Development of the Rehabilitation Treatment Specification System

A female therapist moving a mouse with here right hand standing next to a male patient sitting in a chair using a joystick with his right hand.

Rehabilitation has been described as a “black box”. We can specify and measure a number of patient features at the time of rehabilitation treatment that predict functional improvement (e.g., demographics, measures of severity). We can also specify and measure the outcomes that rehabilitation treatments hope to achieve. However, we have no shared language for specifying and measuring the rehabilitation treatments themselves. In the case of drug treatments, this is straightforward: specifying the treatment amounts to naming the active chemical ingredient and the dose. In contrast, most rehabilitation treatments involve some form of interaction between clinician and patient/client. What “active ingredients” are delivered during these interactions and in what “dose”?

The words "Impairments Activity limitations" with arrows directing towards "The black box of rehabilitation" and "Improved functioning?" "Better quality of life?"

Until now, we have had only very crude ways of defining rehabilitation treatments. Sometimes we talk about exposure to a particular kind of facility (12 days of inpatient rehabilitation) or discipline (3 one-hour sessions of PT per week). In some cases, we name treatments by the problem they address (gait training, memory remediation). Neither of these approaches is sufficient. Two clinicians providing “gait training” might be pursuing very different training regimens, and we cannot assume that either everything or nothing a PT does in a session is “effective”; we need to know what they did. The current state of rehabilitation treatment specification makes it hard to:

  • replicate treatment research (replication means delivering the same active ingredients in a new study)
  • disseminate effective treatments or ensure clinicians are delivering them correctly (i.e. what would a supervisor look for to ensure that the active ingredients are being delivered?)
  • synthesize evidence across studies (i.e. should we combine studies of memory notebooks, mnemonic strategies, and reminder technology in a meta-analysis because they are all “memory remediation”?)

For more than 10 years, a group of rehabilitation scientists and clinicians, at MRRI and elsewhere, have been working to develop a standardized system for specifying any and all rehabilitation treatments. We have established already that there is more than one way to do this, so the question is, Of the many ways that we could define and categorize rehabilitation treatments, which would be most useful in advancing science and practice? We argue for a treatment specification system based on the treatment’s known or hypothesized active ingredients. In this way, testing the efficacy of a treatment called “Treatment X”, is a test of the efficacy of a replicable set of ingredients as well as a test of the theory that those ingredients should produce clinical change: the treatment theory.

With an initial grant from NIDILRR (PI: Marcel Dijkers, PhD), the group developed this conceptual framework, the Rehabilitation Treatment Specification System (RTSS). With subsequent PCORI funding (PI: John Whyte, MD, PhD), these concepts were elaborated into a procedural process in the Manual for Rehabilitation Treatment Specification and described in a set of interrelated articles. The RTSS and its manual have now found a home at the American Congress of Rehabilitation Medicine (ACRM)’s Rehabilitation Treatment Specification Networking Group (RTS-NG), which serves as an organizing hub for the many clinicians and researchers around the world that seek to implement the RTSS framework into their work.

Anticipated benefits of the RTSS have been framed around three areas of rehabilitation: research, clinical practice, and education. We believe that use of the RTSS in the design, replication, and reporting of research will improve the development of treatments. It will encourage more systematic descriptions of the target of the proposed intervention – the direct, functional change that it is designed to cause; as well as the treatment ingredients – what is required in enacting the treatment in order to bring about the desired change in the target. Implementation of research into practice will also benefit, as providing more explicit descriptions of treatments and having a clearer understanding of the relevant components will assist the clinician in using these treatments with their individual patients.

Within clinical practice, use of the RTSS is also expected to enhance clinical reasoning, as the system facilitates consideration of the theoretical mechanisms that underlie rehabilitation treatments. The RTSS recognizes that, for example, many treatments across diverse rehabilitation settings rely on the mechanism that when a skill is practiced in the right way, that skill is improved upon. Whether the skill involved is reaching, articulating a word, or the act of walking, the RTSS directs considerations such as:

  • What are the important ingredients involved in the practice of that skill?
  • In what way is that skill desired to be changed?
  • Is it conceptually plausible? that the ingredients used will make the desired change?
  • What is the scope of the desired change in terms of generalizability, and will the ingredients support that?

The RTSS also has benefits in clinical education and training. Communication of treatments, both within and across disciplines, is enhanced through not only better identification of these essential elements of treatments as mentioned above, but also by providing a common language and systematic framework to describe treatments.

The RTSS has been used at MossRehab by groups of clinicians, including residents and fellows in MossRehab’s advanced training programs for occupational and physical therapists. While many trainees endorsed the benefits of more thoughtful consideration of both ingredients and targets of treatments, they also encountered some challenges in adopting this new system.

One common issue among clinicians was difficulty learning new RTSS terminology and needing time to “convert” daily documentation to align with RTSS guidelines. Not surprisingly, the extra time is a considerable barrier to clinical implementation. However, over time, we think that barrier will be reduced because academicians are interested in using the RTSS to teach methods of therapy delivery to their students. This conceptual framework can help students link clinical theory to specific actions (ingredients) by facilitating discussion regarding the treatment targets and details of intervention delivery. Active learning experiences during case studies and client simulations can engender habits of clearly describing treatments and evaluating the fit between ingredients and targets. The RTSS provides the structure and terminology to depict how the ingredients can be modified, based on patient performance. As such, students fortified with the RTSS will be better equipped to examine and understand the process of therapeutic change. Further, on a larger scale, colleges with allied health programs now have a structure that crosses multiple disciplines and can naturally enhance their inter-disciplinary education experiences.

These ongoing efforts in education, clinical practice, and research support our hope that the RTSS can be unifying for the field of rehabilitation.

For more information, please see these additional articles on the RTSS:

Van Stan J, Dijkers MP, Whyte J, et al. (2019). The Rehabilitation Treatment Specification System: Implications for improvements in research design, reporting, replication and synthesis. Archives of Physical Medicine and Rehabilitation.  100(1), 146-155.

Whyte, J., Dijkers, M., Hart, T., VanStan, J., Packel, A., Turkstra, L., Chen, C., Zanca, J., & Ferraro, M. (2019). The importance of voluntary behavior in rehabilitation treatment and outcomes. Archives of Physical Medicine and Rehabilitation. 100(1), 156-163.

Zanca, J., Turkstra, L., Chen, C. Packel, A., Packel, Ferraro, M., Hart, T., VanStan, J., Whyte, J., & Dijkers, M. (2019). Advancing rehabilitation practice through improved specification of interventions. Archives of Physical Medicine and Rehabilitation.  100(1), 164-171.

Hart, T., Dijkers, M., Whyte, J., Turkstra, L., Zanca, J., Packel, A., VanStan, J., Ferraro, M., & Chen, C. (2019). A theory-driven system for the specification of rehabilitation treatments. Archives of Physical Medicine and Rehabilitation. 100(1), 172-180.

Dr. Amanda Rabinowitz Interviewed on the People Behind the Science Podcast

Dr. Rabinowitz's headshot

Amanda Rabinowitz, PhD, was recently selected to be featured in an episode of the People Behind the Science podcast hosted by Marie McNeely PhD. In this interview, Dr. Rabinowitz discusses her exciting ongoing research identifying personal characteristics associated with better recovery trajectories in people following traumatic brain injury (TBI), and how she is applying mobile health technology to help patients better engage in and adhere to rehabilitation. She also speaks about her career path, advice for aspiring scientists, and the excellent mentors who helped cultivate and refine her research interests. Dr. Rabinowitz also gives listeners insight into her passions outside of research, including her love of cooking and baking sourdough bread.

Dr. Rabinowitz is an institute scientist and director of the Brain Injury Neuropsychology Laboratory, which examines the neurobiological and psychosocial factors that influence recovery from TBI across the spectrum of injury severity.

Listen to the full interview on the People Behind the Science website.

August 2020 Updates from MRRI

Moss Rehabilitation Research Institute scientists and staff members had a variety of accomplishments and events to celebrate during the month of August. First, we would like to congratulate Laurel Buxbaum, PsyD, and Amanda Therrien, PhD, who each received new grant awards from the Peer Review Committee (PRC). Under her award, Dr. Buxbaum will conduct initial feasibility and pilot studies using virtual reality to assess arm choice under cognitive load in people after stroke. Dr. Therrien’s award will fund a pilot study to assess behavioral predictors of responsiveness to a new movement training intervention for cerebellar ataxia.

Last month, we were also pleased to welcome two new postdoctoral scholars to our team of exceptional researchers. They have been meeting remotely with their mentors and have begun work on research activities. You can learn more about MRRI postdocs Haley Dresang, PhD, and Cory Potts, PhD, in our recent blog article. We also published a new blog post on the Parkinson’s Extension of the MRRI Research Registry featuring Emily Fannick and Katie Cornell, key staff members involved in recruiting new research volunteers.

MRRI scientists continued to make important contributions to the scientific literature in the field of neurorehabilitation with five new publications that were published or accepted for publication in peer-reviewed journals.

One of these papers, authored by Tessa Hart, PhD, Amanda Rabinowitz, PhD, and collaborators, describes the development and impact of a clinical protocol to improve communication with patients experiencing post-traumatic amnesia following brain injury. Post-traumatic amnesia commonly occurs immediately following a traumatic brain injury (TBI) and is characterized by confusion, disorientation, and memory loss. This protocol was developed to help clinicians better treat and effectively communicate with patients with TBI.

Amanda Therrien, PhD, and collaborators also published an article which builds upon their previous work studying a new method of movement training for individuals with cerebellar ataxia – a condition is normally associated with impaired motor learning. By altering training conditions to leverage reinforcement-based learning mechanisms that do not depend on the cerebellum, they showed that individuals with cerebellar ataxia can learn, in a complex reaching task, to reduce features of their ataxia. This work suggests that reinforcement-based interventions may hold promise as a new method to improve rehabilitation training for cerebellar ataxia.

In addition, Dylan Edwards, PhD, was selected among top experts to co-author a chapter in a new edition of the book Neurovascular Neuropsychology. This book provides updated information on our understanding of the brain and its blood supply, including advances in medical and surgical treatments and their impacts on neurocognitive outcomes. The chapter to which he contributed describes the state of the evidence and new advances in application of non-invasive brain stimulation to facilitate recovery in stroke survivors.

We are pleased to acknowledge these recent successes, and our scientists look forward to continuing to make important contributions to the field of neurorehabilitation research to improve the lives of individuals with neurological disabilities.

MRRI Welcomes Two New Postdoctoral Fellows

This month, the Moss Rehabilitation Research Institute (MRRI) welcomed two new postdoctoral fellows to its team of scientists. Over the course of their careers, these two scientists have developed expertise in scientific domains spanning human cognition, metacognition, motor planning, cognitive neuroscience, neurolinguistics, and neuroimaging.

Cory Potts, PhD, (featured above on the left) began his fellowship at MRRI on August 3rd. Prior to accepting his new position, Dr. Potts was a Visiting Assistant Professor of Psychology at Bucknell University, both teaching and conducting research.  He completed his undergraduate and graduate training in Psychology at The Pennsylvania State University.

Dr. Potts’s research examines interactions between cognition and action, focusing on the planning, performance, and metacognition of physical action.

In his prior work, Dr. Potts has investigated topics including the coordination of walking and reaching, comparisons of cognitive and physical effort, and the control of manual postures at various wrist angles.

His most recent research has examined the subjective experiences that accompany physical actions, such as feelings of control or agency, and the level at which actions are identified. Actions can be identified at levels ranging from higher-level, outcome-related descriptions to lower-level, movement-related descriptions.

Through his work, Dr. Potts aims to identify the factors that determine the level of action identification, how these levels of action correspond to perceived control, and how the metacognition of action can be used to improve outcomes for people who have impaired movement.

During his time at MRRI, Dr. Potts will be mentored by Associate Director Laurel Buxbaum, PsyD, and Institute Scientist Shailesh Kantak, PhD, PT.

Haley Dresang, PhD, (featured above on the right) started her fellowship on August 17th. Dr. Dresang completed her undergraduate training at the University of Wisconsin-Madison, specializing in Communication Sciences and Disorders as well as Spanish Language and Hispanic Studies. She was recently awarded her PhD in Communication Science & Disorders from the University of Pittsburgh and served as a Visiting Professor at the Universidad Nacional de Colombia.

Dr. Dresang’s research aims to elucidate how healthy and disordered brains process language and recruit semantic memory to support language processing. Her goal is to improve our understanding of cognitive and communication impairments caused by brain injury.

In her dissertation research, Dr. Dresang examined the cortical systems responsible for core language and memory processes, particularly semantic memory for actions and events. Her recent research has used cutting-edge neuroimaging methods and behavioral measures to identify how conceptual and linguistic processes are related and may be dissociated.

Through her research program, Dr. Dresang aims to characterize the cognitive and neural networks underpinning action and event semantic knowledge in language processing, and also to investigate the neuroplasticity and reorganization of these networks post-stroke.

Her long-term goal is to advance our knowledge of how semantic memory for actions and events can facilitate language recovery and successful communication strategies in adults with neurogenic communication disorders.

Dr. Dresang will be mentored by MRRI Associate Director, Laurel Buxbaum, PsyD, and Roy H. Hamilton MD, MS, Associate Professor at The University of Pennsylvania.

An Inside Look at the Parkinson’s Extension of the MRRI Research Registry

The pioneering research led by investigators at Moss Rehabilitation Research Institute (MRRI) would not be possible without the many dedicated research participants who have contributed their time and effort over the years. As part of the Klein Family Parkinson’s Rehabilitation Center at MossRehab, established in 2019, MRRI and MossRehab have worked together to expand the MRRI Research Registry. The Research Registry is a list of volunteers who are interested in participating in research at MRRI, and it now includes individuals with a diagnosis of Parkinson’s disease or Parkinsonism. Emily Fannick and Katie Cornell are two staff members who are integral to the process of recruiting new research volunteers. In this interview, Emily and Katie share more about their roles, this new extension of the MRRI Research Registry, and research opportunities at the Klein Family Parkinson’s Rehabilitation Center.

What prompted the development of a new extension of the MRRI Research Registry for MossRehab patients interested in participating in Parkinson’s related research?

Emily: People with Parkinson’s disease and related disorders frequently participate in programs at MossRehab. Advancing the scientific and clinical communities’ understanding of evidence-based neurorehabilitation for these individuals has recently emerged as a new but expanding area of research interest and was identified as critical to MRRI’s mission. Since its beginning nearly 20 years ago, our research registry has enrolled about 4,000 individuals who have experienced stroke (cerebrovascular accident; CVA) or traumatic brain injury (TBI). We are confident that expanding the MRRI Research Registry to include individuals affected by Parkinsonism will be a successful way to help researchers identify volunteers interested in learning about opportunities to participate in Parkinson’s-related research.

How is the Klein Family Parkinson’s Rehabilitation Center unique?

Katie: The Klein Family Parkinson’s Rehabilitation Center exemplifies MossRehab’s culture of research integrated with clinical care by focusing on improving the quality of care for individuals with Parkinson’s disease and related disorders through innovative approaches in rehabilitation. By expanding the MRRI Research Registry to include individuals with Parkinson’s disease and related disorders, the Klein Family Parkinson’s Rehabilitation Center will allow a variety of Parkinson’s-related research opportunities to flourish. In this way, it empowers patients from across the MossRehab network to help shape future care by participating in research studies designed to help better understand Parkinson’s disease and its treatment. This supports the central mission of the Klein Family Parkinson’s Rehabilitation Center “To provide evidence-based care by increasing our understanding of the effectiveness of current rehabilitation treatments while promoting greater synergy between clinical and research staff to increase collaborative innovation.”

What are some of your key responsibilities within the Parkinson’s extension of the MRRI Research Registry?

Katie: When individuals express an interest in becoming a member of the Research Registry, we facilitate this by walking them through the informed-consent process and enrolling them in the Research Registry so that they may be contacted about future research opportunities. We also help to raise awareness of this new extension of the MRRI Research Registry by holding information sessions at MossRehab outpatient centers. In addition, we develop and modify recruitment and enrollment procedures specifically for the needs of those affected by Parkinsonism and maintain the information in the Research Registry (e.g., updating contact information for Research Registry volunteers).

Every study is different, but can you give a general overview of the kinds of research studies that are conducted?

Emily: MRRI is home to approximately a dozen laboratories that have specific research focuses, with Parkinson’s and related disorders being one of them. Research studies are designed to investigate different areas of functioning within these patient populations, such as problems with speech and language, attention, memory, movement, and emotional well-being. Researchers also study which treatments work best in these areas. Patients may complete assessment batteries; participate in speech, language, movement, and/or cognitive tasks (e.g., talking about pictures and videos, imitating actions); and/or answer questions about how their lives are affected by their symptoms of Parkinsonism. Experiments may also make use of cutting-edge technologies such as immersive virtual reality and interacting with robots.

What is the process like for a patient who wants to join the Research Registry and the steps someone would go through to participate in a Parkinson’s-related research study here?

Emily: The process for an individual to volunteer to be a participant in the Parkinson’s extension of the Research Registry is twofold. After expressing their interest, the individual would first need to complete the informed-consent process to join the Research Registry. MRRI researchers are then able to search the Research Registry to identify and contact individuals that may be eligible to participate in their research studies. If the Research Registry member is eligible and interested in participating in a particular study, a second informed-consent process specific to that study will take place. The second informed-consent process provides the participant with details about the study (e.g., study duration, examples of tasks involved, and the risks and benefits of participation) and provides an opportunity to have their own questions about the study answered. It is really that simple! This same process applies to stroke, TBI, and Parkinson’s-related research. The informed-consent process, as well as all aspects of the Research Registry and any study that takes place at MRRI, is conducted with Institutional Review Board oversight.

For people who are considering getting involved in research, what are some of the benefits?

Katie: Getting involved in research allows people to contribute directly to science. Researchers rely on volunteers to participate in research so they can learn more about rehabilitation, Parkinsonism, and the brain, which may help improve rehabilitation services in the future for all of those living with the effects of neurological disease or injury.

What are some of your goals for the Parkinson’s extension of the MRRI Research Registry?

Emily: The overall goal for Parkinson’s research is to continue to develop best practices for treatment. For the Parkinson’s extension of the Research Registry specifically, we are really focused on streamlining our procedures to ensure we are reaching as many people as possible that might be eligible and interested in joining the Research Registry.

Katie: We also continue to strengthen our relationships with clinicians across MossRehab outpatient centers to raise awareness of this new extension of the Research Registry as well as all of the research opportunities at MRRI and MossRehab.

What do you like most about what you do?

Katie: The best part of what I do is interacting with potential Research Registry participants and their family members. I have met so many interesting and friendly people that are eager to get involved!

Emily: I have two favorite parts of my position that make working as a Research Registry Recruiter very special and rewarding. The MRRI Research Registry staff, researchers at MRRI, and all therapists, clinicians, and physicians at MossRehab are very passionate about what they do and why they do it — to help others. That passion resonates with me and motivates me in my own work every day. Secondly, working with patients and their families one-on-one really puts into perspective the benefits that research can deliver for the patient populations that we study.

July 2020 Updates from MRRI

Last month, MRRI scientists continued to make progress remotely on a variety of research projects and to engage virtually with the broader community. We published a blog article highlighting newly published criteria to care for patients with disorders of consciousness, as well as an article shining the spotlight on the generations of Klein family members who have supported MRRI, MossRehab, and the Einstein Healthcare Network.

In addition to being sought-after experts in their respective research areas, our scientists are also important contributors at a national level in advocating for science and medicine. MRRI Director and Director of the Human Motor Recovery Laboratory, Dylan Edwards, PhD, was recently featured in an article in Philadelphia Magazine discussing the challenges that Black scientists continue to face in securing funding from organizations like the National Institutes for Health (NIH). In this article Dr. Edwards describes potential factors that may contribute to a lower likelihood of funding success in Black or other minority applicants and important steps that should be taken to remedy these disparities.

Further, John Whyte, MD, PhD, Former MRRI Director and Founding Director of the TBI Rehabilitation Research Laboratory was interviewed by the Association of Academic Physiatrists about his dedication to advocacy throughout his career. Dr. Whyte shares what motivated him to become involved in advocacy efforts, challenges he has encountered, and why he believes it is important for physicians to take an active role in these national conversations that impact the patients they serve.

In some cases, the perception that scientists are somehow different from others may be a barrier in fostering connections and conversations between researchers and our communities. To help overcome this barrier, Dr. Umesh Venkatesan, PhD, Institute Scientist and Director of the Brain Trauma and Behavior Laboratory, was recently featured on the People Behind the Science podcast. Through this program, Dr. Venkatesan shares his research on aging with moderate-to-severe TBI in a way that is interesting and accessible to a wide audience, and he gives the public insight into what life is like as a scientist.

We feel honored and privileged to have the opportunity to continue to dedicate our voices to reducing disparities, promoting equity, and fostering connections between scientists and the people within our own communities and around the world.

Spotlight on the Legacy and Contributions of the Klein Family

It all began in 1952. When Albert Einstein Medical Center was created, Julius Klein was among the community leaders in Philadelphia who came together to form the first Board of Trustees. Over the years, Julius continued his service on the Board of Trustees, and later held positions as President, Chairman of the Board, and Lifetime Chairman. His enthusiasm for the Einstein Health Network and the services it provided the community was contagious. Other members of the Klein family soon joined Julius in supporting Einstein, including Julius’s wife Eleanor, as well as his siblings, nieces, nephews, and his own son Robert. For five generations now, the Klein Family has been dedicated to working with the Einstein Healthcare Network to make a difference in the health and wellness of patients. Five generations of Klein family members have been involved with Einstein in different roles, serving as executive leaders, board members, volunteers, ambassadors, philanthropists, and dedicated supporters.

In addition to their legacy of giving back to their community through service to Einstein, Klein family members have provided many significant gifts to support the important work being done across Einstein Healthcare Network. The legacy of the Klein family is found in the many capital projects which are both a testament to their love of Einstein, its history, and patients, like the  restoration and re-dedication of Einstein’s historic Henry S. Frank Synagogue and the design and construction of  the Klein Family Garden, a welcoming space for patients, families, and caregivers, as well as the Samuel and Minna Daniel Klein Professional Office Building which houses some of Einstein’s exceptional health care programs like the Center for Advance Liver Disease and Transplantation.

Einstein Healthcare Network and MossRehab are fortunate to be affiliated with the Moss Rehabilitation Research Institute (MRRI), founded in 1992 by Myrna F. Schwartz, PhD, and John Whyte, MD, PhD. The goal of the Institute was to consolidate research activities happening at MossRehab and cultivate new initiatives in rehabilitation research. Not long after MRRI began its work, Judy Klein Franken, daughter of Julius Klein, was diagnosed with Parkinson’s disease. She realized the treatment options available at the time (primarily dopamine replacement therapies and deep brain stimulation) were limited, and she wanted to be part of the effort to develop new and innovative treatments for Parkinson’s disease. Judy began dedicating her time to volunteering as a research participant and, to date, she has participated in 17 research studies.

More recently, Judy’s nephew Peter Klein was also diagnosed with Parkinson’s disease. When Peter realized that MRRI and MossRehab were interested in developing a groundbreaking new model of integrated Parkinson’s research and care, he quickly took action. Peter, Judy, and other members of the Klein family came together to bring this initiative to fruition.

In 2019, the Klein Family Parkinson’s Rehabilitation Center was established at MossRehab as the first integrated rehabilitation program to use research-supported clinical interventions for rehabilitation in people with Parkinson’s disease. Within its first year, the Klein Family Parkinson’s Rehabilitation Center has made tremendous strides integrating innovative research from MRRI with world-class rehabilitation services from MossRehab to help people with Parkinson’s disease remain active and maintain a high quality of life. To that end, we have combined efforts with MossRehab to establish a database of patient volunteers who are interested in participating in Parkinson’s-related research at MossRehab, modeled after their successful stroke and TBI Research Registry. Currently enrolling research participants, this effort creates valuable opportunities for patients to participate in pioneering research studies led by investigators within MRRI. In addition, a major emphasis of the Klein Family Parkinson’s Rehabilitation Center is to facilitate evidence-based care through in-depth analysis of current clinical practices and their impacts on patient outcomes throughout Einstein Healthcare Network.  

We are grateful for the generous support provided by the Klein family which has allowed us to establish the Klein Family Parkinson’s Rehabilitation Center to advance scientific and clinical knowledge about Parkinson’s disease and serve as an important resource for patients and their families. The Klein family’s philanthropic contributions were further recognized in 2019 with receipt of the Multigenerational Family Achievement Award from the Greater Philadelphia Chapter of the Association of Fundraising Professionals. Their nomination was initiated by Einstein Healthcare Network. Looking forward, the legacy of the Klein family at Einstein continues as we are proud to have Julius’s great-grandson Sam Klein serving as a member of the Einstein Healthcare Network Board of Overseers.

Donations of all sizes help support important research at MRRI as well as clinical activities across Einstein Healthcare Network. Philanthropy and service are great ways to engage with your community, and the Klein family has shown how the spirit of giving back to the community can be a uniting force that spans generations.

June 2020 Updates from MRRI

A group of individuals sit around a table clapping to a beat.

June was National Aphasia Awareness Month, and our scientists and staff members had opportunities throughout the month to share their important aphasia research and help increase awareness of this language impairment that may occur after a stroke or other brain injury. The MossRehab Aphasia Center is well-known worldwide for exceptional research and treatment of aphasia, and we were excited to highlight some of the outstanding work being done there. We published blog posts on the history of aphasia research at MRRI and important contributions to the field by MRRI Co-Founder Myrna Schwartz, PhD, the Constance Sheerr-Kittner Conversation Cafés, and the Musical Mondays Program.  

Throughout the month of June, members of the Aphasia Center were involved in various presentations and outreach events. In case you missed any of these, we’ve included links below. 

In addition to shining a spotlight on our work on aphasia, we were excited to publish a blog post sharing the story of one of our research participants with traumatic brain injury and a post highlighting research on the role of sustained attention and effort in arm non-use in people with stroke conducted by Laurel Buxbaum, PsyD, MRRI Associate Director and Director of the Cognition and Action Laboratory. Further, MRRI Scientists were authors on three new research papers that were recently published or accepted for publication in peer-reviewed scientific journals.  

We are also pleased to congratulate Shailesh Katak, PT, PhD, on being awarded the Michael L. Berger Faculty Scholars and Artists Prize from Arcadia University. In addition to his appointments as MRRI Institute Scientist and Director of the Neuroplasticity and Motor Behavior Laboratory, Dr. Kantak is Assistant Professor in the Department of Physical Therapy at Arcadia University. This recent award recognizes his groundbreaking scholarly work in the area of motor control and skill learning.  

As we enter the second half of 2020, we look forward to continuing to make progress on research and sharing our innovative rehabilitation research with the scientific community and the public.  

The People Behind the Science Podcast Features Dr. Umi Venkatesan

Portrait of Dr. Vankatesan

In its most recent episode, the People Behind the Science podcast interviews Umesh “Umi” Venkatesan, PhD. Umi is an Institute Scientist at MRRI and Director of the Brain Trauma and Behavior Laboratory. In his interview, Umi discusses his research on medical and psychosocial risk factors that may contribute to outcomes and outcome trajectories after traumatic brain injury. He also shares his path to becoming a scientist at MRRI, from his very first psychology class in high school to getting a job offer and launching his independent research lab. In addition to academic topics, the podcast’s host Marie McNeely, PhD, explores Umi’s interests outside of science, including his passion for music, dance, culture, and cuisine.

You can listen to Umi’s full interview on the People Behind the Science website.

Criteria to Care for Patients with Disorders of Consciousness

Head shot of Dr. John Whyte

Rehabilitation after brain injury has traditionally required the active participation of the patient to learn new skills and ways of coping with their disability. As a result, for many years, patients with a disorder of consciousness (DOC – i.e., unconscious or minimally conscious) after brain injury, were typically excluded from acute inpatient rehabilitation and treated, instead, in subacute nursing facilities or in family homes with medical support. Recent research has shown that patients who are unconscious when they enter acute rehabilitation often show great improvement in function and participation before discharge. Moreover, their complex medical and physical problems are best managed by experienced brain injury rehabilitation professionals in specialized programs.

Clinicians and researchers within the Traumatic Brain Injury Model System (TBIMS), in collaboration with colleagues with similar interests from the American Congress of Rehabilitation Medicine (ACRM), seek to expand access to rehabilitation for DOC patients. However, since access has been restricted for many years, even facilities with substantial TBI rehabilitation expertise are not necessarily skilled in caring for patients with DOC. Thus, if rehabilitation access for this population is to expand, it is important to ensure that the necessary staff, resources, and skills are available to treat them.

Experts in DOC rehabilitation from the TBIMS and the ACRM have collaborated to develop consensus-based recommendations for the minimal competencies needed by programs serving this population. The 21 recommendations focus on skills and processes needed for diagnosis and outcome prediction, treatment, transitioning of care, and ethical issues. Recommendations are supported by research when available, and are accompanied by an “audit checklist” for program evaluation.

The recommendations are available in an article in the journal Archives of Physical Medicine and Rehabilitation with former MRRI Director John Whyte, MD, PhD, as a lead author.

This article was adapted from an article originally published in The MossRehab Traumatic Brain Injury Model System’s Spring 2020 Edition of Brain E-News.