The Rocky Mountain Regional Spinal Injury System (RMRSIS) is committed to achieving the goal of providing comprehensive, multidisciplinary services for individuals with traumatic spinal cord injury (SCI) and conducting research that develops evidence-based rehabilitation interventions. Our application proposes to build upon over 45 years of continuous participation in the SCI Model Systems (SCIMS) program by continuing to assess long-term outcomes of people with SCI, conducting an innovative site-specific study, proposing and participating in collaborative module research, maintaining exemplary SCIMS National Database participation, and advancing an established SCI system of care and research. The application outlines our plans for 1) ensuring that we include individuals from racial/ethnic minority backgrounds, 2) carrying out activities to develop accessible disseminated materials, 3) coordinating with the Model Systems Knowledge Translation Center, and 4) collaborating with people with SCI throughout the program. The objectives are to 1) conduct a site-specific randomized controlled trial to investigate the efficacy of three approaches (functional task specific practice [FTP] alone, conventional functional electrical stimulation [FES] plus FTP, and wide pulse/high frequency FES plus FTP), to improve upper extremity (UE) function and trunk stability in people with SCI; 2) lead a module research project to evaluate the oral health status among a US SCI sample; 3) contribute at least 30 new Form I and 50 new Registry cases annually to the SCIMS National Database and continue contributing high numbers of follow up data that meet high quality standards; and 4) maintain a successful system of care. Anticipated outcomes include 1) yielding robust evidence regarding FES technology use to improve UE function and trunk stability after cervical SCI to inform clinicians and consumers about the most efficacious intervention being delivered to promote UE
and trunk recovery; 2) obtaining evidence about the oral health status of people with SCI in the United States that can support providers to deliver better services and sets the stage for developing targeted interventions to help people with SCI improve their oral health; and 3) continuing to improve our world-renowned system of care in meeting the lifetime needs of people with SCI through regular evaluation of service efficiency and benefit. Expected outputs include manuscripts in high-impact peer-reviewed journals, presentations at national professional scientific meetings, plus a factsheet and resource guide on maintaining oral health for people with SCI.