Initiatives in rehabilitation research.

Federal funding of rehabilitation research depends on how much that research is valued, both within the physical therapy profession and among the external groups and individuals who have a stake in the research outcomes. To help advance rehabilitation research, the American Physical Therapy Association (APTA) forges partnerships, coalitions, and collaborations for advocacy, awareness, and legislative action; promotes the appointment of physical therapists to federal panels; and fosters infrastructure and research capacity building. To further cement the physical therapy profession's relationship with policymakers, APTA also is identifying health policy questions.

Enhancing the awareness of and advocacy for rehabilitation research by physical therapist scientists is a long-term process and requires the commitment of individuals from all sectors of the profession. One of the key elements to achieving this objective is to bring federal policymakers into the physical therapy research environment to observe the process of rehabilitation research firsthand. Monitoring a 6-month-old infant's movement patterns, watching as a patient receives electrical stimulation to activate muscle, or observing a patient walk on a force plate might seem like an odd way for legislators to spend a few hours--but not when they see how it translates into meaningful outcomes for patients with impairments, functional limitations, and disabilities. This powerful message communicates the value of physical therapy to key stakeholders who fund federal research and to patients who seek cost-conscious, efficient, and effective interventions to address their health care needs. Seeing effective physical therapy in action can make the difference between a member of Congress simply signing on to support legislation or a member of Congress becoming a champion of the profession and the research associated with it.

As part of a larger advocacy plan, APTA's Government Affairs Department launched its practice visit initiative following the successful PT March on Washington, which put physical therapists in every Congressional office on 1 single day in June 2003. The aim of the practice visit initiative is to put each member of Congress in a physical therapy clinic, research laboratory, education program, or hospital department.

Putting policymakers in touch with patients, clinicians, researchers, educators, and advocates only enhances policymakers' knowledge and appreciation for the work that physical therapists do on a daily basis. This year during May's Federal Government Affairs Forum, APTA hosted a roundtable discussion on how to host a practice visit. Applying the advice and encouragement from the Forum was University of Delaware faculty member, Joseph Lucca, PT, PhD, GCS. Lucca, a long-time advocate for physical therapy legislation and policy, saw the perfect match between the University of Delaware and US Congressman Mike Castle (R-DE). Both Lucca and Congressman Castle have a strong interest and strong track records in advancing research.

Months of planning came to fruition, when, on July 6, 2006, the University of Delaware hosted Congressman Castle for a practice visit with a specific focus on federally funded research at the university. Congressman Castle spent more than an hour touring various clinics and laboratories and discovering the investment that the National Institutes of Health (NIH) and other federal agencies have made in the University of Delaware to advance rehabilitation research. Congressman Castle is a leader in the US Congress on biomedical research and a champion of the doubling of NIH funding in the late 1990s. Recently, Congressman Castle was the lead Republican on legislation to allow for federal funding of stem cell research. During his visit, various researchers at the university were able to show the link between basic and translational science as exemplified by a continued investment in rehabilitation research as stem cell research is expanded and refined. The tour began in the faculty clinics at the university, where Congressman Castle observed a patient receiving a rehabilitation session. This patient was able to communicate the value of physical therapy in keeping him mobile, productive, and functioning in his home and community.

After the clinic portion of the visit, Congressman Castle spent time reviewing the extensive research portfolio that the faculty has assembled. Physical therapist scientists at the university were able to highlight rehabilitation research throughout the lifespan as well as in the specific areas of osteoarthritis, stroke, and musculoskeletal impairments. Following the practice visit, Congressman Castle spent time addressing the doctor of physical therapy (DPT) students and faculty on issues in Congress that are important to physical therapy and rehabilitation. Congressman Castle highlighted legislation to add physical therapy to the National Health Service Corps for the purposes of student loan repayment and efforts to extend the exceptions process for patients needing care beyond the restrictions imposed by the therapy cap. Congressman Castle also discussed the importance of rehabilitation research conducted at the University of Delaware and its importance to the state as an economic engine and as a way to help keep its citizenry healthy and productive. The presence of media representatives further increased the impact of the event. Several news articles highlighting physical therapy issues and a radio and television interview appeared following the visit. Thus, a larger audience in the Newark, Delaware, community was made aware of the positive value that physical therapist scientists contribute to advancing the health of individuals through research.

Replicating these visits in other physical therapy research environments and targeting key legislators and other federal officials are essential as the profession increases efforts to enhance rehabilitation research. Nothing makes a point better than having a physical therapist perform a computerized gait analysis on a legislator and then explain the results, particularly if there are any gait abnormalites. Likewise, observing a clinical study is more powerful than merely reading a position paper on the value of rehabilitation research. APTA staff is available to assist you in organizing and implementing an effective practice visit and is particularly interested in visits that focus on rehabilitation research.

For more information or resources, please contact Justin Moore at [e-mail] or 703/706-3162. Lucca; Stuart Binder-MacLeod, PT, PhD, Chair of the University of Delaware physical therapy program; Lynn Snyder-Mackler, PT, DSc, SCS, FAPTA, an extremely well-funded scholar; and the entire faculty at Delaware provided a great environment to positively influence one policy maker's impression of the research expertise of physical therapists. Having a similar impact on other policy makers through practice visits is paramount to APTA's research initiative and to the advancement of the profession toward achievement of Vision 2020.

[DOI: 10.2522/ptj.2006.86.9.1306]