Milne Institute Completed Research

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Completed Research

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.

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.

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.

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.

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.

A new research study will be conducted to determine if patients who have dysphagia resulting in a thickened liquid diet or NPO status can safely tolerate thin liquid water at the inpatient level of care and if so, to what degree of benefit. This study will incorporate a modified Frazier Free Water Protocol which has been widely researched and used by speech language pathologists in the healthcare field.  Oral care, hydration status and patient satisfaction will be closely tracked. The study hopes to prove that patients with dysphagia can have thin liquid water without any adverse reactions to improve overall quality of life and swallow function.

For more information, including a consent form for the study, contact Stefanie Gaidos at 203-741-3482 or [email protected]

Our paper, "Patient Outcomes and Lessons-Learned from Treating Patients with Severe COVID-19 at a Long-Term Acute Care Hospital," describes the treatment strategies and precautions used at our facility during the early days of the pandemic while treating and rehabilitating patients after a COVID-19 diagnosis. Further, we examined how specific risk factors (i.e., age, sex, and BMI) affected disease severity and patient recovery (i.e., patient length of stay) in this population. Next, we review our COVID-19 patients' outcomes treated by Respiratory Therapy, Physical and Occupational Therapy, and Speech-Language Pathology. Lastly, we discuss our observations and how our findings relate to rehabilitation for this population. FULL RESEARCH PDF

For more information contact Henry Hrdlicka at (203) 284-2864, email: [email protected]

Poster Presentations

2014 - 2019 Poster Presentations

Recent Publications

Are Stroke Survivors Discharged to the Recommended Postacute Setting?, Joel Stein, MD, Pamela Borg-Jensen, MPH, Alyse Sicklick, MD, Barry M. Rodstein, MD, Robin Hedeman, OTR, MHA, Janet Prvu Bettger, ScD, Roseanne Hemmitt, BA, Brian M. Silver, MD, Henry C. Thode, PhD, Zainab Magdon-Ismail, DrPH, Published:April 06, 2020DOI:


Clinical utility of the TOMMe10 scoring criteria for detecting suboptimal effort in an mTBI veteran sample, Anthony Rinaldi, Jada J. Stewart-Willis,David Scarisbrick



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