Through basic, translational, and clinical research, the NCMRR aims to foster development of scientific knowledge needed to enhance the health, productivity, independence, and quality-of-life of people with physical disabilities. The NCMRR supports research on the following topics: pathophysiology and management of chronically injured nervous and musculoskeletal systems (including stroke, traumatic brain injury, spinal cord injury, and orthopedic conditions); repair and recovery of motor and cognitive function; functional plasticity, adaptation, and windows of opportunity for rehabilitative interventions; rehabilitative strategies involving pharmaceutical, stimulation, and neuroengineering approaches, exercise, motor training, and behavioral modifications; pediatric rehabilitation; secondary conditions associated with chronic disabilities; improved diagnosis, assessment, and outcome measures; and development of orthotics, prosthetics, and other assistive technologies and devices.
The NCMRR has its own National Advisory Board on Medical Rehabilitation Research that meets twice a year to discuss the Center's portfolio and research directions. Minutes from these meetings are posted for public review, and sections of the meeting are open to the public.
NCMRR led the development of the plan for the conduct, support, and coordination of medical rehabilitation research across the NIH. The NIH Plan on Rehabilitation Research identifies current medical rehabilitation research activities at NIH, opportunities and needs for additional research, and priorities for this research.
New: Research Priorities
Gap: Many rehabilitation interventions are multimodal, but there are few funded studies that particularly target combination therapies.
Priority: Explore multimodal approaches that promote plasticity and sensorimotor function, particularly the combination of physical therapy with regenerative, pharmacological, or stimulation treatments.
Objective Markers of Progress
Gap: Prognosis and outcomes are difficult to predict and measure objectively. Patient-reported outcomes are not used as primary and/or secondary endpoints in trials, even though their psychometric properties are well established. A number of functional assessment measures that rely on clinician judgment have limited reliability and validity.
Priority: Develop objective measures and biomarkers that may predict rehabilitation treatment response, monitor functional progress, and tailor interventions to the individual abilities, needs, and resources of the person with disabilities.
Gap: Many rehabilitation outcome measures are targeted to clinic- or hospital- based assessments and do not generalize to function in real-world settings.
Priority: Develop scalable strategies and technologies to monitor outcomes in real-world settings (e.g., home, community, workplace and school). This approach includes the use of engineering and social-science to understand environmental supports and barriers, monitor individual participation, understand health service access, and support health and independence.
Gap: There is a limited understanding of the incidence and prevalence of secondary conditions (e.g., pain, musculoskeletal dysfunction, deconditioning, skin breakdown, cognitive impairment, behavioral/social/emotional difficulties, and sleep disturbances) in individuals with physical disability; similarly, there are relatively few targeted strategies to prevent or treat these conditions.
Priority: Focus on identifying, preventing, and treating key secondary conditions that are associated with physical impairments and disabilities.
Transition to Adulthood
Gap: The field lacks data on the types of interventions, services, and outcome assessments needed to ensure successful transition between pediatric rehabilitation care and general medical services.
Priority: Enable rehabilitation research that addresses key lifespan transitional issues, such as the physical and developmental transition from adolescence to early adulthood and functional independence.