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Rehabilitation Research & Development Service 2009 ORD Local Accountability for Research. Michael E. Selzer, MD, PhD Director Patricia A. Dorn, PhD Deputy Director Office of Research and Development Joel Kupersmith, MD, CRADO. Department of Veterans Affairs.

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Rehabilitation Research & Development Service 2009 ORD Local Accountability for Research


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rehabilitation research development service 2009 ord local accountability for research

Rehabilitation Research & Development Service2009 ORD Local Accountability for Research

Michael E. Selzer, MD, PhD

Director

Patricia A. Dorn, PhD

Deputy Director

Office of Research and Development Joel Kupersmith, MD, CRADO

department of veterans affairs
Department of Veterans Affairs

“To care for him who shall have borne the battle, and for his widow and his orphan.”

A. Lincoln, 1865

Mission of VA Research and Development

“To discover knowledge and create innovations that advance the health and care of veterans and the nation.”

mission of rehabilitation research and development
Mission of Rehabilitation Research and Development

To discover knowledge and create innovations that restore veterans who have become disabled due to injury or disease to their greatest possible functional capacity

  • In their persons
  • In their families
  • In their communities
  • In their work places

Tom Andriacchi – Center for Bone and Joint Rehabilitation (Palo Alto)

slide4

Veterans Health Administration

Office of Research &

Development

Joel Kupersmith, CRADO

Tim O’Leary, Acting Deputy CRADO

Research-Funding Services

Biomedical

Laboratory

R&D

Ron Przygodski

Clinical

Science

R&D

Tim O’Leary

Health

Services

R&D

Seth Eisen

Rehabilitation

R&D

Mickey Selzer

va research organization fits an interdisciplinary time model of medicine
VA Research Organization Fits an Interdisciplinary Time Model of Medicine

Limitation

of Damage

BLR&D

CSR&D

Restoration

of Function

RR&D

Prevention

HSR&D

Implementation

Steve Fausti – National Center for Rehabilitative Auditory Research (Portland)

scope of rehabilitation research and development
Scope of Rehabilitation Research and Development
  • REPAIR:
    • Basic research to repair injured organs and tissues
    • Translational research to bring basic discoveries to clinical use
  • REPLACE:
    • Prosthetics, orthotics and assistive device research to replace what cannot be repaired
  • RESTORE:
    • Physiological function
    • Social integration (including return to work)

Bruce Sangeorzan – Center for Limb Loss Prevention and Prosthetic Engineering (Seattle)

levels of functional recovery

Social Integration

Levels of Functional Recovery

Physical and Mental Function

Molecule

Cell, & Tissue

15%

8%

77%

RRD Portfolio as of June, 2007

rehab r d scientific organization
Rehab R&D Scientific Organization

Prosthetics/

Rehabil Engineering

Bob Jaeger

Sensory

Systems

Pending

Director, Mickey Selzer

Deputy Director, Tricia Dorn

Scientific Program Managers

SCI/

Regen Med

Audrey Kalehua

Aging/

Neurodegen Dis

Tshaka Cunningham

Brain Injury/

Stroke

Jean Langlois

Musculoskel/

Med Comorbidity

Tom Pierce

Social Reintegration/

Mental Health

Sunil Sen-Gupta

Career Develop/

Special Projects

Jay Freedman

Neuroplasticity/

PT, OT, etc.

Pending

how the rehabilitation research mission is carried out
How the Rehabilitation Research Mission is Carried Out

Merit Awards – Awards to VA investigators to support individual research projects

3 yr, $750K total, $250K/yr

4 yr, $925K total, $300K max in any yr

Pilot Projects – support research leading to Merit project

2 yrs max, $75K/yr

Centers of Excellence (13) and Research Enhancement Award Programs (5) – Groups of scientists collaborating to achieve goals in a broad area of concern to disabled veterans, e.g., SCI, limb amputation, stroke, blindness, deafness, etc.

5 yrs, Centers: $950K/yr, REAPs: $325K/yr

how the rehabilitation research mission is carried out1
How the Rehabilitation Research Mission is Carried Out

Career Development Awards – To support promising investigators starting out in VA research

CDA-1, 2yr, salary support

CDA-2, 3 – 5 yr, salary support, operational funds up to $50K/yr

Transition Award, salary support

Career Scientist and Senior Career Scientist Awards – To provide stable salary support for accomplished VA scientists

Journal of Rehabilitation Research and Development

process of review
Process of Review
  • Pre-Application
    • Letter Of Intent Oct 15 and April 15, Assignment to Review Panel (may request panel)
  • Submit Proposal: Dec 15 and June 15
    • Review: Feb/March and Aug/Sept
    • Approved and Scored 1.0 - 5.0 (best-worst)
    • No automatic pay line, but after review most awards made in sequence of score
    • Additional Proposals Funded Based on Priority
  • Post-Review
    • Proposals to be funded enter Just-In-Time process.
    • Un-funded proposals revised for resubmission (max. 3 submissions)
  • Grants.gov/eRACommons on line submission for Merit and Pilot Project applications only
  • Center and REAP applications by special solicitation only
areas of strength and opportunities for growth
Areas Of StrengthAnd Opportunities For Growth

Leslie Gonzalez-Rothi – Brain Rehabilitation Research Center (Gainesville)

slide16
Collaboration Among VA Scientists, DARPA, and Industry may Restore Fine Upper Limb Control to Veteran Amputees
research to promote social reintegration
Research to Promote Social Reintegration

Community Based Exercise for Stroke Recovery

  • A Pilot Study in Italy Suggested that Exercise Conducted in Community Setting Provided Longer Lasting Improvement in Functional Measures
    • Was this because of better compliance with exercise or some other factor associated with socialization?
    • Would the effect be seen in US Veterans?
  • RR&D Investigators are Now Doing a Study to Answer these Questions
    • Compare exercise in VFW Posts vs. hospital settings
    • Compare exercise program with sedentary socialization
research to promote vocational reintegration
Research to Promote Vocational Reintegration

SCI-Vocational Integration Program

  • Integrating Compensated Work Therapy (Evidence–Based Supported Employment) with Comprehensive SCI Rehabilitation
  • VA SCI Strategic Healthcare Group
  • Focus on Factors Preventing Return to Work
    • Workplace Accommodations
    • Psychological and Physical Disabilities
    • Drug Addiction when Applicable (Untreated Persons Excluded from Study)
  • Interventions, Including Counseling, Training, Health Status Education
  • Comparison of Interventions to Obtain Best Outcomes
research to promote social and vocational reintegration
Research to Promote Social and Vocational Reintegration
  • Our Initiatives will:
    • Develop Outcomes Measures for Social Reintegration Research.
    • Develop Meaningful and Appropriate Outcomes Measures for Return to Work Research.
    • Determine the Best Incentive Structures to Optimize Social Reintegration and Return to Work.
  • These Innovations Could Revolutionize Research in Social and Vocational Rehabilitation for VA and Nationwide.
research on regenerative medicine

Research on Regenerative Medicine

Mesenchymal stem cells for bioengineered joints

Bioengineered bone

Directed differentiation of stem cells into neurons

Glickstein, Current Biology, 2008; MIT HST coursework

regenerative medicine in sci

Regenerative Medicine in SCI

Biopolymer scaffolds seeded with genetically engineered cells producing neurotrophic factors

Hemisection model of SCI

Functional recovery post-transplant

Tysseling-Mattiace et al., J Neurosci, 2008; Taylor et al., J Neurosci, 2006

how are we addressing the new priorities
How are We Addressing the New Priorities?
  • SOTA on TBI (resource documents to be published in JRRD; results to be published separately)
  • RFAs
    • ORD-wide TBI solicitation
    • Centers of Excellence and Research Enhancement Award Programs, intention is to increase numbers, Review January 27 – 28
      • Regenerative Medicine
      • TBI
      • Social Reintegration and Vocational Rehabilitation
  • Increased Collaborations Between ORD Research Services, Between ORD and Prosthetics and Patient Care Services, and Between VA and Non-VA Investigators

Hunter Peckham – Center for Functional Electrical Stimulation (Cleveland)

oef oif 2007 projects
OEF/OIF 2007 Projects

OIF/OEF 2007 Projects

rehab r d career development program
Rehab R&D Career Development Program
  • RR&D began offering Career program in 1997
  • Over 100 awardees trained
  • Career program is growing
  • Currently receive over 30 applications per cycle
    • ~ 5-fold increase over past 5 years

Bill Bauman – Center for Medical Consequences of SCI (Bronx)

career program statistics fy07
Career Program Statistics FY07
  • 18.9% Career Awards (all types)
    • All awards Merit & Career (397), Career (75)
  • 12.6% Funds in Career Program
    • $6.9 mill of $54.7 mill
  • Typically fund at ~30th percentile

Joe Rizzo – Center for Innovative Visual Rehabilitation (Boston)

examples career development training areas
Examples Career Development Training Areas
  • Spinal Cord Injury
  • Stroke
  • Biomedical Engineering
  • Prosthetics / Orthotics
  • Mental Health
  • Vocational Rehabilitation
  • Hearing
  • Vision

Ron Triolo – Center for Rehabilitation Engineering Platform Technology (Cleveland)

activities with va office of academic affiliations
Activities with VA Office of Academic Affiliations
  • Polytrauma & Traumatic Brain Injury Advanced Fellowship Program
      • Jointly supported by OAA & RR&D
      • Provide post-residency MDs & post-doc associated health professionals in-depth preparation in clinical care, research & leadership in polytrauma, TBI & related neuroscience fields
      • 2 year program, with possibility of 3rd year upon approval

Rich Macko – Center for Task Oriented and Robotics in Neurological Disease (Baltimore)

activities with va office of academic affiliations1
Activities with VA Office of Academic Affiliations
  • Rehabilitation Research Predoctoral Fellowships
  • Assist with
    • drafting announcement
    • dissemination to field and academic affiliates
    • recommending reviewers

Krish Satian – Center for Aging Veterans with Vision Loss (Atlanta)

da vinci awards
Da Vinci Awards

Honoring Exceptional Design & Engineering Achievements in Accessibility & Universal Design that Empowers People of all Abilities

  • 2008 Lifetime Achievement Award to: Jeff Kocsis
  • 2008 Spirit of da Vinci Award to: Hugh Herr
  • 2007 Lifetime Achievement Award to: Rory Cooper

Rory Cooper – Center for Wheelchair and Associated Rehab Engineering

thank you
THANK YOU !

Michael Selzer 202-461-1740; michael.selzer@va.gov

Patricia Dorn 202-461-1755; patricia.dorn@va.gov

Program Managers

Tshaka Cunningham 202-461-1853; tshaka.cunningham@va.gov

Jay Freedman 202-461-1699; jay.freedman@va.gov

Rober Jaeger 202-461-1751; robert.jaeger@va.gov

Audrey Kalehua 202-461-1749; audrey.kalehua@va.gov

Jean Langlois 202-461-1847; jean.langlois@va.gov

J. Thomas Pierce 202-461-1758; john.pierce3@va.gov

Sunil Sen-Gupta 202-461-1754; sunil.sen-gupta@va.gov

Administrative Officer

Ricardo Gonzalez 202-461-1750; ricardo.gonzalez@va.gov

Review Administrator

Terri Carlton 202-461-1757; terrilynn.carlton@va.gov

Steven Waxman – Center for Restoration of Function in SCI and MS (West Haven)