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Spinal Cord Injury: Progress, Promise, and Priorities
areas relevant to spinal cord injuries, including rehabilitative technology, health and function, and independent living and community integration (NIDRR, 2004). From 2000 to 2004, NIDRR provided funding of approximately $12 million annually for research on rehabilitation from spinal cord injuries (Personal communication, R. Melia, NIDRR, November 10, 2004). NIDRR uses a variety of funding mechanisms, including individual grants, fellowships, and centers of excellence.
The Model Spinal Cord Injury Care Systems, which are funded and administered by NIDRR, were designed in the 1970s to develop a comprehensive integrated system of care for individuals with spinal cord injuries (Tulsky, 2002). Sixteen centers throughout the country are currently designated model systems. This program focuses on providing a multidisciplinary system of rehabilitation services and on collaborative approaches to rehabilitation research (DeVivo, 2002). The level of funding designated for the Model Systems has varied widely over the past 30 years, with current funding being at fairly minimal levels. In the past 5 years, each of the 16 centers has received an average of $340,000 (Personal communication, R. Brannon, NIDRR, January 26, 2005). For FY 2005, an additional $2 million has been designated to develop a multicenter clinical trials network.
Each of the centers contributes data on patient demographics, treatment, and costs of care as well as follow-up data to the National Spinal Cord Injury Model Systems Database, which is run by the National Spinal Cord Injury Statistical Center at the University of Alabama in Birmingham. The Model Systems centers have conducted a number of clinical trials, including studies examining treatments for urinary tract infections and pain therapies. Studies examining the effects of body weight support and treadmill training are under way (Tate and Forchheimer, 2002). Although this program offers the potential to coordinate multicenter trials, it has been minimally funded in recent years. Increased funding is urged to bolster this program and to use its resources to conduct multicenter clinical trials. Furthermore, collaborative efforts between the “care” and “cure” communities and resources are critically important for the development of therapeutic interventions for spinal cord injuries (see Chapter 6).
Spinal cord injury research is also supported by funds provided by individual states. Currently, 14 states have enacted legislation to provide funds totaling more than $27 million for spinal cord injury research (see Chapter 8 and Appendix H). Many of the states that fund spinal cord injury research do so through surcharges on fines for traffic violations. For example, New York State collects approximately $8 million each year from a