Brooks Center takes team approach
By DIANE CHUN
Sun medical writer
After a 29-year career in rehabilitation research, Pamela Duncan knows the value of rehabilitation to someone who has been left disabled by an accident, disease or the simple process of growing older.

"Historically, we haven't had rehab research, we just knew it was a good thing to do," said Duncan, the director of the Brooks Center for Rehabilitation Studies at the University of Florida. "Today we have to ask what works, what doesn't work and who might benefit by a particular therapy. We can't cure everybody, but rehabilitation research is clearly about optimizing recovery."
With the help of Dr. Andrea Behrman, center, two physical therapists and a body-weight support system, Paul Schauble is able to walk or run on a treadmill in the motor behavioral lab located in the physical therapy education building on the University of Florida campus. Schauble, a UF psychology professor, was left an "incomplete" quadriplegic after a biking accident in March of 2001.
DOUG FINGER/The Gainesville Sun


Duncan assumed her post as director of the new center in January, coming from Kansas City, where she had served as director of research for the University of Kansas Center on Aging and senior health researcher at the Veterans Affairs Medical Center.

The purpose of the Brooks Center, Duncan said, is to build interdisciplinary programs and get colleagues across the UF campus - and beyond - to work together for rehabilitation.

"The research that we will cover will include everything from basic science to clinical intervention to outcome research," she said.

The center, affiliated with the College of Health Professions and the Jacksonville-based Brooks Health System, is just in its start-up phase, the new director said. Research initiatives under its umbrella will target Parkinson's disease, stroke and spinal cord injury, pain management and falls and instability in the elderly.

Effective rehabilitation, she said, requires multiple disciplines, with input from physicians, therapists, psychologists, epidemiologists, biostatisticians and more.

"I'm building interdisciplinary research teams, and my job will be to assure that we're all rowing the boat together," Duncan said.

A team approach


Paul Schauble, a UF psychology professor, is walking proof of the benefit of the team approach to rehabilitation research.

On March 6, 2001, Schauble was riding his bike when a dog darted out from between two parked cars.

"I didn't have a chance to stop, and hit the dog at a pretty good clip," he recalled. "I had a racing bike, and my feet were stirruped into the peddles, so they didn't disengage when I hit the dog. I pitched over the handlebars, and the bike followed me."

Schauble bruised his spinal cord so badly that for a time he was left paralyzed, with no feeling in his arms or legs.

"Now I've regained some feeling and am classified as an incomplete quadriplegic, meaning I've regained some function but I still have involvement in four limbs," he said.

After four weeks in the hospital and six more at the Shands rehabilitation facility, Schauble heard of a study being conducted by Andrea Behrman, an associate professor in UF's department of physical therapy.

As a research investigator with the VA's Brain Rehabilitation Research Center, Behrman was working with people who have incomplete spinal cord injuries.

"When you say the word 'incomplete,' it covers a lot of ground," Behrman said. "I work with those who have the potential to walk, or are up on their feet walking some, but don't walk well. Some use power wheelchairs, and may be on their feet part of the day, but they don't walk well enough to leave the wheelchair.

"What we're going to do is generate this real clear picture of walking to the spinal cord, and retrain it from the bottom up, if you will - that is from the spinal cord up to the brain," Behrman said. "That way, we are taking advantage of the circuits below the damaged area of the spinal cord that are still intact."

For Schauble, that approach proved "a godsend." Training on a treadmill, supported by a harness that held much of his weight, he put in an hour and a half a day walking under supervision. The study continued five days a week for nine weeks.

"The treadmill training taught me how to walk again properly," Schauble said. "I still have a relatively awkward gait, but if I walk at a slow pace, I don't think you'd notice it.

"I'm back to work full-time now, as of the end of spring term, teaching psychology, and can do pretty much what I could do before, outside of vigorous physical activity," he said.

"Being under the Brooks Center umbrella enables us to put teams of people together to look at problems from a number of perspectives," Behrman said. "We want to provide the best interventions for the best outcome for each individual."

What's ahead


As the College of Health Profession's newest component in the rehabilitation field, the initial goal of the Brooks Center is to coordinate research efforts at UF and Brooks Health Care, according to Dean Robert G. Frank.

"Our long-term goal is to establish one of the best rehabilitation research programs in the world, one that addresses both clinical interventions and health policy," Frank said.

The center, located in Gainesville and Jacksonville, is a joint effort between UF and the Brooks Health System, which gave $2.5 million toward its establishment. That endowed gift was matched with state funds.

Brooks Health System operates Brooks Rehabilitation Hospital, a 127-bed nonprofit facility for acute medical rehabilitation, and a network of outpatient therapy centers in North Florida.

Research will be conducted at UF, for the most part, then tested and applied at the hospital, at the Shands rehabilitation facility here and at Shands Jacksonville.

In the next year, UF will build what Duncan describes as a state-of-the-art core human performance facility to offer a very high-tech assessment of motor performance.

"Not only are we building this for the research perspective, but for education and training," she added. "We are going to train the next generation of scientists to evaluate rehabilitation right here."

A satellite clinical research center at the Jacksonville facility will link UF researchers with clinicians there.

Duncan admits that the agenda for the new Brooks Center is an ambitious one - to change the way rehabilitation services are provided and financed. But she is convinced that it can be done.

"I recognize that we have tremendous talent and depth in the medical community here," she said. "This is the epitome of a center created so that the sum will prove greater than its parts."



Diane Chun can be reached at 374-5041 or diane.chun@gainesvillesun.com



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