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The primary objectives of any resident research project are to ensure that the experience is educational, ethical, productive and an overall positive experience. The Department of Physical Medicine & Rehabilitation research staff and faculty work with our residents to meet the needs of their project and research education. This includes:

  • Consultation
  • Guidance
  • Direction to needed resources
  • Information on applying for Carolinas HealthCare Foundation funds
  • Explanation of IRB procedures
  • Training in regulatory oversight and Good Clinical Practices
  • Financial administration and project management

Mark Hirsch, PhD, and Tami Guerrier are here to help guide you through a successful research experience.

Research Directors and Faculty

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 Mark A. Hirsch, PhD

Senior Scientist
Director, Resident Research Education (PM&R)

The aim of my current research is to understand the neuroplastic mechanisms that link neurotrophic factor expression levels, physical exercise and social-functional health outcomes, and to bring such insights into the clinical context of physical medicine and rehabilitation.  In particular, my research is focused on determining how physical activity and social capital control and affect improvements in quality of life and motor function. Our current studies work with Parkinson’s disease (PD) patients to determine the role of exercise on neurotrophic levels and motor and non-motor features of the disease.  Recently, we have shown that physical exercise triggers increase in circulating brain-derived neurotrophic factor in human PD. 

We are also promoting patient/provider/scientist collaboration in all of our research studies and, specifically, how patients with PD experience and benefit physiologically from participation in health care as peer health coaches. The insights gained will aid in our understanding of neurodegenerative disease progression and intervention efficacy for patients with neurologic conditions and ultimately increase the quality of care of our patients with cost containment.

In other words, our laboratory is focused on understanding how physical exercise and social capital affect the brain and how changes in brain function affect physical and social performance.  Our first step has been to test the effect of a peer-assisted physical exercise intervention on equilibrium control and falls in individuals living with Parkinson’s disease within a community-based setting (the intervention took place in a health club).  Our highly cited randomized controlled trial found that peer-assisted training, in which patients with PD and their care-partners were engaged in the research as partners in administering the high-intensity intervention, is feasible and results in improved PD participant motor function (https://www.ncbi.nlm.nih.gov/pubmed/12917847).  In 2007 we developed and implemented a regional, professional, collaborative network to bring these insights into the context of clinical rehabilitation for community-dwelling patients at all stages of Parkinson’s disease.  In 2011 the network received funding from the Park Foundation and the Carolinas HealthCare Foundation and became known as the RENEW Carolinas Parkinson Initiative (Research and Education in Neuro-wellness).  RENEW has received numerous awards for clinical care, innovation and dedication to research, including the 2016 Ray of Hope Award.  Our next step is to develop and test interventions collaboratively aimed at improving quality of life, social capital, motor performance and neurotrophic levels.  We use neurophysiologic techniques (such as computerized dynamic posturography, surface EMG, Inertial Measurement Units or customized body worn sensors) and lab-based approaches (ELISA, enzyme linked immunosorbent assay) in our research on PD, concussion care, traumatic brain injury, and stroke. 

To further strengthen our research endeavor our department uses elements of an approach termed Participatory Action Research or Community-Based Participatory Research to engage members of our Parkinson disease patient community advisory board, scientists, clinicians and patient advocacy groups to develop and run studies. Patients are one of the most underutilized resources in health care today (attributed to B. Bloem). We call the system we envision “participatory health care”. 

5 key publications:

  1. Hirsch MA, van Wegen EEH, Newman MA, Heyn PC. Exercise-induced increase in brain-derived neurotrophic factor in human Parkinson's disease: A systematic review and meta-analysis. Translational Neurodegeneration. 2018;7:7. DOI : 10.1186/s40035-018-0112-1.
  2.  Heyn PC, Hirsch MA, York MK, Backus D.  Physical activity recommendations for the aging brain: A clinician-patient guide. Arch Phys Med Rehabil. 2016;97:1045-7.
  3. Mougeot JL, Hirsch MA, Stevens CB, Mougeot FK. Oral biomarkers in exercise-induced neuroplasticity in Parkinson’s disease. Oral Dis. 2016 Feb 15. doi: 10.1111/odi.12463.
  4. Hirsch MA, Sanjak M, Englert D, Iyer SS, Quinlan MM.  Parkinson patients as partners in care.  Parkinsonism Relat Disord. 2014 Jan;20(Suppl 1):S174-179.
  5. Hirsch MA, Iyer S, Englert D, Sanjak M.  Promoting community-based participatory research exercise programs in Parkinson’s disease.  Neurodegenerative Disease Management. 2011;1(5):365-377.

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Tami Guerrier, LRT/CTRS, CBIST, Assistant Director

 Tami Guerrier, CARA, CBIST

Assistant Director, Carolinas Rehabilitation Research Department

 Ms. Guerrier, a certified research administrator, holds a Bachelor of Science degree from the University of Iowa, Iowa City, Iowa. She has over 30 years of experience in the field of physical rehabilitation with over 20 years of experience with demonstration grants and research administration. Ms. Guerrier has specialized in grants management providing administrative oversight for multiple federal grants including National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) grants for TBI Model System and National Institute of Health grants, as well as state and private grant contracts.

Ms. Guerrier is a published author and a presenter at local, state, and national conferences. In her present role as research manager, Ms. Guerrier works with the PM&R research faculty in managing a strong, nationally-recognized research program in addition to providing administration for PM&R Research industry sponsored trials.

Guerrier, T., Hammond, F., Lash, M. (2011). Cognition: Compensatory strategies after brain injury. Wake Forest NC: Lash & Associates Publishing/ Training, Inc.
Guerrier, T. & Hammond, F. Eds. (2010) Brain injury it is a journey: A practical guide for families. Wake Forest, NC: Lash & Associates Publishing/Training, Inc.
Guerrier, T. & Hammond, F. Eds. (2006). Brain Injury it is a journey: A practical guide for families. Wake Forest, NC: Lash & Associates Publishing/Training, Inc.
Guerrier, T. & Bostic, A. (2001). Bridging the gap: Community integration through collaboration between a community college and a rehabilitation program. Cognitive Technology 2001 6 (1).
Pringnitz (Guerrier), T., & Dillinger, G. Leisure counseling with chronic pain patients. Expanding Horizons in Therapeutic Recreation Journal. 1983 (4).
Pringnitz (Guerrier), T. & MacNeil, R. The Role of Therapeutic Recreation in Stroke Rehabilitation. Therapeutic Recreation Journal. 1982. 4 (16).

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Tami Guerrier, LRT/CTRS, CBIST, Assistant Director

 Mark Newman, Ph.D.

Research Scientist

 Dr. Newman received his Ph.D. and MPH degrees from the University of Pittsburgh.  Throughout his career he has worked on federally funded research investigations with various physical function measures as the primary outcome. Dr. Newman has experience in the design and implementation of physical activity interventions as well as experience analyzing and presenting data from these trials.  Currently, Dr. Newman’s research interests include using technology to assess physical function in rehabilitation populations; with a focus on aging and mobility disability.  Additional research interests include using large databases to assess patient outcomes following inpatient rehabilitation.  As a Atrium Health Data Steward, Dr. Newman has completed advanced training on database construction, data management, and data quality principles and application using the Research Electronic Data Capture (REDCap) database platform.  Dr. Newman has served on grant review panels for the National Institute on Disability, Independent Living, and Rehabilitation Research and the United States Department of Defense.

Key Publications:

Newman MA, Hirsch MA, Peindl RD, Habet NA, Tsai TJ, Runyon MS, Huynh T, Zheng N, Carolinas Trauma Network Research Group. Reliability of the sub-components of the instrumented timed up and go test in ambulatory children with traumatic brain injury and typically developed controls. Gait and Posture, 2018; 63:248-253.

Hirsch MA, vanWegen EEH, Newman MA, Heyn PC. Exercise-induced increase in brain-derived neurotrophic factor in human Parkinson's disease: a systematic review and meta-analysis. Translational Neurodegeneration, 2018; 7:7.

Kumar RG, Wang Z, Kesinger MR, Newman MA, Huynh TT, Niemeier JP, Sperry JL, Wagner AK. Probalistic Matching of Deidentified Data from a Trauma Registry and a Traumatic Brain Injury Model System Center: A Follow-up Validation Study. American Journal of Physical Medicine and Rehabilitation, 2018; 97(4):236-241.

Niemeier JP, Leininger SL, Whitney MP, Newman MA, Hirsch MA, Evans SL, Sing RF, Huynh TT, Guerrier TP, Perrin PB. Does history of substance use disorder predict acute traumatic brain injury rehabilitation outcomes?  NeuroRehabilitation, 2016; 6,38(4):371-383. 

Rejeski WJ, Axtell R, Fielding R, Katula J, King AC, Manini TC, Marsh AP, Pahor M, Rego A, Tudor-Locke C, Newman MA, Walkup MP, Miller ME. Promoting physical activity for elders with compromised function: the Lifestyle Interventions and Independence for Elders (LIFE) Study physical activity intervention. Clinical Interventions in Aging, 2013; 8:1119-1131.  

Santanasto AJ, Glynn NW, Newman MA, Taylor CA, Brooks MM, Goodpaster BH, Newman AB. Impact of Weight Loss on Physical Function with Changes in Strength, Muscle Mass and Muscle Fat Infiltration in Overweight to Moderately Obese Older Adults: A Randomized Clinical Trial. Journal of Obesity, 2010; 2011.

Newman MA, Pettee KK, Storti KL, Richardson CR, Kuller LH, Kriska AM. Monthly Variation in Physical Activity Levels in Post-Menopausal Women. Medicine and Science in Sports and Exercise, 2009; 41(2) pp. 322-327.

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Research Curriculum
Required Elements

Human Subjects Protection Education Web Course: This simple, self-paced course offers an excellent overview of the protection of human subjects involved in clinical research.
Annual Biostatistics Course: A six session Biostatistics Course is offered each September through October by our Biostatistics department. Quarterly Research Conference: Research Conferences are held five times yearly and are scheduled during Thursday noon lectures. Conference topics vary, and are developed in accordance with the education needs of the residents and faculty. Topics cover four broad categories:

•Regulations, ethics and good clinical practices
• Literature searches, electronic resources, research funding, statistics and project management
• Dissemination of research findings
• Critical review of the literature

These conferences are designed to provide an interactive forum that complements the activities of residents as they move through the different phases of research project cycles.
Journal Club: Journal Club is held five times per year. The goals of the Journal Club are:

• To teach critical review of the literature
• To prepare residents to pursue their academic and research interests
• To provide exposure to the fundamentals of research design, statistical analysis and data interpretation
• To allow for discussion of articles that describe changes in practice or current thinking

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Research Curriculum
Non-required Elements

Resident Research Project: Research creates countless opportunities for critical thinking and literature interpretation. In the era of evidence-based medicine, it becomes necessary for each specialty to create practice guidelines with a rigorous scientific basis. The resident research project prepares residents to:

• Search and review literature with a critical approach
• Pursue their career/academic vision
• Present clinical and research findings effectively
The curriculum is individualized and designed to be practical, interactive and inspiring. A variety of levels of research endeavors are available, including
• Case studies
• Case series
• Article and chapter review
• Database research
• Prospective and retrospective original studies

The faculty help guide each resident throughout the research process, preparing each resident to meet the academic challenges ahead. Some are so inspired by their research experience that they choose to continue to focus on much-needed PM&R research.

Industry-Sponsored Research: Residents may be offered the opportunity to participate in industry-sponsored clinical trials.
Research Elective: Residents may elect to spend up to one month on research. They may choose to focus this time on their own project, or to work on other research department activities. Prior to the elective, the resident and faculty develop individualized objectives specific to the upcoming rotation. In order to get resident research projects completed before the end of residency, residents are encouraged to complete their "research month" during the PGY-3 year or in early PGY-4.

Co-Investigator Meetings: Research project participants meet regularly with co-investigators who guide the project from inception to completion. This forum provides a perfect platform for both education and collaboration.

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Carolinas Rehabilitation Research Excellence Award

Upon completion of the residency, the class of PGY-4 residents will be considered for the Clinical Research Award. In order to be eligible the resident must do the following:

• Complete their research project
• Submit the manuscript for publication
• Demonstrate excellence in research

Though eligibility will be reviewed annually, this award acknowledges the highest standards of research, and thus may not be granted every year.

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Scholarly Activities and Awards

2018 CONFERENCE POSTERS AND PRESENTATIONS 
*denotes Resident or medical student
 
Kirsteins A, Nguyen V, Chae J.  Diagnosis, treatment and prevention of hemiplegic shoulder pain (HSP). Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA. February 16, 2018, Oral Presentation. 
 
Raj VS.  The business of medicine: Fiscal drivers of rehabilitation. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 13, 2018, Oral Presentation.
 
Bockenek WL. Program for academic leadership. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 15-17, 2018, 2.5 Day Course Director.
 
Pinto SM. Kumar RG, Sperry JS, Wagner AK.  Increased risk of mortality in patients with venous thromboembolism following traumatic brain injury. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 15, 2018, Poster.
 
*Ference EW, *Bailowitz Z, Ost E , Bockenek W, Shauger K. Amyotrophic lateral sclerosis presenting in myxedema coma. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Poster.
 
Nguyen V, Kirsteins AE, Chae J.  Diagnosis, treatment, and prevention of hemiplegic shoulder pain. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Oral Presentation.
 
Chandler L.  AAP quality improvement MOC committee. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Panelist Speaker.
 
Kim ML, Loo L, Nguyen V.  “ACEing” the evidence within PM&R. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Poster.
 
*Michunovich A, *Sestak J, *Davisson A, Guile D, *Boncimino J, Clunan D, Nguyen V. The medical decision-making capacity and social complexities of a brain injured patient. Annual meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Poster.
 
*Kult J, *Payne CL, *Held K, White H, Nguyen V.  Rubrospinal tract injury resulting in tremor: A case report. Annual Meeting of the Association of Academic Physiatrists, Atlanta, GA, February 12-14, 2018, Poster. 
 
Kauserud S.  Quality Measures for inpatient rehabilitation facilities. Rehabilitation Administrators' Workshop: Tips (Secrets) to Managing a Successful Rehabilitation Hospital or Unit, Washington, DC, March 11, 2018, Oral Presentation.
 
Sanjak M, Mabe C, Holsten S, Rozario N, Bravver E, Bockenek W, Brooks B.  Sit to stand (STS) vs. stair climbing (SC) as a measure of lower extremity (LE) function in ambulatory patients with Amyotrophic Sclerosis (ambALS). Annual Meeting American Academy Neurology, Los Angeles, CA, April 21-27, 2018, Poster.
 
Chandler L. The opportunities and gaps in rehabilitation education in low income countries. International Society of Physical and Rehabilitation Medicine World Congress, Paris, France, July 8-July 12, 2018, Poster.
 
Nguyen VQC, Yang Q, Thomas JG, Guerrier T, Hirsch MA, Pugh T, Harris G, Prvu Bettger J. The association of neurostimulant and antidepressant use with functional recovery during stroke rehabilitation. International Society of Physical and Rehabilitation Medicine World Congress, Paris, France, July 8-July 12, 2018, Poster.
 
Prvu Bettger J, Yang Q, Thomas JG, Guerrier T, Hirsch MA, Pugh T, Harris G, Nguyen VQC. Cognitive impairment and discharge home for stroke patients with mild, moderate and severe motor impairment.  International Society of Physical and Rehabilitation Medicine World Congress, Paris, France, July 8-July 12, 2018, Poster.
 
Erickson KI, Devos H, Heyn PC, Hirsch MA.  NDNG lecture luncheon: Fit body, fit brain: Exercise is the key. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Symposium.
 
Erickson KI, Heyn PC, Hirsch MA.  Aging, exercise, and brain plasticity. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Invited Plenary.
 
Heyn PC, Carollo J, Kaya M, Devos H, Hirsch MA.  Intricate association between motor & cognition: Evidence of neurophysiological and behavioral outcomes. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Invited Special Symposium.
 
Van Wegen EEH, Hirsch MA.  Moving from clinician centered to patient centered research and clinical care. Annual Meeting of the American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Plenary.
 
Hirsch MA, Katz DI, Silver J, Kim S, Heyn PC, Guclu-Gunduz A.  2nd annual women in rehabilitation science symposium. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Special Symposium.
 
Hirsch MA, van Wegen EEH, Newman MA, Heyn PC.  Exercise-induced increase in brain derived neurotrophic factor in human Parkinson’s disease. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Symposium.
 
Gross M, Johnson M, Cohen R, Hirsch M.  Community-based group Alexander technique programming to promote long-term health, independence, and agency. Annual Meeting American Congress Rehabilitation Medicine, Dallas, TX, Sept 30-Oct 3, 2018, Symposium.

AWARDS

Dr. Vu Nguyen, Vice Chair of Academics and Residency Program Director in the Dept. of PM&R received the Association of Academic Physiatrists (AAP) Outstanding Service Award for 2018. The prestigious award was presented during the annual AAP conference on February 14, 2018 held in Atlanta, Georgia.

Ray of Hope Award honored Dr. Mark A. Hirsch and Dr. Sanjay S. Iyer.  This award is given annually by the Parkinson Association of the Carolinas to a person who has supported its mission “to serve as a resource for individuals and their families affected by Parkinson’s disease in the Carolinas through education, community outreach, and direct support.” The honorees Sanjay S. Iyer, MD, Danielle Englert, MD, and Mark A. Hirsch, PhD, were presented the award during the 2016 Bill & Betty Ray Awardees Luncheon and Awards Ceremony in recognition of their dedication to research and treatment of Parkinson’s Disease and support of the Parkinson’s Association of the Carolinas.

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