|
|
The
Foundation
for Physical Therapy has awarded a
$1.5 million 3-year clinical research
network grant to Principal Investigator
Carolee J Winstein, PhD, PT, to establish
PTClinResNet, a multisite clinical research
network that links together five premier
centers of physical therapy research and
practice. Joining USC in this clinical
research endeavor are Northwestern University,
Rancho Los Amigos National Rehabilitation
Center, Southwest Missouri State University,
and the University of California at Los
Angeles. These centers will come together
through the network to carry out four
clinical research projects. The projects
share a common theme: to assess the effects
of strength-training exercises that are
designed to improve muscle performance
and movement skill in patients with physical
disabilities.
PTClinResNet
has three primary goals. The first is to
evaluate the effects of strength training
for the physically disabled. Second, the
network will create the infrastructure necessary
to sustain clinical research in physical
therapy. Finally, the network will provide
education and training opportunities for
present and future clinical scientists in
physical therapy, and for the PT practice
community beyond the five immediate research
locations. PTClinResNet will build support
for evidence-based practice, in the area
of strength training first, then in other
types of PT interventions. Adopting the
disablement model as a framework for analysis,
PTClinResNet will evaluate outcomes from
studies based on changes in individual’s
impairments, functional limitations and
disabilities. There is also a coordinated
effort between research centers to compare
the treatments across types of disabilities,
including adults following stroke, children
with cerebral palsy, individuals with spinal
cord injury and persons with orthopaedic/low
back pain and dysfunction. This has been
achieved by using a common set of valid
outcome measures across all categories of
the research.
PTClinResNet
will be conducting four projects. STEPS,
strength-training effectiveness post stroke,
is a Phase III type study that is designed
to demonstrate efficacy of intervention
in a large scale, well controlled randomized
and multi-center clinical trial. The remaining
three projects are Phase I clinical trials
which are smaller in scale and are used
to establish the feasibility and safety
of interventions with a limited number of
patients. These projects are named: PEDALS,
Pediatric Endurance Development And Limb
Strengthening; MUSSEL,
Muscle-Specific Strengthening Effectiveness
Post Lumbar Microdiscectomy; and STOMPS,
Strengthening And Optimal Movements For
Painful Shoulders in chronic spinal cord
injury.
According
to Dr. Winstein, “It is clear that
a critical objective for our profession
is to examine the efficacy of physical therapist
practice through sound scientific methods
of clinical research. The unique collaborative
arrangement that the funding from the Foundation
will allow us to build is designed to foster
cutting-edge clinical research now and into
the future, across a wide domain of physical
therapy practice. We believe that, by combining
the talent and resources at many institutions,
we can accomplish much more than if we were
all working separately. Indeed, we anticipate
that the concept of a clinical research
network, which the Foundation had the vision
to promote, may eventually become recognized
as the optimal arrangement for carrying
out clinical research, and that PTClinResNet
will be the first of many such networks.”
|
 |
| |
|
|
STEPS
focuses on the locomotor disability that frequently
remains a major obstacle to community function
in persons with chronic post-stroke hemiplegia.
Reduced gait speed, which is caused by a combination
of decreased muscle strength and poor muscle
coordination, is present in the majority of
persons post-stroke. The STEPS project will
determine if functional outcomes, primarily
gait speed, are improved with: strength training
as an adjunct to body weight supported treadmill
training; locomotor-based strength training
compared with muscle specific strength training;
and locomotor-based strength training compared
with body weight supported treadmill training.
David Brown, PhD, PT, will serve as the Lead
Investigator of the STEPS project. Dr. Brown
is an Assistant Professor at Northwestern University.
His previous research dealing with the effect
of increased workloads to enhance force output
in persons with post-stroke hemiplegia provides
an excellent foundation for this project.
 PEDALS
Lead Investigator Eileen Fowler, PhD, PT, Associate
Professor at UCLA, is conducting research to
determine if a 12-week program of stationary
cycling can enhance function in children with
cerebral palsy (CP). Cycling is a rehabilitation
tool that is often used by physical therapists
to improve strength and fitness. Children with
CP can use cycling as an activity that not only
allows them to participate in family and social
activities, it is a means of providing mobility
and independence. Dr. Fowler and her team of
investigators will be analyzing the outcomes
of the cycling intervention on strength, cardiorespiratory
endurance during walking, gross motor functional
performance, perception of change in activities
of daily living, sport, and play activities,
health related quality of life and measures
of gait performance.
 MUSSEL
is led by USC Associate Professor Kornelia Kulig,
PhD, PT. Dr. Kulig will be addressing muscle-specific
strength training effectiveness post lumbar
microdiscectomy. Up to 33% of the adult work
force is affected by low back pain each year.
It is the number one reason for missed work
days and restricted-activity days. Unlike other
orthopaedic disorders, the expenses associated
with management of back pain have increased
over the last 20 to 30 years. Because of the
frequency of this injury, surgeons have sought
ways to minimize the operative trauma. Microdiscectomy
is often the procedure of choice for single
level injuries in younger adults as it has been
shown to have a high level of success. Dr Kulig’s
team will evaluate the ability of muscle specific
strengthening to result in: immediate improvement
in function, quality of life, pain and disability
reduction; long-term effects on these same outcomes;
and immediate improvement in muscle performance
as assessed by muscle activation.
 STOMPS,
strengthening and optimal movements for painful
shoulders in chronic spinal cord injury (SCI),
is the 4th Project. Lead Investigator Bryan
Kemp, PhD, Director, Rehabilitation Research
and Training Centers on Ageing with SCI and
Aging with a Disability at Rancho, has a long
history of research dealing with the effects
of aging with a disability. Upper extremity
pain is one of the common problems in the long-term
SCI population and shoulder pain can have a
significant detrimental effect on function and
independence. STOMPS will investigate the effectiveness
of a combined shoulder exercise and optimization
of performance technique program on pain reduction,
performance, and health-related as well as overall
quality of life in patients with chronic spinal
cord injury.
|
|
|
|
|
