This Rehabilitation Research and Training Center on Health and Function for People with Physical Disabilities targets people with physical disability who have Neurogenic Lower Urinary Tract Dysfunction (NLUTD). NLUTD cuts across multiple types of physical disability and commonly affects people with spinal cord injury and disease (SCI/D), stroke, spina bifida, multiple sclerosis, Guillain-Barre, brain injury, Parkinson’s disease, and others. As such, a broad range of people with physical disability will be served by this RRTC. Focusing on three novel, innovative and potentially transformative interventions, and a wide range of consumer and professional training, this RRTC will leverage expertise and strengths in the areas of: rehabilitation research and clinical care; post-doctoral, graduate, and undergraduate training; neurogenic bladder research and advocacy; consumer engagement in research; disability-related national advocacy; online education development; and dissemination outreach. Because of our close proximity to national elected officials, policymakers, and the national media, this RRTC can also be a particularly compelling advocate for persons with physical disabilities.
Led by MedStar National Rehabilitation Hospital (MedStar NRH), whose credo is to “Add Life to Years”, this RRTC is a collaboration of rehabilitation centers (Georgetown University (GU), The Institute for Rehabilitation Research(TIRR), Children’s National Medical Center (CNMC)) that partner with national organizations (Neurogenic Bladder Research Group, Spina Bifida Association, United Spinal Association, National Multiple Sclerosis Society), together serving people with physical disabilities. MedStar NRH is an ideal home for this RRTC because MedStar Health is the primary provider of medical (including rehabilitation) clinical services within the Baltimore - Washington corridor, and together MedStar Health and GU represent one of the strongest academic–research-clinical infrastructures in the mid-Atlantic region.
We propose three research projects that squarely meet RRTC and NIDILRR priorities. In Research Project 1, we expand our use of intravesical Lactobacillus for urinary symptoms among people with NLUTD who use indwelling catheters for bladder management. In Research Project 2, we will assess neuromodulation of the bladder using transcutaneous tibial nerve stimulation in a randomized controlled trial. In Research Project 3, in conjunction with an ongoing clinical trial, we will describe the impact that bladder management has on quality of life and participation outcomes and then assess these in the context of the first-in-human clinical trial of the Connected Catheter (a urethral prosthetic designed to allow for on-demand voiding in people with NLUTD). Consumer Experts (people with or caregivers for people with NLUTD) have been and will continue to be integrated with all research and dissemination (including leading consumer dissemination activities) to ensure that our research activities are relevant and impactful for the community of people with physical disability and NLUTD.
We integrate a strong educational and training program in this RRTC that combines outstanding mentorship and educational opportunities in clinical rehabilitative care and research to foster studies and develop capacity in rehabilitation research to enhance health and function outcomes for individuals with physical disability. Specifically, we propose the career development training for three Early Career Investigators, and capacity for training of postdoctoral fellows, clinicians, under/graduate students, and consumers, with GU providing access to facilities and coursework for trainees. In sum, the research activities of this RRTC comprise novel interventions, our consumer education and training are expansive and far-reaching, and individualized professional training opportunities for professionals will ensure the continued growth of high level rehabilitation research.