The candidate is a physiatrist-biomedical engineer with established funding and publication track record in patient oriented research (POR) in the area of functional electrical stimulation. His career development goal is to stimulate the field of Rehabilitation Medicine to build a critical mass of independent investigators to serve as principal investigators for clinical trials in stroke rehabilitation. The candidate's specific mentoring objectives are to 1) stimulate resident physicians to pursue a career in POR, and 2) equip and train junior faculty who are already committed to a career in POR to develop into independent investigators. These mentoring objectives will be met in the context of the training and research infrastructure provided by the General Clinical Research Center and the candidate's ongoing funded projects in 1) electrical stimulation for motor restoration in hemipleiga, 2) electrical stimulation for hemiplegic shoulder pain and 3) the proposed new project on the effectiveness of subacromial steroid injections for hemiplegic shoulder pain.
The specific aims of the proposed new project are 1) to compare the effectiveness of subacromial steroid injection versus placebo in reducing hemiplegic shoulder pain and 2) to compare the effectiveness of standard versus high dose subacromial steroid injection in reducing hemiplegic shoulder pain. A placebo controlled, double-blinded, randomized clinical trial with 3 treatment arms (placebo, standard dose, high dose) will be conducted to address the specific aims. The project will develop new directions in POR for the candidate by providing him with the initial investigative experience with a non-electrical stimulation intervention so that he may contribute to a more comprehensive treatment approach to hemiplegic shoulder pain.

Public Health Relevance

There are over 4 million stroke survivors in the U.S. with over 700,000 new strokes occurring each year. Many stroke survivors exhibit severe paralysis and shoulder pain, both of which are associated significant activity limitations and reduced quality of life. However, the field of Rehabilitation Medicine is in dire need of clinician investigators who can develop and evaluate novel interventions that will reduce activity limitation, and improve societal participation and quality of life of these stroke survivors.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24HD054600-04
Application #
7775030
Study Section
Special Emphasis Panel (ZHD1-DSR-T (CC))
Program Officer
Ansel, Beth
Project Start
2007-03-02
Project End
2012-02-29
Budget Start
2010-03-01
Budget End
2011-02-28
Support Year
4
Fiscal Year
2010
Total Cost
$146,330
Indirect Cost
Name
Case Western Reserve University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
077758407
City
Cleveland
State
OH
Country
United States
Zip Code
44106
Wilson, Richard D; Knutson, Jayme S; Bennett, Maria E et al. (2017) The Effect of Peripheral Nerve Stimulation on Shoulder Biomechanics: A Randomized Controlled Trial in Comparison to Physical Therapy. Am J Phys Med Rehabil 96:191-198
Sheffler, Lynne R; Taylor, Paul N; Bailey, Stephanie Nogan et al. (2015) Surface peroneal nerve stimulation in lower limb hemiparesis: effect on quantitative gait parameters. Am J Phys Med Rehabil 94:341-57
Makowski, Nathaniel S; Knutson, Jayme S; Chae, John et al. (2015) Control of robotic assistance using poststroke residual voluntary effort. IEEE Trans Neural Syst Rehabil Eng 23:221-31
Sheffler, Lynne R; Bailey, Stephanie Nogan; Gunzler, Douglas et al. (2014) Effect of body mass index on hemiparetic gait. PM R 6:908-13
Wilson, Richard D (2014) An etiological paradigm shift for chronic hemiplegic shoulder pain. Am J Phys Med Rehabil 93:929-30
Wilson, Richard D; Gunzler, Douglas D; Bennett, Maria E et al. (2014) Peripheral nerve stimulation compared with usual care for pain relief of hemiplegic shoulder pain: a randomized controlled trial. Am J Phys Med Rehabil 93:17-28
Crago, Patrick E; Makowski, Nathaniel S (2014) Alteration of neural action potential patterns by axonal stimulation: the importance of stimulus location. J Neural Eng 11:056016
Makowski, Nathaniel S; Knutson, Jayme S; Chae, John et al. (2014) Functional electrical stimulation to augment poststroke reach and hand opening in the presence of voluntary effort: a pilot study. Neurorehabil Neural Repair 28:241-9
Sheffler, Lynne R; Taylor, Paul N; Gunzler, Douglas D et al. (2013) Randomized controlled trial of surface peroneal nerve stimulation for motor relearning in lower limb hemiparesis. Arch Phys Med Rehabil 94:1007-14
Chae, John; Wilson, Richard D; Bennett, Maria E et al. (2013) Single-lead percutaneous peripheral nerve stimulation for the treatment of hemiplegic shoulder pain: a case series. Pain Pract 13:59-67

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