The mission of RC-1 is to design, implement, and evaluate clinical and translational research in exercise rehabilitation and recovery in older patients with stroke, hip fracture, and other medical conditions associated with functional limitations in aging. Reorganization of UM-OAIC from a project to a Core based Center led to the proposed core, which provides access and leadership to Pepper and other university resources to conduct translational rehabilitation research in functionally limited older people. Two levels of translation: bench to clinical laboratory;and clinical laboratory to community, are facilitated. Core directors were chosen for their leadership in common and costly disabling conditions in older people, stroke and hip fracture. Our stroke rehabilitation program investigated physiological and functional efficacy of motor learning-based exercise rehabilitation interventions via relatively small intervention development studies in the UM-OAIC that included examination of biological mechanisms underlying functional impairment. The Baltimore Hip Studies (BHS) have been ongoing for >20 years and emphasized larger epidemiological studies. In these investigations, we have examined physiological and functional sequelae of hip fracture in community settings, and exercise interventions implemented in the home. The intention for the proposed UM-OAIC is to apply constructive methods and knowledge from each disabling condition, to the other condition so that stroke research can be taken into community settings, and hip fracture research can be pursued in the clinical and basic science laboratories, including a focus on exercise-mediated biological adaptations. Increasing collaborations represented by dual core leadership provide a translational research model that focuses on the following aims: 1)To facilitate design and conduct of research mechanisms underlying functional limitations associated with stroke, hip fracture and other chronic diseases in older people to determine the disability phenotype across a spectrum of neuromuscular, cardiovascular, functional and behavioral domains. 2)To facilitate evaluation of the multi-faceted processes by which older persons who develop disabling medical diseases such as stroke or hip fracture decline functionally, and either recover with rehabilitation or develop comorbid medical conditions that worsen their prognosis. 3)To facilitate development and implementation of disease and disability specific exercise and motor learning interventions, including application of new technologies, adherence strategies and treatment fidelity to optimize clinical and functional outcomes.4)To utilize infrastructure of the Pepper to facilitate testing of exercise interventions at the community level, and help investigators study the factors that could impede or facilitate the broader dissemination of health and function promoting exercise interventions for aging populations with functional limitations.
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