The MetroHealth Rehabilitation Institute of Ohio
The MetroHealth Rehabilitation Institute of Ohio is expanding its Spinal Cord Injury Medicine fellowship program from one to two fellows starting this year. The additional fellow is made possible by a $75,000 grant from the Craig H. Neilsen Foundation.
Fellows for 2011-1012 will be Deborah Kaplan, MD, who graduated from Yale School of Medicine and is finishing her PM&R residency at the University of Cincinnati Medical Center; and Kristi Henzel, MD, PhD. Dr. Henzel earned both her PhD in biophysics and MD from the University of Louisville; completed PM&R residency training at the University of Pittsburgh Medical Center; and is currently doing a year of grant-funded spinal cord injury research at the Louis Stokes Cleveland VA Medical Center.
Geoffrey Smith, MD, is the current SCI fellow. Smith earned his MD from The Ohio State University School of Medicine and did his PM&R residency at the Mayo Clinic. He is originally from Central Ohio.
Recently, Dr. Smith talked about the fellowship experience.
Q. What attracted you to the SCI fellowship program?
A. First, I was attracted by the opportunity to be exposed to and participate in the Cleveland FES Center. Also, the fellowship's schedule allows for training in three distinct SCI systems of care.
A little bit over one-third of the year is spent at MetroHealth, where I get great exposure to patients with traumatic spinal cord injuries. With MetroHealth being a county-owned hospital and Level 1 Trauma Center for the region, it serves the community with top-notch services. Another third of my fellowship is spent at Cleveland Clinic Foundation, with exposure to other disciplines (such as neurosurgery and urology) which are part of the health care team for a patient with spinal cord injuries. The last third is spent at the Louis Stokes Cleveland VA Medical Center. There I get exposure to serving the veteran population with SCI. The system and resources there are different from the other two sites. I think there is much to learn from each system, and this fellowship allows great exposure to all three.
Q. What is the clinical research project you are working on as part of your fellowship? How did you decide on making this your project?
A. I have two projects. The first involves using temporarily implanted percutaneous neuromuscular electrodes to treat shoulder pain in the SCI population. This technique has been used successfully with treating shoulder pain in the stroke population, but no one has looked at its usefulness in the SCI population. My role is to assess the usefulness of ultrasound to measure migration of the leads during the implanted period and then to employ ultrasound for electrode relocation.
The second project is using high-frequency stimulation of peripheral nerves to block nerve transmission, which should allow us to treat spasticity and spasms in the SCI population. This would be an adjunct to implantable FES systems like the multichannel hand neuroprosthesis. My role is to gather baseline data on spasms in the SCI population to determine patterns of muscle involvement and to see if the electrical signal produced by a spasm has a recognizable pattern that allows it to be detected early enough to employ the nerve block before the full spasm occurs.
Q. What are your professional goals following this fellowship?
A. To apply what I am learning to provide state-of-the-art care for patients with spinal cord injury, ideally incorporating clinical applications of FES technology as appropriate.