As MRRI celebrates Black History Month, the Institute recognizes and honors the extraordinary contributions of individuals who have left an indelible mark on their fields. One such luminary figure is Carl V. Granger, MD, a third-generation African American physician whose groundbreaking work has significantly shaped the landscape of Physical Medicine and Rehabilitation (PM&R).

Dr. Granger’s legacy is perhaps most prominently defined by his visionary role in developing the Functional Independence Measure (FIM) instrument. This instrument, for many years, served as the gold standard for measuring the functioning and functional independence of patients in rehabilitation. Today, it remains a cornerstone in rehabilitation research, a testament to the enduring impact of Dr. Granger’s innovative contributions.

In 1987, Dr. Granger, in collaboration with the State University of New York (SUNY) Buffalo, founded the Uniform Data System for Medical Rehabilitation (UDSMR). This groundbreaking initiative marked a pivotal moment in the history of PM&R, as it introduced a standardized data set for medical rehabilitation. Dr. Granger’s foresight and dedication paved the way for a systematic and uniform approach to measuring rehabilitation outcomes, significantly advancing our understanding of treatment effectiveness.

Beyond his instrumental role in data standardization, his impact on the profession is evident through his presidency of the American Association of Electromyography and Electrodiagnosis in 1968-69, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) from 1975-76, and the International Federation of PM&R from 1978-1980. As President of these esteemed organizations, Dr. Granger played a crucial role in shaping the direction and standards of the field. He was the author or co-author of over 275 scientific articles. In 2010, a comprehensive review of 45,700 articles within rehabilitation journals identified Dr. Granger as a co-author of 10 among the top 100 cited articles, with him serving as the first author in five instances—more than double the count of any other author.

The impact of Dr. Granger’s work extends to his establishment of the world’s largest and most sophisticated rehabilitation outcomes database. This monumental effort, containing over 13 million patient assessments, positioned PM&R at the forefront of tracking outcomes in medicine. Dr. Granger laid the foundation for “evidence-based” care in the field of rehabilitation, a paradigm shift that has shaped contemporary healthcare practices.

On December 29, 2019, in Buffalo, New York, Dr. Carl V. Granger passed away at the age of 91. Born into a family of African American physicians in Brooklyn, he carried on the family legacy with distinction. As we reflect on Dr. Carl V. Granger’s legacy during Black History Month, we celebrate his vital contributions to physiatry and rehabilitation research.

Thank you to Brandon Knight for inspiring the Black History Month blog series.

As we begin this Black History Month at Moss Rehabilitation Research Institute (MRRI), our leadership and staff acknowledge the importance of recognizing the contributions of Black Americans to the work that we do. Here at MRRI, we are dedicated to improving the lives of individuals with neurological disabilities through research. This work cannot be meaningfully conducted without attention to the racial healthcare disparities and history of injustice that impact the experience of the populations we study.

Beyond this month and throughout the year, it is crucial to respect and understand the historical context of this country’s relationship with the Black community. At MRRI, we find ourselves at a unique intersection of research and healthcare, shaped by the historical context of events such as the Tuskegee Syphilis Study and other historical injustices. Many of our research participants come from the same racially and economically diverse communities that have been exploited by medical research in the past. Rebuilding trust, promoting transparency, and prioritizing ethical conduct to address the historical injustices that have contributed to healthcare disparities is critical to the work we do at MRRI.

In reflecting on the composition of research and healthcare professions, it is evident that Black Americans are often underrepresented, and when present, they may occupy fewer positions of influence or comparable roles. The statistics from the Society for Neuroscience’s 2017 report shed light on the stark disparities in the field, revealing that Black PhD recipients constituted only 4% of those awarded a PhD in the 2015-2016 academic year, while White/Caucasian recipients accounted for a significant 72% of the total population. The underrepresentation extends to postdoctoral trainees and faculty, with Black individuals comprising 3% and 1%, respectively (Society for Neuroscience, 2017). Although efforts are being made to increase diversity in these fields, the numbers underscore the need for continued awareness and action.

While acknowledging the atrocities of the past, it is equally vital to recognize the significant contributions Black Americans continue to make in advancing research and healthcare. Actively recognizing our history and the achievements of the Black community, this month and throughout the year, is crucial in dismantling systemic racism and fostering a truly inclusive environment. The advancement of knowledge depends on diversity, and by embracing different perspectives, we strengthen our collective pursuit of scientific and medical breakthroughs.

As MRRI celebrates Black History Month, we honor the past and commit to creating a future where diversity thrives, acknowledging the invaluable contributions of Black individuals in shaping the landscape of research and healthcare.

Thank you to Brandon Knight for contributing to the ideas and data included in this post and inspiring the Black History Month blog series.

References:

Society for Neuroscience. (2017). Diversity in Neuroscience.

After traumatic brain injury (TBI), it is common for individuals to experience difficulties regulating their emotions and behaviors, leading to anger and aggression that may negatively impact their relationships and societal participation. Currently, evidence-based treatments addressing these emotional challenges are lacking. A collaborative study funded by The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) is exploring this topic to better understand why events in everyday life result in feelings of anger and aggression in people with chronic TBI. Led by Flora Hammond, MD, and Dawn Neumann, PhD, at Indiana University, the Reactions Events Appraisals and Context in TBI (REACT) Study spans five Traumatic Brain Injury Model Systems Sites (Indiana University School of Medicine, Moss Rehabilitation Research Institute (MRRI), TIRR Memorial, Spaulding Rehabilitation, and Craig Hospital).

At MRRI, Amanda Rabinowitz, PhD, serves as the site principal investigator for the REACT Study. Dr. Rabinowitz brings to this project extensive experience using mobile technology for assessment and treatment of people with TBI, as well as expertise in ecological momentary assessment (EMA). EMA involves real-time data collection which can be more accurate than relying on recall of past events. Dr. Rabinowitz has completed various studies using EMA and is currently working on a separate ongoing project characterizing the temporal dynamics of chronic post-concussion symptoms.^1-4

In the REACT Study, researchers will sample the thoughts, feelings, and experiences of people with TBI during their daily lives using an accessible mobile application. Participants will report on their experiences of frustrating events, and their emotional and behavioral responses over a two-week period. The study will also examine potential connections between these emotional reactions and factors including the circumstances, patient characteristics, how they assess real-life situations, and their methods of emotional management.

Gaining insight into why people with TBI experience anger and aggression will help scientists and clinicians improve care in a number of ways — by developing better educational approaches for patients and their families, refining screening methods to identify patients at risk, and informing targeted treatments to improve outcomes. “By leveraging valuable collaborations through the TBI Model Systems, this project will bring us closer to developing effective evidence-based interventions to help people with TBI better manage their emotions in real-world situations,” Dr. Rabinowitz remarked.

References

1) Rabinowitz, A. R., & Fisher, A. J. (2020). Person-specific methods for characterizing the course and temporal dynamics of concussion symptomatology: a pilot study. Scientific reports, 10(1), 1-9.

MRRI is pleased to release its Annual Report for fiscal year 2023. This report includes updates from Institute leadership, details about our facilities and collaborative team, and information on MRRI’s activities in the past year. We share details about our scientists’ recent publications, presentations, research funding, and summaries of the research conducted within our Laboratories and Programs.

Read the 2023 Annual Report

After a wonderful holiday season, Moss Rehabilitation Research Institute (MRRI) is pleased to welcome the New Year and all of the forthcoming opportunities and events of 2024. We look forward to continued growth, new collaborations, exciting discoveries, and further disseminating our research that spans the translational continuum in neuroscience and neurorehabilitation.

The past year has seen MRRI rapidly integrating with the Jefferson Enterprise, and we are proud to see how the Institute and our individual Scientists are adapting and leveraging the opportunities offered by this position. We are delighted to celebrate the many accomplishments of our scientists over the past year, and the Institute is already bustling with activity to advance ongoing research and begin new projects this year.

We truly appreciate the support of our donors, scientists, staff, trainees, collaborators, clinical colleagues, and all others who help enable our ground-breaking work towards our mission.

Wishing the entire MRRI community and beyond a happy, safe, and productive New Year.

Sincerely,
Dylan J. Edwards

Nancy Wachtel Shrier Director, Moss Rehabilitation Research Institute
Professor, Rehabilitation Medicine, Thomas Jefferson University

Successful communication depends on a multitude of factors, including the ability to produce information that is relevant for discourse between individuals in a real-world setting. This is one of the features of communication that can be disrupted in individuals with post-stroke aphasia, an acquired language impairment that can impact language production or comprehension.

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The researchers, clinicians, and staff at the MossRehab Traumatic Brain Injury (TBI) Model System have been busy and productive over the last several months and are excited to share news and updates in the latest edition of Brain E-News. This edition includes information about their recent presentations at the National Academy of Neuropsychology (NAN) Annual Meeting held in Philadelphia, PA, in October. The newsletter also shares new research examining the relationship between adverse experiences during childhood and health after brain injury, as well as updates on an ongoing collaborative research project focused on developing a program to train inpatient rehabilitation staff how to best communicate with patients after brain injury to maximize learning and performance during rehabilitation. In addition, there are staffing updates from the Elkins Park Empowerment Group, which provides support for people with TBI and their families and caregivers.

Click here to read the full newsletter.

Amanda Rabinowitz, PhD, Associate Director at MRRI, contributed as one of the collaborating authors in the recent publication of the updated diagnostic criteria for mild traumatic brain injury (TBI) by The American Congress of Rehabilitation Medicine (ACRM). This significant initiative, spearheaded by Noah Silverberg, PhD, Chair of ACRM’s Brain Injury Interdisciplinary Special Interest Group Mild TBI Taskforce, represents the first revision of ACRM’s widely utilized definition of mild TBI in three decades.

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MRRI is delighted to have a diverse staff of scientists, clinicians, trainees, and research support personnel. This month, the Brain Injury Neuropsychology Laboratory, directed by Amanda Rabinowitz, PhD, welcomed three new research assistants, McKenzie Buszkiewic, Dennis Tirri, and Julia Witkowski, who will work on a variety of projects in the lab.

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On September 26, 2023, the Director of the National Institute on Minority Health and Health Disparities (NIMHD), Eliseo J. Pérez-Stable, MD, announced that people with disabilities are now designated as a population with health disparities for all research supported by the National Institutes of Health (NIH). This designation will have far-reaching impacts in terms of increased representation and consideration in NIH-funded research, and ultimately, improved health outcomes for people with disabilities. We anticipate these impacts will be particularly pronounced for people with disabilities who also belong to other minority groups, a segment of the population which has faced tremendous inequities in healthcare and beyond.

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