VA Rehabilitation Research: Achievements and Future Directions

M e e ti n g f o r V A I R B C h a i r p e r s o n s : A u g u s t / 2 0 1 2

Patricia A. Dorn, PhD, Interim Director

Department of Veterans Affairs

To care forhim who shallhave bornethe battle, andfor his widowand hisorphan.”

Lincoln, 1865

RR&D Scientific Programs (alphabetical)

• Prosthetics/Orthotics/ Rehab Engineering

• Regenerative Medicine• Sensory Systems:

Hearing, Vision, Pain• Social Reintegration• Spinal Cord Injury

• Aging• Brain Injury: TBI, Stroke• Medical Comorbidity• Mental Health• Musculoskeletal• Neurodegenerative

Diseases

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Mission of Rehabilitation Research and Development Service

To discover knowledge and stimulate innovations that restore Veterans who have become disabled to their greatest possible functional capacity

• In their person• In their families• In their communities• In their work places

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Levels of Functional Recovery

• Molecule• Cell, & Tissue

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Scope of Rehabilitation Research and Development

• REPAIR: • Research to repair injured organs and tissues• Translational research to bring basic discoveries to clinical

use• REPLACE: • Research to replace functions that cannot be repaired• Encompasses research in devices, implants,

pharmacological interventions • RESTORE: • Physiological and Psychological well-being

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Another Perspective on Recovery and Reintegration ...

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Examples of VA RR&D Research

Vocational Rehabilitation: Spinal Cord Injury–Veterans Integrated Program (SCI-VIP)

• Will introducing Supported Employment (SE) Services into SCI continuum of care improve employment outcomes compared to Treatment as Usual (referral to provider or agency outside SCI Center)?

• 5-year prospective RCT, multi-site

• Findings support inclusion Vocational Services in SCI continuum care – Integration: Key Element– Clinician, Leadership Support: Critical– SCI specific modifications

Plot: % subjects answering ‘During this time period,

did you have a paying job?

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0 4 8 120

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20

30

SE TAU-IS TAU-OS

MonthPe

rcen

t

Vocational Rehabilitation: SCI-VIP Predictive Models Over Time for Employment (PrOMOTE)

• PrOMOTE is an extension of SCI-VIP – Employment Status

– Levels of Supported Employment and Cost Effectiveness

– Measures of Functional Abilities and Impairments, Quality of Life, Depression

– Health status information

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Mr. Marvel

Voc Services

Transportation

Employer

Natural Support

A.T.

Wayfinding: Improved Mobility

By combining computer vision with GPS, digital compass, Google

Map©

Now possible for individual with visual impairment to find their way to novel locations

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