Vol. 36 No. 1, January 1999
Pages vii — viii
Mindy L. Aisen, MD
Director, VA Rehabilitation Research and Development/VAHQ; Editor in Chief, Journal of Rehabilitation Research and Development
The Rehabilitation Research and Development Service looks to the next century with great optimism. Its potential for clinical advances in rehabilitative care is enormous. Building on the progress made by clinician researchers over the last half century, we anticipate advances that will not only improve functional recovery, but enhance genuine recovery. It is within our grasp to expand the armamentarium of rehabilitative therapies beyond adaptation to increasingly greater restoration, promoting optimal independence for our veterans.
Restoration of function will grow from the fundamental core of traditional rehabilitation thinking: the maximization functional recovery through compensatory techniques and adaptive equipment. Our research efforts will continue to adapt emerging technologies to bring new developments in knowledge and materials to the immediate use of the veteran, and we shall continuously validate rehabilitation therapies while seeking consensus on outcome instruments in the light of these developments. Clinicians caring for persons with chronic impairments are in the best position to observe and define intrinsic mechanisms of healing; since the VA is the hands-on service for a large population of such persons, we are uniquely positioned to advance this knowledge, and it, in turn, can enable the rehabilitation research community to devise new therapies to enhance recovery, approaching the ultimate goal of all rehabilitation clinicians: healing the whole person.
Dedicated to promoting the health of veterans with disabilities through a wide spectrum of research activities, Rehab R&D is working to elucidate the pathophysiology of, and implement new restorative treatments for, chronic impairments of all sorts: paralysis, hearing and vision loss, amputation, and cognitive defects. Our engineers create accessible environments and apply novel technologies to the rehabilitative care of veterans. Individual investigators focus on a wide array of relevant areas ranging from amputation prevention and joint replacement to optimal wheelchair propulsion and guidance techniques to the early detection of hearing loss.
Several funding mechanisms have been initiated or enhanced to build VA research capacity in these areas and to expand our reach.
Approximately 75% of Rehab R&D funding supports investigator-initiated studies emanating from VA clinicians and investigators within the veterans health care system. Investigator proposals are reviewed biannually in priority areas of Prosthetics/Amputation/Orthotics; Spinal Cord Injury; Communications, Cognitive, and Sensory Aids; and Disabilities associated with Aging. In addition, Rehab R&D targets underserved areas of need within the veteran population by direct solicitation for studies. Recent special reviews have included proposals focused on Rehabilitation Outcomes, and this will become a regular study priority area. Additional targeted areas, now in the planning stages, include Telemedicine, Assistive Technology, Multiple Sclerosis, Traumatic Brain Injury, and NeuroRehabilitation.
The new VA Rehabilitation Research and Development Centers cultivate communities of researchers focused on discrete areas of investigation. The various Centers study aging with a disability, functional electrical stimulation (FES), mobility for persons with neurologic and orthopedic impairments, geriatric rehabilitation, amputations and prosthetics, and hearing impairment. Through them, VA has been at the forefront of award-winning innovations, such as the Freehand System, an implantable FES device that allows persons with spinal cord injury to grasp, hold, and release objects of various sizes and shapes. We have recently begun the process of establishing new Centers, considering the areas of Low Vision, Upper Extremity Prostheses, Traumatic and other Brain Injury, Novel Rehabilitation Interventions for Parkinson's Disease, Stroke and Neurologic Repair, Multiple Sclerosis, and Spinal Cord Injury/Disease for this concentrated research approach.
We are developing a series of research programs for clinicians interested in developing research skills: the Career Development and Advanced Career Development Awards give VA clinicians 3 years of protected time to conduct research in a mentored environment. Eligible candidates are fully trained clinicians entering a research career after completing their residencies. For clinician scientists with some research experience, but who are not yet fully independent investigators, we have advanced awards appropriate to their needs and interests; additionally, we provide enhancement awards for those experienced investigators who wish to pursue new areas of research. Our goal with these is to promote the intellectual cross-pollination that occurs when knowledgeable individuals encounter new new problems and possibilities.
We also provide 1-year pre-doctoral fellowships through the VA Office of Academic Affiliations. These are intended to attract bright young minds into rehabilitation by supporting their work on a research dissertation of relevance to the health care needs of veterans with disabilities.
Finally, we have established a Research Career Scientist program for PhD scientists to attract and keep stellar investigators under 5-year contracts, with the design of building a stable core of senior scientists to innovate and to mentor the innovations to come.
The world of Rehab Research is growing and ever changing. To stay on top of what's going on visit our Web sites at http://www.va.gov/resdev and http://www.vard.org.
Mindy L. Aisen, MD
Director, VA Rehabilitation Research and Development/VAHQ;
Editor in Chief, Journal of Rehabilitation Research and Development
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