Clinical Trials in Stroke Rehabilitation

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DESCRIPTION (provided by applicant): PROJECT SUMMARY: The candidate is a physiatrist-biomedical engineer with established funding and publication track record in patient oriented research (POR) in the area of functional electrical stimulation. His career development goal is to stimulate the field of Rehabilitation Medicine to build a critical mass of independent investigators to serve as principal investigators for clinical trials in stroke rehabilitation. The candidate's specific mentoring objectives are to 1) stimulate resident physicians to pursue a career in POR, and 2) equip and train junior faculty who are already committed to a career in POR to develop into independent investigators. These mentoring objectives will be met in the context of the training and research infrastructure provided by the General Clinical Research Center and the candidate's ongoing funded projects in 1) electrical stimulation for motor restoration in hemipleiga, 2) electrical stimulation for hemiplegic shoulder pain and 3) the proposed new project on the effectiveness of subacromial steroid injections for hemiplegic shoulder pain. The specific aims of the proposed new project are 1) to compare the effectiveness of subacromial steroid injection versus placebo in reducing hemiplegic shoulder pain and 2) to compare the effectiveness of standard versus high dose subacromial steroid injection in reducing hemiplegic shoulder pain. A placebo controlled, double-blinded, randomized clinical trial with 3 treatment arms (placebo, standard dose, high dose) will be conducted to address the specific aims. The project will develop new directions in POR for the candidate by providing him with the initial investigative experience with a non-electrical stimulation intervention so that he may contribute to a more comprehensive treatment approach to hemiplegic shoulder pain. RELEVANCE: There are over 4 million stroke survivors in the U.S. with over 700,000 new strokes occurring each year. Many stroke survivors exhibit severe paralysis and shoulder pain, both of which are associated significant activity limitations and reduced quality of life. However, the field of Rehabilitation Medicine is in dire need of clinician investigators who can develop and evaluate novel interventions that will reduce activity limitation, and improve societal participation and quality of life of these stroke survivors.