PHYS THER
Vol. 87, No. 5, May 2007, pp. 619-620
DOI: 10.2522/ptj.2007.87.5.619
Scholarships, Fellowships, and Grants |
News from the Foundation for Physical Therapy
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Recipients in the News
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Laura C Schmitt, PT, PhD, a Promotion of Doctoral Studies (PODS) II recipient (2004 and 2005) was recently awarded her PhD from the University of Delaware. The topic of her dissertation was "Knee Stabilization and Medial Knee Osteoarthritis." Schmitt is currently a postdoctoral fellow at the University of Cincinnati College of Medicine, Department of Pediatrics, Sports Medicine Biodynamics Center, Cincinnati Children's Hospital Medical Center.
Joanne M Wagner, PT, PhD, a Promotion of Doctoral Studies (PODS) II recipient (2004 and 2005) recently co-authored an article based on the research done while supported by her PODS awards. The article, "Upper Extremity Muscle Activiation During Recovery of Reaching in Subjects with Post-Stroke Hemiparesis," co-authored with Alexander W Dromerick, MD, Shirley A Sahrmann, PT, PhD, and Catherine E Lang, PT, PhD, appeared in the January 2007 issue of Clinical Neurophysiology (2007;118:164-176).
Sahrmann and Lang also are past recipients of Foundation funding. Sahrmann received Foundation funding in 1977 and 1978 and Lang was awarded Promotion of Doctoral Studies (PODS) II scholarships in 2004 & 2005.
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Nominations for Scientific Review Committee Due June 22
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The Foundation is seeking recommendations for individuals to serve on its Scientific Review Committee (SRC). Well-qualified physical therapist researchers will review doctoral, fellowship, and research grant applications received by the Foundation and will serve a 3-year term. To be considered, individuals must meet the criteria for SRC membership posted on the Foundation's Web site (www.FoundationforPhysicalTherapy.org). Self-nominations are welcome. Please e-mail your recommendations by June 22 to victoriamatthews{at}apta.org.
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Clinical Research Network (CRN) Update #13—Choosing the Appropriate Comparison Group: Considerations from PTClinResNet
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The barriers to conduct randomized clinical trials (RCTs) are not unique in rehabilitation. However, there are unique issues related to the development and implementation of trials in rehabilitation. For example, multidisciplinary or multifocal interventions, which are characteristic of rehabilitation practice, are necessary when dealing with patients with complex problems such as the disabling consequences of cerebral stroke, spinal cord injury, cerebral palsy, or low back pain. Also unique to rehabilitation is the "activity trial"—a trial in which the interaction between clinician and patient and the patient's engagement in the activity are critical. The 4 RCTs hosted by PTClinResNet are defined as "activity trials." In these trials, the behavior, attention, and thought of the individual are of extreme importance. Exercise and learning involve activity and participation, and, therefore, rely on complex interactions between the patient and clinician.
These activity trials pose yet another challenge—choosing the appropriate comparison group. In large part, because of the concept of clinical equipoise, it would be unethical to deny adaptive experiences and activities to participants in a comparison control group. Clinical equipoise means a genuine uncertainty on the part of the expert medical community about the comparative therapeutic merits of each arm of a clinical trial. Clinical equipoise provides a clear moral foundation to the requirement that the health care of subjects not be disadvantaged by research participation.1
For the 4 PTClinResNet RCT trials, it was important to provide the strongest possible basis for a causal inference so that the observed results of activity interventions could be attributable to that intervention and not to other factors. Fuhrer suggests that, "particularly strong causal inferences can be drawn from the randomized clinical trial in which participants are assigned on a random basis to either the intervention of interest or to a comparison condition."2(pS8)
In other words, the only difference between the treatment groups is the activity or intervention, with all other factors (eg, patient characteristics, motivation, etc) being equal across groups. This, in turn, requires knowledge of the factors that are likely to predict the chosen outcomes, regardless of treatment. Whyte and Hart3 call that the "active ingredient" of a complex intervention. Finally, and consistent with that knowledge, the choice of comparison group must be appropriate for the level of prior evidence and activity-specific research. For example, in the case of the Strength Training Effectiveness Post Stroke (STEPS) trial, a no-treatment control condition would not have met the criteria for clinical equipoise, particularly given prior evidence supporting a benefit from locomotor training after stroke. Instead, prior evidence supported a focus on the specific active ingredients of locomotor training by identifying an appropriate participatory comparison condition (ie, upper-extremity exercise), choosing paired interventions, and using a multiple group design. We outline the characteristics of the comparison/control conditions for each of the four RCTs and highlight the conceptual rationale in the summary Table.
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Foundation PT2007 Events Not to Be Missed
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Register for the Foundation's "Farewell to Frank" Dinner Dance
Don't miss the annual Foundation Dinner Dance on June 28 at PT 2007 in Denver, Colorado. Share in an evening of tributes and country music as the Foundation honors APTA's retiring CEO Frank Mallon, Esq. Tables for 10 are $2,000 and include a listing of your name, company, or organization in the program. Individual tickets are $150 ($100 for students). Order through APTA's Service Center at 800/999-2782, ext 3395, or online at www.apta.org/annualconference. Tickets will also be available at a Foundation table set up at the Omni Shoreham at the House of Delegates/Advocacy Academy. Be sure to include the name of a company or organization contact for a table purchase. Tickets will not be sold onsite in Denver.
PT: 2007 Session to Offer Advice on Applying for Foundation Funding
The Foundation will once again offer the opportunity for PTs and PTAs who are considering applying for Foundation scholarships, fellowships, and grants, to obtain expert advice and helpful tips at PT: 2007 APTA's Annual Conference and Exposition in Denver.
Plan to attend "Foundation Funding for Post Professional Doctoral Study: Options and Guidelines" on Friday, June 29, from 8:00 AM to 9:30 AM. The program will include 4 roundtable discussion groups, one for each Foundation funding program: Florence P Kendall Doctoral Scholarships; Promotion of Doctoral Studies (PODS) I & II; New Investigator Fellowship Training Initiative (NIFTI); and Research Grants. Each discussion group will be led by a current member of the Scientific Review Committee (SRC).
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References
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- World Medical Association. Declaration of Helsinki. 1964, revised 1996, para. A.3. Available at: http://www.wma.net/e/policy/b3.htm.
- Fuhrer MJ. Overview of clinical trials in medical rehabilitation: impetuses, challenges, and needed future directions.
Am J Phys Med Rehabil. 2003;82(suppl):S8–S15.[CrossRef][Web of Science][Medline]
- Whyte J, Hart T. It's more than a black box: it's a Russian doll.
Am J Phys Med Rehabil. 2003;82:639–652.[CrossRef][Web of Science][Medline]
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Copyright © 2007 by the American Physical Therapy Association.
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