In much the same way that the Centers for Medicare & Medicaid set the standards for health care reimbursement, the National Institutes of Health (NIH) sets the standards for research priorities. Over the past 2 decades, many of the researchers who have published their work in the Journal of Neurologic Physical Therapy (JNPT) have been beneficiaries of the 1993 Rehabilitation Research Plan of the NIH National Center for Medical Rehabilitation Research. In addition to developing and supporting rehabilitation research at the NIH, the associated investment in rehabilitation training has resulted in a substantive increase in the number of rehabilitation scientists, a large proportion of whom are physical therapists.

The recently released NIH Research Plan on Rehabilitation1 signals a renewed commitment to supporting rehabilitation research. In reviewing the 6 primary goals that are delineated in the 2016 Rehabilitation Research Plan, it is clear that researchers and clinicians in neurologic physical therapy have much to contribute to achieving the goals and objectives of the new plan. Below are the 6 goals, along with 1 objective associated with each goal that I believe has particular relevance for research in neurologic physical therapy, and to which physical therapist researchers are making impactful contributions.

Goal A, Rehabilitation Across the Lifespan, Objective 1: Increase the quality of evidence for rehabilitation interventions in populations of people with disabilities across the lifespan (pediatrics, adult, and geriatrics) through increased focus on the design, dose, intensity, timing, mechanisms, and specified targets and outcomes of these interventions. For many neurologic clinical populations, physical therapeutics and rehabilitation are the only available approaches for improving function. Our neurologic physical therapy research community has been at the forefront of asking and answering questions related to outcomes that are truly meaningful to persons with disabilities. Although there is still much work to be done, in partnering with our basic science research colleagues in collaborative efforts we have pushed the boundaries of knowledge related to rehabilitation interventions and the parameters that optimize effectiveness.

Goal B, Community and Family, Objective 6: Determine the ways in which individuals with disabilities can partner with caregivers and care providers as active members of the rehabilitation team, either in promotion of adherence and assistance with in-facility or home-based care or in setting treatment goals to optimize outcomes. In many forms of rehabilitation research, long-term outcomes depend on the ability of the research participant to practice the intervention activities after the intervention period has ended. Physical therapist researchers and their research teams develop a close collaborative relationship with their research participants and their caregivers by virtue of the nature of our interventions. Partnering with caregivers as part of the intervention strategy represents an important opportunity for promoting beneficial long-term outcomes.

Goal C: Technology Use and Development, Objective 6: Support technology development that incorporates monitoring and remote access in the acquisition, analysis, and monitoring of data from individuals who are receiving care or continued support in their homes. For rehabilitation research that is aimed at improving function and mobility in the home and community, the true test of the value of outcomes is whether the individual is able to incorporate the new skills into daily activities. There is growing use of technology to understand the real-world impact of interventions, along with expanding use of telerehab technologies for remote delivery of the research intervention itself. Recent articles in the JNPT have provided valuable insights regarding the interactions among physical functioning, self-efficacy, biopsychosocial factors, and real-world community activity.2

D: Research Design and Methodology, Objective 2: Conduct both efficacy and effectiveness trials, including not only randomized clinical trials, but also adaptive and pragmatic trials and trials using other innovative designs. These days we often need to be reminded that the randomized clinical trial, which arose almost a century ago and has had held sway as the gold standard in medical research,3 is only one of many valid approaches to research. Attention is increasingly turning to more pragmatic study designs that have the capacity to assess interventions in the multifaceted and variable context of real-world clinical practice.4 These alternative designs provide outstanding opportunities for clinician-researcher partnerships that have the potential to capitalize on the pairing of clinical expertise and scientific rigor.

E: Translational Science, Objective 5: Determine the effectiveness of integrative, multimodal interventions that focus on defining the optimal combination and "dosing" of individual interventions to improve and possibly accelerate recovery following injury or disease. Neurologic physical therapist researchers have made substantive contributions to the literature related to questions of dose. In the last 2 years in the JNPT alone, several articles have addressed the issue of dose in the conventional terms regarding amount of activity.5-7 In addition, the question of dose and combination therapies has been addressed in the less typical sense of stimulation frequencies used when neuromodulatory stimulation is combined with training.8

F: Building Research Capacity and Infrastructure, Objective 5: Identify methods to encourage knowledge translation to promote clinical competence based on evidence-informed treatment. The vitality of the physical therapy profession has at its core the desire to provide the best possible care for our patients. Accordingly, we have embraced a focus on evidence-informed practice as key to achieving this goal. The 2016 JNPT special issue on Knowledge Translation and Implementation Science in Neurologic Physical Therapy included valuable guidance for translating evidence to practice. These articles included models9 and frameworks10 to guide translation, as well as clinical practice guidelines,11 and technology-based approaches12 for facilitating access to evidence.

Neurorehabilitation research in particular has been at the forefront of addressing many of the challenges confronting rehabilitation research overall. Each of the 6 goals described above has multiple associated objectives beyond to those on which I have commented in this editorial. I believe that clinicians and researchers alike will find value in reviewing these objectives, and reflecting on the opportunities we have and the contributions we can make to promoting progress on these research goals. With our strong cadre of internationally respected researchers and renowned expertise in clinical rehabilitation, we are poised to offer the leadership that is required to address the needs of our patients, who are also our research participants. In neurorehabilitation research our partnerships among patients/participants, clinicians, neurologic physical therapist researchers, and our colleagues in other disciplines offers an outstanding model for the wider world of rehabilitation research.

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