By Erin Jester
After a spinal cord injury seven years ago, Jared Hogg found himself learning how to navigate life with the help of a team of clinicians and researchers at Brooks Rehabilitation Clinical Research Center in Jacksonville.
Then, he joined them.
Hogg is now a member of the leadership team for the Spinal Cord Injury Health Research Partnership, or SHARP, which is part of the Brooks-UF PHHP Research Collaboration, an interdisciplinary group across University of Florida College of Public Health and Health Professions scientists and Brooks Rehabilitation. SHARP, a community engagement and advocacy group, aims to improve the quality and impact of rehabilitation research by uniting researchers, clinicians and people with spinal cord injury.
A naturally curious person, Hogg said getting involved with SHARP gave him a new outlet to learn more about rehabilitation and the research that goes into it.
“I’m in my element,” he said. “Research was a way for me to ask a lot of questions and get answers.”
To celebrate Spinal Cord Awareness Month in September, SHARP partnered with the UF Breathing Research and Therapeutics, or BREATHE, Center to showcase innovation in spinal cord injury rehabilitation, with lectures by prominent researchers and demonstrations featuring research participants with spinal cord injury. The celebration was part of a larger slate of events co-hosted by BREATHE, including a panel on epidural stimulation to restore breathing featuring Daryl Fields, M.D., Ph.D.; an assistant professor of neurosurgery in the College of Medicine and interim chief of neurosurgery at the Malcom Randall Department of Veterans Affairs Medical Center; Erica Dale, Ph.D., assistant professor in the College of Medicine’s Department of Physiology and Aging; and Dimitry Sayenko, M.D., Ph.D., associate professor of neurosurgery at Houston Methodist Hospital; as well as a guest lecture by Neuralink Head of Neurosurgery Matthew MacDougall.
SHARP grew out of a recent push in the field of rehabilitation science for people with lived experience of spinal cord injury to be involved in research that affects them. To that end, Emily Fox, Ph.D., D.P.T., director of the Brooks-UF PHHP Research Collaboration and clinical associate director of BREATHE, founded the group to serve the community and involve them in research in meaningful ways.
“We are seeking to bring people together and influence the dissemination, consumption and creation of research, in part, by creating space and opportunity to come together as a community,” said Fox, who is also an associate professor in the Department of Physical Therapy and director of neuromuscular research at Brooks.
Fox said groups like SHARP are uncommon, although some of the larger rehabilitation research centers in the U.S. have them.
SHARP is important because of the symbiotic relationship created among researchers and people with spinal cord injury. Research participants want to have a voice in the process and to better understand the science and how it could impact their lives, Fox said, and at the same time, researchers studying spinal cord injury at the most mechanistic levels can benefit from having the exposure to the communities that they ultimately want their work to impact.
The National Institutes of Health estimates there are about 18,000 new cases of spinal cord injury annually, and more than a quarter of a million people living with spinal cord injuries in the United States. Injuries vary in severity based on the location of the injury to the spinal cord and whether the injury is considered incomplete or complete. Complete spinal cord injuries usually mean a loss of abilities below the injury, including paralysis.
The most common cause of illness and rehospitalization after spinal cord injury is respiratory failure, and a considerable amount of PHHP’s research into rehabilitation after spinal cord injury addresses breathing rehabilitation in the BREATHE Center. Members include faculty from the departments of physical therapy, biostatistics, and speech, language and hearing sciences, as well as the College of Medicine, the Herbert Wertheim College of Engineering and the College of Veterinary Medicine.
At the Brooks-UF PHHP event, SHARP members with spinal cord injury participated in demonstrations of current studies examining innovative techniques for walking rehabilitation, swallowing and respiratory function. The demos included cough and breathing assessments; Hoffman reflex testing, which electrically stimulates nerves to gain a better understanding of spinal cord function; and a treatment to improve breathing in people with spinal cord injury called acute intermittent hypercapnic hypoxia, developed by BREATHE Center director Gordon Mitchell, Ph.D. Mitchell co-leads a current Department of Defense-funded study on the intervention with Fox, who is the principal investigator.
Physical and occupational therapists also showcased new technologies and specialized machines used in spinal cord injury rehabilitation, including a zero-gravity harness on a track that allows patients to safely practice stepping over curbs and navigating stairs, and a robotic lower-limb exoskeleton that helps patients re-learn to walk using their own neurological signals.
The event wrapped up with lectures from two researchers — Fox and Daryl Fields, M.D., Ph.D., — and Hogg sharing some of his experiences as a person living with spinal cord injury. Organizers stressed the importance of bringing together researchers, clinicians, the public and people with spinal cord injury to increase awareness, foster collaboration and, ultimately, improve the health and wellbeing of people with spinal cord injury.