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 Physical Therapy & Rehabilitation Sciences Department

Developing Industry Leaders

Through technology-enhanced practice facilities and cutting-edge research labs, Drexel’s PT programs allow students to develop advanced skills through evidence-based clinical practice, teaching and research.

Research

At the forefront of research, our world-class faculty will support you in your efforts to advance knowledge and make an impact. Explore our current research areas and view the dedicated laboratory space.

Mentors

DHSc Faculty Mentors

PhD Faculty Mentors

Research Studies

Engagement in the Pediatric Rehabilitation Intervention Process: Its Nature, Measurement, and Role in the Determination of Outcomes


Investigators

  • Gillian King, PhD, Holland Bloorview Research Institute, Toronto, Ontario, Canada
  • Lisa Chiarello, PT, PhD, PCS, FAPTA; Drexel University, Philadelphia, PA, USA
  • Jenny Ziviani, OT, PhD, University of Queensland, Brisbane, Australia
  • Anne Poulsen, OT, PhD, University of Queensland, Brisbane, Australia
  • Virginia Wright, PT, PhD, Holland Bloorview Research Institute, Toronto, Ontario, Canada
  • Heidi Schwellnus, OT, Holland Bloorview Research Institute, Toronto, Ontario, Canada
  • Roger Ideishi, OT, JD, FAOTA; Temple University, Philadelphia, PA, USA

Summary / Overview

The engagement of children and youth with disabilities, and their parents, in rehabilitation interventions is critical to the success of these therapies. A fully engaged client is actively invested in the intervention session. He or she is receptive to what is happening, shares thoughts and experiences, and shows enthusiasm. She/he is also actively involved in a physical and behavioral sense. Client engagement has long been considered to enhance goal attainment and increase the cost-effectiveness of services; however, there are no measures of client engagement that have been created or validated for use in pediatric rehabilitation. Accordingly, research on the best ways of fostering engagement and its predictive value with respect to outcomes and costs has been hampered. >> (Download PDF)

Developmental Trajectories of Impairments, Health, and Participation of Children with Cerebral Palsy - Monitoring Development of Children with Cerebral Palsy or Gross Motor Delay

On TRACK Study


Investigators

  • Doreen Bartlett, PT, PhD, University of Western Ontario 
  • Sarah Westcott McCoy, PT, PhD, University of Washington
  • Lisa Chiarello, PT, PhD, PCS, FAPTA, Drexel University
  • Robert Palisano, PT, PhD, FAPTA, Drexel University
  • Lynn Jeffries, PT, PhD, PCS, University of Oklahoma Health Sciences Center
  • Alyssa LaForme Fiss, PT, PhD, PCS, Mercer University
  • Steve Hanna, PhD, McMaster University
  • Jan Wilem Gorter, MD, PhD, McMaster University

Summary / Overview

Cerebral palsy (CP) is the most prevalent childhood onset neuromuscular condition, and over 90% of all individuals with CP live well into adulthood. Beginning when their children are young, families need evidence to guide decisions on effective and cost efficient services and supports that build capacity and prepare children and youth for life as adults. The clinical manifestations of CP change with age, including a decline in motor function, which occurs in late childhood through adulthood, yet changes over time in postural control (a defining feature of CP), secondary impairments, and co-occurring health conditions have not been quantified. We propose to create developmental trajectories of impairments that change throughout childhood, the number and impact of associated health conditions, self-care abilities, and participation in family and community recreation. Creation of developmental curves would enable families of children with CP and health care providers to: 1) monitor a child’s development (developmental surveillance), 2) anticipate a child’s future strengths and needs (prognosis), and 3) proactively plan efficient services and supports to optimize a child’s health, function, education, social participation, and prevention of secondary impairments. >> (Download PDF)

Biomechanics of Lower Extremity Overuse Injuries in Recreationally Active People

Investigators
  • Clare E Milner, PhD, FACSM (PI) – Physical Therapy & Rehabilitation Sciences
  • Trey Brindle, MS (Co-I) – PhD student, Physical Therapy & Rehabilitation Sciences
Summary / Overview Unfortunately, there is a high rate of musculoskeletal injury in all runners, with some overuse injuries disproportionately affecting women. Three common overuse injuries occur in female runners more often than male runners: patellofemoral pain syndrome, iliotibial band syndrome, and tibial stress fracture. >> (Download PDF)

Relationship between Core Stability and Athletic Injuries

Core Stability StudyInvestigators
  • Sheri P. Silfies, PT, PhD (PI) – Physical Therapy & Rehabilitation Sciences, Drexel University
  • David Ebaugh, PT, PhD – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Marisa Pontillo, PT, DPT, PhD Student, Physical Therapy & Rehabilitation Sciences, Drexel University
  • Courtney Butowicz, MSEd, CSCS- PhD student Physical Therapy & Rehabilitation Sciences, Drexel University
Summary / Overview The objectives of the grant are to 1) determine the strength of the association between clinical and lab-based measures of core stability in the athletic population and 2) identify the clinical and lab-based measures of core stability that are significant predictors of shoulder injuries in athletes.. Read Full Report. >> (Download PDF)

Mechanical Low Back Pain

Investigators
  • Sheri P. Silfies, PT, PhD (PI) – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Marco Cannella, PhD — FDA
  • Susan Smith, PT, PhD – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Simon Giszter, PhD – Neurobiology & Anatomy, College of Medicine, Drexel University
Summary / Overview

The objectives of the grant are to gain a better understanding of how trunk movement and stability are coordinated. Read Full Report. >> (Download PDF)

Validation of Clinical Observation of Aberrant Movement Patterns in Patients with Mechanical Low Back Pain

Investigators
  • Scott A. Biely, PT, DPT, OCS, MTC (Co-PI) – PhD Candidate, Physical Therapy & Rehabilitation Sciences, Drexel University; Assistant Professor, Department of Physical Therapy, Neumann College
  • Sheri P. Silfies, PT, PhD (Co-PI) – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Susan Smith, PT, PhD (Co-PI) – Physical Therapy & Rehabilitation Sciences, Drexel University
Summary / Overview
Observation of abnormal back movement patterns is considered an important characteristic in identifying patients who will respond positively to low back stabilization exercises or who have low back pain attributed to clinical spinal instability. Read Full Report. >>(Download PDF)

Osteoporosis & Bone Health

Investigators
  • Susan Smith, PT, PhD — Physical Therapy & Rehabilitation Sciences, Drexel University
  • Jan Meiers, PT, DPT, GCS — Physical Therapy & Rehabilitation Sciences, Drexel University
  • Elizabeth Wang-Hsu, PT, MS — PhD Candidate, Physical Therapy & Rehabilitation Sciences, Drexel University
  • Han Chen, MD — PhD Student, Physical Therapy & Rehabilitation Sciences, Drexel University
Summary / Overview
Osteoporosis is “a disease characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist, although any bone can be affected”. Read Full Report. >>(Download PDF)

Shoulder Dysfunction

wires taped to shoulderInvestigators
  • David Ebaugh, PT, PhD – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Bryan Spinelli, PT, MS, OCS, CLT – PhD Candidate, Physical Therapy & Rehabilitation Sciences, Drexel University
  • Marisa Pontillo, PT, DPT, PhD Student, Physical Therapy & Rehabilitation Sciences, Drexel University
Summary / Overview
Shoulder impingement syndrome (SIS) is a significant cause of shoulder pain in overhead athletes. Read Full Report. >>(Download PDF)

Activity and Participation of Children with Cerebral Palsy

Move & Play - Movement and Participation in Life Activities of Young Children

  mother and toddlers on slideInvestigators
  • Doreen Bartlett, PT, PhD, University of Western Ontario
  • Lisa Chiarello, PT, PhD, PCS, Drexel University
  • Robert Palisano, PT, PhD, Drexel University
  • Peter Rosenbaum MD, FRCP(C), McMaster University, CanChild Centre for Childhood Disability Research
  • Sally Westcott McCoy PT, PhD, University of Washington
Summary / Overview
Cerebral palsy (CP) is the most prevalent childhood neuromuscular condition seen by rehabilitation practitioners; however, the evidence base supporting rehabilitation practice from a holistic perspective is very weak. Read Full Document. >> (Download PDF)

Biomechanics of Running

therapist facing girls kneesInvestigators
  • Margo N. Orlin, PT, PhD – Physical Therapy & Rehabilitation Sciences, Drexel University
  • Oluwabunmi (Bunmi) Oladeji, PT – PhD Candidate, Physical Therapy & Rehabilitation Sciences, Drexel University
  • Sirinart (Gan) Laibsirinon, PT, MS - PhD Candidate, Physical Therapy & Rehabilitation Sciences, Drexel University
Summary / Overview
This project seeks to characterize the biomechanics of running in children with cerebral palsy ages 7-14. Read Full Document. >> (Download PDF)

Health Promotion, Fitness and Physical Activity

Validity of Accelerometry to Measure Physical Activity Intensity for Clinical Trials in Youth with Cerebral Palsy

 Investigators
  • Margaret E. O’Neil, PT, PhD, MPH, Drexel University
  • Maria Fragala-Pinkham, PT, DPT, MS, Franciscan Hospital for Children
  • Nancy Lennon, PT, MS, Nemours/AI duPont Hospital for Children
  • Stewart Trost, PhD, The University of Queensland, Queensland, Australia
  • Stephen M. Haley, PT, PhD, Boston University, School of Public Health, Health and Disability Research Institute
Summary / Overview
Cerebral palsy (CP) is the most common physical disability of childhood. Although CP is a non-progressive neuromuscular disorder, children with CP often experience decreased physical activity, fitness and functional mobility as they grow and age. Current trends in rehabilitation interventions include activity-based interventions to promote health and function. Objective measures of physical activity (accelerometers) are important to examine outcome effectiveness of these interventions. Further research is needed to validate accelerometers specifically for use in measuring physical activity levels in children and youth with CP. Read Full Document. >> (Download PDF)

School-Based Physical Therapy Services

Investigators
  • Susan Effgen, PT, PhD, FAPTA, University of Kentucky
  • Lisa Chiarello, PT, PhD, PCS, Drexel University
  • Sarah Westcott McCoy, PT, PhD, University of Washington
  • Lynn Jeffries, PT, PdD, PCS, University of Oklahoma
  • Heather Bush, PhD, University of Kentucky
Summary / Overview

Physical therapy as a related service in schools contributes to the educational programming of students in the least restricted environment, enhancing students’ successful participation in school and community activities leading to further education, employment and independence. Read Full Report. >>(Download PDF)

News & Events

 

11/30/17

CNHP students are unique and amazing. Their dedication to health and healing and passion for their work is incredible. Off the Charts highlights some of these students to show what motivates them to want to help people.

Where did you receive your undergraduate degree and what is it?

I received my Bachelor of Science in Health Sciences from Drexel. I was in the 3+3 accelerated program which means that I completed my undergrad in three years, with one co-op experience, and then began full-time graduate school my fourth year. I knew I wanted to pursue a DPT degree when I applied to Drexel. The requirements of the 3+3 program stipulated I needed to maintain a certain GPA, finish specific classes, pass my GREs and apply to Drexel’s DPT program within my junior year. I wasn’t guaranteed a spot; I had to complete the interview and be accepted to the program just like anyone else.

You’re a third-year DPT student. Why did you choose to pursue a DPT degree?

I want to be able to help people get back on their feet after injury and live their lives to the fullest. I love all the different ways physical therapists help patients through manual techniques, therapeutic exercise, education and progression to independent management of one’s own symptoms. I love how much time physical therapists get to spend with their patients and the relationships we can develop.

What are your thoughts about CNHP’s program?

Drexel’s DPT program is unique because of the professors and staff who help make the program as successful as it is. Each professor is so knowledgeable about their course material and always willing to help the students in any way possible. I would not have been as successful in this program if it wasn’t for the dedication and wonderful personalities of each of my professors. Drexel also has amazing relationships with so many clinical education sites, making for an abundant selection for all students. There is also an opportunity to travel to the yearly American Physical Therapy Association Combined Sections Meeting conference. And I went on a service trip to Guatemala.

What are your career aspirations?

Currently, I am applying to pediatric residency programs for the upcoming year. I am hoping to pursue a residency and become specialized in this area to better influence the lives of all children.

What is your approach with patients?

Every patient I treat I approach with an open mind, clear head and variety of possibilities. I allow the patient to tell me exactly what is bothering them and how it makes them feel before assessing them myself. I then perform an examination then piece together both objective and subjective information to determine the proper care and treatment approach for that specific individual. I then create a plan, with the help of the patient and any family members present, that will best suit the needs of that patient and help them to feel better.

What is the yoga program and what is your involvement with it?

For my final research project, I was lucky enough to be selected, along with a small group of classmates, to perform yoga research with children at the Blossom School in Philadelphia. Using the work of previous students, we created a yoga program for typically and atypically developing children to help enhance strength, flexibility, coordination and motor control. We went to Blossom multiple times to implement the program throughout different classrooms and perform the yoga with the children. We made corrections and changes to the program based on how the children responded during the session. We worked with children with special needs for the first time this year and adapted the program to best suit their needs. It was challenging and rewarding to find adaptations that allowed these children to participate and succeed. We are currently going back to Blossom to collect data on the children from pre- and post-implementation to assess its effects and benefits. We designed Yoga Flashcards for the Blossom teachers so that they could do the yoga program daily. We conducted teacher surveys to assess the use of these flashcards and utilized the data to make the flashcards more conducive to the classroom environment.

Can you tell me about the Guatemala trip and why you went?

When applying to Drexel’s DPT program, one of the highlights of the curriculum was the opportunity to go on a service trip to Guatemala during my third year. From the moment I saw this trip, I counted down the days until I could participate. I love to travel and am passionate about helping others. I wanted to share my skills and abilities with people who needed it the most. This trip was life-changing—a once-in-a-lifetime opportunity. My classmates and I traveled to Guatemala, not knowing what to expect, but quickly learned about the impact we could have on this population. For five days, we moved to different locations treating patients who traveled many miles to see us. The first day we went to a school to set up a “pop up” physical therapy clinic. One of my patients was a barefoot little girl who came in with fractures in both feet and a family who could not afford surgery. We didn’t have shoes that would fit her, so I gave her the ones I wore that day. On the last day of treatment, we went to a nutrition center and participated in the weekly meal for the children of the community. We provided physical therapy services to people in the community and children at the nutrition center.

What was the biggest impact it had on you?

This trip impacted me as a person and the way I approach treatment with all patients. This trip taught me that you couldn't treat every single impairment that a patient has because you would never be able to get anything done. You must focus in on what you can do to help impact the patient’s life the most. I saw first-hand how little these people have and how fortunate we are to live the way we do.

What do you do for fun or in your downtime?

In my downtime, I enjoy running, exploring Philadelphia and spending time with family and friends.

Things I would like to recommend:

Book: Left Neglect and Inside the O’Briens both by Lisa Genova.

TV or movie: I just binge watched Grace and Frankie on Netflix and love Grey’s Anatomy. My favorite movie all time is Mary Poppins.

11/30/17

What is the best way to warm up before running?
How to do a dynamic warm-up and why you should.

Many runners believe that stretching muscles before running is a good idea. A commonly held belief is that loosening up your muscles will get them ready for a run and will help prevent injuries. What the research tells us is quite the opposite. Static stretching, where you hold the muscle in a lengthened position for anywhere from 10 seconds up to a minute, does affect the responsiveness of the muscle but probably not in the way we would expect. CNHP's senior graphic designer Craig Schlanser running in the Philadelphia MarathonDue to a reflex that is triggered when a muscle is lengthened, static stretching causes a decrease in the excitability or reactivity of a muscle. This reduces the effectiveness of the muscle to respond rapidly as it becomes inhibited or relaxed. Research suggests that some amount of leg stiffness may be beneficial to improve running efficiency. The muscle can then be used as a spring, absorbing energy as it is compressed and using it to recoil for an effective push off against the ground in order to move your body forward efficiently. A study published in The Journal of Strength and Conditioning showed that static stretching prior to running actually led to an increase in energy cost of running and a negative impact on performance in a group of runners compared to a no stretching situation. The runners became less efficient and covered less distance in a prescribed amount of time if they did static stretching before the run. Static stretching decreases the ability of muscle to generate force, affecting strength and endurance. This is not what you want to do before a race or a training run.

Another reason to reconsider pre-run stretching is that research has demonstrated that static stretching before a run does not decrease injury risk for runners. Results from a USA Track & Field-sponsored study analyzing nearly 3,000 runners confirm there is no difference in the risk of injury for those who stretched before running and those who did not. So it appears that stretching prior to running does not reduce the risk of injury and will likely have a negative impact on running performance. So what is the best way to prepare your body for running?

Female runner performing dynamic warm-upUsing a warm-up that prepares your muscles for the upcoming task should involve dynamic movements rather than static positions. This type of dynamic warm-up trains the muscles to activate in a way that simulates running movements but at a lower intensity level. Research comparing dynamic warm-ups to static stretching or no stretching situations demonstrate superior performance in the dynamic warm-up condition. Preparing your muscles to run by using running specific warm-up movements appears to be a better way to run more effectively. There are many benefits to utilizing a dynamic warm up prior to running.

Some of the benefits of a dynamic warm-up include:

  • increased body and tissue temperature
  • increased circulation
  • increased neural activation
  • improved tissue extensibility and joint range of motion
  • accentuated proprioception (body awareness)

All of these effects help prepare your body for more demanding activities. Dynamic movements can help prepare your body for greater load absorption and muscular force output required during running.

What is the best way to implement a dynamic warm-up? A very slow jog of three to five minutes can be used to increase muscle blood flow. This can be followed by six to ten minutes of progressive, dynamic movements. There are many movement patterns that can be utilized to reach all necessary running muscles and prepare them for activity. These movements should be through a comfortable range (not to end range). The movements should not be held statically and should not be painful. The movements should progressively load the tissues and become more ballistic as you progress from start to finish.

However, static stretching isn’t all bad it just depends on when it is done. After a run may be the best time for static stretching. If legs are tight and sore post-run, stretching is appropriate to decrease the excitability or tightness of the muscle to improve comfort and flexibility. It may be beneficial after the run, but not before.

Watch the Dynamic Warm-up Program video.
Visit the Drexel University Running Performance and Research Center website.

Rob MaschiBy Robert Maschi, PT, DPT, OCS CSCS
Associate Clinical Professor and Physical Therapist
Department of Physical Therapy and Rehabilitation Sciences
Drexel University Running Performance and Research Center

11/30/17

Sarah Wenger, PT, DPT works with a patient in the gymAccording to the Institute of Medicine, chronic pain is a major health issue affecting approximately 100 million Americans and amounting to a cost of roughly $635 million a year. The healthcare community has a history of poor outcomes for chronic pain that have frustrated both patients and providers. Chronic pain can be very challenging to treat. It is an evolving condition with remodeling of neurological structures and biological, behavioral, environmental and societal influences. The focus is shifting from eliminating pain completely to minimizing the impact of pain on quality of life and building resilience to better cope with chronicity. The opioid crisis has drawn attention to how chronic pain is understood and managed. In 2016, the Centers for Disease Control and Prevention recommended that nonpharmacological therapies be the first line treatment of chronic pain. Mental health, physical therapy and a variety of other professions and wellness strategies are fast becoming that first line defense. Interdisciplinary approaches are considered best practice in treating both chronic pain and substance use disorders. Interdisciplinary care that addresses health and wellness across physical, mental, and social domains is most effective. Healthcare providers need to have a good understanding of chronic pain neuroscience, biopsychosocial components of pain management, issues related to substance use disorders and pain management strategies so that they can effectively integrate their expertise within the context of interdisciplinary care and reinforce strategies used by other team members.

Sarah Wenger, PT, DPT works with patient using a exercise ballAt Drexel University’s Stephen and Sandra Sheller 11th Street Family Health Services, we developed a psychoeducational group called Power Over Pain (PoP). Research has indicated that an interdisciplinary approach aids in improving the functional status and quality of life of patients with chronic pain. PoP is an interdisciplinary program that empowers patients through education to self-manage their pain. The group is based on a framework we developed, the Clinical Reasoning Model for Chronic Pain.

 

Power over Pain Plan of Care

The top of the diagram represents the goal of treatment: patients who are using healthcare services appropriately as they self-manage their pain with little or no opioid use. To reach this goal, patients need education, mentorship for behavioral change, help to address cognitive-affective factors and an understanding of the roles various healthcare providers serve in their health and wellness.

Sarah Wenger, PT, DPT in the gymThe middle of the diagram depicts an interdisciplinary team that includes the patient. All members of the interdisciplinary team collaborate to arrive at unified goals and a unified plan of care. This differs from a multidisciplinary approach where patients see different professionals who are not functioning as a cohesive team, each providing different goals and treatment plans leaving the patient to sort through an often overwhelming amount of information and action items. Good communication among professionals, the patient, the patient’s family and other stakeholders is essential in forming the collaboration needed for efficient and effective care management.

Each pillar at the bottom of the model represents a different area of research important for chronic pain management. While each team member specializes in their discipline, everyone should have a broad knowledge of all areas so that they can effectively situate their expertise within the fabric of the whole patient and a holistic treatment approach that will prepare patients for a resilient path forward.

The PoP group will be re-starting at Stephen and Sandra Sheller 11th Street Family Health Services and will be offered for the first time at Parkway Health and Wellness in this spring. Information about the group and its curriculum can be found at http://poweroverpain.sarah.pt/.

*Note: Wenger's article, “Reducing Opioid Use for Patients with Chronic Pain: An Evidence Based Perspective,” is getting published in the Physical Therapy Journal in print in April and on-line early 2018. 

By Sarah Wenger, PT, DPT, OCS

Associate Clinical Professor, Coordinator of Experiential Learning
Physical Therapy and Rehabilitation Sciences Department

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