Much of what a rehabilitation hospital does today, from body-weight-supported gait training to standardized outcome scores and plain-language factsheets for families, came out of a small number of research programs funded by the US government since the 1970s. Knowing how that system is organized helps patients, families and clinicians find current evidence, clinical trials and the hospitals that take part in research.
NIDILRR: The Federal Funder
The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) is the main federal funder of applied disability and rehabilitation research in the United States. Where the National Institutes of Health concentrate on biology and medical treatment, NIDILRR funds research on function, participation and independence: returning to work, living in the community, using technology and aging with a disability.
Until 2014 the institute was called NIDRR and belonged to the Department of Education. The Workforce Innovation and Opportunity Act of 2014 renamed it and moved it to the Administration for Community Living (ACL) in the Department of Health and Human Services. A 2025 HHS reorganization plan to fold ACL into other agencies has been challenged in court, and the timing of new NIDILRR grant competitions has been uncertain, which researchers’ organizations have raised with Congress.
Types of NIDILRR Grants
Rehabilitation Research and Training Centers
Rehabilitation Research and Training Centers (RRTCs) receive five-year grants to work on a single theme, such as employment of people with disabilities, community living, aging with a disability, or health and function. Each center must do three things: carry out research, train clinicians and other professionals, and share its results with people with disabilities and their families. Most are based at universities or rehabilitation hospitals and offer free webinars, toolkits and reports.
Rehabilitation Engineering Research Centers
Rehabilitation Engineering Research Centers (RERCs) do the same for technology. Their topics include wheelchairs and seating, prosthetics and orthotics, communication devices for people who cannot speak, and accessible information technology. Several standards for wheelchair testing and accessible design grew out of this work.
Other Grant Programs
NIDILRR also funds Disability and Rehabilitation Research Projects (DRRPs) on topics it selects, field-initiated projects proposed by researchers, small business innovation research grants that help companies develop products, and postdoctoral fellowships that train the next generation of rehabilitation researchers.
The Model Systems
The Model Systems are networks of hospitals, funded by NIDILRR, that provide comprehensive care from the emergency room to life at home and follow their patients for decades in shared national databases. Because the same data are collected at every center, researchers can study long-term outcomes that no single hospital could.
Spinal Cord Injury Model Systems
The oldest network dates from 1970. Its National Spinal Cord Injury Statistical Center at the University of Alabama at Birmingham holds data on more than 30,000 people. Its annual facts and figures estimate about 18,000 new spinal cord injuries a year in the United States and track life expectancy, causes of injury, employment and secondary conditions such as pressure injuries and bladder complications. These data underpin many clinical guidelines in the field.
Traumatic Brain Injury Model Systems
The brain injury network has run since 1987, with its own national data center. Its studies cover long-term outcomes, return to work and school, depression and anxiety, and the needs of caregivers years after the injury.
Burn Model Systems
Since 1994 a smaller network has followed survivors of major burns, with research on scarring, itch, pain, return to work and quality of life.
Turning Data into Factsheets
The Model Systems Knowledge Translation Center (msktc.org) turns the results into free plain-language factsheets, videos and slideshows, for example on bladder management after spinal cord injury, fatigue after brain injury or itch after burns. NARIC, the National Rehabilitation Information Center, is NIDILRR’s library; its searchable database lists funded projects and research articles.
Other Funders
National Institutes of Health
The National Center for Medical Rehabilitation Research (NCMRR) was created in 1990 within the Eunice Kennedy Shriver National Institute of Child Health and Human Development and coordinates rehabilitation research across NIH. NIH institutes fund basic science on nerve repair and brain plasticity and clinical trials, including trials of stroke recovery.
Veterans Affairs and Defense
The Department of Veterans Affairs has its own Rehabilitation Research and Development Service, with work on prosthetics, spinal cord injury, brain injury and hearing and vision loss, and runs regional amputation and polytrauma centers. The Department of Defense funds spinal cord injury and traumatic brain injury research through its Congressionally Directed Medical Research Programs, with a focus on service members.
Private Foundations
The Craig H. Neilsen Foundation is the largest private funder of spinal cord injury research and rehabilitation programs in the United States. The Christopher and Dana Reeve Foundation funds research and runs a paralysis resource center for families.
Outside the United States
Canada, the United Kingdom, Australia and European countries fund rehabilitation research through their national health research councils. Two international resources are useful to anyone: Cochrane Rehabilitation, which gathers systematic reviews of rehabilitation treatments, and PEDro, a free database of physiotherapy trials and reviews run from the University of Sydney.
How Patients and Families Can Use This Research
- Read the factsheets first. The MSKTC factsheets and the RRTCs’ materials are written for patients and reviewed by researchers.
- Check the guidelines. For stroke, the American Heart Association/American Stroke Association guideline on adult stroke rehabilitation and recovery (2016) summarizes which therapies have good evidence.
- Look for clinical trials. ClinicalTrials.gov lists studies by condition and location, with eligibility criteria and contacts.
- Ask the physiatrist. The treating doctor can judge whether a trial fits. Participation is voluntary; some trials compare a new treatment with a control or placebo group, and it is worth asking who funds the trial and what costs are covered.
- Consider a research hospital. Model System centers and hospitals with active research programs tend to adopt new methods earlier. The list of current Model System centers is on msktc.org.
A Caution About Unproven Treatments
Clinics in the United States and abroad sell stem cell and other “regenerative” treatments for spinal cord injury, stroke and brain injury outside approved clinical trials, often for large sums paid in advance. The FDA has warned the public about unapproved stem cell products. A legitimate trial is registered, has approval from an ethics board and does not charge participants for the experimental treatment itself.
Frequently Asked Questions
What is an RRTC?
A Rehabilitation Research and Training Center: a five-year NIDILRR grant for research, professional training and public information on one theme, such as employment or community living.
What are the Model Systems?
Networks of hospitals for spinal cord injury, traumatic brain injury and burns that provide full-course care and follow patients for decades in shared national databases.
How can I find a clinical trial?
Search ClinicalTrials.gov by condition and location, then discuss promising studies with the treating physiatrist before contacting the trial team.
Who funds rehabilitation research in the US?
Mainly NIDILRR, the National Institutes of Health through NCMRR, the Department of Veterans Affairs, the Department of Defense and private foundations such as the Craig H. Neilsen Foundation and the Reeve Foundation.
This site is an independent reference on rehabilitation medicine.
