Perspective: Impact of the IIISTEP Conference on Clinical Practice

Journal of Neurologic Physical Therapy,  Sep 2006  by Callahan, Janet,  Parlman, Kristin,  Beninato, Marianne,  Townsend, Elise

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ABSTRACT

In July 2005, physical therapy clinicians, educators, and researchers gathered for the IIISTEP (Symposium on Translating Evidence to Practice) conference. The purpose of IIISTEP was to link research and clinical practice through the exchange of ideas and research findings between scientists and clinicians. This paper represents the personal perspective of a group of colleagues who attended IIISTEP as clinicians/educator teams. The purpose of this paper is to illustrate how information from IIISTEP has challenged our existing concepts regarding physical therapy practice and begun to alter our clinical practice. Some key concepts presented by scientists and clinicians at IIISTEP are reviewed including current perspectives on neuroplasticity and frameworks for considering function, health, and the disablement process. Considerations for clinical application are outlined. Patient cases are used to illustrate how integration of this information has altered our approach to patient management.

Key Words: rehabilitation models, neuroplasticity, skilled movements, practice

INTRODUCTION

Recent advances in neuroscience, motor learning and control, and evidence-based practice are contributing to an evolution in physical therapy education and practice. As part of this evolution, 632 clinicians, educators, researchers, neuroscientists, movement scientists, biotechnologists, and representatives from the National Institutes of Health gathered in July 2005 for the I1ISTEP (Symposium on Translating Evidence to Practice) conference. The mission of IIISTEP was to link research and physical therapy practice through the exchange of ideas and research findings between basic and clinical researchers. Scientists, expert clinicians, researchers, and educators presented the latest research in the fields of neuroplasticity, motor control, and rehabilitation as well as current concepts surrounding models of rehabilitation and clinical practice. The conference was also intended to foster dialogue between the scientific and clinical communities to assure that evidence-based interventions reach the consumers of physical therapy. Participants were encouraged to attend as clinician/educator teams to both promote academic-clinical partnerships and facilitate application of the knowledge and insights gained at IIISTEP into physical therapy practice and education.

We are a group of IIISTEP participants, comprised of both clinicians and educators, who hold clinical and/or academic positions at Massachusetts General Hospital and the MGH Institute of Health Professions. We include 2 clinicians and 2 educators. The clinicians practice in an outpatient (JC) and in-patient (KP) adult neurological settings. They have 28 (JC) and 14 (KP) years of clinical experience, respectively. Their academic degrees include a Bachelor of Science and Masters degrees in physical therapy (JC), and a Masters degree and a Doctorate (DPT) in physical therapy (KP). Both clinicians are board certified neurologic clinical specialists. One of the educators (MB) has a Doctorate (PhD) in anatomy with an emphasis in neuroscience, a Bachelor of Science degree, and a Doctorate (DPT) in physical therapy. She has 17 years experience teaching neuroscience and neuropathology content in professional-level physical therapy programs. She does not currently have a patient care practice. The other educator (ET) has her Doctorate (PhD) in child psychology, a Masters and a Doctorate (DPT) in physical therapy and 9 years clinical experience in various in-patient pediatric settings. She is primarily responsible for the pediatric content in our professional-level curriculum.

Attending the conference as teams fostered collaboration in identifying ways to best incorporate information from IIISTEP into our clinical practices and classrooms. Upon returning from IIISTEP, we met on a regular basis to continue to dialogue and reflect on the information presented at the conference. Our intent was to foster discussion surrounding integration of the concepts from IIISTEP into our clinical practice and to determine the best strategies for disseminating IIISTEP content to our colleagues and students. Our collaboration resulted in the development of formal presentations as well as the integration of principles into case reports, patient care strategies, and curricular content. We continue to support and challenge each other in this process.

The purpose of this paper is to illustrate how information from IIISTEP has challenged some of our pre-existing concepts regarding physical therapy practice and begun to alter clinical practice in our various settings. Although not all of the information presented at the conference was new, there was a consolidation and reframing of relevant information, from our perspective, that allowed for the possibility of new conclusions. This paper represents a personal perspective of the impact of the IIISTEP experience on this team of clinicians and educators. It is not our intent to review all the information presented at IIISTEP. Although a vast amount of information covering years of clinical and scientific research was reviewed and discussed, our purpose here is to highlight how certain key points have affected and continue to shape our thinking.