Top (l-r): Joel A. DeLisa, MD, MS, Professor and Chair, Department of Physical Medicine and Rehabilitation (PM&R), UMDNJ-New Jersey Medical School (NJMS), and President and CEO, Kessler Medical Rehabilitation Research and Education Corporation (KMRREC); John R. Bach, MD, Professor and Vice Chair, PM&R, and Professor, Department of Neurosciences, NJMS. Bottom: Mitchell Rosenthal, PhD, COO, KMrReC, and Professor, PM&R, NJMS.

Physical medicine and rehabilitation is a specialty that deals with restoring human function. The physician practitioners, who are known as physiatrists, treat any disability resulting from a disease or injury to the human body, regardless of the specific organ system involved. The prescribed treatment often involves a variety of therapies beyond traditional medical care, including social, emotional and vocational interventions. Any physical condition that impacts functionally on the patient’s quality of life can fall within the physiatrist’s scope of practice.

Physical disabilities are quite common. According to the National Center for Health Statistics, 34.3 million people (12% of the U.S. population) are physically limited in their usual activities due to a chronic condition. More than seven million people use assistive technology for mobility impairments (such as canes, walkers, wheelchairs), and more than four million people use assistive devices such as back braces and artificial limbs to compensate for musculoskeletal impairments. Added to these figures are those patients experiencing acute limitations in function, such as those with low back pain, shoulder pain or neck pain. Ten percent of all visits to physicians’ offices in the U.S. involve musculoskeletal conditions. These figures are expected to increase with the aging of the baby boom generation.

Several important barriers limit effective research within our specialty. There are national shortages of both research funds and well-trained investigators, as well as a lack of tools that have been validated in the ambulatory setting for measuring rehabilitation outcomes. The fact that rehabilitation outcomes must often be studied over months, years or even decades, drives up the cost of many basic clinical trials (aside from drug trials). For example, the high cost of caring for a patient with tetraplegia for just two or three weeks while undergoing a new therapy will limit the ability of many grants to achieve a meaningful statistical power in their conclusions. Moreover, the relatively small bed complement and long lengths of stay at most rehabilitation hospitals reduces the number of subjects who can be studied on an inpatient basis. Despite these barriers, clinical research is essential for the growth and improvement of the specialty.

The Kessler Medical Rehabilitation Research and Education Corporation (KMRREC) in West Orange, NJ is the center of research activity for the UMDNJ-New Jersey Medical School Department of Physical Medicine and Rehabilitation. With a staff of 75 employees, nearly 20 of whom are physicians or doctorally trained investigators holding NJMS faculty appointments, KMRREC’s mission is to conduct research and sponsor educational programs within this specialty. KMRREC is a non-profit organization and is a subsidiary of the Henry H. Kessler Foundation.

The major areas under investigation at KMRREC include spinal cord injury, traumatic brain injury, stroke, gait, neuro-imaging-supported behavioral studies, health outcomes and rehabilitation engineering. KMRREC also has several grants in multiple sclerosis, and serves as the site for several training grants dealing with rehabilitation research. About $3 million per year is provided by external funding agencies, including the NIH and the National Institute on Disability and Rehabilitation Research. Several studies are also being conducted by our Newark-based faculty, involving clinical drug trials in the subspecialty of musculoskeletal medicine. Other studies in Newark have: evaluated devices used as respiratory muscle support to prevent respiratory failure; compared student outcomes under various teaching strategies; evaluated public policy options relating to long-term care; and investigated rehabilitation outcomes following the injection of autologous cells.

Our department’s long-term strategy is to consolidate most of our research capacity in Newark. We believe that such a redeployment of our investigators and scientists will yield tangible economies, and will position UMDNJ to become even more effective in its research on restoring human function. §