The convergence of regenerative medicine and rehabilitation: federal perspectives

Abstract

Regenerative rehabilitation is the synergistic integration of principles and approaches from the regenerative medicine and rehabilitation fields, with the goal of optimizing form and function as well as patient independence. Regenerative medicine approaches for repairing or replacing damaged tissue or whole organs vary from utilizing cells (e.g., stem cells), to biologics (e.g., growth factors), to approaches using biomaterials and scaffolds, to any combination of these. While regenerative medicine offers tremendous clinical promise, regenerative rehabilitation offers the opportunity to positively influence regenerative medicine by inclusion of principles from rehabilitation sciences. Regenerative medicine by itself may not be sufficient to ensure successful translation into improving the function of those in the most need. Conversely, with a better understanding of regenerative medicine principals, rehabilitation researchers can better tailor rehabilitation efforts to accommodate and maximize the potential of regenerative approaches. Regenerative rehabilitative strategies can include activity-mediated plasticity, exercise dosing, electrical stimulation, and nutritional enhancers. Critical barriers in translating regenerative medicine techniques into humans may be difficult to overcome if preclinical studies do not consider outcomes that typically fall in the rehabilitation research domain, such as function, range of motion, sensation, and pain. The authors believe that encouraging clinicians and researchers from multiple disciplines to work collaboratively and synergistically will maximize restoration of function and quality of life for disabled and/or injured patients, including U.S. Veterans and Military Service Members (MSMs). Federal Government agencies have been investing in research and clinical care efforts focused on regenerative medicine (NIH, NSF, VA, and DoD), rehabilitation sciences (VA, NIH, NSF, DoD) and, more recently, regenerative rehabilitation (NIH and VA). As science advances and technology matures, researchers need to consider the integrative approach of regenerative rehabilitation to maximize the outcome to fully restore the function of patients.

Human Wounds and Its Burden: An Updated Compendium of Estimates

“…152 With an effort to maximize restoration of function and QoL in service members with combat-related extremity trauma, the VA and DoD have increased their research and clinical care efforts with a focus on regenerative medicine. 153…”

Regenerative Injections Including 5% Dextrose and Platelet-Rich Plasma for the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-Analysis

“…The aforementioned result is consistent with that of a previous systematic review that revealed the short-term (at one month) benefits of corticosteroid injection in the treatment of CTS [14]. Injected corticosteroid is known to have an effective duration of 1-4 weeks in the target tissue [15]; however, its long-term advantage for CTS is also not supported by the available literature [14].Regenerative medicine techniques, which involve regenerating human cells, tissues, or organs to restore normal function, have been increasingly used in the treatment of various musculoskeletal disorders [16]. In this regard, dextrose and platelet-rich plasma (PRP) are the two most commonly used regenerative injection regimens, and numerous in vitro and in vivo studies have shown their potential role in promoting tissue repair [17,18].…”

“…Regenerative medicine techniques, which involve regenerating human cells, tissues, or organs to restore normal function, have been increasingly used in the treatment of various musculoskeletal disorders [16]. In this regard, dextrose and platelet-rich plasma (PRP) are the two most commonly used regenerative injection regimens, and numerous in vitro and in vivo studies have shown their potential role in promoting tissue repair [17,18].…”

Musculoskeletal Regeneration, Rehabilitation, and Plasticity Following Traumatic Injury

“…Volumetric muscle loss injury is recognized as a primary barrier to functional recovery of the severely traumatized extremity. Due to recognition of the increased incidence and loss of function in battlefield injured service members, the Department of Defense initiated a regenerative medicine research program to develop novel therapeutics for muscle tissue restoration [69]. As a result, much of what is currently understood of the natural pathophysiology of VML injury has been learned in animal models.…”