We propose the creation of the Minnesota Regional Spinal Cord Injury Model System (MN Regional SCIMS) in response to the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) 2021 call for proposals. The MN Regional SCIMS is a multidisciplinary continuum of care for people with spinal cord injury (SCI), including emergency medical services, acute care services, acute rehabilitation services, and post-acute services. Our system brings together internationally recognized leaders in SCI clinical care, research, and lived experience advocates as well as the world-renowned resources of Courage Kenny Rehabilitation Institute (CKRI), Mayo Clinic, Regions Hospital (Regions), and University of Minnesota (UMN)/MHealth Fairview. Our system fills a critical SCI Model Systems gap in the upper Midwest region and is in the heart of Minnesota’s “Medical Alley,” widely referred to as the Silicon Valley of healthcare and medical technology. The overall goal of the MN Regional SCIMS is to provide a multidisciplinary continuum of care for people with SCI as a basis for research that aligns with NIDILRR’s Long Range Plan and expands existing research that can be used to improve services and outcomes for people with SCI. To accomplish this, we propose the following system goals:
1. Leverage our multidisciplinary system of care to advance national SCIMS initiatives.
2. Collect high-quality, representative, longitudinal data that will increase the racial, ethnic, and socio-economic diversity of the National Spinal Cord Injury database.
3. Implement an SCI model system founded with Diversity, Equity, and Inclusion ideals while ensuring that the input of people with SCI is used to shape our system activities. We are committed to providing exemplary care to all individuals of all backgrounds. Consistent with the SCI community’s call for research that is “with us, not for us,” our Community Engagement Committee will ensure active involvement of individuals with lived experience on the Executive Committee and in clinical program development, advocacy efforts, and all aspects of the research process.
4. Contribute to improving long-term SCI outcomes and improved services through participation in one site-specific and at least two modular research projects. Consistent with the research priorities highlighted during “SCI 2020: Launching a Decade of Disruption of Spinal Cord Injury Research,”(Morse, Rodreick, Wudlick, et al) our site-specific project is focused on improving the health and function of people with SCI and reducing secondary complications by determining the efficacy of a novel therapeutic intervention to treat neuropathic pain. We will conduct a randomized, double blind, placebo-controlled trial to determine whether a three-month course of daily brivaracetam reduces below-level neuropathic pain and improves related outcomes including mood, satisfaction with life, vocational activities, and community integration. This project was selected with the input of our Community Engagement Committee who consider the work to be important to the SCI community (see letter of support). As a high-volume system engaged with a diverse and representative community of individuals with SCI and neuropathic pain, we are uniquely positioned to successfully complete this clinical trial. We also propose one modular research project and will collaborate on at least one other project led by another funded center.
5. Implement our dissemination plan to share our clinical expertise and scientific results with multiple audiences (clinicians, researchers, individuals with lived experience, advocates, payors, and policy makers) and to continue our work with the Model Systems Knowledge Translation Center (MSKTC, see letter of support).