N OT E WO RT H Y
P R E S E N TAT I O N S
F E AT U R E D
Pregnancy. Labor, Delivery,
and Postpartum Outcomes
of Women with and without
Spinal Cord Injury (SCI): an
Observational Study. The
study will follow women with
SCI through pregnancy and
postpartum to determine if they
experience unique complications
during pregnancy and delivery
that able bodied women do
not experience. This will be
accomplished by pairing age- and
parity-matched pregnant, ablebodied women through pregnancy
and delivery. The study will also
determine if unique psychosocial
concerns arise for women with
SCI. Results will provide the
ﬁrst, prospective, longitudinal
data on this important group of
individuals to help with education
of professionals as to their unique
care needs. PI: Amie B. McClain,
MD. Contact: Jan Troncale,
UAB PM&R Finding Promise in Constraint-Induced Therapy for
Limb Paralysis Due to Stroke, Multiple Sclerosis
Rehabilitation specialists at UAB are investigating constraintinduced (CI) movement therapy as an initiative for stroke
rehabilitation and multiple sclerosis. The technique has found
success in several other neurological disorders, including children
with cerebral palsy.
CI therapy founder Edward Taub, PhD, of the Department of
Psychology, joined UAB in 1986 following his seminal animal
studies that found an intensive training program could remodel the
brain and counteract partial paralysis from neurological injury. Taub
began human studies, including one of the earliest randomized,
controlled clinical trials in neurological rehabilitation. The approach
has since been reproduced successfully in numerous trials. It is now
considered a mainstream program, and patients travel from around
the world to UAB for th e program.
Patients in CI therapy wear a restraint on the unaffected arm to
Dr. Mark and physical therapy assistant Katherine Pinion work with a head
injury patient in clinic.
A systematic program of behavior-reinforcement techniques
keep it from assisting the arm that has paralysis, says Victor Mark,
takes treatment benefits from the clinic to the real world. The
MD, associate professor in the Department of Physical Medicine
patients sign a contract with the therapist, agreeing to perform
and Rehabilitation. Restraining the “good” arm encourages the
after-hours homework exercises, keep a home-practice diary,
brain to “rewire” itself. Mark, Taub, and project leader Gitendra
report daily in a structured interview about how the limb was used
Uswatte, PhD, are funded by the NIH to study whether the
the previous day, and meet with the therapist for 30 minutes before
treatment can be given entirely in the home setting with a therapist
each training session.
monitoring the patient’s training practice via Internet.
“Current findings are very encouraging, and if this is successful,
the treatment can reach out to patients far from major centers, with
substantial reduction in treatment costs,” says Mark.
CI therapy requires the patient to undergo intensive, outpatient
Mark is also medical director for the UAB outpatient adult CI
therapy clinic that provides therapy for restricted limb use following
stroke, traumatic brain injury, or neurosurgery for tumors.
He also has National MS Society funding to study CI therapy
for restricted arm use in adults with MS. “Results so far have been
work for 3 hours at a time for 2 or 3 consecutive weeks, moving the
outstanding, and soon we hope to see whether the treatment can
patient to progressively more challenging tasks.
also benefit restricted walking in this population,” he says.
continued from cover
rehabilitation and research we can provide as a
member of the model system program,” says Novack.
After completing projects on return-to-driving over
partnership with components of the UAB Health
weight control compared to other states. Our pilot data
“We are proud of the high level of treatment,
unfortunately are particularly challenged by issues of
organizations such as the Alabama Department of
are obese a year after the injury.”
DeSilva Codirects Neuroscience Graduate Program
Researcher Tara DeSilva, PhD, who recently joined
the faculty of PM&R and the UAB Civitan International
Research Center, has been appointed codirector of the UAB
Neuroscience Graduate Program.
DeSilva recently finished her postdoctoral training at
Harvard Medical School and Children’s Hospital, Boston.
She earned her PhD degree in biological chemistry from the
University of Pennsylvania.
The program seeks to train students to become innovative
neuroscientists through a theme-based curriculum that teaches
neuroscience ideas that become stepping stones to more indepth research. The program is offered through many labs, not
limiting students to a department but to a discipline.
MS Research: ‘Reinsulating’ Neuronal Pathways
The demyelination of pathways between neurons in the
brain is known to lead to the motor dysfunctions that are a
MEASURES OF SUCCESS
Rehabilitation Services and the Alabama Head Injury
The new, in-house project proposes a lifestyle
intervention, tailoring an established, evidence-based
The TBI Model System of Care Program was
the past few years, the UAB TBIMS is pivoting to a
program that has proven successful with other groups,
established by Congress in 1988 and is funded by the
new research focus on lifestyle change following TBI,
he adds. Researchers Laura Dreer, PhD, and Laura
National Institute on Disability and Rehabilitation
specifically emphasizing weight control/loss, he says.
Vogtle, PhD, are PI and co-PI, respectively.
“Obesity is a national issue, and Alabama’s citizens
Floyd Named PM&R Research Director
Candace Floyd, PhD, recently was named PM&R director
of research. Floyd, an associate professor who joined UAB in
2006, holds positions from Virginia Commonwealth University
and completed postdoctoral training at the University of
California-Davis before joining the Davis faculty. She holds
positions at several UAB interdisciplinary centers and is
secretary-treasurer of the National Neurotrauma Society. Her
research projects are funded by the DOD, NIH, and National
Football League, and last year she was named scientific
director for the T. J. Atchison Spinal Cord Injury Research
Program. Floyd recently was appointed to hold the Women’s
Committee of Spain Rehabilitation Center Endowed Chair in
Rehabilitation Neuroscience Research.
System and between UAB and community
indicate that a fourth of patients with TBI seen at UAB
UAB MEDICINE NEWS
Activities of the UAB TBIMS reflect an active
UAB TBI Outcomes
Since funding began in 1998, the UAB TBI Model
System has enrolled 860 participants in the
national TBI database, placing UAB in the top ﬁve
in the country for enrollment. One-year-after injury
statistics show promising results. Funding for the TBI
Model System is provided by the National Institute
on Disability and Rehabilitation Research.
prominent feature of multiple sclerosis. Now research efforts in
the Department of PM&R are attempting to improve the brain’s
ability to myelinate, or “insulate,” the pathways to ensure
proper communication between neurons.
Tara DeSilva, PhD, is looking for why myelin injury is
important for understanding why the brain is susceptible to the
devastating syndrome. She focuses on the role of glutamate, a
brain transmitter that plays an important signaling role during
the myelin insulating process. Her research has shown that
when glutamate production is disrupted, the insulation around
the nerves decreases substantially.
DeSilva’s laboratory also is interested in how glial
progenitor cells, which are found near brain lesions in MS, can
be activated to restart the myelination process. The research has
shown that certain signaling pathways in glial progeni tor cells
are necessary for remyelinating the brain, providing a possible
therapy for brain repair.
The Neurobehavior Clinic is a program focusing on
people with acquired brain disorders who exhibit significant
behavioral and/or emotional problems. The clinic is a
collaboration between the UAB Department of Physical
Medicine and Rehabilitation and the Alabama Head Injury
Foundation (AHIF) and takes place at the Linc Point facility
operated by United Cerebral Palsy. Robert Brunner, MD,
and Thomas Novack, PhD, provide information regarding
medication management and behavioral interventions.
Service coordinators with the AHIF, who also attend the
clinic, then assist the consumers and family members in
implementing the recommendations. The clinic, unique in
Alabama, operates once a month.
Eick J* and Richardson EJ.
“Investigating Effective Components
of Two Virtual Walking Paradigms:
Subjective Report and Validation with
Objective Measures of Sensorimotor
Cortical Activation,” Association of
Academic Physiatrists Annual Meeting,
March 6-10, 2013, New Orleans.
Hagan K* and Floyd CL. “Neurogenesis
and cognitive impairment following mild
traumatic brain injury,” Association of
Academic Physiatrists Annual Meeting,
March 6-10, 2013, New Orleans.
*Awardee of Fellowship for Rehabilitation
Research Experience for Medical Students 2012.
FAC ULT Y BY
SP ECI A LT Y
Johnny Markus Carter, DO
Laura B. Kezar, MD
Anthony C. Pitts, MD
Danielle K. Powell, MD
Martin Setliff, MD
Musculoskeletal & Occupational Medicine
Michelle J. Turnley, MD
Amie Knight, PhD
Thomas A. Novack, PhD
Sarah Wright, PsyD
J. Scott Richards, PhD
Elizabeth Richardson, PhD
Yu-ying Chen, MD, PhD
Tara DeSilva, PhD
Michael J. DeVivo, DrPH
Candace Floyd, PhD
Spinal Cord Injury
Amie B. McLain, MD
Keneshia M. Kirksey, MD
Victor W. Mark, MD
Xiaohua Zhou, MD
Traumatic Brain Injury
Robert C. Brunner, MD
F OR REF ERR A L S: 1- 8 0 0 - 8 2 2- 6 47 8
MOR E INF OR M AT ION: uabmedicine.org /physician