for Patients Post CVA

Admission FIM score was found to be a strong factor on discharge destination. These results support the few earlier findings that demonstrate individuals with a higher admission FIM score are more likely to be discharged to the community.   As is evidenced by the numbers there was wide variability in admission FIM scores, which were taken into account in this study therefore the generalizability, is great for individuals who have suffered a CVA.

The Effects of the EKSO Exoskeleton Device on Improving Cardiovascular Endurance, Gait Speed, Fatigue and Pain in Individuals with Spinal Cord Injury and Stroke

Since most individuals with spinal cord injury have a level of compromise to their respiratory system, introducing the EKSO may help limit complications of the respiratory system in as little as eight sessions. Preliminary data is showing EKSO can affect endurance as seen in the improvements in 6MPT and further supported by the increase in mean steps taken per session of the EKSO without an increase in RPE in as little as eight sessions. The EKSO does not appear to impact pain.

Evaluation of the Ekso GT Robotic Exoskeleton

This internal quality improvement study gathered data and provided “real-life” feedback to the device manufacturers to improve user and patient experience in the device. Data was gathered regarding new features of the Ekso GT and the information was analyzed by Ekso staff and incorporated into the feedback on the product design and revision.

Can Use of the Passy Muir Valve during Nighttime Sleep be Considered Safe?

The objective of this study was to determine if patients could safely sleep with a Passy Muir Valve (PMV) in place. The partial pressure of carbon dioxide did not differ between nights and a minority of patients subjectively reported sleep disturbance. We believe that the PMV can be safely used in a select patient population during sleep and that this does not adversely affect sleep quality. Therefore, the PMV does not need to be limited to daytime use and can be used 24 hours per day for certain patients.

Insulin Resistance Intervention after Stroke Trial (IRIS)

The Insulin Resistance Intervention after Stroke Trial (IRIS) was a randomized, double-blind, placebo-controlled trial that is testing the hypothesis that reducing insulin resistance and its sequelae with thiazolidinedione therapy will prevent stroke and myocardial infarction among patients with a recent ischemic stroke or transient ischemic attack. Pioglitazone reduced the relative risk of the primarily outcome (fatal & non-fatal stroke and MI) by 24% (p=0.007) vs. placebo.

Wound Care Protocol Use Survey for Registered Nurses

Baseline determination knowledge of wound care protocols was obtained. Then, education on the protocols and ease of finding them within the electronic medical system was completed and a similar survey was completed.  The education on skin care protocols was provided in both written and demonstration of where to access and how to use the protocols. The result was that the average score on the Likert scale was higher than the initial survey score showing improvement in clinical use and knowledge based on the education provided.

Survey of Prosthetic Management: Patients and Clinicians

This study was designed to test a mobile apps efficacy that could improve the comfort and quality of life of newer prosthesis users. Usability and acceptability of education materials appears high, with a significant difference between the two types of educational materials (app/paper) in time and efficacy outcomes.

Validation of the Aeolus – Precision Flow automatic FiO2 Controller for Maintaining Oxygenation in Exercising Adult Patients Receiving High Flow Nasal Cannula Therapy for Unstable Blood Oxygen Saturation

The study looked at the Vapotherm Aeolus and using it in conjunction with the Vapotherm Precision Flow to treat adult pulmonary rehabilitation patients during exercise-induced fluctuations in SpO2 with heated, humidified high flow respiratory gas delivery.  It measured how well the devices maintained patients’ arterial blood oxygen saturation in a clinically meaningful target range for a longer percentage of time compared to a control condition, and thus prolongs exercise periods and decrease recovery times, while minimizing the exposure to elevated levels of oxygen in the inspired.

Walking Improvement for SCI with Exoskeletons

Gaylord Specialty Healthcare is participating in a multi-center study with Ekso Bionics called the WISE study (Walking Improvement for SCI with Exoskeletons).  This study will evaluate changes in independent gait speeds of participants with spinal cord injury. It will be conducted with the Ekso GT and results will be compared to both conventional therapy and usual care control groups. Data collection is complete and analysis is underway