First-Rate Rehab

SHP Positioned to Take Lead in Rehabilitation Science

By Rosalind Fournier

When the UAB School of Health Professions and the Lakeshore Foundation announced the formation of the first-of-its-kind UAB/Lakeshore Research Collaborative in 2009, job number one was to find the right person to serve as its inaugural director. The collaborative had a clear mandate—to spearhead groundbreaking research in rehabilitation science that brings together UAB’s research expertise with the Lakeshore Foundation’s life-enhancing programs for people with physically disabling conditions—but there was no preexisting model. The person chosen to lead it would play a defining role in plotting the course. “The first director needed to be capable of creating an exciting and compelling vision for the collaborative,” says Harold Jones, Ph.D., dean of the UAB School of Health Professions.

2013_coverstoryFrom left, James Rimmer, David Brown, and Brian Dudgeon are leading the way in UAB's new efforts in rehabilitation science education and research.In Jones’s mind, one person who fit all those requirements was James Rimmer, Ph.D., a longtime faculty member at the University of Illinois at Chicago (UIC) and also director of two federally funded centers focused on improving the lives of people with disabilities. “Dr. Rimmer is arguably the most recognized and accomplished leader in the area of physical activity and disability in the world,” Jones says. “To be honest, he was my choice from the very beginning.”

The question was, could he be lured to Birmingham? Rimmer says he enjoyed great latitude, support, and staff at UIC to set his own agenda. And on a personal level, he and his wife were firmly ensconced in their life in the Windy City.

Instead, he signed on as a consultant to help in the search for the first Lakeshore Foundation Endowed Chair in Health Promotion and Rehabilitation Sciences at UAB, and through that process, he grew more and more excited about the tremendous potential the position holds. “In my entire 32-year history in this field of work, this was the first position I encountered that was front and center of what I do,” Rimmer explains. He says he was also overwhelmed by the positive response he got from his contacts at the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and other federal agencies when they heard he was considering the move to Birmingham. “Everybody I spoke to said, ‘This is a great opportunity to work at a great institution.’” Rimmer started at UAB in January 2012.

The energy surrounding Rimmer’s hire and the new UAB/Lakeshore Research Collaborative reflects an even larger momentum to propel the School of Health Professions into the upper echelons of research for rehabilitation sciences nationwide. That push also includes another major initiative for the school: the launch in 2011 of a new Ph.D. in Rehabilitation Science, which ushered in its second wave of Ph.D. candidates this fall. Jones says the SHP is now poised to build world-class programs in rehabilitation science that are in keeping with the stature of the school’s other renowned programs. Its health administration program is ranked fifth in the nation by U.S. News and World Report, and the SHP is the only school in the country to have both an NIH-funded nutrition and obesity center and an NIH-funded diabetes research center. But while the school’s occupational therapy and physical therapy programs have long been respected for the quality of the education they offer, Jones says it’s time to build on those strengths by taking research to the next level. That focus is already apparent with the addition of two new centers— the National Center on Health, Physical Activity and Disability (NCHPAD) and the Rehabilitation Engineering Research Center (RecTech). Funded by the CDC and the National Institutes on Disability and Rehabilitation Research, respectively, the new centers effectively double the number of centers located in the SHP. (See Centers of Progress.)

“Rehabilitation science is the next logical place for us to become research leaders,” Jones says, explaining that the field goes beyond acute care in the immediate aftermath of an injury or onset of physically disabling condition into what he calls “post-rehab,” the work to study, assess, and improve patients’ long-term quality of life. “And the Lakeshore collaboration, paired with the new Ph.D. program, offers an opening into what is arguably the most important emerging field in health care today.”

Breaking the Mold

Just as Rimmer heightens the profile of the UAB/Lakeshore Research Collaborative, the new Ph.D. in Rehabilitation Science program comes with a top-notch recruit of its own in David A. Brown, PT, Ph.D., to serve as its inaugural director. Considered a leading expert in neurological rehabilitation, Brown was recruitedfrom Northwestern University, where his research focused on locomotor and balance dysfunction of people with neurological impairments. Along with being heavily involved with Northwestern’s Movement and Rehabilitation Science Track of the neuroscience program, he had 15 years of experience working as a clinical physical therapist. He is also the founder of a research, development, and engineering firm, KineaDesign, L.L.C., a subsidiary of HDT Robotics, which specializes in human interactive mechatronics. “Both temperamentally and in terms of background, Dr. Brown was a perfect fit to lead this new program,” Jones says.

David Brown, left, and postdoctoral fellow Christopher Hurt observe how the device protects a falling patient.
Sensors placed on the patient's skin provide researchers with precise data on the person's movement and gait.
As Brown and Capo-Lugo demonstrate the system, graduate student Deanna Rumble, right, checks data on a monitor.

At UAB, Brown saw an opportunity to build from the ground up a more dynamic, interdisciplinary Ph.D. program than he had experienced anywhere else. “The traditional Ph.D. model is that you take an individual and squeeze or mold them into something the program wants them to be,” he says. “As a former Ph.D. student who went through that process many years ago and has fought against it ever since, I made a promise that if I was ever in a position to change that way of doing things, I would do that. So this is now my opportunity. Similar to the rehabilitation process, our Ph.D. candidates will have the opportunity to actualize their own goals.”

 

SHP Welcomes Brian Dudgeon as Chair of Occupational Therapy

2013_dudgeonContinuing its momentum in building highly competitive programs in the rehabilitation field, the UAB School of Health Professions welcomed the arrival of Brian J. Dudgeon, Ph.D., OTR, FAOTA, as the new chair of the Department of Occupational Therapy in October 2012. 
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Brown envisions the program as one that transcends boundaries. “Rehab science is, and should be, a very interdisciplinary field,” Brown says. “It requires not just a focus on a particular body structure or function area of the human body, but also how that body structure or function relates to a health condition or disease process, and how it relates to that person’s ability to participate in life.

“UAB shares my point of view about science and education in general—that science should be a collaborative and integrated process where people and information from a variety of fields can coalesce around the work of coming to a broader, greater understanding of a problem,” he continues. “So I felt very excited and challenged by the idea of coming down here and putting together a program like that.”

In keeping with that mission, the first students accepted into the new Ph.D. program, which is housed jointly in the departments of Occupational Therapy and Physical Therapy, represent a broad spectrum of backgrounds and interests—from exercise physiology, physical therapy, music therapy, and experimental psychology— that all fall under the broad umbrella of rehabilitation science. In addition to working with the primary occupational and physical therapy faculty, the students are also encouraged to work with faculty from other departments on campus and beyond, including taking advantage of UAB’s external relationships with the Veterans Affairs Medical Center and now the Lakeshore Foundation to find research experiences that fit their needs and interests.

A New Frontier

For his part, Rimmer sees rehabilitation science as a field still in its infancy relative to its potential—a powerful statement given Rimmer’s own 30-plus years of experience at the forefront of health and exercise research for people with disabilities. Yet in the UAB/ Lakeshore Research Collaborative—or BLADE2S (Birmingham- Lakeshore Aging Disability Environment Exercise Study)—he envisions opportunities for research that cuts deeper and reaches farther than anything possible before now.

Centers of Progress
Two New Centers Coming to SHP

When James Rimmer joined the SHP faculty, UAB gained more than just a nationally renowned scientist. It also got two new federally funded centers.

A $3-million, three-year grant from the Centers for Disease Control and Prevention will fund the National Center on Health, Physical Activity and Disability, which is located in Birmingham as part of the UAB/Lakeshore Research Collaborative. The center focuses on the relationships between good health and physical activity in people with disabilities.

Additionally, Rimmer recently received a $6-million, five-year grant from the National Institute on Disability and Rehabilitation Research. The grant will fund the Rehabilitation Engineering Research Center on Interactive Exercise Technologies and Exercise Physiology Benefiting People with Disabilities (RecTech).

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“It’s a chance to serve as a catalyst for answering long-term, critical questions about the effects of physical activity and other areas of health promotion across the lifespan for people with disabilities,” Rimmer says. “For instance, research has established that exercise is not harmful to people with disabilities. But we don’t know why there is still such a high rate of inactivity among people with disabilities. Is it the built environment? Attitude? Lack of access? Secondary health conditions?

“The other part of the formula is building data and recommendations about the actual ‘dosing’ of exercise,” he continues. “There is a tremendous need to examine what types of exercise, how much, and so on produce the best results for different populations. Exercise is an elixir for depression, cardiometabolic disorders, osteoporosis, and many other disorders, but we don’t have clear answers in terms of what people with physically disabling conditions need to do to achieve similar results as the findings on non-disabled cohorts.”

He says one hindrance has traditionally been the challenge of recruiting large enough groups of study participants among people with disabilities. “Think about it,” he says. “If you’re an obesity researcher and need to find 500 women between the ages of 20 and 40 who are overweight, it’s a slam dunk. Now try doing that with 500 people with spinal cord injury when the total population of people with spinal cord injury is about 250,000 nationwide.”

Through the unique partnership with Lakeshore, however, researchers will have the built-in advantage of access to a large population of individuals representing a broad spectrum of physically disabling conditions who come to Lakeshore to make use of its stateof- the-art fitness and aquatics facility and to take part in recreational and education programs.

With several million dollars to build a research agenda and the potential to attract even more funding from other sources, Rimmer wants to invite researchers from across the UAB community who are interested in a specific disability group. “We need to have science that has a high level of inclusion, just like we need to have a high level of inclusion in health, fitness, and exercise,” he says. Long term, Rimmer believes the UAB/Lakeshore Research Collaborative will become the epicenter of rehabilitation science nationwide. “With data that no one else has anywhere in the world, we could be the model,” he says.