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Click here to view all stories from our Year End 2016 Newsletter
Part of the mission of ENACT’s Rehabilitation Research and Training Center grant is to contribute to the future of rheumatological research by supporting doctoral students to obtain advanced degrees in rehabilitation science. In addition to tuition support, ENACT doctoral fellows assist in ongoing ENACT research and receive rigorous, interdisciplinary mentoring. Two ENACT doctoral fellows have completed their training and are now working in the field.
Rawan AlHeresh, PhD, OT, completed the doctoral program in July 2015 and was accepted as an Advanced Rehabilitation Research and Training postdoctoral fellow at Boston University’s Health and Disability Research Institute, where she pursued her interest in outcome measurement. This postdoctoral fellowship program is supported by the National Institute for Disability Independent Living and Rehabilitation Research (NIDILRR). During her fellowship, Dr. AlHeresh worked with Elizabeth Marfeo, PhD, MPH, OTR/L, an Assistant Professor within the Tufts University Occupational Therapy Department and forged connections with researchers there. She will be joining Mass General Hospital’s Institute of Health Professions in the Department of Occupational Therapy in January.
Molly Vaughan, PhD, DPT, completed the doctoral program in April 2016 and began working as a Research Associate on ENACT’s Walkability Study, a collaboration with the University of North Carolina’s Thurston Arthritis Center funded jointly by the Centers for Disease Control (CDC) and Arthritis Foundation. Molly recently accepted a position with RTI International as a Research Public Health Analyst where she will be working on post-acute care setting outcome measure development and standardization as part of the Impact Act of 2010.
We look forward to the contributions of these scholars over the coming years! See more of our fellows’ work in the newsletter publications summary.
Click here to view all stories from our Year End 2016 Newsletter
Keep a look out for upcoming webinars where we’ll disseminate findings from our 2-year randomized controlled trials: 1) Efficacy of a Modified Vocational Rehabilitation Intervention for Work Disability (the “Work it Study”), and 2) Can computer-based telephone counseling improve long-term adherence to strength training in elders with knee OA? (the BOOST study).
In the Work It Study, we evaluated whether a job barrier identification and solution generation process delivered by trained occupational and physical therapists minimized work disability among people with rheumatic and musculoskeletal conditions who were at risk of work loss over the upcoming few years. This study addresses an extremely important outcome for people with chronic rheumatological and musculoskeletal conditions, with estimates showing approximately 33% of people with these conditions are unemployed within 10 years of diagnosis.
The BOOST study investigated if a remote interactive technology intervention could improve adherence to a strength training program over 2 years in people with knee OA more than an automated message to encourage adherence. The efficacy of strength training to impact pain and function for people with knee OA is well-established, but less than 15% of individuals over age 65 report doing any strength training and poor long-term adherence has been observed in other trials. An effective approach to encourage adherence to strength training activity could be helpful for this population.
Once the manuscripts are accepted and in press, we will host webinars to share our results. Stay tuned! We think we have important findings for the field and welcome discussion with our colleagues.
Click here to view all stories from our Year End 2016 Newsletter
If you’ll be in San Antonio in February for APTA-CSM, Julie Keysor, PhD, PT, will be there presenting results from the “Work It Study” trial. Physical therapists delivered a novel intervention addressing work-related barriers and solutions among adults with chronic rheumatological and musculoskeletal conditions who were at risk of work loss due to their health. This study could lead the way for therapists to intervene to prevent work disability for a population that is at high risk of work loss.
ENACT pre-doctoral fellow Aileen Ledingham, PT, MS will also be presenting her poster “Adults with Knee Osteoarthritis: Perspectives on Telephone Technology to Support Adherence to Exercise”, an ancillary qualitative study to ENACT’s BOOST trial. With her study, Ms. Ledingham explores the BOOST participant’s thoughts and perspectives on the technology used in the BOOST adherence study. Ms. Ledingham’s work may lead to novel ways to promote adherence to physical therapy programs.
ENACT investigators also brought the results of both randomized controlled trials to the arthritis research community at the November 2016 ACR/ARHP Annual Meeting in Washington, DC.
Dr. Keysor presented the main results from the “Work-it” employment outcomes study during a joint ACR/ARHP on November 15th and Kristin Baker, PhD, presented results from the “BOOST” trial on November 16th.
In addition, recent ENACT graduate Molly Vaughan, PhD, DPT, presented her dissertation research to the ACR/ARHP audience. Her work, which analyzed data from the Multicenter Osteoarthritis Study (MOST) to examine, looked at the relationship between positive/negative affect and participation restriction among persons with knee osteoarthritis.
Did you miss these presentations? You can still find abstracts for all three talks here
ENACT's recent webinar "The Work-it Study for People with Arthritis: Study Protocol and Baseline Sample Characteristics" is now available (free) on YouTube.
Part of the Learn at Work webinar series, the hour-long presentation gives an overview of the background, methods, and baseline sample characteristics for ENACT's 2-year longitudinal randomized controlled trial on work disability outcomes for people with arthritis, "Efficacy of a Modified Vocational Rehabilitation Intervention for Work Disability" (more on the trial here).
Director and Principal Investigator for the "Work-It" study Julie Keysor, PhD, PT and Health and Disability Research Institute postdoctoral fellow Rawan AlHeresh, PhD, MS, OT delivered the talk with Karen Jacobs, EdD, CPE, OTR/L, FAOTA, founding editor of WORK: A journal of Prevention, Assessment, and Rehabilitation, as moderator.
Watch the full presentation, here:
ENACT’s presence at this year’s American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP) Meeting will focus on bringing the results of ENACT's two randomized controlled trials to the arthritis research community. Both trials achieved excellent retention over two years of subject follow-up. The meeting will take place November 11-16, 2016 in Washington, DC.
Dr. Julie Keysor, PhD, PT, will present the main results from the "Work-it" employment outcomes study during a joint ACR/ARHP session on Tuesday, 11/15/16, from 4:30-6pm. Her talk is titled “Efficacy of a Work Disability Prevention Program for People with Rheumatic and Musculoskeletal Conditions: A Randomized Controlled Trial.” Read the abstract here
Dr. Kristin Baker, PhD, will present results from the "BOOST" exercise adherence study on Wednesday, 11/16/16 from 11-12:30pm. Her ARHP talk is titled "A Randomized Trial of Automated Telephone-Linked Communication to Improve Exercise Adherence for a Progressive Resistance Training Program in People with Knee Osteoarthritis." Read the abstract here
Dr. Molly Vaughan, PhD, DPT, will present her work with the Multicenter Osteoarthritis Study (MOST), "Incident Participation Restriction in Adults with Knee Osteoarthritis: Do Positive and Negative Affect Matter? The Multicenter Osteoarthritis Study." Visit her during the Sunday AM poster session from 9:00-11:00. Read the abstract here
Don't miss these exciting talks! Keep an eye on ENACT’s Presentations page for full presentation slides (coming soon)!
Two manuscripts related to ENACT's work on employment retention have recently been accepted for publication.
The Work-It Study:
Findings from Dr. Keysor's research on preventing work loss among people with arthritis has been accepted by the WORK Journal. The article details the sample characteristics for the Work-It study, a randomized controlled trial testing the efficacy of a problem solving program to prevent work loss over a two-year period among people with arthritis and rheumatological conditions. Read the full abstract here
The main results for this trial will be published soon!
Keysor JJ, AlHeresh RA, Vaughan M, LaValley M, Allaire SA. The Work-It Study for People with Arthritis: Study Protocol and Baseline Sample Characteristics. WORK Journal. 2016 Jun 14.
Work Outcome Measurement:
Doctoral fellow Rawan AlHeresh, PhD, OT, recently had her dissertation research accepted for publication by Arthritis Care and Research. The article is a systematic review assessing the literature on the measurement properties of work functioning instruments for people with arthritis and other rheumatological conditions. Read the full abstract here
AlHeresh R, Vaughan M, LaValley M, Coster W, Keysor, JJ. (2015). Critical appraisal of the quality of literature evaluating psychometric properties of arthritis work outcome assessments: A systematic review. Arthritis Care Res (Hoboken). 2015 Dec 17. doi: 10.1002/acr.22814. [Epub ahead of print]
Read more ENACT faculty publications here
A huge congratulations to our former ENACT doctoral fellow, Molly Vaughan, PhD, DPT, on successfully defending her dissertation and completing her course of study with the Sargent College of Health and Rehabilitation Sciences-Doctor of Rehabilitation Sciences Program at Boston University.
Dr. Vaughan entered ENACT’s training program in September 2012 with a background in architectural design and physical therapy. She attained her Doctor of Physical Therapy degree at Boston University's Sargent College. While at Sargent College, Molly was mentored by Dr. Julie Keysor, ENACT’s director. Under Dr. Keysor’s guidance, Molly assisted with the development of Access Wiki, a navigational tool to help people with disabilities avoid built environment barriers in order to increase their participation. This is an important contribution because, as Molly says, “the barriers that the environment may pose to both older people or people with disabilities may accelerate their loss of function and disability.” The experience motivated her to pursue her Doctor of Science in Rehabilitation Sciences. Molly says, “Dr. Keysor has conducted environmental research in rehabilitation, and her intelligence and passion for this topic were instrumental in my decision to pursue a PhD at Sargent.” At ENACT, Molly worked on ENACT research projects, including the Work IT vocational retention project.
Upon completion of her degree requirements, Dr. Vaughan has stayed on at ENACT as a research associate and is pursuing other opportunities as well.
We look forward to watching Dr. Vaughan’s contributions to the field over the coming years. Congratulations Molly!
We are excited to report that all three research projects supported by our Rehabilitation Research and Training Center (RRTC) grant through the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) have concluded data collection and final analyses are underway.
Through the diligent work of our center staff, our two RCTs achieved excellent retention, with both above 85% at 2-year follow up. In addition, we achieved high participation of underrepresented minorities (at nearly 30%) in both trials.
Continue below for project-specific updates:
Project 1 “Efficacy of a Modified Vocational Rehabilitation Intervention” (WORK-IT)–
Also called “Work-It”, our first of 2 randomized controlled trials investigated if a modified vocational rehabilitation intervention could affect work limitation outcomes among people with arthritis over two years of follow-up compared to people receiving a control intervention. Data collection concluded in December 2015 with the largest sample to date for an arthritis employment retention study! We anticipate disseminating primary results in 2016.
Project 2 “Can computer-based telephone counseling improve long-term adherence to strength training in elders with knee osteoarthritis?” (BOOST) –
Our second randomized controlled trial, the “BOOST” study, aimed to compare outcomes for participants with knee OA randomized to either a computer-based telephone counseling (TLC) or control group and determine whether or not TLC enhances adherence to and participation in exercise over 2 years. The study also aimed to determine the association of function and pain at 1 year and 2 years with adherence to the exercise program at the same time points. Data collection concluded in November 2015 and we anticipate disseminating primary results in 2016.
Project 3 “Community and Home Participation after Total Knee Replacement” –
ENACT’s third study, with both observational and qualitative arms, has concluded both data collection and analysis and results are being disseminated. This observational study aimed to explore home and community participation among persons with a total knee replacements at least 2 years to determine the risk factors associated with limited participation using the data from the Multicenter Osteoarthritis Study (MOST). The study also had a qualitative arm, which aimed to gain insight into people’s perceptions of factors that influence participation among people experiencing difficulties following a total knee replacement procedure. Two manuscripts are pending. PI Dr. Jessica Maxwell recently presented results from the qualitative arm of this study at the American Physical Therapy Association Combined Sections Meeting (APTA-CSM).
Look for upcoming manuscripts from ENACT and for presentations on these results and more at upcoming professional conferences in 2016!
ENACT’s spotlight for the March 2016 Newsletter features Dr. Kristin Baker, Principal Investigator for ENACT’s BOOST study. Dr. Baker’s background is in exercise physiology and nutritional science and her primary research interest lies in improving functional quality of life for people living with arthritis.
In her current position as a Research Assistant Professor in the Physical Therapy Department of Boston University’s Sargent College of Health and Rehabilitation Sciences, Dr. Baker is leading ENACT’s BOOST trial, a five-year project investigating how best to support people with arthritis to adhere to physical activity using existing technologies and behavioral science theory.
In the BOOST study, ENACT recruited 104 people with knee osteoarthritis to participate in a group strength-training program with 3 primary focuses: body alignment and mechanics, achieving the proper exercise intensity to improve muscle strength, and learning to progress through the exercises for continued improvement in muscle strength over time. After the group strength training program, participants were randomized to receive one of 2 follow-up interventions, a non-interactive automated message to remind participants to exercise or an automated interactive telephone system providing coaching and counseling information to promote continued exercise.
Though the benefits of physical activity to improve arthritis pain and function have been established and are widely accepted, adherence to exercise programs remains low among people with arthritis. According to Dr. Baker, if a telephone-based supportive technology proves to be effective for people with arthritis, it could be a cost-effective way to reach a wide range of people with rheumatic conditions, even potentially, “improving quality of life, and maybe prolonging the time before they need a knee replacement or reducing the number of doctor visits for medication.” In the long term, says Dr. Baker, it could have implications for the practice of physical rehabilitation by enabling patients to better adhere to therapeutic physical activity recommendations.
As technology continues to advance, the field of rehabilitation is recognizing and acting on the potential for technology to serve as a resource that may be modifiable for use in different populations, including those with rheumatic conditions. Dr. Baker’s ultimate goal would be to widely disseminate the technology used in the BOOST study, thus adding another resource to the technology toolbox for rehabilitation practitioners and researchers.
Data collection for this study was completed in late 2015 and the efficacy of the interactive telephone system is now being assessed. In addition, research assistant and ENACT doctoral fellow Aileen Ledingham received an ancillary grant to assess participant satisfaction with the system. Look for results to be released in Spring 2016!
To read more from Dr. Baker on the use of technology in rehabilitation, access the ENACT Presentation page here
ENACT’s site may look different, but the URL is the same!
The newly updated site features a cleaner design and updated look, simplified navigation to promote access to under-utilized areas of the site, and both updated and new content areas. It is now optimized for mobile platforms and features increased font size throughout the site for enhanced readability. We’ve expanded content areas on exercise and employment and created new content on the impact of community environment on participation, our work with the University of North Carolina-Chapel Hill on neighborhood walkability, and total knee replacement (TKR).
Please take a look around around our new site! Click here to redirect to the homepage