BERNADETTE GILLICK, PT, MSPT, PhD2018-08-29T13:49:47+00:00

Project Description

Two-Time Scholarship Recipient Bernadette Gillick, PT, MSPT, PhD, Studies Constraint-Induced Movement Therapy to Help Patients Regain Motor Skills

— When Bernadette Gillick, PT, MSPT, PhD, was in high school, one of her major assignments was to job-shadow five different occupations. The final job she chose to observe was a physical therapist. Science and math were always her favorite subjects in school, and Gillick knew that she wanted to work in a profession where she could help other people, so physical therapy seemed like an appealing career path.

Gillick remembers the physical therapist telling her something important that day: “If you want to have a happy life, work in healthcare and have the honor of working with people in need, you should become a physical therapist.” Those words stayed with her. Not only has she worked as a clinician for over 17 years and as an instructor at a number of universities, but she has earned an Advanced Masters Degree in Neurologic Physical Therapy and is now making her mark in physical therapy research and pursuing a PhD in Rehabilitation Science at the University of Minnesota.

Gillick received a Promotion of Doctoral Studies (PODS) II Scholarship in 2009 and another in 2010. Her research as a PhD student is focused on pediatric neuroplasticity, meaning how the brain changes as it grows, how it is affected after injury, and how those changes affect a child’s development.

Her experiences as a clinician have had a major influence on her decision to pursue pediatric physical therapy. Although she primarily worked with adult patients when she worked in Chicago, Illinois, and managed a hospital in Anchorage, Alaska, some native children in Alaska living with cerebral palsy and spina bifida needed treatment, so she switched gears and began working with children—and loved it. After she moved from Alaska to Seattle, Washington, she began working as a pediatric physical therapist and an Anatomy and Physiology instructor at Seattle University.

In addition to working with children in Alaska and Washington, Gillick also worked as a clinical instructor for Marquette University and Creighton University students at a hospital and an orphanage in the Dominican Republic. As an instructor for the Institute of Latin American Concern (ILAC) at Creighton University in Santo Domingo, Dominican Republic, she supervised graduating physical therapy students participating in the 4-week clinical immersion program.

Throughout her teaching career, Gillick taught classes of anywhere from 20 to 200 students for various physical therapy and biology departments, which later helped her adjust back to life as a student in the classroom. “Keeping my foot in the academic door made it very easy for me to step back into academics as a student again because I had already been in that environment. I had never really left it, so it was an easier transition than I had anticipated.”

Gillick gains hands-on experience in the Brain Plasticity Laboratory at the University of Minnesota working with other PhD students and two professors. The focus of the lab is to measure changes in brain function.  Gillick’s thesis, “Pediatric Hemiparesis: Synergistic Treatment using rTMS and CIMT,” measures gross motor outcomes in children before and after going through constraint-induced movement therapy (CIMT). This method encourages the use of the affected side by restraining the unaffected side. The study also incorporates use of repetitive transcranial magnetic stimulation (rTMS) and its effect on motor learning tasks. The rTMS uses a magnet to create an electric current to measure or influence electrophysiologic outcomes. Along with behavioral components, the two interventions of CIMT and TMS allow the researchers to detect any changes in the brain and observe any changes in the patient’s behavior.

On a typical day, Gillick will conduct a magnetic resonance imaging (MRI) on the brain of a child who has had a stroke, and then transcranial magnetic stimulation (TMS). The Food and Drug Administration (FDA) and National Institutes of Health (NIH) have approved that children between the ages of 8 and 16 be used for this phase of the lab’s clinical trial. The lab has recruited patients through many means, including an online, nationwide listserv and the study Web site. Although there has been a significant response, Gillick is finding that several parents are hesitant to allow their children to participate at first.

“I’ve literally driven out to the middle of Minnesota to talk to families and explain who I am and why they should let their children, who have had a stroke, come to the lab and participate in this research. I explain that there’s a low risk of inducing a seizure with the treatments, but that the research might actually be able to make a difference in their child’s hand function.”

Along with her advisor at the University of Minnesota, James R. Carey, PT, PhD, Gillick co-authored a $1.1 million NIH Challenge Grant.  The grant funds this pediatric study which collaborates with Seattle Children’s Hospital, where Gillick holds a clinical position.

Gillick has been a member of the American Physical Therapy Association (APTA) throughout her whole career, and actually first became involved with the Foundation as a donor. “I donated to the Foundation before I became a PhD student. I’m very honored to have received these scholarships. You can bet that after I’ve earned my PhD, I’ll be going back and donating to the Foundation.”

She has made an impact on the profession as a clinician, an instructor and now a researcher. Gillick has been invited to speak on her research in four different cities in just this past year and always remembers to recognize the Foundation for helping her get her start in research. “The final slide of my presentation says ‘supported in part by the Foundation for Physical Therapy.’ If I hadn’t received the PODS II scholarships, I probably would’ve either had to quit my research projects for lack of funding, or I would’ve (gone) part-time, and this probably would’ve gone on for years. Foundation-funding has allowed me to fully commit to my research and progress in a timely manner.  I am very grateful to the Foundation.”

Select Foundation Grants and Scholarships Awarded

Transcranial Direct Current Stimulation (tDCS) and Constraint-Induced Movement Therapy (CIMT) in Pediatric Hemiparesis

Weakness on one side of the body due to stroke or related events at or around the time of birth can affect the functional ability of an individual during childhood and throughout the lifespan. Emerging research using non-invasive brain stimulation to stimulate the involved areas of the brain has shown improvements in recovery of function. In this study, we are seeking to combine specific forms of brain stimulation and rehabilitation training in order to maximize this effect. Using transcranial direct current stimulation, brain cells that were inactive due to stroke injury have the potential to become active and contribute to improved function. This form of stimulation is painless, cost-effective, portable, and has shown no evidence of seizure or other serious adverse event. Importantly, it also has the potential to be applied in the clinical setting, simultaneous with rehabilitation training. Using a specific form of rehabilitation training called constraint-induced movement therapy, the hand that is less affected by the stroke is temporarily constrained with a solid mitten or a sling, allowing unique training of the hand which is more affected. Treatment focuses on training and activity in the more affected hand in isolation. These two forms of interventions may therefore be combined in order to investigate the potential effect of improving hand function in children with weakness due to stroke.

The long-term objectives of this study are to combine these two types of rehabilitation to investigate the benefit on hand function in children with weakness due to stroke. The translational potential of this intervention may directly impact pediatric clinical applications. The specific aims of the study are established to assess the safety, tolerability and success of the intervention in improving hand function in children with stroke. We are also assessing the feedback from the children and their caregivers as well as a cost-analysis of the intervention compared to usual and customary treatments. The research design would incorporate a 2-week camp-style setting of constraint-induced movement therapy while working with a therapist in combination with brain stimulation delivered at the beginning of each therapy session. Two groups would be established wherein all children receive therapy while one group receives an active form of tDCS and the other a sham tDCS stimulation. A therapist would perform the behavioral and brain stimulation assessments and testing, while a physician would perform medical evaluations for safety assessment. Such a team approach would advance the study toward the stated goals.

If, as physical therapists, we are able to maximize the potential recovery of a child who had a stroke early in their life the potential impact throughout their lifetime could be positively influenced. The current comprehensive cost of care for a person with cerebral palsy is estimated to be 1 million US dollars. The proposed intervention has potential to decrease cost of care through improved lifetime activity and participation.

In the course of my career in physical therapy to date, I have been exposed to many different areas. I have taught students both in the clinic and classroom, worked as a legislative chairman for the Eastern District of the Illinois Physical Therapy Association and held both clinical and administrative positions. I have been an instructor in the Physical Therapy Program at Marquette University, an instructor and pre-Physical Therapy advisor at both the University of Alaska and Seattle University and now an instructor in Neuroanatomy for Physical Therapy and Medical Students at the University of Minnesota. All the while, I have advanced my own education and continued to treat patients in the clinic simultaneously. I would now like to use that education and experience more fully by combining teaching, research and clinical work in a physical therapy academic setting. My overarching goal is to challenge traditional ideas about optimal therapies, best practice and outcomes. As our profession continues to increase its role in interdisciplinary teamwork, I would like to be on the leading edge of
those professionals who continue to work toward questioning our practices and the manner in which we contribute to the rehabilitation of an individual. Specifically, I would like to spend my doctoral work developing an advanced foundation in rehabilitation research and neuroscience. I am interested in post-doctoral training specifically to further my ability to pursue neuroscientific research, and I intend to apply for a position at the Berenson-Allen Center for Noninvasive Brain Stimulation (CNBS) at Beth Israel Deaconess Medical Center/Harvard Medical School. During this post-doctoral pursuit I would also like to complete the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) interdisciplinary training program. This program is geared toward post-graduate fellows who are interested in assuming leadership roles in providing health care services for children with neurodevelopmental disabilities and their families. I hope to apply this postdoctoral training by obtaining an academic position in a Physical Therapy program that would allow me to
combine research and clinical work with teaching. I was recently asked what I would like to have said about me, one day, when I retire. I would be honored to have it said of me that I somehow contributed to the growth and quality of life of others, whether towards the growth of the student who is interested in becoming a PT or the patient who recovers function. I am confident that my doctoral work will give me all the tools I need to make that contribution.

In the course of my career in physical therapy to date, I have been exposed to many different areas. I have taught students both in the clinic and classroom, worked as a legislative chairman for the Eastern District of the Illinois Physical Therapy Association and held both clinical and administrative positions. I have been an instructor in the Physical Therapy Program at Marquette University, an instructor and pre-Physical Therapy advisor at both the University of Alaska and Seattle University and now an instructor in Neuroanatomy for Physical Therapy and Medical Students at the University of Minnesota. All the while, I have advanced my own education and continued to treat patients in the clinic simultaneously. I would now like to use that education and experience more fully by combining teaching, research and clinical work in a physical therapy academic setting. My overarching goal is to challenge traditional ideas about optimal therapies, best practice and outcomes. As our profession continues to increase its role in interdisciplinary teamwork, I would like to be on the leading edge of
those professionals who continue to work toward questioning our practices and the manner in which we contribute to the rehabilitation of an individual. Specifically, I would like to spend my doctoral work developing an advanced foundation in rehabilitation research and neuroscience. I am interested in post-doctoral training specifically to further my ability to pursue neuroscientific research, and I intend to apply for a position at the Berenson-Allen Center for Noninvasive Brain Stimulation (CNBS) at Beth Israel Deaconess Medical Center/Harvard Medical School. During this post-doctoral pursuit I would also like to complete the Leadership Education in Neurodevelopmental and Related Disabilities (LEND) interdisciplinary training program. This program is geared toward post-graduate fellows who are interested in assuming leadership roles in providing health care services for children with neurodevelopmental disabilities and their families. I hope to apply this postdoctoral training by obtaining an academic position in a Physical Therapy program that would allow me to
combine research and clinical work with teaching. I was recently asked what I would like to have said about me, one day, when I retire. I would be honored to have it said of me that I somehow contributed to the growth and quality of life of others, whether towards the growth of the student who is interested in becoming a PT or the patient who recovers function. I am confident that my doctoral work will give me all the tools I need to make that contribution.

BERNADETTE GILLICK, PT, MSPT, PhD

SELECT PUBLICATIONS

  • Rich T, Menk J, Rudser KD, Chen M, Meekins GD, Pena E, Feyma T, Bawroski K, Bush C, Gillick BT. “Determining electrode placement for transcranial direct current stimulation: A comparison of electroencephalogram versus transcranial magnetic stimulation-guided methods”. Clinical EEG and Neuroscience. (In Press)

  • Chen CY, McGee C, Rich T, Prudente C, Gillick BT. “Reference Values of Intrinsic Muscle Strength of the Hand of Adolescents and Young Adults”. Journal of Hand Therapy, 2017. (in press)

  • Rich TL, Menk JS, Rudser KD, Chen M, Meekins GD, Peña E, Feyma T, Bawroski K, Bush C, Gillick BT. Determining electrode placement for transcranial direct current stimulation: A comparison of electroencephalogram versus transcranial magnetic stimulation guided methods. Clin EEG Neurosci 2017 May

RESEARCHER VIDEO