Current Research | Site-Specific Studies | Multi-Center Studies | Other SCI Research | Self-Management of SCI

The University of Michigan is a leader in research to improve life for individuals with SCI. Much of our research dissemination is done through publications in peer-reviewed journals and conference presentations.

If you are interested in participating in research on spinal cord injury, you can join our Research Registry, and your name will be placed on a confidential list of people whom we contact about studies for which they may be eligible.

Current Research Projects 2011-2016

For the 2011-2016 Spinal Cord Injury Model Systems grant, we will be conducting two site-specific research projects and two multi-center studies along with other SCI Model Systems. In addition, we will continue to participate in the National SCI Model Systems Database.

The National SCI Model Systems Database

Newly injured individuals who receive their inpatient rehabilitation for SCI at the University of Michigan Hospital are invited to participate in this longitudinal study. During participants' initial hospitalizations, data is collected about their injuries and a brief survey is conducted. Participants are contacted one and five years after their injuries and every five years thereafter to complete follow-up interviews. The data collected is confidentially added to the database of the National Spinal Cord Injury Statistical Center, the world's largest database about SCI. This database currently includes information on over 27,000 people with SCI, nationwide, of whom over 1,000 have come from our Model System. In addition to collecting data, we continue to actively conduct research with it.

Principle Investigators: Denise Tate, Ph.D. and Anthony Chiodo, M.D.


Current Site-Specific Studies at the U-M SCI Model Systems

Site-specific Study 1: Bladder and Bowel Complications and their Impact on Quality of Life Outcomes after SCI

Site Specific Study #1 is evaluating the relationships between methods of bladder and bowel management and other associated health behaviors with personal and injury characteristics, prescribed treatments, and environmental supports to see how the effect bladder and bowel complications and ultimately quality of life (QOL) among people with chronic SCI. The scope of this study builds on and broadens research in this area by accounting for not only physiological factors such as injury level, but also contextual factors such as the environment, alliance with care providers and behaviors. This project has collected data from over 300 people with SCI.  New measures were developed through this project to assess people’s management behaviors and other health behaviors that impact bladder and bowel health. Analysis of study data is underway.

Principle investigator: Denise G. Tate, PhD, ABBP


Site-specific Study 2: Bladder and Bowel Complications and their Impact on Quality of Life Outcomes after SCI

This study has looked at day-to-day life with bowel and bladder issues and how they impact QOL in the SCI populations. Participants have been a subset of the people who participated in Study #1. These people have been randomly asked to keep daily records for a one week period about events that have occurred relating to their bowel and bladder, what happened and how it affected them. Data collection for this study is completed.

Principle Investigator: Claire Kalpakjian, Ph.D.


Site-specific Study 3: Applying Health Mechanics to Enhance Bowel and Bladder Health for Persons with Spinal Cord Injury

This study is evaluating the efficacy of a self-management program, Health Mechanics, to develop and improve bladder and bowel management skills among persons with SCI. It is hoped that through participating in the program, participants will develop better self-management skills and that this will lead to improved management with a resulting decrease in complications and increase in both social participation and QOL. People have been randomly selected to either a usual care control group or the Health Mechanics intervention. The intervention group receives self-management training via telephone, so that distance from UM Hospitals is not a barrier to participation. The program focuses on enhancing skills, encouraging positive health behaviors and empowering people within their environments, recognizing that people have different resources and abilities. Participants are interviewed prior to joining the study and then again several times over the course of one year.  Recruitment for this study was recently completed.

Principle Investigator: Michelle Meade, Ph.D.

Multi-Center Studies at the U-M SCI Model Systems

Multi-Center Study 1: Evaluating the sensitivity and responsiveness of the SCI-QOL CATs

Multi-Center Study 1: Evaluating the sensitivity and responsiveness of the SCI-QOL CATs
The SCI-QOL measurement system was developed during the 5 years prior to the start of this grant to measure patient reported outcomes across 3 broad domains: physical medical issues; emotional functioning; and social participation. Unlike traditional measures, the SCI-QOL was developed specifically for people with SCI. The measures making up the SCI-QOL were tested in large samples of individuals with traumatic SCI. They were developed so that they could be given using Computer Adapted Testing (CAT). This study, involving 7 SCI Model Systems has evaluated the CAT's sensitivity to clinically meaningful changes over time as well as how scores on the CATs relate to those on existing measures and participants' perceptions of change. Participants are first interviewed near the time of their initial hospital discharges following SCI and then again, 1 and 2 years later. Data collection for this study was recently completed.

Principle Investigator: Claire Kalpakjian, Ph.D.


Multi-Center Study 2: Enhancing and Evaluating the SCI-CAT

The SCI-CAT is a patient-reported tool to evaluate functional well-being. It was developed as a Model Systems multi-center study during the 2006-2011 grant cycle. It has 5 scales: Ambulation; Basic Mobility; Fine Motor Function; Self-Care; and Wheelchair Mobility. This study started by modifying the scales to more fully address the range of assistive technologies that people use. It is evaluating the modified SCI-CAT in comparison to the Functional Independence Measure (FIM), the current standard for functional assessment. Data collection for this study was recently completed.

U-M Principle Investigator: Denise Tate, Ph.D.


 

Other SCI Research at the University of Michigan

SCI Research Registry

People with SCI who are interested in participating in clinical or survey research are welcome to join the SCI Research Registry. U-M Investigators conducting studies use the Registry to locate potential subjects. Any individual with a SCI is welcome to join the Registry. Access to the Registry is controlled to ensure safety and confidentiality.

Project Director: Claire Kalpakjian, Ph.D.

Recruitment: Send an e-mail to: SCIRegistry@umich.edu.


Prevalence and Correlates of Secondary Conditions following Spinal Cord Injury

While it is understood that there are a number of health conditions that occur commonly among people with SCI, though they are not directly caused by the spinal cord trauma, such as urinary tract infections and pressure ulcers, it is unclear to what degree other health conditions that commonly occur as people age happen more frequently among those with SCI. Examples of these conditions include hypertension and heart attacks and are called comorbidities. This study has looked at the prevelance of both of these types of conditions and their relationship to participation in society and overall quality of life. A second sub-study involved interviewing people who have had a SCI for an extended period to evaluate the relationships of health to functional independence, activity, stress, community engagement and QOL. Final analyses for this study are currently being done.

Principle Investigator: Denise Tate, Ph.D.

Funding Source: University of Michigan Injury Center Grant
 


Psychosocial and Behavioral Factors Associated with Bowel and Bladder Management after SCI

Bladder and bowel dysfunction is a critical issue for people with SCI, their families, caregivers and clinical providers. Yet little is known about the role of personal behaviors in preventing related complications and the psychosocial consequences of neurogenic bladder and bowel, and their impact on QOL. This study has two aims. The first is to identify risk factors associated with loss of neurogenic bladder and bowel which may increase medical and psychosocial complications after SCI. The second aim is to determine the influence of bladder and bowel management, complications and psychosocial and behavioral factors on QOL.  A mixed method approach is used for data collection and analysis, involving extended qualitative interviews that were conducted with two groups of participants: persons with SCI (N=40) and caregivers (N=20). Additional qualitative data was collected through a set of focus groups. This qualitative data has been supplemented with information collected through traditional survey measures to evaluate the extent and severity of bowel and bladder related health problems and quality of life ratings. A focus group comprised of caregivers was also conducted. This project included an equal number of participants with military and non-military backgrounds. Data collection is complete and analysis is underway.

Principal Investigator: Denise G. Tate, PhD, ABBP