Pragmatic clinical trials bridge the gap between controlled research settings and real-world clinical practice. Stephanie Di Stasi, PT, MSPT, PhD, an experienced physical therapy researcher focusing on ventral hernia disease, believes in the value of pragmatic trials, which aim to inform rehabilitation in real-world conditions and improve patient outcomes.

A study she conducted, funded by the Foundation for Physical Therapy Research, gave her “the foundational experience I needed to successfully operationalize a larger, more pragmatic trial.” Di Stasi is now a multiple principal investigator on a study addressing ventral hernia disease, a condition where the abdominal wall separates, allowing intestinal contents to push through the opening. This disorder causes considerable functional disability for those affected. Di Stasi’s passion for this research stems from her belief that physical therapy has great potential to reduce pain and restore quality of life for these patients.

Rather than giving strict instructions to follow a fixed order of exercises, Di Stasi worked with the clinical experts on the team to refine existing trunk and pelvic muscle rehabilitation strategies to ensure physical therapists can individualize treatment to best fit the patient’s functional needs and goals. The range of options includes different types of neuromuscular activities, therapeutic exercises, and posture and body mechanics training, allowing therapists to use their professional judgment to select the best combination for each patient. The key idea is to trust that physical therapists, when given flexibility within evidence-driven programs, will make informed decisions that align with the research process and also meet the specific needs of the patient in front of them. For Di Stasi, this pragmatic trial approach embraces the complexities of real-world clinical environments, where interventions are adapted and applied in dynamic and sometimes unpredictable settings.

Di Stasi’s ventral hernia disease research aims to integrate physical therapy into postoperative care in a more structured way. Her goal is to ensure that “every patient who has ventral hernia disease” has access to an effective rehabilitation program, helping them recover faster and reducing recurrence rates. Since ventral hernia surgery involves a major tendon repair of the trunk, the central premise of the team’s work is that post-operative physical therapy is necessary to optimize trunk muscle performance and restore functional mobility. Di Stasi hopes to see a shift in how these cases are managed, working closely with surgeons to improve outcomes for these patients.

Looking to the future of pragmatic trials in physical therapy research, Di Stasi emphasizes the need to improve patient outcomes through tailored interventions. For her, the research “is really about studying human movement to inform rehabilitation so that we get people better, faster, and back to the things they want to do.” Ultimately, Di Stasi envisions routinely bringing the “quality of assessment that we have in our lab environment” into real-world settings. She envisions the future of physical therapy as one where interventions are “customized to [the patient’s] needs, blending data from advanced lab assessments with real-world patient experiences.” This, she believes, is the next step in developing individualized programs that make rehabilitation both effective and personalized.