Rehabilitation

Regenerative medicine focuses on the repair or replacement of tissue lost to injury, disease, or age, primarily via the enhancement of endogenous stem cell function or the transplantation of exogenous stem cells. The focus of rehabilitation science is on the use of mechanical and other stimuli to promote functional recovery. The field of Regenerative Rehabilitation integrates these two approaches, with the ultimate goal of optimizing outcomes.  It is where applied biophysics meets tissue engineering and cellular therapies.

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Darshit Thakrar, MD, is a California physician who lost his left leg in an accident five years ago but hasn’t let this tragedy be an obstacle when it comes to accomplishing his dreams. The surgical expertise of McGowan Institute for Regenerative Medicine faculty member J. Peter Rubin, MD, FACS, Chair of the Department of Plastic Surgery, the UPMC Endowed Professor of Plastic Surgery, Director of UPMC Wound Healing Services, and Professor of Bioengineering at the University of Pittsburgh, was instrumental in helping Dr. Thakrar with his plans to run in an upcoming race for which he was training prior to the accident.

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The University of Pittsburgh is conducting a $2 million study to determine the best way for the Marine Corps to approach gender integration at its two boot camps per an article by Caitlin Kenney, a writer for Stars and Stripes.

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Regenerative Rehabilitation seeks to optimize patient outcomes through an integration of two fields: regenerative medicine and rehabilitation science. The former focuses on tissue repair or replacement due to loss from injury, disease, or age. This is achieved primarily through the enhancement of endogenous stem cell function or the transplantation of exogenous stem cells. The latter focuses on the use of mechanical and other stimuli to promote functional recovery. This synergy between biological and bioengineering advances is critical to developing novel and impactful translational therapies. However, there currently are few opportunities for regenerative scientists to be exposed to the methodologies commonly employed in the clinic by rehabilitation professionals. Conversely, most rehabilitation scientists and clinicians are not exposed to the many advances of regenerative medicine. This disconnect has impeded the pace of progress in the field. To this end, the International Consortium for Regenerative Rehabilitation—comprised of 16 institutions—aims to increase interdisciplinary interaction. Thus, as technologies are developed and our understanding of regenerative biology progresses, advances may be efficiently translated to the clinic.

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Imagine tying your shoes or taking a sip of coffee or cracking an egg but without any feeling in your hand. That’s life for users of even the most advanced prosthetic arms.

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NIH awarded The Alliance for Regenerative Rehabilitation Research and Training (AR3T) a 5-year renewal of the AR3T grant totaling $5,010,083. AR3T was one of six resource centers selected for this funding, all of which are a part of the Medical Rehabilitation Research Resource (MR3) Network.

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McGowan Institute for Regenerative Medicine affiliated faculty member Thomas Rando, MD, PhD, is the co-founder and chair of the board of directors of Fountain Therapeutics.  At Fountain Therapeutics, the research team has combined the expertise of leaders in aging research and computation to build a pipeline of therapeutics aimed at reversing cellular aging. The company’s mission is to decouple aging from disease and significantly extend human health span.

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According to a new study by researchers at the Stanford School of Medicine, a nightly jaunt on the exercise wheel enhances muscle-repair capabilities in old mice.  Only older mice saw this benefit, which the researchers found is due to the rejuvenation of the animals’ muscle stem cells.

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An article by Alicia Lasek for McKnight’s noted how nurse practitioners spend their time in eldercare facilities has changed little in 20 years, a new study has found. In fact, much of their work time remains nonclinical in these settings, reported investigators.

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The National Institutes of Health recently awarded $3.8 million to the R01 Grant Project entitled “Physical exercise and blood-brain communication: Exosomes, Klotho and the Choroid Plexus.”  The project’s co-principal investigators include:

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McGowan Institute for Regenerative Medicine faculty member Fabrisia Ambrosio, PhD, MPT, Director of Rehabilitation for UPMC International and Associate Professor in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh with secondary appointments in the Departments of Physical Therapy, Bioengineering, Orthopaedic Surgery, and Microbiology & Molecular Genetics, and Carnegie Mellon University’s Philip LeDuc, PhD, William J. Brown Professor of Mechanical Engineering with appointments in Biological Sciences, Computational Biology, and Biomedical Engineering, the Founding Director of the Center for the Mechanics and Engineering of Cellular Systems, and a McGowan Institute affiliated faculty member, are the co-principal investigators on a recently awarded National Institutes of Health R01 grant entitled “Role of Extracellular Matrix in Age-Related Declines of Muscle Regeneration.”

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A new bed transfer device makes life easier — and safer — for patients and caregivers.  NextHealth, Inc., in partnership with McGowan Institute for Regenerative Medicine affiliated faculty member Rory Cooper, PhD, and team members from University of Pittsburgh’s Human Engineering Research Laboratory (HERL), developed the AgileLife Transfer & Mobility System™ (“TMS”), the only “Zero Lift” transfer and repositioning system that affects better outcomes for immobile individuals, their families, caregivers and their providers through the continuum of care.

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In her PittMed article, Elaine Vitone reviewed human performance optimization efforts by numerous University of Pittsburgh researchers and the results of their studies on the functioning of the human body.  Included in her article were highlights from the work of McGowan Institute for Regenerative Medicine affiliated faculty members:

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Dr.  Maria Simbra, Health Editor from Pittsburgh’s local CBS channel KDKA, recently visited the University of Pittsburgh’s Rehab Neural Engineering Lab for an update on the work being done with the sensorimotor microelectrode brain-machine interface and generating ‘touch’ sensations.  She visited with Nathan Copeland who injured his spinal cord in a 2004 car accident, and he has been instrumental to the research in the lab.

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Katherine Malmo recently reported for PT in Motion the importance of physical therapy in the success of future regenerative medicine therapies.  As regenerative medicine helps the body restore biological function lost to age, disease, injury, or congenital abnormality, it can be accomplished with the help of medical devices and organs, biomaterials, and cellular therapies.  These latter treatment options need support through focused, personalized physical therapy to be successful.

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Pre-surgery exercising—prehabilitation—before that total knee replacement may not sound like an activity you want or can participate in however clinicians have found that the benefits may have a significant impact on your recovery.  The intention is that the fitter patients are when they have surgery, the quicker they will recover from surgery.

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One of the downsides to getting older is that skeletal muscle loses its ability to heal after injury. New research from the University of Pittsburgh implicates the so-called “longevity protein” Klotho, both as culprit and therapeutic target.

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As reported by Gary Rotstein, Pittsburgh Post-Gazette, the CDC says about one of every four older adults falls in a year. In 2016 those resulted in 29,668 deaths, and the mortality rate attached to such falls has been increasing about 3 percent annually.

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Diastasis recti is a non-life-threatening condition affecting the pair of long, flat muscles, known as the rectus abdominis, that run vertically down each side of the abdomen. These muscles are referred to as “six-pack muscles” and help stabilize the body’s trunk and hold in the abdomen’s internal organs. Mostly affecting women, diastasis recti happen when these muscles separate, often during pregnancy or after giving birth, leaving a gap, a belly pouch, or a sense of abdominal weakness.

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Researchers at the University of Pittsburgh School of Health and Rehabilitation Sciences (SHRS) recently received a combined $7.5 million in grant funding from the Department of Defense, Congressionally Directed Medical Research Programs. The three funded projects will study aspects of both physical and mental recovery to improve care practices for future active and retired service members.  One of the projects, entitled “Studying Cognitive Readiness and Resilience,” will be co-led by McGowan Institute for Regenerative Medicine affiliated faculty member Bradley Nindl, PhD, SHRS professor and director of Pitt’s Neuromuscular Research Laboratory/Warrior Human Performance Research Center.

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McGowan Institute for Regenerative Medicine faculty member Fabrisia Ambrosio, PhD, MPT, is the new Director of Rehabilitation for UPMC International as well as an Associate Professor in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh. Dr. Ambrosio’s primary responsibility in her new role will be to coordinate and supervise operations, including clinical and research initiatives, associated with rehabilitation programs offered through UPMC International. Currently, she is working with colleagues from UPMC Italy toward the development of an Integrative Wellness Center in Tuscany. This Center, which is slated to open in February 2017, will operate as an advanced and integrated center for preventative medicine focusing on primary and secondary prevention of metabolic syndrome, cardiovascular diseases, and musculoskeletal dysfunction. The longer-term research objective is to establish a biomarker discovery platform to aid in the identification of minimally invasive indicators of health status over time, with the goal of optimizing the efficacy of rehabilitation interventions. The center in Tuscany will serve as a prototype for multiple similar centers around the world.

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Rotator cuff tears are one of the most common injuries seen by orthopedic surgeons, resulting in 30 percent of all visits to orthopaedic surgeons and over 150,000 surgical procedures per year in the United States. The preferred initial treatment is 6 to 12 weeks of physical therapy (PT), but 25-50 percent of those cases still require surgery. Researchers at the University of Pittsburgh’s Swanson School of Engineering recently received a $2.79 million award from the National Institutes of Health to develop diagnostic methods to allow surgeons to determine whether PT or surgery is the most effective initial treatment.

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A voice therapy program that was refined by experts at the UPMC Voice Center and successfully piloted on a small group of patients with voice disorders, will be reaching more patients due to a $300,000 National Institutes of Health (NIH) grant recently awarded to the University of Pittsburgh School of Medicine.  McGowan Institute for Regenerative Medicine affiliated faculty member Clark Rosen, MD, Director of the University of Pittsburgh Voice Center and Professor of Otolaryngology in the School of Medicine, is a co-investigator on the 3-year grant (R03 DC015305) awarded by the National Institute on Deafness and other Communication Disorders.

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Heidi Mitchell, The Wall Street Journal, recently reported on the best way to stretch your back after sitting in a chair too long at work or elsewhere.  Americans sit on average for 6 hours to 13 hours a day, depending on which study you read, said McGowan Institute for Regenerative Medicine affiliated faculty member Anthony Delitto, PhD, PT, FAPTA, professor of physical therapy and dean of the School of Health and Rehabilitation Sciences at the University of Pittsburgh. Being sedentary for long periods has been linked to an increased risk for heart disease and other life-shortening illnesses. But one of the biggest problems arising from prolonged sitting is pressure between the disks of the spine, he says.

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It was in 2010 that the Journal of Rehabilitation Research & Development published the guest editorial article entitled “Regenerative rehabilitation: A call to action” which was co-authored by McGowan Institute for Regenerative Medicine faculty member Fabrisia Ambrosio, PhD, MPT, Assistant Professor in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh with secondary appointments in the Departments of Physical Therapy, Orthopaedic Surgery, and Microbiology and Molecular Genetics.  In that piece, the authors explained:

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Physical Therapy, Surgery Produce Same Results for Stenosis in Older Patients

Symptoms from lumbar spinal stenosis, an anatomical impairment common with aging, were relieved and function improved in as many patients utilizing physical therapy as those taking the surgical route, McGowan Institute for Regenerative Medicine affiliated faculty member Anthony Delitto, PhD, and University of Pittsburgh researchers discovered in a 2-year study published in Annals of Internal Medicine.

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McGowan Institute for Regenerative Medicine affiliated faculty member Anthony Delitto, PhD, chair of the Department of Physical Therapy in Pitt’s School of Health and Rehabilitation Sciences, and researchers from the University of Pittsburgh will lead a $14 million clinical trial to determine how well an intervention that helps people better understand their back pain early on works toward promoting recovery and keeping the pain from becoming chronic down the road. UPMC will be the first in the trial to offer the intervention, followed by four other academic medical centers nationwide.

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Pitt Team Developing Technology to Allow Amputees to Feel with Prosthetic Limb, Improving Its Function

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Fourth Annual Regenerative Rehabilitation Symposium

The annual Regenerative Rehabilitation Symposia series is a unique opportunity for students, researchers, and clinicians working in the interrelated fields of regenerative medicine and rehabilitation to meet, exchange ideas, and generate new collaborations and clinical research questions.

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Project: Create Global Network to Improve Lives of Wheelchair Users

Of the nearly 70 million people worldwide who require wheelchairs for mobility and function, most lack access to appropriate wheelchairs or services to fix them. Now, a handful of University of Pittsburgh scientists are working with the U.S. Agency for International Development (USAID) under a 2-year, $2.3 million sub-award to develop the new International Society of Wheelchair Professionals, a global network to teach and professionalize device repair, build affiliations to put better equipment in the right hands, and ensure a level of standardization, certification, and oversight.

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Wheelchair-Mounted Mobile Robotic-Assisted Transfer System

The Patient Assist Robotic Arm (PARA, pictured) is University of Pittsburgh-developed and -patented technology which is licensed to RE2, Inc., which stands for Robotics Engineering Excellence, a local Pittsburgh-based small business.  Since RE2’s inception more than 10 years ago, the company has been developing and improving mobile robots used for dismantling explosive devices in far-off wars or safely clearing a meth lab’s cache of weapons here at home.

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NVWG:  Where Heroes Make History

Each year more than 500 novice and experienced athletes meet for a week of archery, swimming, weightlifting, basketball, quad rugby, and more. It’s the National Veterans Wheelchair Games (NVWG), the largest annual wheelchair sports competition of its kind in the world.  The 34th National Veterans Wheelchair Games were held in Philadelphia, Pennsylvania, August 12-17, 2014.  This year’s theme was “Where Heroes Make History.”

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Ballet and Sports Medicine

Led by McGowan Institute for Regenerative Medicine faculty member Freddie Fu, MD, today the UPMC Sports Medicine’s staff of experts is skilled in the assessment, treatment, and rehabilitation of dance-related injuries and dance-specific training programs. As reported by Jane Vranish of the Pittsburgh Post-Gazette, Dr. Fu has been attending to Pittsburgh Ballet Theatre dancers since 1983 when he quickly embraced the connection and singular importance of dance.  Dr. Fu has been attending to the dancers ever since, physically, mentally, and emotionally.  He realized that it was an art form that didn’t have the financial wherewithal to care for artists who often just had to dance “hurt,” grinning and bearing it for the audience, or simply quit.

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Muscle Morbidity and Reduced Regenerative Capacity 

While the widely reported incidence of arsenic use in past centuries for medicinal, industrial, and homicidal purposes has declined dramatically, modern times have seen a resurgence in the attention paid to this organic metalloid. This is due, in large part, to the increasingly recognized presence of arsenic in the food and drinking supplies serving more than 140 million individuals worldwide and nearly 4 million individuals in the United States alone. Unfortunately, the very same characteristic that makes arsenic such an effective tool for acute poisoning also makes it a dangerous environmental contaminant: it is largely undetected because it is odorless, tasteless, and colorless. Increasingly, however, arsenic is being recognized for its adverse, yet clandestine, effects on tissue functioning and regenerative capacity—even at low, everyday concentrations.

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Third Annual Regenerative Rehabilitation Symposium, April 10-11, 2014, San Francisco, California

Like no other time in our nation’s history, the enthusiasm surrounding regenerative medicine is now being matched with clinical deliverables, and the number of clinical trials in the field is growing at an unprecedented rate. Over the next decades, stem cell and tissue engineering protocols hold the possibility of becoming the standard of care for several diseases and injuries.

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Highlights from the Second Annual Symposium on Regenerative Rehabilitation

A team of McGowan Institute for Regenerative Medicine affiliated faculty members and the Institute’s director recently coordinated and celebrated the 2nd Annual Symposium on Regenerative Rehabilitation held on November 12 & 13, 2012, at the University Club in the Oakland neighborhood of Pittsburgh. The event attracted approximately 120 participants – an international audience comprised of scientists, educators, rehabilitation clinicians, and students/ trainees. The overall objective of this symposium series is to highlight and provide evidence for the synergistic relationship between regenerative medicine and rehabilitation, and to promote cross-fertilization between these two fields.

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