The official newsletter of the University of Miamiâ€™s Department of Physical Therapy
Pictured above: Dr. Lauren Lagaron serves as a clinical instructor as second year DPT students James Denis and Katie Dabrowski demonstrate manual muscle techniques to first year student Miles Slay. More on page 5!
Research Spotlight In the modern climate of asserting physical therapy as an evidence-based profession, variance in therapeutic approaches call into question the efficacy of our intervention applications. While exercise is well known to maintain brain health, specifics in therapeutically significant parameters are not as clear. Dr. Joyce Gomes-Osman currently has several interdisciplinary studies underway in the domain of neurophysiologic-based rehabilitation interventions. Her research aims at harnessing neuroplasticity in the form of brain stimulation and exercise and assessing its effect on the human nervous system, as well as understanding the relationship between neuroplasticity, exercise and cognitive functioning. Transcranial magnetic brain stimulation has been studied for its efficacy in helping neurologic populations, but the optimal
outcomes are anticipated with the best application of PT interventions. Current practices in the management of individuals with Parkinson’s Disease (PD) address deficits in divided attention and dual task performance. One prong of Dr. Gomes-Osman’s research investigates the theory that combining these interventions would allow for compounded benefits. At the UMH PT Clinic adjoined to the Medical Wellness Center, Dr. Gomes-Osman has developed a 3-week evidence-based protocol incorporating current practices, including external cuing with various sized obstacles to ascertain responses of different groups. The study included 20 people with PD staged 3 or 4 with and without freezing of gait and both groups experienced a clinically significant overall improvement in walking speed as well as a significant improvement in freezing of gait for those who
experienced that symptom. This represents meaningful findings by showing that interventions can not only slow the neurodegenerative condition, but actually improve it! Patients with PD aren’t the only ones getting attention from her research. Dr. Gomes-Osman is currently collaborating with a physician colleague at in the Department of Neurology under a grant from the American Heart Association to assess the participation of individuals post-stroke in 12 weeks of combined aerobic and resistance training isolated or with cognitive training. While she’s still in the early stages of these studies, Dr. Gomes-Osman hopes to identify people who are going to respond better by looking at their walking and their plasticity potential. Shifting gears, a 2015 Institute of Medicine Report on Cognitive Aging sought to establish terminology and educate health care
“It’s an incredible time to be a PT and a PT scientist.” Dr. Lawrence Cahalin, PhD, PT attended the European Respiratory Society annual congressional meeting in Milan, Italy on September 9-13, to present evidence in the realm of cardiorespiratory physical therapy. PhD student Magno
Markus de Oliveria had three abstracts on COPD and inspiratory muscle performance. Dr. Cahalin also presented Dr. Marlon Wong’s research ﬁndings on Low Back Pain and respiratory muscle performance, including a poster discussion, whcih garnered high evels of interest.
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Dr. Ignacio Gaunaurd, PT, PhD, MSPT and a team of mobility researchers, scientists, and engineers through the Mobile Device Outcomes - based Rehabilitation Program showcased the Rehabilitative Lower-Limb Orthopedic Analysis Device (ReLOAD) at the ACCelerate: ACC Smithsonian Creativity and Innovation Festival which ran October 13-15, 2017 at the Smithsonian’s National Museum of American History in Washington, D.C. The project has been underway for several years and is making headway in helping amputees correct gait deviations. (See photos on page 20)
providers and the general population. Although everyone experiences it to a degree, cognitive aging has variability which makes it difficult for us to project its progression. However, we have identified two key players in this process: physical activity levels and sedentary behaviors. This question then arises: What kind of guidance can we give our patients, our families, our loved ones? To answer that, Dr. Gomes-Osman endeavored to define palpable constraints to an optimal dose of exercise prescription as well as determine which parts of cognition will incur the greatest improvements. After putting 98 studies that represented 11,061 participants through data analysis, the parameters of approximately 60 total hours over 25 weeks at a frequency of 3 times a week and mean intensity of 66% of Target Heart Rate appeared to be the most effective. What’s exciting is that most of these studies reported good adherence. Now, to assess the specific improvements in cognition, each measure was classified into six dimensions of cognition: processing speed and attention, visual-spatial processes, memory, executive functioning, working memory, and global cognition. The most frequent positive changes were observed in processing speed/attention, executive function, and global cognition for the general population, older healthy adults, and people with mild cognitive
impairments. This is because these three constructs are the first to go when we start aging, so by doing exercise, we can set the neurological clock back. Individuals with more compromised cognition also have more room for improvement. The data showed that people with dementia, who have more significant memory deficits, picked up the extra improvements in memory that their healthy and mildly impaired counterparts did not have. These findings were submitted to the Journal of Neurology for peer review and the next step is prescribing these within a study to determine its efficacy. An innovative facet of her research is neuroplasticity testing. The term neuroplasticity describes that process of the nervous system reorganizing itself in response to new situations or changes in the environment. Exercise can enhance plasticity by stimulating the release of brain-derived neurotropic factor (BDNF), a protein that supports neuronal cell function and differentiation. In about 30% of the general population, there is a difference in DNA sequence that impairs the release of BDNF in the nervous system. In early October, a trial using Dr. Gomes-Osman’s method for assessing plasticity in humans through Intermittent Theta Burst Stimulation, a type of transcranial magnetic stimulation, was published. This plasticity test may allow for future detection of the less neuroplastic individuals as well as assess-
“Good science is collaborative”
ing if they benefit less than others from activity-based interventions. Dr. Gomes-Osman envisions the profession of physical therapy becoming more comfortable with genetics because it may be able to help us predict how people are going to do. If we see we might not be able to make such robust improvements, we need to figure out how to boost plasticity before we introduce patients to interventions. This past October, Dr. Gomes-Osman was recruited to write the content for an app being developed in collaboration with the Center on Aging to promote increased participation in exercise for middle aged adults. Additionally, she is involved in a project based in Brazil that is aimed at increasing movements in elders through workshops for exercise implementation that involve activity monitoring and social interactions.
Dr. Joyce Gomes-Osman, PT, PhD is an Assistant Professor in the Department of Physical Therapy, Miller School of Medicine with aﬃliations with the McKnight Brain Institute, Department of Neurology, and Center on Aging at the Miller School of Medicine. Her interest in clinical research was sparked by a pursuit of the truth and a desire to determine eﬃcacy of treatment applications for optimal physical therapy intervention.
Residency Program The University of Miami’s Department of Physical Therapy has a history of supporting residency education by providing both didactic and clinical education in the specialty areas of geriatrics, orthopedics, pediatrics and sports. Our residency programs are 52 weeks long and generally start in August and end in August the following year. Residents receive a minimum of 150 hours of one-on-one clinical mentoring and 75 hours of didactic education. Residents develop a clinical case throughout their residency year and present them at the end of the residency year in a consortium.
2002 UM Department of Physical
Therapy provided much of the didactic education for the St. Catherine's Rehabilitation Hospital & Villa Maria Nursing Center Geriatric Residency. In 2002, the program was led by Greg Hartley, PT, DPT, Board Certiﬁed Geriatric Clinical Specialist (MSPT, class of ‘90) and was the ﬁrst accredited Geriatric Physical Therapy Residency program in the United States. We continue to provide didactic education and support the Geriatric Residency Program.
2013 the University of Miami – Nicklaus Children’s Hospital Pediatric Residency Program became the ﬁrst pediatric residency program to be accredited by ABPTRFE with Jim Moore, PT, PhD, Board Certiﬁed Pediatric Clinical Specialist (MSPT, class of ‘90) serving as program director. 2015 the University of Miami Orthopedic Residency Program was accredited with Marlon Wong, Pt, PhD, Board Certiﬁed Orthopedic Clinical Specialist serving as program director. 2017 the University of Miami Sports Residency Program moves into candidacy status and admits its ﬁrst cohort of resident with Luis Feigenbaum, PT, DPT, ATC, LAT, Board Certiﬁed Sports Clinical Specialist, serving as program director.
Introducing the 2017-2018 Residency Class Geriatric Rosanna Gelaz Mary Laura Hood
Orthopedic Genesis Exposito Jessica Haynes Lauren Lagaron Abilio Rodriguez
Residency applications opened in October and each program has its own speciﬁc application deadline between December through March. Each program is unique, so check out their link on the UM Physical Therapy website for more information about a speciﬁc program as well as the mission statements and respective goals. You can also contact the residency program director directly if you have further questions.
Pediatric Sports Lindsey Adelstein Julia Rapicavoli Brittany Aquart Julian River
Geriatric Residency Program Director JCabrera@chsﬂa.com
Sports Residency Program Director LFeigenbaum@med.miami.edu
Pediatrics Residency Program Director JGMoore@miami.edu
Orthopedics Residency Program Director MWong2@med.miami.edu
Tips for Applying to a Residency Program:
• Research the programs – ﬁnd the right match for you – they are all diﬀerent. • As a new graduate, you may be competing with applicants that have experience. Make sure you have experience working with the population you hope to specialize in, and take continuing education or electives that give you additional knowledge or skills (beyond the DPT curriculum). • If you are asked to respond to essay questions (all of UM residencies do), be sure you write well, respond to the prompt, and tell us anything special about yourself that your CV, transcripts or grades do not show. • If you are asking a faculty member for a reference, be sure to give them enough time and information to reﬂect and write a supportive reference. • Pay attention to deadlines!
PhD Studies UM PT PhD Students 2017-2018
The Department of Physical Therapy established the Doctor of Philosophy (PhD) Program in Physical Therapy in 1995. It was the ﬁrst PhD in Physical Therapy Program in the Southeastern US and its mission is to prepare physical therapists for leadership positions in academic and research settings. Our current Department Chair, Dr. Neva Kirk-Sanchez, was one of the ﬁrst two students to enroll in the program. To date, 23 students have graduated from the program and the overwhelming majority of them currently hold faculty or research positions. The PhD students come from a wide variety of backgrounds. The current cohort of PhD includes graduates of the UM DPT program as well as students who received their PT degrees in Minnesota, Michigan, Brazil, Israel and Saudi Arabia. Each PhD student works with a faculty mentor who guides the PhD student’s plan of study and helps the student develop their dissertation research topic. Areas of dissertation research range widely from the role of inspiratory muscle weakness in COPD to functional mobility in individuals with lower limb loss.
Jennifer Lucarevic Fall 2013 Advisor: R. Gailey
Sheila Qualls Fall 2013 Advisor: R. Gailey
Nicole Eustis Fall 2014 Advisor: L. Cahalin
Magno Markus de Oliveria Fall 2014 Advisor: L. Cahalin
Robyn Porter Spring 2015 Advisor: M. Raya
Abdulaziz Alomerini Spring 2016 Advisor: K. Roach
Anat Kristal Fall 2016 Advisor: R. Gailey
Anne Palermo Fall 2016 Advisor: M. Nash
Jordyn Rice Fall 2016 Advisor: J. Gomes-Osman Shatha Aldraiwiesh Spring 2017 Advisor: J. Gomes-Osman
Tamira Bartholomew Spring 2018 Advisor: K. Roach
Sulaiman Alanazi Spring 2018 Advisor: J. Gomes-Osman
PhD Program Design:
The University of Miami, Doctor of Philosophy in Physical Therapy Program is designed to prepare physical therapists for leadership positions in academic and research settings. The program also promotes professional socialization into the role of an academic faculty member. We believe that this preparation should include the following: 1) Expertise in a specified content area 2) Advanced knowledge and skill in research methods, design, and implementation of analysis and communication of results 3) Proficiency in instructional design, teaching methods, and evaluation.
Building student connections through involvement DPT Students clean Wynwood for PT Day of Service
By: Alicia Canton-Rodriguez
For PT Service Day, we partnered with Debris Free Ocean to clean up the streets of Wynwood. They are a local group that focuses on cleaning up the beautiful oceans in South Florida. We had over 20 volunteers, mostly Physical Therapy students, walk around the streets of Wynwood and collect trash that would otherwise end up in our beautiful oceans. In only a few hours we collected over 230lbs of trash walking just a few blocks of the Wynwood area. It was a great feeling to give back to a community that is striving to be better but still has a long way to go. It was astonishing to see how easy it was to collect so much trash. It really got you thinking about ways outside of the health field in which we could improve our community so that the impacts of humans on Earth are lessened.
Photo courtesy of Kayla Weber
UM Physical Therapy Students give back to Sabrina’s Adaptive Beach Day By: Gary Benjamin As skilled volunteers, the UMPT students transfer the participants to and from their wheelchairs into the specialized chairs that can be rolled down the beach and into the water. In the water we use a variety of maneuvers to transfer the participants so they can float or swim. We spend about 20 minutes with the participants in the water, talking and swimming. As reported by our UMPT volunteers, the students feel they are receiving invaluable real-world experience. Students are provided the opportunity to get hands on experience in transfers, participant safety, education and interaction. The participant’s impairments are highly variable (participants with SCI’s, amputations, vision impairments, Guillain–Barre, and CVA’s attended the event) which often requires critical thinking and excellent communication among the volunteers to ensure participant safety. The event has gotten very large and I've seen it grow from a free-for-all type event to online-time slots and sign-ups for volunteers and participants alike. Here is a link to their website if you are curious: http://sabrinasadaptivebeach.com. The foundation just won permission to build a multi-million dollar facility on North Beach that will provide accessible exercise classes and equipment storage.
Photos courtesy of Gary Benjamin
Marquette Gala’s Lucky Bidders Enjoy a Homemade Cuban Dinner By: Craig Sykes This was my second year winning the bid for the Cuban dinner with Dr. Drevyn. The afternoon starts off with pastelitos, croquetas, and both red and white sangria. There were 10 of us in addition to Dr. Drevyn's family all enjoying several hours of conversation in and around the pool. Just as we began to have room for a little more food, dinner was ready, which included Cuban style black beans, rice, chicken, salad, and shredded pork. The house always smells amazing. Lastly, the night finished with flan, Cuban coffee and a great game of Cards Against Humanity. Dr. Drevyn is always an amazing host, and the dinners were worth every penny. Photo courtesy of Dr. Elsa Drevyn
Third Year DPT Students Participate in Interprofessional Education Week By: Dr. Greg Hartley, DPT Interprofessional Education is vital in a collaborative healthcare environment. Not just for patient safety (the theme of the IPE event), but also for improving patient outcome. This kind of collaboration between nursing, medicine, and PT teaches participants about the roles and responsibilities of the other professions, builds leadership skills, fosters communication skills, and sets up participants for successful roles on interprofessional teams in the future. Feedback from the course was overwhelmingly positive. One comment that stuck with me (made by a medical student) was, “PT’s are vastly underutilized.” I believe our presence had a profound effect on the dynamics of the week. Everyone benefited, but the profession of PT likely stands to gain the most from this initial experience.
IPE Week was amazing and gave PT students an opportunity to learn alongside UM’s finest while also advocating for our profession. It was really eye opening to learn about medical errors that occur and the steps each person can take to prevent them. I enjoyed meeting other students and discussing medical issues, topics and contemplate ways to improve. This learning experience impacted my growth as an SPT because as a PT student interesting in the acute setting, it really brought learning to life and was a great experience to have before embarking on acute clinicals. ~Allie Lawing
Photos courtesy of Dr. Greg Hartley
Professional Development The National Student Conclave was held in Portland, Oregon on October 19-21, 2017. DPT Student Amber Horn attended the conference as a student representative for the Federal Physical Therapy Section of the APTA. Highlights from the conference included a keynote speech from USA Champion runner Alysia Montaño about the benefit of Physical Therapy for injury prevention and performance enhancement. Amber also had the opportunity to attend a town hall with APTA President Sharon Dunn, PT, PhD as well as various workshops offered throughout the weekend focused on professional development and improving confidence in Physical Therapy student practice. “I particularly enjoyed the adaptive sports lecture,” Amber said of the Adaptive Sports: PTs Within the US Paralympics Workshop, which was designed to bring awareness to athletes with physical disabilities and opportunities for physical therapists to work within the US Paralympics. “I really wanted to know more about how PTs can get involved in this realm of service.” Amber learned about different routes she can pursue in hopes of becoming a physical therapist for paralympic athletes and is currently seeking local opportunities to gain more experience.
Dr. Neva Kirk-Sanchez, Dr. Teresa Glynn, Dr. Elsa Drevyn, and third year DPT student Johanna Segura presented a poster at the Educational Leadership Conference (ELC) that took place in October, showcasing the collaboration between the pro-bono LAGO clinic and the Spanish for Physical Therapists elective offered each summer and taught by Dr. Drevyn. The educational model was showcased and garnered great foot traffic and interest.
UM DPT Students and Dr. Michelle Raya, PhD, PT, SCS attended the 2017 Sports Health Symposium at Nicklaus Children’s Hospital on Satudary, November 11th. The symposium featured lectures in injury prevention and return to sport for the pediatric and adolescent athlete. The interdisciplinary symposium included discussions led by physical therapists and physicians in topics ranging from visual skills training to sports medicine for children with special health care needs.
Representation & Recognition Congratulations to Annie Palermo PT, DPT on selection of her Promotion of Doctoral Studies I grant application for funding by the Foundation for Physical Therapy. The proposed work entitled “The relationship of Orthostatic Hypotension and Maximal Inspiratory Pressure in Spinal Cord Injury” was the highest scored award, and was thus also designated as the 2017 Patricia Leahy Award for the outstanding PODS application in neurology. The study will form the foundation for her pre-dissertation work. ~Mark S. Nash, Ph.D., FACSM
Congratulations, Dr. Gray!
The Mary McMillan Scholarship Award honors students currently in their last year of an accredited program for their superior scholastic ability and measurable potential for future contributions to both the physical therapy profession and the American Physical Therapy Association. This past June, Megan Gray, DPT of the Class of 2017, was presented with this prestigious award at the NEXT Conference in Boston. Dr. Gray graduated this past May with her clinical doctorate in Physical Therapy, but reminisced on her
fondest memories at the University of Miami, noting the projects that she had invested time into. Dr. Gray was involved in the annual Hurricane Challenge and Sabrina’s Adaptive Beach Day, helping establish a relationship with the organization that current DPT students continue to volunteer through. “It was a lot of work,” Megan recalls, “but it was well worth it to see the smiles on faces. I can remember those feelings really well.” Dr. Gray remembers the moment she received the phone call marking her for the acknowledgement and the swarm of emotions she experienced, including feeling incredibly honored. “I couldn’t fathom this happening, [I was] amazed that the things I had been involved with were recognized to that level.” Her humility was
underscored by her regard for her classmates, who she states were inspiring in their own pursuit of personal endeavors and service projects. Dr. Gray truly felt that she was built up by the people around her. “[It was] great to be able to represent the program at that level,” she said. “Nothing I had accomplished would have been possible without the support of my classmates and faculty.” After graduating, Dr. Megan Gray spent a month traveling in Europe and went on to accept a position at Back on Track Physical Therapy, an outpatient orthopedics clinic, in Boston this past August. She is currently integrating her love of aquatherapy into her interventions, finding joy in the providing her patients with a supportive environment.
Representation & Recognition At the national level... The University of Miami Department of Physical Therapy is proud to have Dr. Martha Bloyer, PT, DPT, PCS, Dr. Lori Gusman, PT, DPT, and Dr. Greg Hartley, PT, DPT, GCS representing the state of Florida as delegates to the American Physical Therapy Association. Representing diverse interests and specialties, Drs. Bloyer, Gusman, and Hartley serve as members of the House of Delegates, the APTAs policy-making body. Members meet throughout the year to discuss national level bylaws and motion changes that affect the profession of physical therapy. Dr. Lori N. Gusman, PT, DPT, MS has also been elected as academic representative at large for the National Consortium of Clinical Educators
(NCCE). The NCCE represents academic and clinical educators and serves as a resource and forum for individuals who have professional interest and responsibilities for the implementation and evaluation of clinical education for physical therapists. With her experience serving as Director of Clinical Education for the DPT program, our department is proud of Dr. Gusman’s achievement and commitment to professional development and clinical education.
At the state level... Dr. Elsa Drevyn, DPT currently serves as the Chair of the Florida Consortium of Clinical Educators (FCCE). Dr. Drevyn serves as our department’s Associate Director of Clinical Education and has led APTA courses for Clinical Instructor Credentialing. As chair of the FCCE, Dr. Drevyn demonstrates her dedication to the development and support of physical therapy and physical therapy assistant students throughout the state of Florida.
Dr. Eileen D. Garay, a clinical assistant professor within our department, serves as District Director of Membership, and assistant instructor Dr. Zahilly G. Salinas serves as District Director of Public Relations for the Florida Physical Therapy Association’s Southeast District.
Thirty attendees, including graduates and faculty members of Keiser’s Physical Therapy Assistant Program, were present at the Clinical Instructor Program, picture above.
Keisure University Fort Lauderdale hosted the Physical Therapy Association Credential Clinical Instructors Two Day Workshop with Instructor Elsa Drevyn, DPT in Augustt 2017. Dr. Drevyn serves as our associate director of clinical education.
Congratulations to first year DPT student Nathan Kuck for setting a new school record at the 2017 ACC Cross Country Championships!
CONTINUED FROM RESEARCH SPOTLIGHT ON PAGE 11 Dr. Ignaucio Gaunaurd and model Jennifer Lopez (pictured left) demonstrate the ReLOAD device at the ACCelerate: ACC Smithsonian Creativity and Innovation Festival in Washington, D.C. this past October.
About the Editor
“I was tasked with the mission of reviving the PT Pride newsletter, and through this process I had the pleasure of seeing first hand how involved and accomplished the members of our department truly are.”
facebook.com/UMiamiPT youtube.com/UMiamiPT pt.med.miami.edu
Marthy Brave, a current second-year DPT student, earned her To submit news regarding alumni Bachelor of Arts in Psychology from the University of Miami in activities, department updates, or 2016. Her journey to become a physical therapist began with a other newsworthy events within the desire to help children with developmental disabilities and a Department of Physical Therapy, passion for wellness. Originally from Miami, she enjoys reading, please contact Marthy Brave at visual and performance arts, and community outreach. email@example.com.
Continuation from Research Spotlight, page 11 onwards.