Brain Rehabilitation at Mayo Clinic

Research

Brain rehabilitation researchers at Mayo Clinic in Minnesota are actively involved in basic science and clinical studies to better understand:

• The cellular mechanisms of recovery after brain function is altered by injury or disease
• How to accurately predict treatment outcomes
• Ways to promote an individual's return to full participation in life's activities and roles

Traumatic Brain Injury Model System

Mayo Clinic is a Traumatic Brain Injury (TBI) Model System Center, one of 16 medical centers in the United States involved in a research consortium funded by the National Institute on Disability and Rehabilitation Research. The Mayo TBI Model System is studying new ways to advance medical services for people with traumatic brain injuries. Model systems are selected based on the breadth of their capabilities for providing comprehensive, coordinated care. They also contribute data to a large database that allows for long-term collaborative research studies.

Using this database, Mayo researchers have studied which clinical characteristics of patients predict activity limitation, independent living and productive activity after injury and inpatient rehabilitation. Researchers also are assessing the course of long-term recovery and outcomes after a traumatic brain injury to develop and identify innovative services that best meet patients' needs and allow them to reintegrate into their communities. In collaboration with other model systems, Mayo shares these research findings with brain injury rehabilitation programs across the country.

Telerehabilitation

Telerehabilitation is provided through phone and computer technology for individuals who do not have access to rehabilitation treatment in their communities. Mayo Clinic researchers are studying the benefits of technology in providing cognitive rehabilitation to improve mental functioning in patients with traumatic and non-traumatic brain injuries.

Patients participating in the initial research rated their telerehabilitation-based treatment experience favorably. They also demonstrated an improvement in using compensation strategies, one of the main methods used to improve mental functioning during rehabilitation. Patients with significant memory impairments learned to apply this technology to practice cognitive rehabilitation.

Ongoing research aims to study the impact of telerehabilitation-based treatment on patient function, community involvement and treatment satisfaction.

The Midwest Advocacy Project

Patients' ability to advocate for their own needs after a traumatic brain injury is an important part of recovery and rehabilitation. The Midwest Advocacy Project is a clinical trial that involves the Mayo Clinic TBI Model System and the Brain Injury Associations in Minnesota, Iowa and Wisconsin. The goal of this research is to determine the best way for patients and their families and significant others to develop advocacy skills.

Researchers are comparing participants' advocacy skills after a formal training program versus the skills of participants in a self-directed training curriculum. They hope to train survivors of brain injury and their family members to be effective self-advocates, advocates for others and community organizers. Based on the results of this research, Mayo investigators plan to develop an advocacy training method that can be used nationwide.

Impact of traumatic brain injury on patient survival

Mayo researchers recently studied the observed versus expected survival of a large group of patients over 10 years, following treatment for a traumatic brain injury. The results indicated that six-month survivors of moderate-to-severe injuries age just as individuals without an injury would age. These findings confirm the importance of providing long-term rehabilitative care over the course of an individual's lifetime.

Stroke rehabilitation

Mayo's brain injury rehabilitation researchers are using models of stroke recovery in animals to study the cellular mechanisms that regulate changes in strength and mobility recovery after stroke. Research findings have shown that task-specific training, which improves mobility and strength recovery, increases the stroke recovery rate, while treatment with a stimulant drug delays recovery.

Uniform Data System collaboration

The Mayo brain rehabilitation research group is collaborating with the Uniform Data System for Medical Rehabilitation (UDS) to analyze UDS's large national database, which contains information about individuals who have had inpatient rehabilitation after stroke. This collaboration is designed to identify clinical patient profiles to allow for accurate treatment outcome prediction. The information will help clinicians customize treatments to individual patient characteristics.

International collaboration

Together with seven other medical centers in the United States and centers in 10 countries, the Mayo brain rehabilitation research group completed an Internet-based study of a behavioral intervention to influence walking speed in patients recovering from stroke. Results show that feedback about performance each day demonstrated gains in walking speed large enough to permit patients to be mobile in their communities at discharge from inpatient rehabilitation. A follow-up study using accelerometer (measuring instrument) sensors is planned.