Rehabilitation Research Center awarded three grants to continue SCI research

MUSC’s Center for Rehabilitation Research in Neurological Conditions has a chance to expand its research, studying the long-term effects on people living with spinal cord injury (SCI) and continuing nearly 50 years of research.

The center’s director, researcher James Krause, Ph.D., professor and associate dean for research in the College of Health Professions and scientific director for the South Carolina Spinal Cord Injury Research Fund, along with the center’s research team were awarded three new grants within a five week stretch to focus on SCI research from the National Institute for Disability Independent Living and Rehabilitation Research.

A five-year $2.5 million grant supports Krause’s ongoing 50-year longitudinal study that focuses on aging and spinal cord injury among over 2,200 participants living with SCI. Participants provide self-assessments every five years that correlates issues related to aging and quality of life in the SCI population. This project is recognized globally as the most long-standing study of disability outcomes.

A new three-year grant, totaling under $600,000, coincides with the SCI Longitudinal Study and evaluates longevity among SCI survivors through self-assessments, standardized tests that focus on what long-term survivors do correctly to exceed their predicted life expectancies. “Our aim is to help others find success,” said Krause.

Finally, a third $2.5 million disability and rehabilitation research project on opioids will study and identify prevalence, risk factors and consequences for opioid abuse and use among people with SCI. The five-year study will include SCI participants from Minnesota, Georgia and South Carolina.

Krause attributes overprescribing to a lack of familiarity or expertise with SCI among medical and health care staff. “There’s a greater tendency for medical caregivers to prescribe opioids to SCI patients to easily address pain,” he said. Krause refers to it as compassionate overprescribing.

“Spinal cord injury people live with a lot of pain in their daily lives. This can be everything from neuropathic pain from neurological problems to pain from injury to burning sensations similar to phantom pain. Our aim in this study is to assess the factors that predict risk-taking behavior among participants and what are the factors that people use opioids,” Krause said.

One issue that Krause and his team plan to explore further with these studies is assessing how people with SCI are coping during the COVID-19 pandemic. Pertaining to elderly populations and others living with disabilities, there is concern about isolation and access to attendant health care. According to Krause, maintaining good attendant care was already a challenge prior to coronavirus, as employers relied on student-aged caregivers. The situation is more strained, especially because of the pandemic.

“One of the great things we’re able to accomplish is because of collaborative work with Dr. Anbesaw Selassie’s registry and surveillance system to help to identify people in communities receiving SCI treatment. Our hope is that we have a better understanding of prevalence of those people abusing opioids and identify risk factors and other associated problems. When you know these things, you can target interventions and begin changing policies,” he said.

Living with spinal cord injury himself, Krause possesses a long record of SCI research dedicated to increasing longevity and living standards for people with an SCI. He serves as scientific director of the S.C. Spinal Cord Injury Research Fund and director of the Center on Health Outcomes Research and Capacity Building for Underserved Populations with SCI and the Rehab Research and Training Center on Secondary Conditions in Individuals with SCI – both federally funded centers.

“These projects ensure this team’s work for the next five years and how we plan to focus on these issues. It gives us a chance to really do something for people living with spinal cord injuries. It provides us with the time and resources that are really needed to conduct these studies,” he said.