Our SCI research is led by “clinician-researchers,” whose hands-on expertise with patient care keeps their research focused on improving patient outcomes. Below are brief descriptions of select projects that are currently ongoing.
Patient Activation and Health Outcomes Across the Continuum of Care
Following SCI individuals have to self-manage diverse aspects of their health and healthcare. This contributes to individuals being at greater risk of health issues such as pressure ulcers, bowel/ bladder dysfunction, depression, and diabetes. As a result, clinicians are challenged to identify individuals who are at greater-risk for being unable to self-manage health and healthcare post SCI. A patient’s “activation” level is recognized as critical to self-management of health and is considered to be an individual’s knowledge, skills, and motivational attributes. Currently, a team at Baylor including Drs. Driver, Hamilton, Sikka, and Warren are examining whether a patient’s activation for self-managing their own health and healthcare (1) changes across the continuum of care following SCI and (2) is associated with health outcomes over time. If we better understand how, following SCI, activation to self-manage health and healthcare changes and is associated to health outcomes, then early identification of individuals with low activation will allow for targeted intervention.
Examining the Relationship Between Resilience and Rehabilitation Overtime
Clinicians at Baylor have questioned why some patients are able to adapt more successfully to traumatic injury than others. Using a ‘positive psychology’ framework, the team, which includes Drs. Driver, Hamilton, and Warren, has examined the construct of resilience. Specifically, we have identified how resilience changes across the continuum of care and how it is associated and predicted by different health factors including injury specific variables, confidence to manage the disability, attachment style, social support, and depression. Our findings are driving our clinical efforts to increase the resilience of patients so they are able to deal more successfully with their injury.
Comprehensive Bowel Management Program
Neurogenic bowel in individuals with spinal cord injury (SCI) is a life altering issue that, if not managed appropriately, will lead to complications associated with increased morbidity and reduced quality of life. Consequently, clinicians are challenged to identify effective bowel management programs for individuals post SCI. The clinical and research team at Baylor, led by Drs. Sikka and Driver, are evaluating the feasibility and effectiveness of a new comprehensive bowel care program for persons with SCI that is initiated in the acute care setting and continues through inpatient rehabilitation to outpatient. The program is in accordance with the Clinical Practice Guidelines by the Consortium for Spinal Cord Medicine and involves the entire clinical team across the continuum of care.
Access to healthcare
Research demonstrates that people with disabilities are relatively high users of health services and disproportionately high users of institutional services, such as hospitals and emergency clinics. It also shows, however, that they have significantly more unmet health needs than comparable members of the general population. In the context of fragmented care, research demonstrates a need for a multidisciplinary approach to services, as many individuals with SCI state that the greatest barrier to needs being met is limited local specialist knowledge about SCI. As a result, a team of clinicians and researchers at Baylor led by Drs. Hamilton and Driver, are examining the health care needs and utilization trends among individuals with SCI with the long-term goal of establishing a multi-disciplinary and accessible health care center to meet the specific and unique needs of this population.
Typical computer input from the patient relies on physical interaction with control devices such as a keyboard or mouse, which is a challenge for individuals with SCI. More recently, Brain Computer Interfaces (BCI) have been under investigation as a new channel for communication and control. Specifically, Electroencephalography provides a means of accessing and recording neural activity, allowing a computer to retrieve and analyze information from the brainwave patterns produced by thought. By removing the need for physical input, BCIs offer a range of assistive and rehabilitative applications for those with impaired or little physical control. Therefore, the purpose of this study, led by Dr. David Salisbury, is to evaluate the feasibility of using BCI gaming for our patients with SCI.
Group Lifestyle Balance Adapted for Impaired Mobility
This is an evidence-based lifestyle intervention program, collaborating with the University of Texas School of Public Health and University of Pittsburgh, specifically modified to meet the needs of individuals with impaired mobility. It is designed to promote improved nutrition and physical activity to assist with weight loss and encourage healthy behaviors.