Carolinas Rehabilitation Research Laboratory

Carolinas Rehabilitation researchers focus on cognitive neuroscience, motor neuroscience, sponsored clinical trials, molecular and translational, rehabilitation outcome and health services research. Thanks to federal and state funding, researchers develop and apply methodologies and innovative treatments that translate into advanced care for traumatic and acquired brain injury, spinal cord injury, neuromuscular and degenerative disorders and brain tumors. Our research program is fully integrated into clinical care and resident education.

Carolinas Rehabilitation Research Team

• William Bockenek, MD, Chief Medical Officer 
• Janet P. Niemeier, PhD, ABPP, Director of Research
• Jesse Lieberman, MD
• Vu Nguyen, MD
• Mark Hirsch, PhD
• Tami Pringnitz Guerrier, Assistant Director
• Dawn Neumann, PhD, MPh

Contact Carolinas Rehabilitation Research Laboratory

Email: Carolinas Rehabilitation Research
Ph: 704-355-9330
Fax: 704-355-0709

Recent Industry-Sponsored Trials

A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of SUN13837 Injection in Adult Subjects with Acute Spinal Cord Injury
Principal Investigator: W. Bockenek, MD

Comparison of HP011-101 to Standard Care in the Management of Stage I-II Pressure Ulcers in Subjects with Traumatic Spinal Cord Injury
Sponsor: Healthpointe
Principal Investigator: L. Lofton, MD

Prospective Multi-Center Pilot Study of the SPR System for the treatment of post stroke shoulder pain
Sponsor: NDI Medical
Principal Investigator: V. Nguyen, MD

Humanitarian Use Device: Synapse Neuro Rx Diaphragm Pacing System
Sponsor: Synapse Biomedical
Principal Investigator: W. Bockenek, MD

Merz Phamaceuticals, LLC, Clinical Tower Study No. MRZ 60201-3053-1 with NT 201  
Sponsor: Merz Pharmaceuticals
Principal Investigator: W. Bockenek, MD

Spinal Cord Injury

Spinal Cord Injury (SCI) Research Registry
The SCI Research Registry is a confidential database of individuals with spinal cord injury. Researchers at Carolinas Rehabilitation established the Registry to learn more about the effects of SCI. The Registry contains contact and health information used to determine study eligibility and to notify participants of existing or upcoming studies in addition to providing information about community opportunities for individuals.
Principal Investigator: J. Lieberman, MD

Improving SCI Rehabilitation Outcomes
This is a multi-center collaborative project sponsored by the US Department of Education, National Institute of Disability and Rehabilitation Research. The goal of the research is to examine in detail the individual steps taken in the treatment of individuals with SCI and explore how the method, order or combination of treatment determines the outcome. The aim is to produce clinical practice improvement and thus improve spinal cord injury patient outcomes.
Principal Investigator: F. Hammond, MD 

Brain Injury

An Acute Neurobehavioral Program for Improving Functional Status after Traumatic Brain Injury (TBI)
The purpose of this research is to conduct a randomized, controlled trial of the effectiveness of a brief, innovative treatment for improving functional status during acute TBI. The First Steps Acute Neurobehavioral and Cognitive Intervention (FANCI) is a 10-session manualized, comprehensive intervention that focuses on multiple concerns and challenges of early TBI recovery. The study is funded through the National Institute of Health (NIH/NICHD).
Principal Investigator: J. Niemeier, PhD, Co-Investigator, M. Dulin, MD

TBI Research Registry
The TBI Research Registry is a confidential database of individuals with TBI. Researchers at Carolinas Rehabilitation established the Registry to learn more about the effects of TBI. The Registry contains contact and health information used to determine study eligibility and to notify participants of existing or upcoming studies in addition to providing information about community opportunities for individuals with TBI and educational information about TBI. 
Principal Investigator: L. Grafton, MD., Co-PI: J. Niemeier, PhD, ABPP  

Carbamazepine for TBI Irritability and Aggression
Approximately 29-71 percent of individuals with traumatic brain injury (TBI) experience the problem of irritability and/or aggression which can interfere with interpersonal interaction, relationships and function. The current medical literature does not support standards or guidelines for the management of TBI irritability or aggression.   Medications commonly used to treat seizures, like carbamazepine, are also thought to reduce irritable and aggressive behavior. Even though this medication has been observed to improve behavior in other populations and after TBI, further studies are needed to learn how its effect compares to “placebo” and who benefits the most. 
Principal Investigator: F. Hammond, MD

Mild TBI Registry
The Mild Traumatic Brain Injury (mTBI) Registry is funded internally through Atrium Health's Center of Excellence. The purpose of this study is to gather information about the effects of mTBI or concussion and follow the changes in symptoms and health status over time to determine best possible treatment interventions. 
Principal Investigator(s): L. Grafton, MD and M. Gibbs, MD, Co-Investigator, J. Niemeier, PhD, ABPP

Stroke Rehabilitation Outcomes Evaluation
This study is a collaborative effort between Carolinas Rehabilitation and Duke University. The retrospective study represents a critical need in stroke rehabilitation research as it will provide a more complete understanding of the patient determinants of meaningful outcomes among individuals who have been diagnosed with stroke.  The most effective forms of rehabilitation care will also be studied. 
Investigators: V. Nguyen, MD, G. Thomas, MD, MA Hirsch, PhD, J. Prvu-Bettger, ScD

Mild TBI Participatory Action Research (PAR) Study
The Mild TBI Participatory Action Research Study is funded internally through Carolinas Healthcare System’s Trauma Center of Excellence. The primary purpose of this study is to characterize the experience of receiving health information about mild TBI from the perspective of the person with the mild brain injury or their family member.  The investigators are also interested in identifying the type of health information about mild TBI that primary caregivers provide to following a mild TBI and which kinds of information are most helpful. 
Investigators: M.A. Hirsch, PhD, L. Grafton, MD, R. Seymour, PhD, R. Pershad, MS, T. Guerrier, BS.

Trauma Diva: Characterizing Moderators of Gender Differences in Outcome after Traumatic Brain Injury (TBI)
This study leverages the expertise of a cross-field collaborative research team to explore the complexities that may underline the mixed findings related to hormonal neuroprotection after TBI. The team includes a basic scientist, an ob/gyn doctor, an Emergency Department physician, an attending physician on the brain injury unit at CR, and a Rehabilitation Psychologist with seven years of experience studying gender differences in outcomes after TBI. We will take blood samples from women, ages 18 – 35, and examine relationships between hormone levels and their recovery.
Investigators: PI: J.P. Niemeier, PhD, ABPP; Co-PI: J-L Mougeot, PhD; Co-Investigators: M. Gibbs, MD; B. Hurst, MD; L. Grafton, MD

TBI Model Systems
Carolinas Rehabilitation was honored to be selected as a TBI Model System from 1998-2012 by the National Institute of Disability and Rehabilitation Research. Carolinas Rehabilitation is currently a Follow Up site for TBI Model Systems. Carolinas Rehabilitation collects data at five years post injury and every five years after this from consented subjects for the TBI National Data and Statistical Center. This involvement allows access and participation in a national database for the purpose of sharing knowledge about recovery following TBI, long-term problems and TBI-related medical issues. Carolinas continues to be a follow-up center for the Model Systems.

Mecklenburg County ABC Board Grant Award. This award is for modifying and testing a 12-step program for persons with traumatic brain injury to help them access meaningful substance abuse recovery resources.
Investigators: S. Bartel, MS, R. Griffin, MS, J.P. Niemeier, PhD, ABPP

Neuromuscular Disorders

Exercise and Parkinson’s disease
This research examines gait, balance and motor coordination among early diagnosed individuals with Parkinson’s disease, the patient “experience” during exercise and the implementation and evaluation of community-based interventions in Parkinson’s disease.
Investigators: M.A. Hirsch, PhD, M. Sanjak, PhD, PT, MBA, P. Russo, D. Englert, MD, S. Iyer, MD, M. Quinlan, PhD

The Traumatic Brain Injury (TBI)

Carolinas Rehabilitation proudly serves as a follow-up site for the U.S. Department of Education’s National Institute on Disability Rehabilitation Research TBI Model System of Care. The TBI Model System includes a national database and collaborations that allow us to learn about long-term outcomes and problems facing individuals with TBI. The project follows individuals with TBI from the time of injury for a lifetime in an effort to improve TBI care through research. More than 7,000 individuals have been enrolled with data up to more than 15 years after injury. The TBI Model System also makes possible local studies of importance to persons with TBI.

Other projects Carolinas Rehabilitation is providing follow-up for through the TBI Model System project are:

• Changes over time
• Outcome measurement
• Medical issues
• Predicting outcomes and quality of life
• Post-acute therapy: cost, efficacy and satisfaction

Traumatic Brain Injury Project STAR

TBI Project STAR is a state-funded, community-based demonstration program that serves individuals affected by TBI by providing information about brain injury, linking to community resources and opportunities, offering educational training and community program development. The program works to facilitate involvement of individuals with TBI in their communities, through referral programs and community program development.

In this study, pertinent information from individuals and families affected by TBI and service providers is collected through focus groups and surveys. Issues studied include barriers to community participation, sports concussion awareness, community opportunities utilized, substance abuse following TBI and use of state-funded services. Researchers analyze results from these to develop a better understanding of how state-provided services and community agency collaborations can meet the needs of individuals with TBI.

Human Performance Laboratory

The Human Performance Laboratory (HPL) aims to characterize neurophysiologic and biomechanical responses to rehabilitation. The HPL is a laboratory that promotes translational research.

Community Participation Laboratory

This effort focuses on furthering knowledge and treatments to enhance participation in the community following neurologic injury. A recent focus of the lab has been on irritability and aggression occurring after TBI that may cause social isolation and disrupt interpersonal relationships. Other areas of research include: marriage, depression, outcome prognostication, and long-term outcomes of TBI.

Future Directions and Planning:

• Investigations of biomarkers toward characterizing persons with TBI and finding predictors of outcomes
• Neurobehavioral and cognitive, Return to Work, Family as Trainer intervention trials post TBI and polytrauma
• Gender differences and clues these may hold to the brain and spinal cord, and healing after injury
• Healthcare disparities
• Benefits of and barriers to exercise following TBI
• Substance abuse recovery following TBI and Provider training project
• Complementary and alternative medicine (CAM) and TBI/SCI/Stroke
• RCTs of treatments/devices for persons with disabilities due to illness or injury

Carolinas Rehabilitation Research Team

This team represents a wide range of interests and expertise in areas such as pediatrics and adult physical medicine and rehabilitation, health and interpersonal communication research, physical therapy, neurophysiology, biomedical engineering, neuropsychology, molecular/translational, occupational therapy, biostatistics and public health.

Support Information

Tax-deductible contributions to the Rehabilitation Research and Education Fund may be submitted via mail:

Rehabilitation Research and Education Fund
c/o Carolinas HealthCare Foundation
P.O. Box 32861
Charlotte, NC 28232-2861

For more information, call 704-355-4048.

1. Transcends the boundaries of medical disciplines (i.e., neurophysiology, physics, biomedical engineering, orthopedics, sports medicine, Physical medicine and Rehabilitation, Kinesiology)
2. Uses a life-span perspective (i.e., including neonate, pediatric, adult and geriatric patients)
3. Serves the needs of persons with diverse pathology (i.e., neurologic, metabolic, orthopedic, or a combination of these, etc).