University of Delaware Department of Physical Therapy faculty are among the headliners of a National Institutes of Health (NIH) conference titled ‘Rehabilitation Research at NIH: Moving the Field Forward.’ Participation from UD faculty includes Cole Galloway, Lynn Snyder-Mackler and department chair Greg Hicks. Tune in as NIH will live-stream sections of the conference, including today’s sessions. The conference runs through May 26.
Here are the sessions that UDPT is taking part in:
Access to the Lived Environment: Low-Cost, In-Home, or Open-Source Solutions: Opportunities and Challenges
Moderator: Melanie Fried-Oken, Ph.D., Oregon Health & Science University 3
Date and time: Wednesday, May 25 at 4 p.m.
Panelists: Cole Galloway, Ph.D., University of Delaware; Maureen Schmitter-Edgecombe, Ph.D., Washington State University; James Coughlan, Ph.D., Smith-Kettlewell Eye Research Institute
This collaborative session will address low-cost, in-home, and open-source assistive technologies that are developed, through NIH funding, for individuals across the lifespan with a range of disabilities. First, panelists will present their individual research programs, identifying how assistive technologies support social mobility with GoBabyGo, functional independence with smart environment technology, and vision impairment with mobile technology. In a discussion format, the rehabilitation scientists will then consider the opportunities and challenges posed by introducing assistive technologies into daily environments to increase participation. Three topics will be addressed: Incorporating participatory action research into rehabilitation science; demonstrating the utility of technologies for value added to users and professionals; and scaling technologies, in terms of sustainability and reaching individuals over time. Conference participants are invited to submit probes in advance of the meeting that will be answered by the panelists, as well. Your questions should address the development, use and measurement of assistive technologies for functional outcomes.
Effective Pathways to Evidence for Rehabilitation
Moderator: James Malec, Ph.D., Rehabilitation Hospital of Indiana
Date and time: Thursday, May 26 at 10 a.m.
Panelists: Lynn Snyder-Mackler, P.T.,Sc.D.,S.C.S.,F.A.P.T.A., University of Delaware; Catherine Lang, Ph.D., Washington University; Susan Horn, Ph.D., University of Utah
This symposium will examine phases, options, and challenges to advancing a line of rehabilitation research. Significant challenges and solutions in incorporating mechanisms, dosing, and examining standard care through practice-based evidence will be discussed in detail. Phases in the progress of a line of research and options for empirical design will be reviewed. Balancing internal and external validity to encourage timely translation into practice will be discussed as well as considerations and challenges in advancing rehabilitation research (e.g., heterogeneity of participants and interventions, fidelity assurance, dosing, blinding, nonspecific factors, measurement). Dr. Snyder-Mackler will demonstrate how the investigation of underlying mechanisms of action in high quality clinical trials and observational quasi-experimental studies within rehabilitation research is achievable, but is fraught with obstacles that do not happen in drug trials that typify clinical trials. Unlike the delivery of an active medication or placebo, rehabilitation interventions are typically multimodal and involve active participation of both the patient and the clinicians. Thus, defining of the intervention(s), assuring that the intervention(s) are reliably applied and defining the active component(s) are unique in studies of rehabilitation. This presentation will discuss the challenges and some approaches that successfully embed mechanistic investigation in clinical trials and observational quasi-experimental studies in rehabilitation. Dr. Lang’s talk will focus on the major challenge that dosing presents for rehabilitation trials, i.e. that essential information about active ingredients, their biological targets and mechanisms of action, and their half-lives, are largely unknown. Key dosing parameters and how they might be measured and controlled in trial designs will be discussed, with the goal of maximizing the amount and specificity of knowledge gained from any trial. Finally, with electronic medical records (EMRs) collecting detailed patient, treatment, and outcome data now and even more in the future, how can we use this information to determine those interventions that are associated with better outcomes for patients with specified sets of characteristics? Dr. Horn will review how Practice-Based Evidence (PBE) study designs address these challenges and present an example of findings from a PBE study of 2130 patients with traumatic brain injury.
Preventing Secondary Disability
Moderator: Diane Damiano, Ph.D., P.T., NIH Clinical Center
Date and time: Thursday, May 26 at 1 p.m.
Panelists: Greg Hicks, Ph.D., University of Delaware; Diann Gaalema, Ph.D., University of Vermont; Sara Mulroy, Ph.D., Rancho Los Amigos National Rehabilitation Center
Our session will involve four speakers who will address different clinical research issues in four very distinct populations: children with cerebral palsy, elderly adults with low back pain, minority patients with cardiovascular disease, and those with shoulder pain secondary to using a wheelchair after a spinal cord injury. However, the talks will intersect and converge on these four broad themes: (1) importance of managing or preventing secondary disability to optimize health and functioning throughout the lifespan; (2) recognizing the major role of pain in further limiting function and mechanisms leading to pain; (3) involving all, especially those are greater risk, in the design of rehabilitation programs and in the ascertainment of strategies to increase access and compliance and (4) leveraging technological advances to enhance rehabilitation outcomes Dr. Damiano will focus on activity promotion to maintain strength and fitness levels across levels of disability throughout the lifespan for those with cerebral palsy and on more recent efforts on preventing secondary disability through limiting primary disability in the first several months of life, with the themes of access to care and technology advances integral to both of these Dr. Hicks will address pain, specifically low back pain (LBP) in older adults and resultant functional disability by identifying modifiable factors to improve outcomes. He has further designed novel interventions to address some of these factors, such as abnormalities in trunk musculature and hip joint pathology. Dr. Gaalema will focus primarily on the third theme to increase access to rehabilitation specifically cardiac rehabilitation, and compliance with important behavior modifications in those at highest risk, but will additionally show how technology can aid in this process. Dr. Mulroy will include multiple themes in her discussion of shoulder pain in wheelchair users after spinal cord injury (SCI) including secondary disability, biomechanical mechanisms as well as psychosocial aspects of pain, inclusion in design of rehabilitation programs and use of technology to advance assessment and outcomes. After short presentations, we will break into smaller groups around each of these themes to foster participation and finally and, most importantly, to invite and solicit audience questions and comments in the summary discussion of research gaps and opportunities.