How Can We Better Measure Outcomes for Patients with Spinal Cord Injury?
Occupational therapy is a branch of health care that helps people recovering from illness or injury, or with a disability, function better in their environments – be that at work, at home, or outside. For instance, with neurological conditions such as stroke, multiple sclerosis, and spinal cord injury, a big part of rehabilitation is regaining the ability to control their limbs, hands, and feet, in order to carry out the tasks of daily life. Namrata Grampurohit, PhD, Assistant Professor, Department of Occupational Therapy, in Jefferson’s College of Rehabilitation Sciences, conducts research on how to better improve functionality in her patients, informing care and rehabilitation goals.
Here we talk to Dr. Grampurohit about her research, her passion for mentorship, and how she uses sewing skills as a teaching tool.
Q: What is your research focus?
My research is focused on enhancing functional outcomes such as self-care and ability to carry out domestic tasks in people with neurological conditions, throughout their lifespan. I have a keen interest in spinal cord injury. In the United States, 17,730 new cases of spinal cord injury occur each year and between 249,000 to 363,000 people are currently living with a spinal cord injury. With an average age of injury of 43 years, the individuals affected by spinal cord injury are in the prime of their lives and it greatly disrupts their ability to care for themselves. More than half of the cases with spinal cord injury occur around the neck and affect all four of their limbs, i.e., tetraplegia. One of my current projects focuses on hand and arm function of individuals with tetraplegia through the Spinal Cord Injury Model System of Delaware Valley funded by the Administration of Community Living. Another exciting project funded through the Jefferson Emerging Medical Scholars Award and Craig Neilson Foundation revolves around developing a new functional movement index in spinal cord injury. This new tool can provide researchers with reliable and valid clinical trial endpoints of function in spinal cord injury.
Q: What’s one question you’re investigating?
The project on developing a new functional movement index in spinal cord injury tries to answer the following research questions: Can we design a highly sensitive measurement scale in spinal cord injury where we can observe individuals doing certain functional tasks? Can we record and analyze these tasks using modern computerized methods of testing to provide good reliability and validity to the measurements?
Q: What first sparked your interest in your area of research?
As an occupational therapist practicing in acute care and inpatient rehabilitation for over a decade, I was always looking for better outcome measures that would be suitable for my patients. I wanted to provide the best care and this included being able to select the most appropriate measurement scale that was relevant to my patients and could track changes over time. I was never satisfied with the existing measures since the test items were not well developed, scores obtained from the tests were not sensitive to gains in function. The drawbacks of the existing scales sparked my interest the field of development and validation of measures.
Q: What’s a cool fact about your study subject?
Rehabilitation professionals have more than 500 different tests available to them for use with their patients, available on the Rehabilitation Measures Database. In collaboration with my students and colleagues, our lab has contributed towards multiple summaries on this database. The goals of this effort are to help researchers and clinicians quickly access the measures available for their area of interest and to help them understand their unique properties.
Q: Many researchers have superstitions. Things they’ve done to cosmically help their research work succeed. What are yours?
Finding my ‘tiger time.’ Tiger time is the time when I am highly focused, productive, and can maintain a strong positive mindset. I have found over the years that I have to allow myself to find my tiger time each day, even on dull days, and I have to always devote this time to writing the next manuscript or research proposal.
Q: What’s the best part of your job?
Mentorship is the best part of my job. I get to seek mentorship from experts in the field and provide mentoring to students. Having the right mix of mentors and mentees in my professional life keeps me going.
Q: What’s something people would be surprised to find out about you?
I used to teach a Sewing Skills Lab for first year occupational therapy students at the University of Washington where I taught them hand sewing, machine sewing, and designing adaptive clothing for people with stroke. In one project, the students designed and fabricated Velcro closures for shirts for individuals who were not able to manipulate buttons due to stroke. The students were always fascinated to learn that men’s shirts have buttons on the right and women’s on the left. As their curiosity piqued, each of them tried to find explanations for these curious facts. A simple Sewing Skills Lab transformed into intriguing lessons on stroke, occupational therapy, sewing, history, and clothing designs.