Clinical Trials in Stroke Rehabilitation

描述(由申请人提供)：项目概要：应聘者是一名生理学家-生物医学工程师，在功能性电刺激领域以患者为中心的研究(POR)方面拥有既定的资金和出版记录。他的职业发展目标是刺激康复医学领域建立一支足够多的独立调查人员，担任中风康复临床试验的首席调查人员。候选人的具体指导目标是：1)刺激住院医师追求POR职业生涯；2)装备和培训那些已经致力于POR职业生涯的初级教员，使其发展成为独立的研究人员。这些指导目标将在综合临床研究中心提供的培训和研究基础设施以及候选人正在资助的1)偏瘫运动恢复的电刺激，2)偏瘫肩痛的电刺激，3)肩峰下类固醇注射治疗偏瘫肩痛的拟议新项目的背景下实现。拟议的新项目的具体目标是1)比较肩峰下类固醇注射与安慰剂在减轻偏瘫肩痛方面的有效性，以及2)比较标准剂量与大剂量肩峰下类固醇注射在减轻偏瘫肩痛方面的有效性。将进行一项安慰剂对照、双盲、随机临床试验，包括3个治疗组(安慰剂、标准剂量、高剂量)，以解决具体目标。该项目将为候选人在POR方面开发新的方向，为他提供非电刺激干预的初步调查经验，以便他可能为偏瘫肩痛的更全面的治疗方法做出贡献。相关性：美国有超过400万中风幸存者，每年有超过70万新中风发生。许多中风幸存者表现出严重的瘫痪和肩痛，这两者都与显著的活动受限和生活质量下降相关。然而，康复医学领域迫切需要临床医生研究人员开发和评估新的干预措施，以减少活动限制，改善中风幸存者的社会参与和生活质量。

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.