In the proposed Texas Model Spinal Cord Injury System (TMSCIS) project, TIRR-Memorial Hermann (TIRR) will our key partners, the University of Texas Health Science Center (UTHealth) and the University of Montana (UM), and other stakeholders to conduct innovative SCI research to improve outcomes and advance rehabilitation methods, procedures, and technologies. TIRR provides a comprehensive system of care for persons with SCI extending from emergency medical services to intensive acute medical care; comprehensive inpatient and outpatient rehabilitation; psychosocial services; and long-term follow-up. The overarching goals of the TMSCIS are to improve health and function and community living and participation among persons with SCI. TMSCIS research is hypothesis-driven with well-articulated aims and expected outcomes to maximize the positive impact on persons with SCI, the field of research, and public policy. As one of the four original SCI Model Systems centers with funding beginning in 1973, we have a long-term record of excellence in clinical care for persons with SCI. TIRR has been ranked among the top five rehabilitation hospitals in the nation for all 27 years that U.S. News & World Report has provided these rankings, with a current ranking of #3.TMSCIS is positioned to continue its high level of contributions to the National SCI Database in the upcoming funding cycle. Using a Community-Based Participatory Research approach in our proposed Site-Specific Project , Living Longer and Stronger with SCI, we will partner closely with two team members with lived experience aging with SCI, a 6-member Community Advisory Board of people aging with SCI, and a Medical Advisory Board on Aging after SCI, to conduct a clinical trial of a ground-breaking, multi-session health promotion group intervention designed to address the aging-related health needs of people with SCI. The program will be delivered in the online virtual world of Second Life. Our inn
ovative approach will respond to the unique, and previously unaddressed, health and function and community living and participation needs of people aging with SCI. The objectives are to conduct a randomized controlled trial testing the intervention compared to a control group with a national sample of 192 men and women with SCI who are at least 45 years of age or who are at least 15 years post-injury. With assessments at three time points (pre-intervention, post-intervention, and six-month follow-up), we will use general linear mixed models (GLMM) to examine the immediate and longer term efficacy of the intervention and mechanisms through which the intervention influences physical, psychological, and social health outcomes. In addition, we will use qualitative and quantitative methodologies to conduct formative and summative evaluations of the program. The objective of our proposed Collaborative Module Project is to examine the relation of standard opioid administration, at the scene of injury and acute care, to a) motor functioning at rehab discharge and b) depression and pain outcomes at 1-year post injury. With rodent models demonstrating negative impacts of early opioid administration on motor recovery, pain, and depression, this cutting-edge proposed project is the first prospective investigation of the relation between early opioid administration after injury and subsequent outcomes in people with SCI. This innovative research could result in a high level of clinical significance and could inform later intervention strategies and acute pain management programming. TMSCIS will develop knowledge translation materials in various accessible media designed to reach consumers, clinicians, and researchers to inform health-related decision-making of persons with SCI and their medical service providers. Our proposed research addresses critical health-related needs of people with SCI with the potential to exert a sustained and powerful influence on clinical practice an
d policy change.