Section II
VA Sponsor Index
with Selected Program Summaries

Part A: Department of Veterans Affairs

Rehabilitation Research and Development Service
810 Vermont Avenue, N.W.
Washington, DC 20420

  The mission of the Rehabilitation Research and Development Service is to support an Intramural Research and Development Program for improving the quality of life of impaired and disabled veterans. This is accomplished by conducting a comprehensive program of research, development, and evaluation of existing and emerging rehabilitation technology (devices, techniques, and concepts of rehabilitation). This provides for rapid transfer of Rehabilitation R&D technology and dissemination of information into the VA medical care system, allowing for greater functional independence in the activities of daily living of disabled veterans and contributes to the nation's knowledge about diseases, disability, and rehabilitation.

  Areas of special emphasis include aging, physical fitness, and psychosocial rehabilitation.

  In areas of prosthetics, amputation, and orthotics, VA-sponsored researchers are continuing to test new materials and use computer technology such as CAD/CAM to develop a new generation of artificial limbs. For spinal cord injuries, the use of robotics continues to be studied, as does the possibility that computer-controlled electrical stimulation can be used to restore function to paralyzed limbs. Research projects in the area of sensory aids include the continuing development of advanced mobility aids for visually impaired people, digital hearing aids for those with hearing impairment, and various studies on treatment strategies and communication systems for aphasic individuals.

  The Department of Veterans Affairs Rehabilitation Research and Development Service (Rehab R&D) sponsors a national program to review proposals submitted by researchers in the field of rehabilitation. The Rehabilitation Research and Development Service Scientific Merit Review Board and ad hoc members assess proposals for their scientific and technical merit, budgetary needs, and time requirements.

  The VA Rehab R&D Program's scientific and technologic operation is located at 103 South Gay Street, Baltimore, MD 21202, which consists of the following two programmatic sections:

Technology Transfer Section
Saleem J. Sheredos, Program Manager

  The Technology Transfer Section (TTS) evaluates potential products emerging from rehabilitation R&D, primarily sponsored by the VA. Requests involving non-VA funded development are also reviewed to identify products or techniques that may meet specific VA needs in one of the designated special emphasis areas: Prosthetics/Amputations/ Orthotics; Spinal Cord Injury; and Communication, Sensory, and Cognitive Aids, with aging and rehab outcomes crossing all three specialties.

  The TTS is responsible for the design and management of a systematic process to validate proven rehab R&D findings and to transfer the successful outcomes into clinical use, product manufacture, and commercial availability. The ultimate goal is for timely transition of prototypes into commercially viable products and techniques that benefit veterans and non-veterans with disabilities. This process partners and coordinates the developer, a manufacturer, VA Headquarters, and clinical test sites.

  Once the research idea/concept has moved into development, the outcome is usually a working prototype, which then completes successful laboratory and limited clinical trials prior to entering the technology transfer process.

  The R&D principle investigator next submits a Request For Evaluation (RFE) to the TTS. The RFE elicits specific information that is used to review the appropriateness and readiness of the development as a TTS project. A RFE peer review then confirms VA's need, interest, and readiness of the developed product or technique for evaluation and clinical use. The following selection criteria are used for the review: 1) VA level of need/interest; 2)fitness for use; 3) manufacturable/pre-commercial; and 4) marketable.

  Once the RFE peer review is complete and responses are positive, the TTS formulates and submits a recommended plan of action, including budget support, to the Director, Rehab R&D Service. Approval at this level commences the manufacture and evaluation phases, after which TTS prepares the final report with specific recommendations for commercial availability.

Scientific and Technical Publications Section
Jon S. Peters, Acting Program Manager

  The Scientific and Technical Publications Section (STPS) disseminates the results of VA and non-VA scientific and engineering projects among researchers, engineers, clinicians, and consumers in the United States and throughout the world. STPS distributes research, development, and clinical information through print and electronic media, including publication of the Journal of Rehabilitation and Development (JRRD), Rehabilitation R&D Progress Reports, and clinical supplements to JRRD. STPS also has an Information Resource Unit with a visual information specialist and a scientific and technical photographer.

Under the Office of Research and Development,
Rehab R&D Service has a Research and
Development Center or Unit in each of the
following locations:

Center of Excellence in Geriatric Rehabilitation

Rehabilitation Research and Development Center
VA Medical Center Atlanta
Decatur, GA 30033

Joseph G. Ouslander, MD, Director

  The Atlanta Center is charged with improving the function, independence, and quality of life of Veterans aging with disabilities by working to understand the mechanisms underlying those impairments and applying this understanding to the design, testing, and evaluation of creative rehabilitative interventions.

  In the fall of 1996, Joseph G. Ouslander, MD, was appointed Director of the Center. Dr. Ouslander is an internationally recognized researcher in long-term care with experience in developing and managing research centers that focus on functionally disabled older adults.

  A graduate of Johns Hopkins with his MD from Case Western Reserve, Dr. Ouslander brings a wealth of general and specialized medical expertise to the Center. He is board-certified in both Internal and Geriatric medicine, in addition to being a Certified Medical Director. He sits on the editorial boards of several journals, as well as reviewing manuscripts for several more, including JAMA and The New England Journal of Medicine.

  As active in teaching as in the practice of medicine, Dr. Ouslander has been on the faculties of Johns Hopkins and UCLA; he presently is Professor of Medicine at the Emory University School of Medicine, where he is Director of the Division of Geriatric Medicine and Gerontology and also Chief of Medicine at the Wesley Woods Geriatric Center. His publications of journal articles, book chapters, and monographs number in the hundreds, as do his presentations and lectures at scientific and medical conventions.

  Though a Rehabilitation Research Unit has been in existence at the Atlanta VA since 1982, we were officially designated a VA Rehabilitation Research and Development Center by the 5-year plan of 1989. Despite an initial lack of space, equipment, and (for nearly 4 years) a permanent Director, the Center has made major contributions to R&D and to the care of aging Veterans with physical, sensory, and cognitive disabilities. We now have 11,000 square feet of newly renovated contiguous office and laboratory space in the main Medical Center tower and an additional 2,100 square feet of laboratory in the new clinical building.

  We direct our research toward understanding the mechanisms underlying the disabilities associated with age and we apply this understanding to the design, testing, and evaluation of creative rehabilitative interventions in three areas: vision, environment and behavior, and physical performance and exercise. We also indertake projects that highlight the interactions among these areas. The Center is structured according to those three areas: supporting the researchers in each are the administrative support and the core services whose functions cut across the research and training programs: statistical and data management and dissemination of information.

  The senior investigators and support group leaders meet monthly as an internal steering group to review both developmental and major research proposals, provide feedback to the investigators, make decisions on which developmental research projects should be supported, and advise the Director on major administrative issues. We benefit from a National Advisory Group of recognized experts in areas relevant to our research that meet with key Center investigators for 2 days yearly to review our research activities and suggest future directions. We also receive annual guidance from a Consumer Advisory Group of representatives from major consumer organizations that meets with investigators and staff on research directions and dissemination activities.

  In addition to major research projects, a developmental research program will utilize Center core support for two projects per budget year in each of the major research areas, and one or two rehabilitation engineering projects in conjunction with a collaborative program among medical and engineering scientists at Emory and Georgia Tech. This program will promote the Center's growth and success by developing preliminary data critical for major research proposals; fostering interdisciplinary research, involving investigators from affiliated institutions, providing opportunities for graduate students and junior investigators, and developing research proposals for submission to the VA, NIH, and other funding sources. We have thus far dedicated $120,000 to the support of eight developmental projects during this budget year.

  We work with our major university affiliates to identify promising graduate students and to involve them in Center research through graduate research assistanceships (GRAs) or other mechanisms. We network nationally to identify promising postdoctoral and junior investigators interested in our research areas. Students involved in Center-based training activities will be enrolled in appropriate programs at Emory (neuroscience, physical therapy, clinical psychology), Georgia Tech (biomechanical and electrical engineering, architecture), and Georgia State (kinesiology and health, gerontology), leading to MS, PhD, or MD degrees. Additionally, Emory has physician residents and fellows in Rehab Medicine and Geriatrics who can be involved in Center research. All trainees will be expected to actively participate and periodically present at the Center's research seminar/journal club. The Center has budgeted $40,000 this year to support trainees: presently, we are working with one graduate student from Georgia State and one graduate and two undergraduate students from Georgia Tech.

  While our primary university affiliation historically has been with nearby Emory University, we are strengthening our relationships with Georgia Tech and Georgia State. With an enrollment of almost 12,000 students and over 2000 full-time faculty and professional researchers, Georgia Tech is the South's largest industrial and engineering research agency. Georgia State University is one of four research universities in the University System of Georgia, providing undergraduate and graduate education to 24,000 students through six colleges offering 46 different undergraduate majors, 23 master's programs, and 14 doctoral degree programs.

  The gold standard of research is publication, and we are proud that so much of our research has been recognized by our peers in the field.

Center of Excellence for Functional Electrical Stimulation

A consortium of the Cleveland VA Medical Center, Case Western Reserve University, MetroHealth Medical Center, and Edison BioTechnology Center
P. Hunter Peckham, PhD, Director

  The Functional Electrical Stimulation (FES) Center of Excellence is part of an internationally recognized consortium known as the Cleveland FES Center. It consists of the Cleveland VA Medical Center, Case Western Reserve University, Metro Health Medical Center, and Edison BioTechnology Center.

  A Professor of Biomedical Engineering and Orthopaedics at Case Western Reserve University (CWRU) and Director of the Rehabilitation Engineering Center in the Department of Orthopaedics of MetroHealth Medical Center (MHMC), P. Hunter Peckham, PhD, received his BS in mechanical engineering from Clarkson College of Technology, Potsdam, NY, and the MS and PhD in biomedical engineering from CWRU. He serves as Associate Editor of the IEEE Transactions on Rehabilitation Engineering, and, in 1996/1997, chaired the National Advisory Board to the National Center for Medical Rehabilitation Research of the National Institutes of Health. His interests include rehabilitation engineering in spinal cord injury (SCI), neural prostheses, and functional electrical stimulation (FES).

  Loss of central nervous system function is a major cause of disability, and presents substantial individual and family burdens as well as major economic consequences. While conventional rehabilitation maximizes the retained function of the disabled individual, few interventions increase control of the paralyzed or paretic functions. One technique that does enhance function is FES, and this technique has its roots in Cleveland, where many of its first accomplishments have been achieved. FES has made the transition from the bench to the bedside, with individuals who have lost function in their hands able to manipulate objects, who have lost function in their legs able to stand and walk, and who have lost control of their bowel and bladder regain active control.

  In 1991, the FES Center was founded in Cleveland to capitalize on this work, fostering a close relationship across institutions to integrate related projects and investigators and provide resources available uniquely through resources of each institution. Recent significant accomplishments of the Center include the FDA approval of a hand grasp system and commencement of clinical trials of an advanced bladder/bowel management system. Current continuing key areas of activity include clinical development of implantable command/control systems for bilateral hand grasp and implantable systems for transfer and mobility, as well as research activities in unassisted standing, upper arm control, and evaluation of FES therapies in the treatment of stroke-related impairments.

  The consortium basis of the Center provides the core support for the program, the working framework for the 20 principal investigators, and various specialized laboratory facilities. Investigators are responsible for developing their own funding outside of the core funding provided by the VA. Personnel are affiliated with the Center through a number of mechanisms: full and part-time term appointments, joint appointments with the consortium partners, and inter-agency personnel agreements. This leads to a multiinstitutional mechanism for conducting the objectives of the Center and for leveraging the grant resources that each of the member institutions has to provide.

  In FY97, the Center's consortium partners generated approximately $2.6 million in funding from foundations and federal agencies other than the VA for more than 20 projects. With core funding of $880,000 and 6 VA Merit Review projects totaling approximately $1.3 million, the Center utilized approximately $4.8 million for the year.

  The core funding resources are used primarily to support the infrastructure of the research consortium. Additional support is provided for assisting fellows and young investigators in establishing careers in the field and creating pathways for their own funding support: 25 individuals are so supported for at least part of FY98, amounting to a total of approximately 11 FTE. Core plus project funding provides support for 50 individuals, for a total of approximately 46 FTE.

  During the past year, the Center has carried out the clinical implementation of fully implanted systems for hand-arm control in two persons with C5/6 SCI. They have obtained the ability to regain control of grasp and release and elbow extension with a fully implanted neuroprosthesis. This is the first implementation of a system including both stimulator and the control sensor. We have implanted systems for standing-transfer and stepping for two persons with incomplete tetraplegia for transfer assist and two persons with paraplegia for walking. The first system employs our 8-channel implant, while the second uses two devices to activate 8 muscles per leg. We have implemented with a percutaneous system in eight persons with stroke to reduce shoulder subluxation and accompanying dysfunction and pain. Preliminary results support the efficacy of this treatment modality. Research is underway in two parallel studies to investigate use of FES of lumbo-sacral nerves to control urination and defecation in persons with SCI. Implants have been performed on 16 persons, confirming the efficacy of this technique. We have developed a smaller, portable external control unit, primarily for use in lower extremity mobility studies: this controller allows user control of two implanted stimulators powered and controlled by radio frequency. Transfer to a manufacturer is underway.

  Since 1989, the FES Center has disseminated research information through the FES Information Center, responding to more than 6,000 inquiries from individuals around the world interested in how FES can help people with disabilities. In FY97, just over 1,000 inquiries were received, representing a 31% increase over the previous fiscal year and demonstrating significant growth over recent years.

  Center publications include the FES Update newsletter (circulation 8,000) and the FES Resource Guide, a 200 page sourcebook for individuals with SCI or multiple sclerosis. In 1996, we established an Internet presence with a pilot web site (http://feswww.fes.cwru.edu) that has logged as many as 1,000 visitors a month. It features a staff directory, project descriptions, our FES Update newsletter and selected bibliographies.

  During the year, Center members published 20 peer-reviewed articles and book chapters, with an additional 18 in press. They gave 65 presentations at national and international meetings, and attended 17 scientific meetings. In addition to their peer-reviewed professional work, they addressed the lay audience in 71 print articles and 12 broadcast presentations.

National Center of Excellence on Healthy Aging with Disabilities

Rehabilitation Research and Development Service, Houston VA Medical Center
Arthur M. Sherwood, PE, PhD, Director

  This new Center will conduct research directed to the elimination of preventable secondary problems and the reduction of risks for all secondary conditions related to disabilities. Researchers will seek to promote early initiation of treatment, to develop more holistic intervention programs, to educate veterans and family caregivers, and to develop better assistive devices, including mobility aids.

  An author of more than 45 scientific papers, 18 book chapters, and 105 abstracts of presentations, Arthur M. Sherwood, PE, PhD, is a biomedical engineer who has worked in the area of assessment of motor and sensory function through use of surface EMG and evoked potentials for more than a quarter century. His work in recent years has focused upon the development of surface EMG techniques for quantitative assessment of motor control problems in severe spinal cord injury (SCI), including tracing residual motor control in paralysis and studies of spasticity.

  The Houston Center is new; approved in May 1997, it began operations in October 1997. Approximately 40 area professionals have indicated an interest in working with the Center, and 9 projects from these individuals are in process of initiation, approval, or funding. Our focus is on collaborative, interdisciplinary research toward new clinical interventions to decrease the number of secondary complications in aging disabled veterans. Enhanced research skills of Center personnel will enable the Center to address an increasing number of important clinical problems. Education programs aimed at the consumer, family caregiver, and general public will convey strategies leading to more healthful lifestyles, increased independence, and a consequent increased quality of life for those veterans.

  The majority of the Center staff are members of the faculty of the Department of Physical Medicine and Rehabilitation of Baylor College of Medicine. Services of those not directly employed by the DVA have been secured through a sub-contract negotiated with Baylor College of Medicine. This contract, totaling nearly $200,000, covers full or partial support for seven faculty and one staff individual. The Center's investigators have a broad array of expertise and research interests, including fitness, nutrition, sexual function and mobility, and motor control. Serving their studies, we have motor and sensory laboratories, prosthetics shops, and a variety of biological laboratories. We are developing a database to capture information from veterans seen through the clinics and admitted to the services for inpatient care. This database will have two basic components: 1) a registry of all persons over 50 years of age with disabling conditions, 2) a sample database containing detailed information on a sample of persons over 50 years of age admitted for inpatient services. By collecting basic demographic, social, medical and disability data on every person seen by the three services in the Center, we shall be better able to identify specific areas for further research and to provide subject information for research studies developed by the Center.

  As the Center did not establish operation until fall 1997, there is no recent work to report. However, the investigators now active in Center programs published widely during the past year.

Center of Excellence on Mobility

VA Palo Alto Health Care System Rehabilitation R&D Center
Felix E. Zajac, PhD, Director

  This Center's task is to increase the independence and improve the quality of life of persons with neurologic and orthopedic impairments through the development of innovative treatments and technical devices.

  Recipient of many awards in engineering and biomechanics, Felix E. Zajac, PhD, serves in a number of advisory capacities to the National Institutes of Health; he is a member of the Scientific Advisory Board of the Paralyzed Veterans of America and a Founding Fellow of the American Institute of Medical and Biological Engineering.

  Dr. Zajak is currently a Professor of Mechanical Engineering in both the Biomechanical Engineering Division (School of Engineering), and the Department of Functional Restoration (School of Medicine) of Stanford University; he has been the Director of the Rehabilitation R&D Center of the Veterans Affairs Palo Alto Health Care System since 1979. He holds the BEE from Rensselaer Polytechnic Institute and both the MS in Electrical Engineering and the PhD in Neurosciences from Stanford. Building on past work on the properties of motor units, Dr. Zajac currently studies the dynamics, muscular coordination, and sensory control of multiarticular motor tasks, with application to the rehabilitation of persons with neurologic and orthopaedic impairments.

  The Center he directs, the VA Palo Alto Rehabilitation R&D Center of Excellence on Mobility, is dedicated to developing clinical treatments and technological devices for physically disabled veterans and others, in order to increase their independence and improve their quality of life. Focusing on the improvement of mobility in persons with neurologic or orthopaedic impairments, the Center's primary emphasis is on restoring and enhancing muscle coordination in persons who have had a stroke or have sustained a spinal cord injury (SCI), and on restoring and maintaining musculo-skeletal function and integrity in persons with osteoporosis, arthritis, or SCI. We also perform basic research to better understand the way in which the nervous system coordinates muscles during complex motor tasks, and the way in which bone grows, maintains, and regenerates itself.

  The Core budget is allocated to salaries, startup projects, and common resource equipment of the Center, and amounts to $1.36 million for FY97. In the same year, the Center received nearly $1.22 million in VA Rehabilitation R&D Merit Review project monies and another $54,194 for projects under the VA Medical Merit Review. We secured an additional $634,000 from non-VA sources, including the National Institutes of Health, The Paralyzed Veterans of America, The Whitaker Foundation, and others.

  The Center has a long-standing affiliation with the Stanford University, particularly with the Departments of Mechanical Engineering (and its new Biomechanical Engineering Division), and Functional Restoration. In fact, all Center investigators have faculty/lecturer appointments in these departments. Graduate and undergraduate Stanford students are routinely involved in Center projects. Investigators also regularly collaborate with outside institutions in areas of relevance to the Center mission.

  Center investigators are currently doing basic research in such areas as, the effect of exercise on the ambulation of stroke patients, and mechanically assisted upper limb movement for them; the noninvasive investigations of musculoskeletal function and the assessment of that function by automated evaluation of electromyograms; work in grafting of peripheral nerves, and comparison of synthetic and autologous connective tissue grafts; the reliability and validity of accelerometric gait, and the functional restoration of grasp in quadriplegia; the basic mechanics of function, and the feasibility of video-based assessment of that function. They are also studying the skeletal changes after spinal cord injury and cast immobilization, the the theory and modeling of bone adaptation during disuse and recovery, and the modeling of tendon development, adaption, and regeneration; the mechanical regulation of peri-prosthetic tissue differentiation, computer simulation analysis of coordination deficits post-stroke, and mechanical loading effects on cartilage repair and regeneration. At the most basic level, they are working on models of human postural coordination, and the intermuscular coordination of mammalian movement.

  In the area of applied technology, Center researchers are investigating obstacle avoidance training with computer-simulated environments, the development of an assistive robot for effective health care delivery, and differential pressure walking assistance.

  During the past year, they have published numerous works, in additions to presentations and lectures to professional organizations.

Portland RR&D Center for Rehabilitative Auditory Research

Portland VA Rehabilitation Research and Development Center
Stephen A. Fausti, PhD, Director

  This new Center for Rehabilitative Auditory Research will work to alleviate the communicative, social, and economic problems resulting from auditory system impairment by focussing on basic research and development, the training of investigators, and the dissemination of results useful to clinicians who assess and treat veterans with hearing loss and tinnitus.

  Chief of Audiology at the Portland VA Medical Center for 25 years, Dr. Fausti has extensive experience as a researcher, clinician, and academician. He is Professor of Audiology in the Department of Otolaryngology of Oregon Health Sciences University, and Adjunct Professor of Audiology at Portland State, both of Portland, and an Editorial Associate of the Journal of the American Academy of Audiology.

  His work in various phases of high-frequency audition and ototoxicity monitoring has also received continuous Medical and Rehabilitation R&D Merit Review funding since 1977. He and his group produced the first papers describing the validity and reliability of high-frequency (>8000 Hz) hearing thresholds and subsequently their efficacy in monitoring hearing for early detection of ototoxicity. Data from these studies formed the basis of national guidelines for a standardized ototoxicity monitoring protocol by the American Speech-Language-Hearing Association. More recently, his program launched investigations into the auditory brainstem response (ABR) as an objective measure of high-frequency auditory function for evaluating patients who cannot provide reliable results to behavioral evaluation methods. In the area of tinnitus his work has led to the development and investigation of an automated tinnitus evaluation system, which obtains reliable measures of hearing thresholds, tinnitus pitch and tinnitus loudness. This research has involved multiple participating sites from 1988 onward: Dr. Fausti has a well-developed expertise in overseeing large multisite prospective studies.

  Dr. Fausti's experience and network of collaborative investigators made Portland an ideal site for the new Center, begun October 1997 to alleviate the communicative, social, and economic problems resulting from sensorineural hearing loss (SNHL) and tinnitus.

  Rehabilitation of persons with SNHL and efficacious alleviation of tinnitus, especially prevalent disorders among veterans because of their history of noise exposure compounded by aging, are the focus of current and future research efforts.

  Speech perception is dependent upon complex functional processes that occur within the peripheral and central auditory nervous system. Auditory disorders in the peripheral auditory system manifest in numerous ways beyond the obvious reduction in auditory sensitivity. For example, impairments in frequency and temporal resolution, loudness growth, sound localization and speech recognition are reportedly impaired by SNHL, and the relationships among these various changes are unclear and their combined effect on speech recognition still speculative.

  While developments in programmable hearing aids are impressive, technology has outpaced our knowledge of the effect of SNHL on the auditory system and speech recognition. Today's tests of speech recognition are poor predictors of speech perception in real life environments. Center will address this problem through a multidisciplinary approach, including some basic research clarifying effects of sensorineural loss on frequency selectivity, temporal resolution, and localization; and applied research designed to provide new methods for assessing speech recognition tests. Other areas of inquiry are the development of hearing aids and assistive devices, which will aid veterans with multisensory disabilities (hearing loss and blindness). Rehabilitative inquiry aims at correcting functional impairments. Identification and correction of impairments permits specific targeting of rehabilitation efforts.

  The Center is currently affiliated with Portland State University, Oregon State University, and the Oregon Health Sciences University (OHSU), including the Departments of Otolaryngology and Neurology and the Oregon Hearing Research Center at the latter. We work closely with the VA Medical Centers at West Los Angeles, CA, Nashville, TN and Albuquerque, NM to conduct jointly sponsored clinical trials with the National Institutes of Health, NIDCD, and the Lexington Center for the Deaf.

  Grant support for FY97 consists of $474,000 in direct funding from the VA (both Medical and Rehabilitation R&D) and the NIDCD.

  In addition to presentations and courses conducted at meetings of professional associations, Center researchers publish widely.

Research and Development Center for Amputation, Prosthetics, Limb Loss Prevention

VA Puget Sound Health Center, Seattle, WA
Bruce Sangeorzan, MD, Director

  This Center was developed to study the prevention of amputation, improvement of lower limb prosthetics, and measurement of outcomes for these patients; and to establish a collaboration between the VA, Departments of Orthopedics and Rehabilitation Medicine at the University of Washington, and the Prosthetics Research Study Group.

  A National Merit Scholar, Bruce J. Sangeorzan, MD, holds the BS in biology from the University of Michigan and the MD from Wayne State. In addition to directing the Center, he is active in both his medical practice and teaching: he is Chief of Orthopedics at the Seattle VA Medical Center and Professor of Orthopaedic Surgery at the University of Washington. He also serves as an Associate Editor for two peer-reviewed journals and reviews manuscripts for four more. Author of some 50 articles and chapters in professional journals and books, he has delivered 125 invited lectures on orthopedics and presented original work to professional meetings across the U.S.

  Dr. Sangeorzan oversees a Center that continues the strong tradition of interdisciplinary amputation research dating back to Dr. Ernest Burgess' initiation of the team approach to prosthetics and amputation in the 1960s that, by the 80s, had grown into the Special Teams for Amputation Mobility Prosthetic/Orthotic (STAMP) program. One of the first to routinely test aging veterans for diabetes (the leading cause of nontraumatic lower-limb loss) Puget Sound has long been a magnet for referrals of veterans with limb-at-risk and amputation-related problems.

  The Center's overall goal is to establish a community of clinical and basic scientists to pursue research objectives in the area of lower limb prosthetics and amputation. We shall seek ways to improve the possibility of preservation of the lower limb, working to make more effective decisions with regard to the surgical issue of amputation versus salvage. Since level is a key factor in abulation and independence, we shall study the effect of location of amputation and its relationship to wound healing and postamputation function and evaluate the mechanical function of prosthetics to allow the optimal design for each individual, continuing our efforts to improve the process of fitting, design, and function of current prostheses.

  Overall, we shall measure functional outcomes of the persons we treat, tracking the results of innovation in terms of their positive impact on the lives of veterans, and we shall continue to disseminate the information we discover.

  The following VA Medical Centers have reported projects sponsored fully or in part by the Department of Veterans Affairs Rehabilitation Research and Development Service. (Note: VA Centers are listed alphabetically by state.)

Birmingham VA Medical Center 700 South 19th St. Birmingham, AL 35233
	Number
Improvements in a New Technique for Increasing Movement after Stroke	112
The Effects of Spinal Instrumentation	260
John L. McClellan Memorial Veterans Hospital 4300 West Seventh St. Little Rock, AR 72205-5484
	Number
Performance-Based Prevention/Rehabilitation of Falls in Elderly Veterans	99
West Los Angeles VA Medical Center Brentwood Division, Wilshire and Sawtelle Blvd West Los Angeles, CA 90073
	Number
Functional Electrical Stimulation of Spinal Cord Injured Patients: Effects on Muscle Blood Flow and Metabolism	89
Computerized Adaptive Methods for Selecting Hearing Aids	227
Long Beach VA Medical Center 5901 E. Seventh St. Long Beach, CA 90822
	Number
Gait Mechanics of the Partial Foot Amputee	18
Effect of the Bankart Lesion on Anterior Joint Stability with Simulated Glenohumeral Muscle Forces	30
Biomechanics of the Patellofemoral Joint and Peripatellar Retinaculum	31
Optokinetic Testing for Diagnosis and Rehabilitation of Balance Disorders	60
Palo Alto VA Medical Center 3801 Miranda Ave. Palo Alto, CA 94304
	Number
Fracture Occurrence and Healing in Spinal Cord Injured Patients	32
Mechanical Loading Effects on Cartilage Repair and Regeneration	33
Obstacle Avoidance Training with Computer Simulated Environments: A Pilot Study	40
Video-Based Functional Performance Assessment and Training Tool: A Pilot Study	61
Reliability and Validity of Accelerometric Gait and Balance	100
Limb Manipulation under Patient Control: A Pilot Study	113
Development of an Assistive Robot for Effective Health Care Delivery	139
Automatic Decomposition of the Electromyogram	161
Modeling Tendon Development, Adaptation, and Regeneration: A Pilot Study	174
Functional Restoration of Grasp in Quadriplegia	261
Skeletal Changes after Spinal Cord Injury and Cast Immobilization	262
Clinical Trial of Artificial Peripheral Nerve Graft	263
High-Frequency Magnetic Stimulation of the Bladder and Bowel	264
Comparison of Semi-Synthetic and Autologous Connective Tissue Grafts: A Pilot Study	295
San Diego VA Medical Center 3350 La Jolla Village Dr. San Diego, CA 92161
	Number
Physiological Basis of Strength following Surgical Tendon Transfer	162
Denver VA Medical Center 1055 Clemont St. Denver, CO 80220
	Number
The Role of Imagery in Auditory Comprehension in Brain-Damaged Adults	114
Improved Bone Cement Fatigue Resistance via Controlled Strength Interfaces	192
West Haven VA Medical Center 950 Campbell Ave. West Haven, CT 06516
	Number
Rehabilitation Effects of Pay, Activity, and Support Intensity on Schizophrenia	226
Miami VA Medical Center 1201 Northwest 16th St. Miami, FL 33125
	Number
Disuse-Induced Articular Cartilage Atrophy, Over-Exercise, and Arthritis	193
Spinal Cord Injury-Induced Bone Loss	248
Atlanta VA Medical Center 1670 Clairmont Rd. Decatur, GA 30033
	Number
The Effect of Hydrostatic Pressure on Intervertebral Disc Metabolism	34
Age-Related Changes in the Triceps Surae Stretch Reflex and Postural Control	101
Exercise Program Designs for Older Adults	102
Behavioral and Functional Problems in Dementia Patients with Sensory Loss	103
Evaluation of Interventions to Prevent Elopement among Nursing Home Patients	104
Development of a Database of Cane Techniques	239
A Study of Illumination Sources for Low Vision Individuals	240
Measuring Low Vision Reading Assessments Using a Scanning Laser Ophthalmoscope	241
Design and Evaluation of Liquid Crystal (LC) Dark-Adapting Eyeglasses for Persons with Low Vision	242
Long-Term Strength Training and Functional Status in Older Adults	308
Team Characteristics and Patient Outcomes on VA Rehabilitation Services	307
VA Medical Center Highway 6 West Iowa City, IA 52240
	Number
Changes in Auditory Abilities with Hearing Aid Use	228
Chicago VA Medical Center (Lakeside) 333 E. Huron St. Chicago, IL 60611
	Number
Technology Transfer of a Computer-Aided Socket Fabrication Technique	1
Generalized Epp Position Controller for Electric-Powered Upper-Limb Prostheses	4
A Study to Determine the Biomechanical Effects of Shock-Absorbing Pylons	19
Finite Element and Gait Analysis: Tools for Prosthesis Design	26
Chicago VA Medical Center (West Side) 820 S. Damen Ave. Chicago, IL 60612
	Number
Evaluation of Central and Peripheral Vision Enhancement Devices for Driving	243
Edward Hines Jr. VA Hospital 5th Ave. and Roosevelt Rd. Hines, IL 60141
	Number
Colonic Rehabilitation with Microstimulators after Spinal Cord Injury	68
Rehabilitation of Urinary Incontinence Using Stimulated Muscle Flaps: A Pilot Study	69
Polestriding Exercise and Vitamin E for Management of Claudication Pain	190
Effect of Surgical Procedures on the Stability of the Lumbar Motion Segment	208
Compliance Monitor to Measure Patient Wearing Time for Spinal Orthoses	212
Microphotodiode Tiles as Prostheses for the Restoration of Visual Function	244
Effect of Supported Standing and Upper Body Exercise on Lower Extremity Spasticity in Persons with Spinal Cord Injury	249
Treatment of Sciatic Nerve Injury with Gonadal Steroids	265
Gonadal Steroids as Rehabilitative Agents after Partial Spinal Cord Injury	266
Fecal Incontinence Treatment in SCI Patients: A Pilot Study	267
Prophylactic Monitoring of Bladder Pressure and Volume	268
Quantitative Study and Augmentation of Cough in Persons with Spinal Cord Injury	269
Cortical Sensorimotor Reorganization in Spinal Cord Injury	270
Enhanced Carbon Filament Prostheses as Substrates for Regrowth of Injured Spinal Cord: Immunocytochemical Studies	282
Electric Fields and Carbon Fibers in the Treatment of Spinal Cord Injury: Comparison of Different Current Levels	283
Richard L. Roudebush VA Medical Center 1481 W. 10th St. Indianapolis, IN 46202
	Number
Is There an "Acclimatization Effect" with Hearing Aids?	229
New Orleans VA Medical Center 1601 Perdido St. New Orleans, LA 70146
	Number
Transport of NGFs±MIF-1 into Spinal Cord	250
VA Outpatient Clinic 21 Causeway St. Boston, MA 02114
	Number
Quantitative Posturography: Age-Related Changes in Postural Stability	105
Brockton/West Roxbury VA Medical Center 940 Belmont St. Brockton, MA 02401
	Number
FES-Aided Paraplegic Gait Using a Controllable Friction Brake	90
Randomized Controlled Trial of Upper-Extremity Exercise Training in Patients with COPD	106
Modification of Polyethylene to Improve the Wear Performance of Joint Replacement Prostheses	204
Advanced Technology Neural Information Sensors for Prosthetic Control by Quadriplegics	271
Device for Treatment of Peripheral Nerve Injury	284
Baltimore VA Medical Center 10 N. Greene St. Baltimore, MD 21201
	Number
Wheelchair Propulsion Performance in Young, Middle-Aged, and Elderly	55
Low Vision Enhancement System (LVES)	245
Ann Arbor VA Medical Center 2215 Fuller Rd. Ann Arbor, MI 48105
	Number
Rising from the Floor in Older Adults	107
Detroit VA Medical Center 4646 John Rd. Detroit, MI 48201
	Number
Immunological Responses to Implant Biomaterials following Arthroplasty	194
Kansas City VA Medical Center 4801 Linwood Blvd. Kansas City, MO 64128
	Number
Post-Stroke Rehabilitation: A Pilot Study	62
Development of the Scanning Laser Opthalmoscope for Low Vision Rehabilitation: Phase 2	246
Durham VA Medical Center 508 Fulton St. Durham, NC 27705
	Number
A Biodegradable Device for Peripheral Nerve Repair	272
A Study of VA Stroke Rehabilitation Services and Patient Outcomes	309
Salisbury VA Medical Center 1601 Brenner Ave. Salisbury, NC 28144
	Number
Factors Leading to Disuse of Low Vision Devices by Visually Impaired Elderly	247
Omaha VA Medical Center 4101 Woolworth Ave. Omaha, NE 68105
	Number
A New Bioelectric Method for early Diagnosis of Delayed Fracture Healing	303
Stimulation of Bone Healing Using Bone-Matrix-Related Biomaterials	304
East Orange VA Medical Center 385 Tremont Ave. East Orange, NJ 07018
	Number
Acclimatization in Monaurally Fitted Adults	230
Cause of Male Infertility after Spinal Cord Injury and Its Prevention	251
Acute Effects of SCI on Sperm Function	273
Albuquerque VA Medical Center 2100 Ridgecrest Dr., SE Albuquerque, NM 87108
	Number
Evaluation of Nonauditory Factors that Affect Hearing Aid Use in Elderly Veterans	231
Neuromuscular Research Center 44 Cummington St., 5th floor Boston, MA 02215
	Number
Effects of Aging on Motor Unit Firing Behavior	176
A Minimal Effort Test for Patients in Pain Using the Back Analysis System	209
Back Exercise Prescription and Implementation by Surface Electromyographic Procedures	210
Samuel S. Stratton VA Medical Center 113 Holland Ave. Albany, NY 12208
	Number
Factors Affecting Time Between CVA Onset and Rehabilitation in the VA	115
Brooklyn VA Medical Center 800 Poly Pl. Brooklyn, NY 11209
	Number
Orthotics Design with Advanced Materials and Methods: A Pilot Study	213
Castle Point VA Medical Center Castle Point, NY 12511
	Number
Comparison of Lower-Limb Artery Size in Men and Women with and without Peripheral Vascular Disease: A Pilot Study	191
New York VA Medical Center 423 E. 23rd St. New York, NY 10010
	Number
Clinical Testing of the Enhanced VA-Cyberware BK Prosthetics Optical Digitizer	27
Developmental Enhancement and Application of the VA-Cyberware Prosthetics-Orthotics Optical Laser Digitizer	20
Computer-Aided Design and Computer-Aided Manufacturing of Orthopedic Footwear	214
Feasibility of Priming to Predict Cuing Responsiveness in Aphasia Treatment: A Pilot Study	234
Syracuse VA Medical Center 800 Irving Ave. Syracuse, NY 13210
	Number
Cortical Contributions to the Recovery of Motor Function	116
Cleveland VA Medical Center 10701 East Blvd. Cleveland, OH 44106
	Number
Restoration of Forearm and Elbow Functions by FNS	79
Functional Neuromuscular Systems for Upper Extremity Control	80
Out-Of-Laboratory, Feedback-Controlled FNS for Locomotion	91
Restoration of Gait in Acute Stroke Patients Using FNS	92
FES Mobility in Paraplegia: Rf-Controlled Implanted System	93
Neuroprosthetic Control of Bladder and Bowel in Spinal Cord Injury Patients	274
Electrical Activation of the Diaphragm for Ventilatory Assist	275
Dayton VA Medical Center 4100 West 3rd St. Dayton, OH 45428
	Number
Muscle Strength and Functional Performance in Parkinson's Disease: A Pilot Study	177
Portland VA Medical Center 3710 Southwest U.S. Veterans Hospital Rd. Portland, OR 97207
	Number
Development of an Assistive Robot for Effective Health Care Delivery	139
Problem-Solving Strategies of Brain-Injured and Normal Subjects	235
Philadelphia VA Medical Center University and Woodland Aves. Philadelphia, PA 19104
	Number
Developing Veterans Administration Rehabilitation-Related Groups: A Pilot Study	310
Pittsburgh VA Medical Center (Highland Dr.) Highland Drive Pittsburgh, PA 15206-1297
	Number
Minimizing Falls in the Elderly	108
Development of an Assistive Memory Device for Patients with Severe Amnesia: A Pilot Study	142
Quantifying Spoken Language Handicap in Aphasia	236
Manual Wheelchair User Upper Extremity Pain	252
Design and Selection Guidelines for Wheelchair Rider Comfort	285
Pittsburgh VA Medical Center (University Dr.) University Drive C Pittsburgh, PA 15240
	Number
N-Acetylaspartate: A Predictor of Outcome in Neurorehabilitation	117
Biochemical Analysis of Synovial Activation in Joint Dysfunction	195
Effect of Component Placement on the Patellofemoral Joint Kinetics with Total Knee Arthroplasty	205
Ralph A. Johnson VA Medical Center 109 Bee St. Charleston, SC 29403-5799
	Number
Fatigue Strength of Composite Femoral Components for Hip Arthroplasty	200
Mountain Home VA Medical Center Mountain Home, TN 37684
	Number
Evaluation of Word-Recognition Performance with Sentence Materials	233
Nashville VA Medical Center 1310 24th Ave., South Nashville, TN 37212-2637
	Number
Cultural Influence on Aphasia in African-Americans	118
Sensitivity and Specificity of a Clinical Examination of Swallowing	180
Houston VA Medical Center 2002 Holcombe Blvd. Houston, TX 77030-4298
	Number
Establishing Standards of Care: Upper Limb Prosthetic Services	5
Effects of Medications on Spasticity in Spinal Cord Injury: A Quantitative Study	276
Prevention of Recurrent Pressure Ulcers after Myocutaneous Flap	296
Use of Tretinoin to Prevent Pressure Ulcers in Spinal Cord Injury Patients	297
Audie L. Murphy Memorial Veterans Hospital 7400 Merton Minter Blvd. San Antonio, TX 78284
	Number
Long-Term Evaluation of Maxillary Sinus Bone Grafts with Dental Implants	109
Salt Lake City VA Medical Center 500 Foothill Blvd. Salt Lake City, UT 84148
	Number
Analysis and Treatment of Apraxic Sound Errors	237
Hunter Holmes McGuire VA Medical Center 1201 Broad Rock Blvd. Richmond, VA 23249
	Number
An In-Vivo Model for Cartilage Regeneration	196
White River Junction VAM&ROC North Hartland Rd. White River Junction, VT 05009
	Number
Implant Retrieval Research, Results and Conclusions, 1988-98: A Special Report	202
The Examination of Explanted, Uncemented Orthopaedic Prostheses	201
Seattle VA Medical Center 1660 South Columbian Way Seattle, WA 98108
	Number
Clinical and Laboratory Study of Amputation Surgery and Rehabilitation	2
Biomechanics of Foot Deformities and Alternatives for Surgical Correction	35
Quantitative Measurement of Upper Limb Spasticity: a Pilot Study	178
Clinical Trial of Footwear in Patients with Diabetes	215
A Prospective Study of Plantar Foot Pressure and Diabetic Foot Ulcer Risk	305
William S. Middleton Memorial Veterans Hospital 2500 Overlook Terrace Madison, WI 53705
	Number
Development of Quality of Life Measures for Use in Dysphagia	63
Effects of Age on Oropharyngeal Swallowing	181
Clement J. Zablocki VA Medical Center 5000 West National Ave., Milwaukee, WI 53295
	Number
Design of a Motorized Prone Cart	289
Rehabilitation R&D Engineering Center VA Medical Center, 3801 Miranda Ave., Palo Alto, CA 94304
	Number
Computer Simulation Analysis of Coordination Deficits in Post-Stroke Hemiplegia	127
Rehabilitation R&D Unit VA Medical Center (Atlanta), 1670 Clairmont Rd. Decatur, GA 30033
	Number
Host the 9Th International Mobility Conference IMC 9	317
Part B: Non-VA Sponsoring Organizations
American Occupational Therapy Foundation 1383 Piccard Drive, Box 1725, Rockville, MD 20850
	Number
Relation of Rehabilitation Intervention to Functional Outcome	315
AO Foundation Paoli, PA 19301
	Number
Impact-Induced Post-Traumatic Arthritis Model	207
Bloorview Foundation 350 Rumsey Rd. Toronto Ontario M4G 1R8
	Number
Cellink, Cellular Telephone Interface	144
Bloorview MacMillan Centre 350 Rumsey Rd. Toronto Ontario M4G 1R8
	Number
Improving Resonance and Articulation through Videonasopharyngoscopic Feedback	238
Bloorview Children's Hospital Foundation Toronto, M4G 1R8, Ontario Canada
	Number
Remote Rehabilitation Services Network	128
Boston University 705 Commonwealth Ave. Boston, MA 02215
	Number
A Minimal Effort Test for Patients in Pain Using the Back Analysis System	209
Back Exercise Prescription and Implementation by Surface Electromyographic Procedures	210
Camera di Commercio di Torin Torino, Italy
	Number
Repeatability of Estimates of Myoelectric Signal Variables and Parameters	163
Model-Based Understanding and Teaching of Surface EMG	164
Crippled Children's Association of South Australia Inc. Regency Park, South Australia 5942
	Number
The Ausmap Database: Customizing MinspeakTM Vocabulary for Australian Use	129
Computer Access Selector and Vocaselect	143
Centers for Disease Control 1600 Clifton Road, NE Atlanta, GA 30333: Web: http://www.cdc.gov
	Number
Breast Cancer Screening among Women with Disabilities	157
Violence Against Women with Physical Disabilities	156
Clinical Trial of Footwear in Patients with Diabetes	215
Ciba-Geigy Jubileum Stiftung Basel, Switzerland
	Number
Effects of Intramuscular Aponeurotomy and Recovery on Pennate Skeletal Muscle	165
Cleveland Clinic Foundation Research Institute 9500 Euclid Avenue, Cleveland, OH 44195
	Number
Measuring Functional Abilities of Wheelchair Users: Design Criteria for Wheelchair Securement	66
Clinical Assessment of Seated Stability during Transportation	293
Conseil de Recherches Medicales No address listed.
	Number
Quantification of Muscular and Tendinous Forces of the Hand during Static Effort	56
Delft University of Technology Laboratory for Measurement & Control, Mekelweg 2 Delft, 2628 CD, The Netherlands
	Number
The Wilmer Cosmetic Prosthetic Prehensor for Children	6
Voluntary-Closing Hand Prosthesis	13
Designing a Ballistic Walking Biped: Actively Variable Passive Stiffness	41
Department of the Army The Pentagon, VA 20310
	Number
The Role of Orthotic Intervention in Resolution of Plantar Fasciitis	216
Dutch Organization for Scientific Research (NWO) Amsterdam, The Netherlands
	Number
Development of a Shoulder and Elbow Musculoskeletal Model: Clinical and Ergonomic Applications	36
Drexel University (The Calhoun Fellowship Endowment) 34th and Ludlow, Philadelphia, PA 19104
	Number
Determination of the Effect of Range of Motion Changes in an Articulated Ankle Foot Orthosis on Lower Limb Muscle Demands	225
Department of Special Education and Rehabilitation No address listed.
	Number
Special Projects and Demonstration: Applications of Technology to Enhance Quality of Life--A Community Model	136
Trans-Train: Transdisciplinary Training of Rehabilitation Personnel in Assistive Technology	137
Down's Syndrome Research Fund 9823 S. Hamlin Avenue Evergreen Park, IL 60642
	Number
Simple Two-Joint Synergy in Individuals with Down Syndrome	179
Dundee University Dundee, DD1 4HN, Scotland
	Number
Detection of Osteoporosis through Computerized Analysis of Distal Radius X-Rays	37
Dutch Prevention Fund Amsterdam, The Netherlands
	Number
Performance Capacity and Physical Strain in Subjects with a Spinal Cord Injury	253
Easter Seal Research Institute of Ontario 250 Ferrand Drive, Suite 200 Don Mills, ON M3C 3P2, Ontario Canada
	Number
Development of a Shoulder and Elbow Musculoskeletal Model: Clinical and Ergonomic Applications	36
Health Behaviors in School-aged Children with Physical Disabilities	318
EC: Telematics Programme Brussels, Belguim
	Number
Daily: Makes Daily Life Easier	130
Engineering and Physical Sciences Research Council Glaskow, UK
	Number
Development of a Biomechanical Model of the Interface Between the Stump and the Prosthesis for Transfemoral Amputees	22
Fondazione Cassa di Risparmio & Compagnia di San Paolo di Torino Veruno, Italy
	Number
Repeatability of Estimates of Myoelectric Signal Variables and Parameters	163
Model-Based Understanding and Teaching of Surface EMG	164
Food and Drug Administration 5600 Fishers Lane, Rockville, MD 20857-0001
	Number
Implantable FNS Systems for Standing Transfers	97
Fondazione S. Maugeri, Regione Piemonte Veruno, Italy
	Number
Repeatability of Estimates of Myoelectric Signal Variables and Parameters	163
Model-Based Understanding and Teaching of Surface EMG	164
Fonds de la Recherche en Sante du Quebec 550 Ouest, rue Sherbrooke, Bureau 1950 Montreal, H3A 1B9, Quebec Canada
	Number
Characterization of Global Synkineses in Hemiparetic Subjects using Static Bi-Articular Multidirectional Dynamometry and Electromyography	64
Foundation for Sports Medicine Education and Research Rosemont, IL 60016
	Number
Preconditioning as a Technique to Minimize Tourniquet-Induced Muscle Injury	198
The Fund for the Promotion of Research at the Technion Technion Israel Institute of Technology Haifa, Israel
	Number
Standing Sway: Kinematics and Dynamics from Forceplate Measurements	58
G.T.H. Lamb Group No address listed.
	Number
Tissue Biomechanical and Vascular Studies for Improved Prosthetic Socket Design	21
Health and Welfare Canada Program Development Section, Extramural Research Programs Ottawa, K1A 1B4, Ontario Canada
	Number
Evaluation of Overdrive Scanning	146
Evaluation of Text Selection Strategies	147
Toward Task Transparency in Alternative Computer Access: Selection of Text through Switch-Based Scanning	148
Health Research Board Dublin, Ireland
	Number
Microcrack Morphology in Fatigued Compact Bone	38
IBM Canada, Ltd. 3500 Steeles Avenue East Markham, L3R 2Z1 Ontario Canada
	Number
WIVIK 2 On-Screen Keyboard	151
WIVIK 2 Scan: 1-5 Switch Scanning Access	152
Keyrep: WIVIK/Keyboard Rate Enhancement	153
WIVOX: Voice Output for Windows	154
IBM Corporation 1000 NW 51st Street Boca Raton, FL 33429
	Number
WIVIK 2 On-Screen Keyboard	151
Keyrep: WIVIK/Keyboard Rate Enhancement	153
WIVOX: Voice Output for Windows	154
Irvin Cahen Chair in Orthopaedic Research No address listed.
	Number
Muscle Co-Contraction: Effect on Intra-Articular Contact Pressure	166
Institute for Fundamental and Clinical Human Movement Sciences Faculty of Human Movement Sciences, Vrije Unitersiteit Amsterdam, The Netherlands
	Number
Ergonomics of Manual Wheelchair Propulsion	286
Industry Canada 3701 Carling Avenue, Box 11490, Station H Ottawa, K2H 8S2, Ontario Canada
	Number
Cellink, Cellular Telephone Interface	144
French WIVIK	145
A Myoelectric Switch for Communication and Computer Access	254
Italian Ministry for University and Scientific Research Lungotevere Thaon di Revel 76 Rome, 00100 Italy
	Number
Application of a 3-D Real-Time Motion Analysis Technique for the Development of Closed-Loop Control Systems for FES	70
Development of a Closed Loop FES System and Application to Standing up Movement for Persons with Paraplegia	94
Repeatability of Estimates of Myoelectric Signal Variables and Parameters	163
Model-Based Understanding and Teaching of Surface EMG	164
Lever Foundation No address listed.
	Number
New Experiences for Young Children with Physical Disabilities: Developing New Products to Access Existing Recreation Technologies	131
Louisiana Board of Regents 150 Riverside Drive, Suite 129 Baton Rouge, LA 70801-1389
	Number
Medical Evaluation of 70 Paraplegics Using a Practical FES Walking Orthosis	217
Multiple Sclerosis Association of America National Headquarters 7006 Haddonfield Road Cherry Hill, NJ 08002; Web: http://www.msaa.com
	Number
Effect of Microclimate Cooling on Physical Function in Multiple Sclerosis	277
National Health Research and Development Programme Department of Health and Welfare, Canada Tunney's Pasture Ottawa, K1A 0K9, Ontario Canada
	Number
Evaluation of Overdrive Scanning	146
Evaluation of Text Selection Strategies	147
Toward Task Transparency in Alternative Computer Access: Selection of Text through Switch-Based Scanning	148
NASA Ames Research Center Moffet Field Mountain View, CA 94035
	Number
Skeletal Changes after Spinal Cord Injury and Cast Immobilization	262
Natural Sciences and Engineering Research Council of Canada 200 Kent St., K1A 1H5 Ottawa Canada
	Number
The Incorporation of a Slip-Sensing, Closed-Loop Control System into a Myoelectric Prosthetic Hand	11
National Institute on Disability and Rehabilitation Research 600 Independence Ave., MES 3060 Washington, DC 22202-2572; Web: http://www.ed.gov/offices/OSERS/NIDRR/
	Number
Clinical Collaboration to Improve Higher-Level Upper-Limb Prosthetic Fittings	7
Body-Powered Toddler Hand	14
How Prosthetic Knee Center Position Affects Toe Clearance and the Hip-Toe Distance	23
The Development of a Direct Ultrasound Ranging System for the Quantification of Ambulation	42
Characteristics of Amputee Gait	43
Three-Dimensional Sensitivity Analysis of Swing Phase Toe Clearance during Gait	44
Examination of Activities around Standing	45
A Simple Model for Standing and Balance	46
The Effect of Pelvic Obliquity and Stance-Phase Knee Flexion on the Vertical Displacement of the Trunk during Normal Walking	47
Gait Assessment from Single Marker Measurements	48
Use of Joint Torque, Energy, and Power in Clinical Gait Evaluation	49
Development of a Gait Interpretation, Instruction, and Report Generation System	50
Refinement, Evaluation, and Dissemination of a Diagnostic and Treatment Assessment Expert System for the Interpretation of Walking Disorders Leading To Disability	51
Determining Soft Tissue Material Properties for the Purpose of Finite Element Modeling of the Residual Limb in Transtibial Amputation	57
Quantification and Assistance of Movement Disorders	65
Discomfort Associated with Percutaneous and Surface Neuromuscular Stimulation during Treatment of Post-Stroke Shoulder Subluxation	81
Percutaneous Neuromuscular Stimulation for the Treatment of Shoulder Subluxation in Hemiplegia	82
A Controlled Study of the Effects of EMG Feedback and Electrical Stimulation on Motor Recovery in Acute Stroke Patients	119
Effects of Aerobic Exercise on Young Persons Post-Stroke	120
Prevention of Thromboembolism in Stroke Rehabilitation Patients	121
The Effectiveness of a Telephone Support Group for Stroke Caregivers	122
Course of Recovery of Cognitive-Communicative Problems in Right-Brain-Damaged Individuals	123
Reducing Motor Disability in Hemiparetic Stroke by Manipulation of Sensory Input from the Paretic Upper Limb: A Quantitative Evaluation	124
The Predictive Value of Cognitive/Behavioral Measures in Patients after Stroke in Assessing Functional	125
Improving Vocational Outcomes of Individuals who Have Sustained a Stroke	126
A Survey of Parents of Children Who Use Orthoses and Prostheses	199
The Quantification and Interpretation of Back Motion as an Evaluative Tool in Low Back Disorders	211
Crutch Ambulation	218
Orthotics for Myelomeningocele Patients, Teenage versus Childhood	220
Development of Lower Extremity Orthotics for Children with Myelomeningocele	221
Mobile Arm Supports for Children	222
Causes and Costs of Unplanned Rehospitalizations among Persons with Spinal Cord Injury	255
Obstetric/Gynecologic Complications in Women with Spinal Cord Injury	256
Natural History and Clinical Course of Urinary Tract Complications in Patients with Spinal Cord Dysfunction	257
Immune Responses to Pneumococcal Vaccine in Spinal Cord Injury	278
A Longitudinal and Cross-Sectional Analysis of Well-Being in Persons with Spinal Cord Injury and Their Caregivers	279
Baclofen Pump: Functional and Neuropsychological Impact	280
The Determination of Environmental Accessibility and Wheelchair User Proficiency through Virtual Simulation	287
The Use of Growth Factors in Pressure Ulcer Healing: Clinical Trials	298
Characteristics of Genital Skin Flora in Persons With SCI and Their Effect on Development of Urinary Tract Infection	299
Problem-Solving Skills Training in the Treatment of Pressure Ulcers	306
Development of Clinical Protocols Based on Ergonomics Evaluation in Response to American Disability Act of 1990	312
Comorbidities and Complications in Stroke: Incidence, Risk Factors, and Effects on Outcomes	313
Development of Clinical Protocols Based on Ergonomics Evaluation in Response to American Disability Act of 1990	312
Relation of Rehabilitation Intervention to Functional Outcome	315
Resource Unit for Information and Education	319
National Institutes of Health 900 Rockville Pike Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Life Interface for Closed Loop Control of Artificial Limbs	8
Measuring Functional Abilities of Wheelchair Users: Design Criteria for Wheelchair Securement	66
Microstimulation of the Lumbosacral Spinal Cord: Mapping	71
Restoration of Shoulder Movement in C5 Tetraplegia	83
Hand Neuroprosthesis in Chronic Hemiplegia	84
Efficacy of Neuromuscular Stimulation in Enhancing the Upper Extremity Motor and Functional Recovery of Acute Stroke Survivors	85
Stimulator for Treating Post-Stroke Shoulder Subluxation	86
Multichannel Implantable System for Neural Control	87
Unassisted Standing by Functional Electrical Stimulation	96
Health Promotion for Women with Physical Disabilities	158
Reducing Risk Factors for Abuse among Low-Income, Minority Women with Disabilities	159
Managed Care Experiences of Persons with Physical Disabilities	160
Biomechanics and Sensory Input of Swallow after Head and Neck Cancer	182
Long-Term Survivors of Head and Neck Cancer	183
The Effects of Radiotherapy/Chemotherapy on Voice, Speech, and Swallowing Function	184
The Effects of Surgical Intervention on Speech and Swallowing Function in Persons with Recurrent/Residual Disease	185
Head and Neck Cancer: Quality of Life, Performance, and Patients' Priorities	186
The Effects of Surgical Intervention on Speech and Swallowing Function in Persons with Recurrent/Residual Disease	185
Clinical Trial of Footwear in Patients with Diabetes	215
Skeletal Changes after Spinal Cord Injury and Cast Immobilization	262
National Cancer Institute National Institutes of Health Executive Plaza North, Room 300 Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Biomechanics and Sensory Input of Swallow after Head and Neck Cancer	182
Long-Term Survivors of Head and Neck Cancer	183
The Effects of Radiotherapy/Chemotherapy on Voice, Speech, and Swallowing Function	184
The Effects of Surgical Intervention on Speech and Swallowing Function in Persons with Recurrent/Residual Disease	185
Head and Neck Cancer: Quality of Life, Performance, and Patients' Priorities	186
The Effects of Surgical Reconstruction on Speech and Swallowing	187
National Institute of Arthritis & Musculoskeletal Disorders National Institutes of Health Executive Plaza North, Room 300 Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Muscle Fiber Damage due to Eccentric Contractions	167
National Institute of Child Health & Human Development National Institutes of Health Executive Plaza North, Room 300 Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Interface Mechanics in Lower-Limb Prosthetics: Experimental Measurements and Finite Element Modeling	28
Restoration of Shoulder Movement in C5 Tetraplegia	83
Hand Neuroprosthesis in Chronic Hemiplegia	84
Efficacy of Neuromuscular Stimulation in Enhancing the Upper Extremity Motor and Functional Recovery of Acute Stroke Survivors	85
Stimulator for Treating Post-Stroke Shoulder Subluxation	86
Paraplegic Walking Made Practical with FNS and Orthoses	95
National Institute of Neurological Disorders & Stroke National Institutes of Health Executive Plaza North, Room 300 Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Life Interface for Closed Loop Control of Artificial Limbs	8
Microstimulation of the Lumbosacral Spinal Cord: Mapping	71
Multichannel Implantable System for Neural Control	87
Paraplegic Walking Made Practical with FNS and Orthoses	95
Unassisted Standing by Functional Electrical Stimulation	96
National Institute of Disability and Rehabilitation Research U.S. Department of Education 400 Maryland Ave., SW Washington, DC 20202; Web: http://www.ed.gov/offices/OSERS/NIDRR/
	Number
Body-Powered Toddler Hand	14
Refinement, Evaluation, and Dissemination of a Diagnostic and Treatment Assessment Expert System for the Interpretation of Walking Disorders Leading To Disability	51
Assessment of Ambulation Motion Parameters for Clinical Evaluation	53
Discomfort Associated with Percutaneous and Surface Neuromuscular Stimulation during Treatment of Post-Stroke Shoulder Subluxation	81
Percutaneous Neuromuscular Stimulation for the Treatment of Shoulder Subluxation in Hemiplegia	82
A Controlled Study of the Effects of EMG Feedback and Electrical Stimulation on Motor Recovery in Acute Stroke Patients	119
Effects of Aerobic Exercise on Young Persons Post-Stroke	120
Prevention of Thromboembolism in Stroke Rehabilitation Patients	121
The Effectiveness of a Telephone Support Group for Stroke Caregivers	122
Course of Recovery of Cognitive-Communicative Problems in Right-Brain-Damaged Individuals	123
Reducing Motor Disability in Hemiparetic Stroke by Manipulation of Sensory Input from the Paretic Upper Limb: A Quantitative Evaluation	124
The Predictive Value of Cognitive/Behavioral Measures in Patients after Stroke in Assessing Functional Outcome	125
Improving Vocational Outcomes of Individuals who Have Sustained a Stroke	126
Special Projects and Demonstration: Applications of Technology to Enhance Quality of Life--A Community Model	136
Trans-Train: Transdisciplinary Training of Rehabilitation Personnel in Assistive Technology	137
Measurement of Plantar Foot Soft Tissue Properties of Persons with Diabetic Neuropathy for Prediction of Plantar Foot Pressures and Assessment of Plantar Ulceration Risk	219
Orthotics for Myelomeningocele Patients, Teenage versus Childhood	220
Development of Lower Extremity Orthotics for Children with Myelomeningocele	221
Mobile Arm Supports for Children	222
Causes and Costs of Unplanned Rehospitalizations among Persons with Spinal Cord Injury	255
Obstetric/Gynecologic Complications in Women with Spinal Cord Injury	256
Natural History and Clinical Course of Urinary Tract Complications in Patients with Spinal Cord Dysfunction	257
Immune Responses to Pneumococcal Vaccine in Spinal Cord Injury	278
A Longitudinal and Cross-Sectional Analysis of Well-Being in Persons with Spinal Cord Injury and Their Caregivers	279
Baclofen Pump: Functional and Neuropsychological Impact	280
The Use of Growth Factors in Pressure Ulcer Healing: Clinical Trials	298
Characteristics of Genital Skin Flora in Persons With SCI and Their Effect on Development of Urinary Tract Infection	299
Problem-Solving Skills Training in the Treatment of Pressure Ulcers	306
National Research Council of Canada Institute for Intelligent Systems Ottawa, K1A OR8, Ontario Canada
	Number
WIVIK 2 On-Screen Keyboard	151
WIVIK 2 Scan: 1-5 Switch Scanning Access	152
Keyrep: WIVIK/Keyboard Rate Enhancement	153
WIVOX: Voice Output for Windows	154
National Science Foundation Biomed. Eng. & Aiding Disabled Room 565, 4201 Wilson Blvd. Arlington, VA 22330; Web: http://www.nsf.gov
	Number
The Dynamic Model of Skeletal Muscles and Joints for FES Applications	72
Determination of the Optimal Motor Unit Recruitment Strategy for Application in a High Performance FES System for Quadraplegics	74
The Use of EMG As Force Feedback in Closed-Loop Electrical Stimulation Systems	73
Assessing Individuals' Predispositions to the Use, Avoidance, Or Abandonment of Assistive Technologies	132
Surface and Wire EMG Crosstalk in Neighboring Muscles	168
Control of Joint Motion with Synergistic Stimulation of its Agonist/Antagonist Muscles	169
Three-Dimensional Description of Muscle Properties	170
Ligamento-Muscular Protective Reflex in the Knee, Shoulder, Ankle, and Elbow	175
Powered Arm Orthosis	223
Natural Sciences and Engineering Research Council of Canada 350 Albert St. Ottawa, K1A 1H5, Ontario Canada
	Number
A Multi-Degree of Freedom Prosthetic Hand for Child User	15
A Knee Joint for Use in a Pediatric Swimming Prosthesis for Persons with Transfemoral Amputation	24
National Center for Medical and Rehabilitation Research National Institutes of Health Bethesda, MD 20892; Web: http://www.nih.gov
	Number
Restoration of Shoulder Movement in C5 Tetraplegia	83
Logic-Controlled Electromechanical Free-Knee Orthosis	224
Netherlands Organization for Scientific Research (NWO-MW) Amsterdam, The Netherlands
	Number
Quantitative Functional Anatomy of the Upper Extremity	39
Neural Prosthesis Program No address listed.
	Number
Unassisted Standing by Functional Electrical Stimulation	96
Ohio State University Center for Automotive Research 1583 Perry St., Room 306 Columbus, OH 43210-1234
	Number
Clinical Assessment of Seated Stability during Transportation	293
Ontario Ministry of Health Queen's Park Toronto, M7A 1L3, Ontario Canada
	Number
A Self-Adaptive Digital Processor for Prosthesis Control	3
Effectiveness of Using Voice Recognition Systems	149
Ontario Rehabilitation R&D Consortium Ottawa, Ontario Canada
	Number
A Self-Adaptive Digital Processor for Prosthesis Control	3
An Adaptive Toileting System for Young Children	133
Computer Software to Assess Visual Learning Problems	150
WIVIK 2 On-Screen Keyboard	151
WIVIK 2 Scan: 1-5 Switch Scanning Access	152
Keyrep: WIVIK/Keyboard Rate Enhancement	153
WIVOX: Voice Output for Windows	154
Seated and Related Postural Devices for Elementary School Environments	290
Custom Car Seats for School-Aged Children with Physical Disabilities	292
An Improved Anterior Pelvic Stabilizer	291
Office of Orphan Product Program Food and Drug Administration 5600 Fishers Lane Rockville, MD 20857; web: http://www.fda.gov/orphan/
	Number
Implantable FNS Systems for Standing Transfers	97
Orthopaedic Trauma Association 6300 North River Road, Suite 727 Rosemont, IL 60559
	Number
The Effects of Training by FES on Muscle Geometry and Force	77
Paralyzed Veterans of America, Spinal Cord Injury Education and Training 801 18th Street Washington, DC 20006; Web: http://www.pva.org/
	Number
Braking Study	288
Improving Tissue Viability of Paralyzed Muscle Using Neuromuscular Electrical Stimulation	300
Paralyzed Veterans of America, Spinal Cord Res Fdn 801 18th Street, NW Washington, DC 20006; Web: http://www.pva.org/
	Number
Force Sensors for Control of Power Wheelchairs	258
Sarcopenia Early after Complete Spinal Cord Injury	281
Post Polio Clinic of the Albert Einstein Medical Center Philadelphia 5501 Old York Road Philadelphia, PA 19141
	Number
The Role of Orthotic Intervention in Resolution of Plantar Fasciitis	216
Determination of the Effect of Range of Motion Changes in an Articulated Ankle Foot Orthosis on Lower Limb Muscle Demands	225
Royal Brisbane Hospital RBH Post Office Queensland 4029, Australia
	Number
Video, Design, and Rehabilitation Engineering	134
Rehabilitation Research and Training Center on Aging Rancho Los Amigos Medical Center 7600 Consuelo St. Downey, CA 90242; Web: http://www.usc.edu/dept/gero/RRTConAging/index.html
	Number
A Study of Policy Barriers Impeding Use of Assistive Technology by Persons Aging with Disabilities	110
Rotary Club of Toronto Toronto, Ontario Canada
	Number
Custom Car Seats for School-Aged Children with Physical Disabilities	292
Rush University Committee on Research RUSH Presbytarian-St. Luke's MC 1653 W. Congress Parkway Chicago, IL 60612
	Number
Postural Adjustments during Standing in Below-Knee Amputees	29
Spina Bifida and Hydrocephalus Assoc. of Canada No address listed.
	Number
Computer Software to Assess Visual Learning Problems	150
Paralyzed Veterans of America, Spinal Cord Research Foundation 801 18th Street, N.W. Washington, DC 20006; Web: http://www.pva.org
	Number
Improving Tissue Viability of Paralyzed Muscle Using Neuromuscular Electrical Stimulation	300
Segal Foundation No address listed.
	Number
The Influence of Fatigue on EMG and Impact Acceleration in Running	52
Standing Sway: Kinematics and Dynamics from Forceplate Measurements	58
Effect of Ingested Sodium Bicarbonate on Muscle Force, Fatigue, and Recovery	75
Dynamics of Force Recruitment of the Paralyzed Muscle by FES	76
The Effects of Training by FES on Muscle Geometry and Force	77
Modeling of Fatigue and Recovery in FES to Allow Prediction of Muscle Force	78
Muscle Coactivation in Transcutaneous FES	98
Smith & Nephew Richards 1450 E. Brooks Road Memphis, TN 38116-1804
	Number
Effect of Intra-Articular Implants on the Health of the Knee Joint	206
Transportation Research Board 2101 Constitution Ave. NW Washington, DC 20418
	Number
Clinical Assessment of Seated Stability during Transportation	293
Thames Valley Children's Centre 779 Base Line Road, East London, Ontario Canada N6H 3
	Number
An Evaluation of the Access Glide System for Mounting Augmentative Communication Devices: A Pilot Study	135
University of Alabama at Birmingham, Southeastern Regional Head Injury Center 1150 10th Ave.-South Birmingham, AL 35294
	Number
Stresses in the Soft Tissue of the Human Buttocks in the Sitting Position	294
Testing of Polyurethane Foams to Determine Their Stress-Strain Relationship	316
University of New Brunswick Research Fund 180 Woodridge Street Fredericton, NB E3B 5A3 Canada
	Number
An Investigation into the Effectiveness of Fitting Powered Upper Limb Prostheses: the UNB Experience	9
Development of a Multifunction Myoelectric Control System	10
Recent Advances in the Development of Partial Hand Prostheses	16
Bilateral Deficit during Knee Extension	59
Evaluation of Various Filtering Schemes in Whitening Biological Noise for Somatosensory Evoked Potential Detection	259
Adaptive Biological Signal Processing	320
University of Salford Venture and Enterprise Fund Statham St. Kent UK England
	Number
A Computerized Technique for the Assessment of Alternating Pressure Relief Index	301
University of Twente Biomedical Engineering Division P.O. Box 217, 7500 AE Enschede, The Netherlands
	Number
Isometric Length-Force Characteristics of Pennate Muscles during and after Shortening: Experimental and Modelling Results	172
Skeletal Muscle Length-Force Characteristics during Maximal and Submaximal Activation	173
University of Western Ontario London, Ontario Canada
	Number
Reliability of the Upper Body Musculoskeletal Assessment (UBMA) in Diagnosis of Work-Related Musculoskeletal Disorders (WRMD)	67
Variety Ability Systems 3701 Danforth Ave., Scarborough, M1N 2G2 Ontario Canada
	Number
The Incorporation of a Slip-Sensing, Closed-Loop Control System into a Myoelectric Prosthetic Hand	11
Variety/The Children's Charity No address listed.
	Number
VV 2-6 Prosthetic Hand Enhancements: Cosmetics and Function	12
Vrije Universitiet Faculty of Human Movement Sciences, Van der Boechorststraat 9, Amsterdam, 1081 BT The Netherlands
	Number
Lateral or Myo-Fascial Force Transmission in Skeletal Muscle	171
Isometric Length-Force Characteristics of Pennate Muscles during and after Shortening: Experimental and Modelling Results	172
Skeletal Muscle Length-Force Characteristics during Maximal and Submaximal Activation	173
Ergonomics of Manual Wheelchair Propulsion	286
Whitaker Foundation 1700 North Moore Street, Suite 2200 Rosslyn, VA 22209; Web: http://www.whitaker.org/
	Number
Mechanical Effects of Muscle Tendon Transfer and Functional Neuromuscular Stimulation	88
Computer Simulation Analysis of Coordination Deficits in Post-Stroke Hemiplegia	127
3-D Contour Tracking of Pharyngeal Bolus Movement Using a Knowledge-Based Snake Search Algorithm	188
The Effect of Bolus Viscosity on the Pharyngeal Phase of Swallowing: A Study Using Computational Fluid Dynamics	189
No Sponsor Listed
	Number
A Multifunction Control System for Powered Upper Extremity Prostheses	17
Three-Dimensional Modelling of the Trans-Femoral Residual Limb Using Ultrasound	25
Effect of an Induced Leg-Length Discrepancy on Gait Biomechanics	54
A Musical Instrument Digital Interface for Children with Physical Disabilites	138
Customization of a Spaceball Interface for the Manus Robot Arm	140
Alternative Controllers for the Myoelectric Quadraplegic Assistive Device (MyQuad)	141
A Biotelemetric EMG Transceiver System for Assistive Devices	155
A Static Heel-Cushion Contact Model Using Finite Element Analysis	302
Failure of Cricopharyngeal Myotomy to Improve Dysphagia Following Head and Neck Cancer Surgery	321

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