Category: Winter 2011 Newsletter
It’s hard to believe we are beginning the second year of our Center. We are fully staffed and working hard towards achieving ENACT’s goal of “making a difference in the lives of people with arthritis and rheumatic conditions such as lupus, scleroderma, and fibromyalgia.” We have exciting projects in progress, talented people in place, and great things on the horizon. In this issue we update the status of our research program area, discuss our training program, roll out our new “Interact with ENACT” educational series, and highlight the excellent work of four Boston University Doctor of Physical Therapy students who have worked with ENACT over the past year.
Our two clinical trials are now in the field and, as researchers know well, it feels great to be enrolling people and exciting to be testing our interventions. For details on our employment retention and exercise adherence studies please visit www-test.bu.edu/enact/research-projects. Our 3rd research study, under the direction of Dr. Jessica Maxwell, is also underway. Dr. Maxwell is analyzing data examining participation outcomes after total joint replacement.
We launched our pre-doctoral training program, welcomed our first two doctoral fellows, and we have the additional privilege to host a visiting scholar. Together, they bring us vast experience and interests from national and international entities, including the World Health Organization. We look forward to the exceptional work that our fellows and visiting scientist will accomplish over the upcoming years. You can learn more about their interests in this newsletter.
Lastly, this issue highlights ENACT’s Director of Training, Dr. David Felson. We are enormously grateful for his leadership of our training program and for his exceptional contributions to the field of rheumatology and epidemiology. Dr. Felson’s sincere interest in advancing rehabilitation in rheumatology will be imparted to our fellows during their training with ENACT. Dr. Felson is an extremely accomplished researcher and mentor and we are fortunate to have someone of his caliber working with our fellows.
On behalf of all of us at ENACT, we wish you a wonderful holiday season and a Happy New Year!
Be well, keep moving, and stay in touch with us!
Julie Keysor, PT, PhD
Director of ENACT
Work It Study Examines the Efficacy of a Modified Vocational Rehabilitation Intervention
Work is an important part of people’s lives. However, people with chronic conditions may have difficulty remaining employed, especially if they do not know how to request appropriate accommodations. ENACT researchers, Drs. Keysor and Allaire, launched the Work It study to tackle this problem.
The Work It study will examine whether a brief job accommodations educational program utilizing the Work Experience Survey for Persons with Rheumatic Conditions (link here for the survey WESRC1), decreases work disability. The study is actively recruiting individuals with arthritis or other rheumatic conditions, such as lupus and fibromyalgia, who are concerned that their health condition will affect their ability to remain employed. For more information link to our website: www-test.bu.edu/enact/2011/10/21/workit_recruitment. Stay tuned for more updates!
BOOST Determines the Benefit of Using Technology to Improve Adherence to a Strength Training Program for People with Knee Osteoarthritis
A multitude of studies have now shown that strength training is an effective treatment to improve pain and function in knee osteoarthritis and it is recommended for the management of knee osteoarthritis. Even with this recommendation, less than 15% of individuals over the age of 65 report doing any strength training and there is poor adherence long term . We need to provide programs to motivate people first to engage and second to adhere to a strength training program. ENACT researcher, Dr Baker, is conducting a clinical trial, Boston Osteoarthritis Strength Training Study (BOOST), to address the low participation rate in strength training in this population.
In BOOST our objective is to engage participants in strength training and motivate them to adhere over the long term using state of the art technology, telephone linked communication (TLC), which has been shown to improve adherence in other health behaviors. We are currently enrolling individuals with painful knee osteoarthritis interested in participating in a long-term strength training trial.
ENACT Study Investigates Community and Home Participation Outcomes after Total Knee Replacement
Over the last decade, there has been a dramatic increase in total knee replacement surgery for people with knee osteoarthritis and rheumatoid arthritis. The goal of surgery is to help people stay active and involved, but little is known about factors that affect these outcomes.
ENACT researcher, Jessica Maxwell, is actively engaged in research to address this problem. She will examine home and community participation among persons who have had total knee replacement surgery in the last two years. The study will identify factors that increase an individual’s risk for reduced participation in everyday activities after surgery. We look forward to sharing our discoveries with you!
Rawan AlHeresh, MS, OT joined ENACT’s training program in July 2011 as the first pre-doctoral fellow. Rawan brings tremendous expertise and a unique international perspective to ENACT. Rawan has worked with the Community-Based Rehabilitation program to share her occupational therapy expertise in Palestinian Refugee camps. This program, which is supported by the United Nations (UN) and World Health Organization (WHO), advocates for the social equalization of persons with disabilities in developing countries.
Rawan comes to ENACT with impressive academic credentials. She holds a BS degree in Occupational Therapy from the University of Jordan and an MS degree from Brunel University in London. Before joining ENACT’s program, Rawan was a full-time lecturer in the Occupational Therapy Department at the University of Jordan’s School of Rehabilitation Sciences where she taught theory and clinical practice to students working with rheumatology patients at the University of Jordan Hospital. Rawan is one of 60 occupational therapists in Jordan, and one of only six in the country with an advanced degree. Upon receipt of her ScD in rehabilitation science from Boston University, she will be the first occupational therapist in Jordan to receive an academic doctoral degre in Rheumatologic Rehabilitation. Rawan plans to return to Jordan to advance the science and health care practice in rheumatologic rehabilitation. This area of practice is much needed in Jordan because rehabilitation is not covered by most insurance policies and, therefore, it is considered a luxury.
Rawan recognizes a clear need for the expertise she will gain through her ENACT fellowship. She says, “I feel lucky to be working with ENACT. I hope to take what I learn and apply it to improve health services, education and research in Jordan and become a national leader in the area of prevention, rehabilitation and policy revision.” Dr. Julie Keysor, Director of ENACT, notes, “Rawan is driven, focused and has good clinical questions. I have no doubt Rawan will improve the lives of people with arthritis within Jordan and beyond.” We extend a warm welcome to Rawan and eagerly anticipate the impact she will make on ENACT’s essential research and teaching content areas.
Aileen Ledingham, MS, PT joined ENACT’s pre-doctoral training program in September. She brings experience treating both young and old patients in both the United States and the United Kingdom. After graduating with a degree in physical therapy from Northeastern University in Boston, she worked as a physical therapist at New York-Presbyterian Hospital. A developing interest in pediatrics led her to complete a Master’s degree in pediatric physical therapy. In 2002, Aileen moved to the UK and specialized in neonatal intensive care.
During her physical therapy career, Aileen made two noteworthy transitions. The first was a shift from direct patient care to a management position at the UK’s National Health Service. This position provided her an opportunity to observe, first hand, the similarities and differences between US and UK health care systems. In her second career transition, Aileen returned to clinical practice with a focus on providing care to geriatric patients.
Aileen’s transition from newborns to geriatric patients provides her with a unique perspective and an ability to address issues that affect health and functioning across the lifespan. Recently, she returned to the States and decided to pursue a doctoral degree. When she learned about the ENACT pre-doctoral fellowship, she knew it was a good match! The program will give Aileen an opportunity to develop the expertise needed to establish a line of research that will help advance rheumatologic rehabilitation. As part of the ENACT team, Aileen’s research will investigate methods to prevent disability and promote activity among older adults with knee osteoarthritis.
According to Aileen, “ENACT’s interdisciplinary approach presents a unique opportunity to learn and develop research skills. The dedicated and enthusiastic faculty who are so willing to share their expertise are a real strength of this fellowship program.” We welcome Aileen to the ENACT team and anticipate that she will make significant contributions during her fellowship and throughout her career.
Cindy Mann, RN, MSc recently joined ENACT as a visiting research scientist from the United Kingdom. Cindy brings both a clinical research and a nursing background to ENACT. While at ENACT, she will investigate interventions aimed at strengthening the role of primary care nurses in arthritis intervention and rehabilitation.
Cindy’s nursing career has focused on primary care and she has specialized in rheumatology practice. Her research is focused on rheumatologic and musculoskeletal conditions with the goal of improving care for people with arthritis at the primary and specialist care levels.
ENACT’s Training Program Director, Dr. David Felson, encouraged Cindy to join ENACT as a visiting scientist. Based on her strong research and clinical background, she found that her interests matched well with ENACT’s focus on research and rehabilitation for improving the lives of persons with rheumatologic conditions.
Cindy is currently working on a grant application to investigate the potential role of nurses in improving arthritis care. This grant will support her pursuit of a doctoral degree. The focus of the grant is to train nurses to run osteoarthritis clinics in primary care settings. Currently, in the UK, persons with osteoarthritis receive care from general practitioners. Patients are rarely referred to specialists until joint replacement is required. As a result, there is tremendous variability in the quality and levels of care. Nurses who complete Cindy’s training program would provide patients with expert, evidence-based information and support from the time of diagnosis, instead of waiting until there is a crisis.
The overall aim of the Cindy’s proposed research is to reduce the restriction of daily activities people with osteoarthritis often experience, which aligns with ENACT’s mission. We welcome Cindy’s expertise and are pleased to support her work to advance arthritis interventions during her tenure as ENACT’s visiting research scientist.
Sara Crandall, candidate for a Doctor of Physical Therapy degree at Boston University, initiated our podcast series, Active Living with Arthritis. Look for the following podcasts as we develop our “Interact with ENACT” program area:
- Top Ten Reasons to Exercise with Arthritis
- Ready to Move with Arthritis: Things to Know Before You Lace Up Your Sneakers,
- Guidelines Guidance: What to Do, How Much to Do, and How Hard to Work When Exercising with Arthritis
- Bumps in the Road Part 1: Finding the Time for Exercise
- Bumps in the Road Part 2: Finding the Place for Exercise.
Sara’s podcasts for ENACT bring evidence-based information to adults with arthritis seeking to learn how they can initiate and sustain active lives. In these podcasts, Sara adeptly highlights physical activity benefits and guidelines yet recognizes that sustaining physically active lifestyles can be quite challenging for people with chronic painful conditions. The podcasts provide innovative ideas for overcoming common barriers and hopes to generate a mechanism for people with arthritis and related conditions to maintain active lifestyles.
Three New Arthritis Foundation Exercise Program Instructors for the Community
Congratulations to Stefanie Howlett, Janice Chen, and Laura Furey – candidates for the Doctor of Physical Therapy degree at Boston University – for their new Arthritis Foundation Exercise Program certification. ENACT continued its partnership with the Arthritis Foundation, New England Region through implementation of a new exercise class at The Reggie Lewis Track and Field Center (RLC) located in Roxbury, Massachusetts. Stefanie, Janice, and Laura implemented this innovative 14-week exercise program for the Sensational Seniors group at the RLC. Ms. Cheryl McDermott, Fitness Coordinator at the RLC, provided guidance and support to the students while they implemented the AFEP. Many thanks to the Arthritis Foundation and Cheryl for supporting these activities!
The Reggie Lewis Track and Field Center strives to optimize health and fitness among children and elders in Boston urban communities. The Sensational Seniors are a vibrant group of older adults striving for good health, strong muscles and bones, and active living. They truly are SENSATIONAL! Stefanie, Janice and Laura loved working with them and are very grateful for the wonderful experience they provided. ENACT hopes to continue collaborating with institutions such as the RLC to provide opportunities in activity enhancement as we continue our community outreach activities
Spotlight on Training: David Felson, MD, PhD, World-Renowned Rheumatology Expert, Mentors ENACT Scientists
Under the direction of Dr. David Felson, ENACT offers a unique, world-class training program in rheumatologic rehabilitation. Dr. David Felson, an international expert in clinical research in osteoarthritis and rheumatology, is the author of more than 400 peer reviewed publications and recipient of numerous grants and awards. Felson is a Professor of Medicine & Epidemiology at Boston University’s School of Medicine, Chief of the Multidisciplinary Clinical Research Center Grant, and Associate Director of the Clinical Translational Science Award Training Program. His commitment to advancing the science of rheumatologic rehabilitation is evidenced by the many researchers who have benefited from his mentorship.
It is unusual for non-physicians to have an opportunity to engage with a researcher of his caliber. However, Felson is eager to share his expertise with ENACT Pre-Doctoral Fellows because he recognizes the link between providing quality research training programs and improving the quality of care. According to Felson, “What we do therapeutically is not based in strong evidence and we need better evidence to advance practice.” His primary interest lies in helping ENACT fellows structure well-designed research studies that will spearhead the development of effective interventions and provide the ability to tailor treatments to individuals. Under Felson’s guidance, ENACT will develop a cadre of new scientists who are able to ask the right questions and produce significant contributions to strengthening the evidence for rheumatologic rehabilitation. ENACT pre-doctoral fellows pursue a doctoral degree in rehabilitation science and receive mentoring from Dr. Felson to become strong clinical researchers.
ENACT’s doctoral trainee program is fully supported by Boston University. Fellows receive tuition remission and a stipend as they pursue an academic research doctoral degree. A unique feature of ENACT’s program is its interdisciplinary focus. Trainees have opportunities to learn from and work with experts from Boston University’s College of Health and Rehabilitation Science, Health and Disability Research Institute (under the direction of Dr. Alan Jette), and the Clinical Epidemiology Research and Training Unit (under the direction of Dr. David Felson). Through this program, fellows develop knowledge and skills in clinical and health services research, rheumatological rehabilitation, public health, and disablement-enablement.
Keep an eye on ENACT fellows! These well-trained researchers will make significant professional contributions as they add their expertise to field of rheumatologic rehabilitation.