Grant will fund potentially game-changing PT study

by John Keenan, UNMC strategic communications | August 26, 2020

Image with caption: Sandra Willett, PhD

Sandra Willett, PhD

The Munroe-Meyer Institute Department of Physical Therapy will take part in a nationwide study that may fundamentally shift the way physical therapy (PT) is provided for young children at high risk for or diagnosed with cerebral palsy.

Sandra Willett, PhD, director of the department, will be the site principal investigator of a five-year study evaluating START-Play (Sitting Together And Reacting To Play), an intervention that incorporates play into PT treatment with the idea that key motor skills, such as sitting up and reaching, promote attention span and problem solving in infants ages 7-24 months.

NIH funding

This grant is one of two that the Munroe-Meyer Institute Department of Physical Therapy was awarded from the most recent National Institutes of Health Pediatric Rehabilitation request for proposals. The two grants, both involving cerebral palsy research, were two of only three grants that were awarded by the NIH for this RFP.

MMI has been taking part in START-Play studies since 2017, but the latest grant is for a National Institutes of Health RO1 study, based out of the University of Southern California. Earlier research had shown promising responses, but the new study will incorporate a dose-matched control group to examine the differences between START-Play and more traditional, motor-focused therapies.

Dr. Willett said the START-Play model could be a paradigm shift for PT delivery to young children.

"This model has the potential to shift both how we train physical therapists and how we deliver early intervention," she said. "It's all grounded in sound developmental science that comes from other disciplines, such as developmental psychology and developmental neuroscience."

In the START-Play model, a therapist interacts with babies and trains caregivers with a focus on how cognitive and motor skills are inter-related. "As an experienced clinician, it's hard for me to adopt this mindset," Dr. Willett said. "As therapists, we are trained to think movement first. Now, we have to step back and ask, 'How do children use movement to learn and socially interact?' It's a motor-based problem solving approach, a much more holistic model."

Seven members of the PT department will be taking part in the grant work. MMI was notified of grant funding in May, but because of the COVID-19 pandemic is not recruiting for the study yet. Dr. Willett said she hopes to start training the team in START-Play therapies this month, with the goal of enrolling participants in January. MMI will aim to enroll children at UNMC over the next five years, contributing to a total nationwide cohort of 150-200.

"We're excited to participate in this work," Dr. Willett said. "It's a potential game-changer for early intervention and the role of physical therapy."

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